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Organizational Readiness

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What is Organizational Readiness?

The proposed capital project should be driven by community and program needs and be consistent with the overall strategic plan. Organizational Readiness includes review of the Strategic Plan (long-term goals and the short-term implementation steps for getting there), assessing organizational capacity (board and volunteer expertise, fundraising capacities, expertise in business planning and financing options, and design and/or construction experience), forming ad hoc committees (i.e. capital campaign committee to cultivate donors/financing, building committee to determine scope and hire design/construction teams), and preparing a budget for planning activities (i.e. space needs study, evaluating fundraising readiness, preliminary schematics, feasibility study).

Organizational Readiness Activities

The tasks are also not always sequential and overlap in most cases. Click on the activities tab on the right to see the common activities within the organizational readiness phase and a brief definition or description. Use the resources tab for tools and other publications for this phase.

Evidence-Based Design

During organizational readiness, two EBD processes are started: Step One) define EBD goals and objectives; and Step Two) find sources for relevant evidence. Click the Evidence-Based Design Tab for more detail about EBD activities during this phase.

Sustainability

Sustainability, as formally achieved through LEED for Healthcare (Leadership in Energy & Environmental Design), an internationally recognized green building certification system through the United States Green Building Council is another aspect to consider for your project.

Not all organizations are ready to become carbon neutral or to achieve zero waste. One of the first steps in the sustainability process is to understand the readiness of executive leadership to assume the mantle of sustainability, and how quickly and aggressively that should occur. If your organization is willing and able, start to define goals for building performance (site, water, energy, materials, indoor environment) and determine the impact sustainability and energy efficiency will have on the life-cycle cost of operating the building.

At this stage, you should define how the organization’s mission supports sustainability initiatives. Review the LEED and Green Guide for Healthcare checklists in the resources tab.

Lean Process

Other aspects to consider for your project during organizational readiness include Lean processes (elimination of “waste,” such as waiting, hunting and gathering, etc.) Is your organization using Lean concepts already or is Lean a cultural change issue? (This ranges from a top management philosophy down to front-line behavior.) Consider a Readiness Assessment for Lean such as:

Standards and norms of the organization
Performance management and measurement
Employees interaction with patients and each other
How employees think about their work
Methods used to identify and solve problems
Other aspects of behavior that must be aligned for continuous improvement.

Evidence-Based Design Activities

Print Evidence-Based Design Activities

EBD Step 1: Define EBD Goals & Objectives

At the core of an evidence-based design process is the link between design and desired outcomes. This can be established early in the process through visioning - defining broad goals and objectives for the project that support the organization’s mission and vision. Continually referencing these goals throughout the process helps the team evaluate various design strategies and keep the project on track. Consider the following steps and related questions.

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Assemble interdisciplinary design team (P)

In addition to the architect, the executive director, the staff, and the board of directors, each have a unique role and perspective to share during the development process. Your team may include an executive steering committee, as well as subgroups. In an evidence-based design process, there is a diverse group of stakeholders who bring varying perspectives to help define the goals, objectives, and solutions. Are there specialty consultants you might need, such as an expert in project development, clinical processes or technology? Determine how patient and staff input will be gathered throughput the process and how they will be represented at an executive level. Have roles and related scope of responsibility been defined for each team member?

In a clinic setting, it is a good idea to poll your Board, staff, and other volunteers to find out what expertise they may be able to contribute to the project, whether developing a business plan or understanding construction. You may also find experts in your community that are willing to help, but it is important to define expectations, especially when work is being offered pro bono.

Identify issues and/or problems (P)

Consider if there are key areas or outcomes that would be of interest to your community and organization. What problems or issues are you trying to solve? What is it that you hope to achieve to support your strategic plan, business case, and/or care model? In a clinic setting, community issues might include access to care or compliance rates for care regimens. Organizational problems might include staff efficiency.

Define Outcomes (P)

Defining the intended outcomes will provide clarity for everyone involved throughout the duration of project. Outcomes may be closely tied to staff, patient and/or family and will most likely involve operational, administrative and cultural changes. What are the anticipate improvements or changes to be achieved through a new or renovated building?

In a clinic setting, outcomes might include patient & clinical outcomes, such as improving access to care by providing easy access to public transportation, improving compliance with care regimens through family engagement in care. Staff outcomes might include improved efficiency offered by a medical home model and its related layout (that may improve patient compliance, as well). It may also include operational outcomes, such as reduced long-term operating costs. Long term costs need to be carefully considered relative to “first” (capital) costs in development of the business case.

EBD Step 2: Find Sources for Relevant Evidence

As the team begins to develop design guidelines, the search for relevant evidence begins. Knowing what strategies are supported by evidence will depend upon a review of the literature. A resulting set of project priorities is defined in conjunction with the literature review findings.

Inform design challenge and formulate research questions (P, R)

In addition to defining the issues and problems, consider what additional questions need to be raised and the evidence that might be used to inform decisions. Learn about what others have done through benchmarking visits or interviews to establish some early ideas to guide the project.

In a clinic setting, this may include better understanding models of care, their delivery, and how this affects the building layout and space requirements. Your questions may focus on how effectively you are able to deliver care in the new model by measuring throughput times, compliance, and satisfaction. You may want to engage a researcher to help identify research questions, but you may be able to identify certain questions and related metrics on your own through information you already gather.

Identify types of evidence (P, R)

Initially, it is important to identify all types of evidence, such as published papers, case studies, peer interviews, site visits, and structured benchmarking. The type of evidence may be tied to the type of information your team is trying to learn – newer information may only be found while conducting a site visit, rather than in a published format.

There are very few peer-reviewed published papers that will identify conditions specific to clinic settings, however, information can often be extrapolated from other environments, whether acute care or ambulatory care. It is important to get help understanding how less rigorous sources can still be applied to a clinic setting. This may be through a researcher or someone well-versed in the EBD process who can establish some guidelines for how you might best use the information collected.

Organizational Readiness

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Organizational Readiness

What is Organizational Readiness?

Organizational Readiness Activities

Evidence-Based Design

Sustainability

Lean Process

Evidence-Based Design Activities

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