Healthcare Industry
Lean Construction Principles in Healthcare
Jan 29th
The Practice of Lean Construction Principles in Healthcare
Are you familiar with principles and processes of lean construction in healthcare? Few people in the construction field have taken the time to actually implement lean construction principles that are found as a result of best practice and experience. Dan D’Amico applies lean construction techniques in all healthcare projects to achieve a level of optimization which is coordinated and determined by what outcome his client desires to achieve . Logistical planning is accomplished and implemented ahead of the project starting, while lean construction is the process of synchronization of supply management with installation, the logistics of design, prefabrication and virtual medical design flowcharting. I am interested in your thoughts. Please comment with your experience.
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Innovative Healthcare reform
Jan 29th
Solving workplace healthcare issues
Below is a video from ABC world news that discusses the reforms set in motion by Safeway CEO Steve Burd. THe video discusses his healthcare reforms from inside his own company.
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Healthcare realty company project overview
Jan 11th
Healthcare realty development project overview
A group of physicians wants to own its own hospital. Clarity Health works with the physicians and provides comprehensive services ranging from consulting services and project syndication to full operations management. These services are provided by a Clarity Health project company that is partially owned by the physicians that are leading the project. This ensures the hospital operating company is viable and can manage its start-up and operating expenses. Clarity Health also tests the viability of the health care model in the marketplace in reference to competition, reimbursement, legal and regulatory requirements. The hospital operating company and the owners of the hospital operating company will be required to guarantee the lease.
Clarity Development provides full development services including the preparation of development plans, negotiating all contracts, managing construction, and sourcing and negotiating the terms of all financing. Clarity Development charges an industry standard development fee, financing fee and leasing commission. All of these services are provided by, and the fees paid to, a Clarity Development project company that may be in part owned by the physicians that are championing the project.
Clarity Development works with Clarity Realty to finance the project. Clarity Realty will set up a Clarity Realty project company to own the real estate. Clarity Realty will work with equity investors and individual physicians or physician groups, to provide equity for the project. The intent is to provide a preferred return on equity. Clarity Realty will work with Clarity Development to obtain financing for the project.
The intent is that the Clarity Realty project company will charge a lease rate equal to a pre determined yield on cost of the project with set annual lease escalation. Clarity Realty charges an asset management fee to the Clarity Realty project company.
Upon completion of the building, the Clarity Realty project company will either hold the building in its portfolio, or sell the completed and leased building to a third party or a Real Estate Investment Trust (REIT) for a determined Capitalization Rate (Cap Rate). The REIT will either be predetermined prior to the start of development or marketed to after lease-up of the facility.
Upon the sale to the REIT, or the refinancing of the building, the intent is that the proceeds will be distributed to the equity investors to make possible a pre determined Internal Rate of Return (IRR). Remaining excess gains will be distributed as per the requirements of the entity financing the project
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Health Care Management and Consulting
Dec 16th
Clarity Health Management and Consulting
“It’s all in the Details of Service”
Financial Development: Providing a complete set of financial data specific to the project:
• Facility revenues
• Operational costs
• Profits
• Assisting in the facility conceptual space plan
• Estimating capital equipment expenditures
• Recommending financing strategies
• Projecting 5 year cash flow statement
• Projecting 5 year profit and loss statement
• Identifying top payers to prioritize contract negotiations
• Offering on-site presentation to physicians and facility partners
Clarity Business Development: Physician Recruitment/Syndication and Legal Documentation
• Identification process of potential partners and their alignment
• Preparation of, and updating if applicable, Syndication Document with supporting financials
• Preparation of, and updating if applicable, Management Agreement
• Establishing pre-syndication meetings, introductions
• Conducting meetings with prospective surgical and medicine groups and individuals
• Facilitating data collection, to include case mix, payer mix, volumes from prospective surgeons
• Collection, accounting and escrowing of funds
Building Site Selection, Design and Development (as applicable)
• Site selection, negotiation and contracting
• Design and building specifications; providing early, as well as ongoing, reviews of architectural plans and space design with client, architect, and contractor
• Serves as construction manager working closely with contractor to ensure timelines, quality standards and budgets are achieved
• Procuring capital equipment in coordinate with physicians
• Establishing equipment cut sheets for the architect and contractor
• Facilitating final facility walk-thru and punch list verification
• Coordination and execution of licensing and accreditation processes
Organizational Structure Development (as applicable)
• Establishing governance structure, governance documents, medical staff bylaws, rules and regulations
• Establishing Board of Managers or Governing Board – insuring minutes are taken early in the process
• Guiding selection of Medical Director, Medical Advisory Committee, QA Committee and key staff
• Guiding mission, vision, goals and objectives statements
• Completing applicable State Licensure and Medicare 855 Certification forms
• Active participation in licensure and certification surveys
• Obtaining business license, if needed
• Assisting in client’s selection of identity, branding, logo and marketing strategy
Operational Systems
• Assisting legal counsel with bylaws
• Hiring on-site Clinical Director
• Assisting Clinical Director in:
• Hiring and training staff
• Setting up employee files
• Developing staffing plans
• Establishing vendor relations with competitive price points
• Developing and implementing employee benefit package
• Designing and drafting policies and procedures
• Overseeing protocols required by State licensing organization
• Preparing staff for Medicare certification process
• Establishing transfer agreements
• Establishing protocols for anesthesia, laboratories, laundry, housekeeping, and other outsourced services
• Guiding client in selection and implementation of management information systems
• Facilitating the integration of systems between facility and group practice(s) to establish economic and systematic efficiency
• Negotiating third-party payor contracting
• Establishing fee schedule for client review
• Developing and implementing recommended credentialing procedures
• Identifying potential Group Purchasing Organization (GPO) arrangements
• Arranging for general liability, malpractice, and contents insurance
• Drafting and implementing clinical, business office, and human resources forms
• Ordering and stocking supply inventories
• Assisting with data entry of inventory variables into management information system
• Developing and implementing physician block schedule
• Coordinating staff in-services on mechanical systems (emergency generator, nurse call system, fire system, security system, etc.)
• Assisting in coordination of the move into and setting up of the center
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Healthcare Management – Healthcare Capacity
Dec 10th
Healthcare Management and Healthcare system capacity.
Healthcare management and Capacity
The U.S. Healthcare system has continued to expand in recent years. With more than $39 billion dollars spent on health care construction projects in the U.S. alone in 2007, with the majority of the monetary spending going to work on new hospitals, ambulatory surgery centers and also to expand on existing healthcare institutions. Growth in physician-owned specialty hospitals has been particularly rapid and strong continued growth is predicted. There has also been significant expansion of ambulatory surgery centers. This growth in facilities coincides with the potential expansion of the physician workforce as well as ever changing and advancing trends in technology. Given these major healthcare growth patterns, policy discussions about the amount and value of care delivered to Americans are increasingly focused on questions about the impact of changes in health system capacity. These findings have led to the conclusion that Healthcare management as a field and as a necessity is an overwhelming simple yet powerful conclusion in finding new ways to handle the growth.
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