183
Chapter 21
Facility Planning: The Role
of the Industrial Engineer
Amanda Mewborn and Richard Herring
What Is a Facility Plan?
Before a facility plan can be created, an organization must rst have a mission, vision, and strategic
plan. e mission describes what an organization does. Often, in healthcare, organizations have
missions related to providing high-quality, compassionate care to patients. A vision describes why
the organization does what it does. Many healthcare organizations are faith based, and therefore
their vision may include references to fullling God’s will or mercy on people. An organization’s
strategic plan outlines how the organization will go about accomplishing its mission and vision.
e strategic plan typically includes details on growth plans to maintain viability. For example, a
strategic plan may describe how the organization plans to become the primary provider of cardiac
services for the community.
Contents
What Is a Facility Plan? ............................................................................................................183
Role of an Industrial Engineer in Facility Planning ................................................................... 185
How Are Industrial Engineers Involved Once a Facility Plan Is Created? ..................................186
Space Programming .............................................................................................................186
Schematic Design ................................................................................................................187
Design Development ...........................................................................................................188
Construction Documents ....................................................................................................188
Construction Administration ...............................................................................................189
Add-On Services: Transition Planning and Move-In ............................................................189
Add-On Services: Operational Planning ..............................................................................189
Add-On Services: Sustainment .............................................................................................190
184 ◾ Amanda Mewborn and Richard Herring
After a strategic plan is created, the next step is to develop a master facility plan. A master
facility plan describes what facilities are needed to accomplish the strategic plan. Some of the
components of a master facility plan include the following:
◾ Analysis of existing facilities, space, and land, to include:
− How the space is utilized
− Benchmarking the existing space against industry standards
− Analysis of regulatory requirements, including zoning and any other factors that deter-
mine how the land or space can be used
− Analysis of the mechanical, electrical, plumbing, and structure of existing facilities
− Review of workow within the existing space, including opportunities for gaining e-
ciency through changes to the physical space
◾ Plan or concept for how the facilities can be used in the future, to include:
− Site plan for how the land and facilities can expand or be reused
− Stack and block plans to demonstrate where departments will be located in relation to
each other
− Exterior building views showing building placement or expansion concepts
− Plans for maintenance of facilities
− Identication of required projects
− A phasing or implementation plan showing project interdependencies
− Estimates of project costs
◾ Sequencing/implementation plan detailing the phases in which the site and facilities can be
modied or built
Master facility planning naturally leads to other types of analyses, such as understanding the
following about the organization:
◾ Market and competitors, geography, and labor
◾ Brand and the opportunities for the facility to support or redene the brand
◾ Organizational structure and how the structure may need to change with the strategic plan
and changes to facilities
◾ Information technology and how changes may aect the organization, including facilities
◾ Operations and logistics
Ultimately, the master facility plan must support the organization’s leadership in demonstrat-
ing that the implementation of the strategic plan and master facility plan will drive the largest
gains for the organization, at the lowest cost and risk.
Some of the additional support that may be needed includes a detailed nancial analysis that
explores the availability of capital, plans for raising capital, and total cost of ownership analysis
(what it will cost to operate and maintain the facilities). Sometimes, a cost–benet analysis is nec-
essary to help decision makers understand the options.
More detailed analyses may also be needed. For example, what is the cost of leasing space
versus owning and building space? Operational variables may also be analyzed, such as whether
to centralize or decentralize departments, and cross-utilization of spaces. Further, analyses
may be needed to determine whether to renovate existing space or tear it down and rebuild.
Some organizations also have options to buy existing facilities or space, and that option must
also be considered.
Facility Planning: The Role of the Industrial Engineer ◾ 185
As one may imagine, each master facility plan and the components are unique to the organiza-
tion, and should be designed to meet the organization’s specic needs. e organization or client
is often referred to as the owner in architecture-related meetings.
Role of an Industrial Engineer in Facility Planning
An architect is usually the lead person in the development of a facility plan. Industrial engineers
can support architects in facility planning in many ways.
Before the facility plan is created, an industrial engineer can support executives in an organiza-
tion with the development of a strategic plan. Some of the questions that industrial engineers may
analyze to support strategic plan decision making may include:
◾ How much of the market demand is the organization currently capturing?
◾ Where are opportunities to capture more market share?
◾ Who are the primary competitors?
◾ What service lines are underserved in the community?
◾ How protable is each service line?
◾ Which conditions are at play in the market that may change the competitive landscape
or protability?
After the strategic plan is dened, industrial engineers may support architects with the mas-
ter facility plan. During the analysis of existing facilities, space, and land, some of the work that
industrial engineers can do includes:
◾ Observational studies to understand how the existing space is utilized. In Lean, this is called
“going to the Gemba,” meaning visiting the front line where work is happening to visual-
ize and experience the environment and culture. Results of observational studies include
opportunities that can be addressed with or without changes to the facility. For example,
an observational study may identify a challenge created by a lack of information technol-
ogy, which could be solved without changes to the facility. Other opportunities may require
changes to the facility, such as excessive clinician travel distance to obtain supplies. In this
example, the facility change may be creation of satellite storage closets for supplies to mini-
mize clinician travel distance.
◾ Research on industry standards for space allocations for various settings, including oce
space, patient care units, and physician practices.
◾ Analysis of workow in the existing space, including development of process ow maps of
the current state operations. Identication of opportunities for improvement to workow,
through rapid improvement events or kaizen, as well as opportunities that require facility
changes or longer-term projects.
