|Testing Design Through Functional Performance|
|By Kate Renner, AIA, EDAC, Lean-Six Sigma CE, LEED AP BD+C, Associate, HKS and Shannon Kraus, FAIA, FACHA, LEED AP, Senior Vice President, Board of Directors, HKS|
your healthcare facility impact your patient outcomes? Every key design
decision is a performance hypothesis with a direct impact on outcomes and the
metrics used to measure patient outcomes, including fall rates, infection rates,
staff injury reports, satisfaction and HCAHP scores. A well-designed building
can improve organizational performance at multiple levels – the human,
organizational and environmental scales. The true test of the success of a
project design is its functionality after occupancy. To measure this
functionality, Post Occupancy Evaluations (POE) were developed as a tool to
evaluate buildings in a systematic and rigorous manner, after they have been
built and occupied for some time.
of a POE, the Functional Performance Evaluation (FPE), includes site audits,
user feedback, environmental analysis, spatial analysis and organizational
success metrics. The FPE is based on the philosophy of “triangulation” in
collecting data. The FPE collects meaningful data using key metrics and
multiple measures, before developing conclusions. This tool provides facility
owners with insight into ways to improve and optimize operations through
facility design, and assists design teams in understanding the consequences of
their decisions and engaging in continuous improvement.
The sound study conducted as a part of
the FPE found that the sound levels are below the US Environmental Protection
Agency’s recommendations in the patient room, both during the day and night.
HOSPITAL C: Greenfield Community Hospital (375,000
SF, 144 Beds)
for this hospital was to create a patient- and guest-centered facility that
would be lean, green and operationally efficient. A key strategy to accomplish
this infused hospitality into the design, which allowed the team to transform
the traditional paradigm of “patient care” into one of “guest care”— where the
human experience is the focus.
the impact of the nursing unit design on nurse walking behavior and travel distances,
the FPE queried nurses about their paths of travel and sequences in care
delivery. The evaluation included asking nurses to identify their patient room
assignments and the path and frequency of travel involved in collecting patient
medication and clean supplies. The analysis revealed that dissatisfaction
with operational efficiency correlated with long walking distances, due to
non-standard stocking of supplies; an operational issue that defeated the
the FPE data, the research team made recommendations to the hospital’s
leadership team and changes were implemented in both the design and operations.
The results suggest that the use of evaluations as an applied research tool
contributes to improvements in design processes, organizational performance and
the industry knowledge-base.
MORE THAN EVALUATION: A TOOL FOR BETTER DESIGN
gained from our FPEs has allowed us to develop a series of analytical and
generative tools that can be used throughout the design process. While POEs are
traditionally one-off assessments of built environments, the FPE is a design
research tool that can inform the entire process, improve operations post
occupancy and become a driver for innovation. This tool can be used to test
both new and existing environments to improve operations in existing conditions
and influence design of future environments. For more information,
contact Kate or Shannon at 202.682.6289 or firstname.lastname@example.org
HKS, Inc. is a leading architectural design firm ranked
among the top six architectural engineering firms, according to Building
Design+Construction magazine. Since its founding in 1939, HKS has completed
construction projects totaling more than $77 billion in more than 1,742 cities
located in 88 countries. The firm operates from 26 offices worldwide.