During the phase where the plan or concept for the use of the facilities in the future is devel-
oped, industrial engineers can assist architects by:
◾ Developing process ow maps of future state operations. ese maps provide detailed
workow specications of how sta would like for work to happen, more eciently, in the
future. ese maps can be used to understand critical working relationships, and determin-
ing placement of personnel, supplies, and work.
186 ◾ Amanda Mewborn and Richard Herring
◾ Coordinating with architects in the development of the stack and block plans to ensure
critical adjacencies are achieved, while minimizing wasted movement of personnel, supplies,
and customers.
◾ Developing estimates of the impact of facility changes on personnel and supply expenses.
◾ Designing the sequencing plan detailing the phases in which the site and facilities can be
modied or built, based on the impact to operations.
Other analyses that the industrial engineer can support during master facility planning include:
◾ Labor market analysis, answering questions about workforce availability; for example, how
nursing or physician shortages will impact the organization
◾ Organizational structure and how the structure may need to change with the strategic plan
and changes to facilities
◾ Information technology analysis, and proposal for changes to inuence the organization’s
eciency and quality
◾ Logistical analyses, such as supply chain and revenue cycle
◾ Cost–benet analyses to identify the opportunities that have the best likely return on investment
◾ Engineering economy analyses such as the cost of renting versus buying versus building space
e industrial engineer’s analytical toolkit can provide a lot of value in the master facility plan-
ning process. Furthermore, understanding the healthcare environment eliminates a steep learning
curve, facilitating faster delivery of value to the customer.
How Are Industrial Engineers Involved
Once a Facility Plan Is Created?
When speaking of facility planning, some people think only of the master facility plan compo-
nents described earlier. Others think of facility planning as the entire architectural process. ere
are many additional components of the architectural process, and those pieces are described here.
Space Programming
e next phase after master facility planning is usually space programming. Space programming
is a listing of all of the spaces, along with their sizes, that will be needed in a building. For exam-
ple, the space program might specify 4 oce cubicles that are sized at 4 feet by 6 feet for personnel
in the medical records department. e space program also estimates the peripheral space that
will be needed, for areas such as hallways, walls, and technical components (mechanical, electri-
cal, and plumbing). Of course, the space program is heavily dependent on the planned workow
within the building. e space program is often compiled based on a series of interviews with
the organization’s personnel, and is therefore based on personal preference. is often results in
more space than is needed, as well as a program reecting operational silos where each person’s or
department’s needs are met, without consideration for the facility as a whole or consideration of
how the silos will operate together.
An industrial engineer can support more ecient space programming through development
of future state process ow maps that integrate the silos and show how the silos will interact. For
example, imagine a physician practice that will run a clinic out of a new building on Mondays and
Facility Planning: The Role of the Industrial Engineer ◾ 187
Wednesdays, and work elsewhere the other days of the week. Within that same building, there
may be another physician practice that will run clinic out of the new building on Tuesdays and
ursdays, and work elsewhere other days of the week. It may be possible for these two physician
practices to utilize the same space in the new building, reducing the overall size of the building.
An industrial engineer can assist by helping to standardize processes and spaces to facilitate both
physician practices utilizing the same space.
Another example where an industrial engineer can assist is in simulation. Imagine that the two
physician practices just mentioned decided that they both wanted to work out of the new build-
ing on Fridays. Simulation can be used to model the physicians’ schedules and identify potential
schedules where both physicians could use the space.
Operational analysis can also be used to identify the correct size of space needed. Continuing
with the physician practice example, operational analysis may identify the correct number of exam
rooms needed per physician.
Additionally, an industrial engineer could optimize the ratios that are utilized to estimate the
support space needed in facilities. Improving the precision of these ratios would certainly result
in better cost estimates. A cost estimate for the project is developed at the end of each phase of
the architectural process. e estimate gains accuracy as the project becomes dened with greater
detail in each phase.
Schematic Design
e next phase after space programming is schematic design. During this phase, the architect pre-
pares diagrams of the buildings or spaces, to provide a general view of the components and scale
of the building or project. is phase is based on information from the master facility planning
and space programming phases, including the components and size of the spaces as well as the
necessary adjacencies. e architect’s plans may also be referred to as drawings, schematics, or SDs
(for schematic designs).
An industrial engineer can support schematic design by optimizing the adjacency relation-
ships. For example, it may be most ecient for radiology and laboratory to be closely located to
the emergency department since these services are utilized heavily by the emergency department.
Furthermore, the emergency department likes to be on the rst level of the hospital for easy patient
access. However, the site may not be large enough to accommodate all of these services on the
rst level. e industrial engineer can quantify the benets of various adjacency relationships to
help prioritize and place services. As an example, the quantication may reveal that there is more
time-intensive patient movement to radiology than to the laboratory; therefore, radiology would
be located on the rst oor with the emergency department and laboratory would be located on
another oor.
Another application of industrial engineering during the schematic design phase is the use of
spaghetti diagrams to measure current movement of people and supplies. is information can be
used to minimize travel distances of heavily traveled routes. Floor plans and designs for changes
to the building can be analyzed and spaghetti diagrams created to measure the changes in the
distances traveled, to identify the most ecient paths.
Industrial engineers can also help to interpret workow plans into design implications. For
example, the future state process maps may indicate that patients will be greeted at one central
welcome desk when they enter the building. Without understanding this workow, architects may
plan for patients to enter the building at multiple locations, such as the emergency department,
cancer center, and radiology. Having multiple entrances is costly for construction, trac ow
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