Existing S

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• What is

FLEXIBILITY
The Ability to Expand or Adapt
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WHY PLAN FOR FLEXIBILITY

• To Accommodate Future Workloads.
• To Allow For Operational Changes.
• To Modernize With New Building Systems.

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• PLANNING CONSIDERATIONS

• PLANNING FOR EXPANSION
• Programming and Planning
• Design and Construction
• PLANNING FOR ADAPTABILITY
• Programming and Planning
• Design and Construction

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• PLANNING FOR EXPANSION

Programming and Planning Considerations
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• PLANNING FOR EXPANSION

1. ESTABLISH A CLEAR CIRCULATION TO SET THE THE
   GROWTH PATTERN
2. UNDERSTAND HOW SERVICES EXPAND
3. PLACE LARGE, HIGH-TECH, LIKELY TO EXPAND SERVICES
   ON AN EXTERIOR WALL
4. VERTICALLY STACK SERVICES LIKELY TO EXPAND
5. LAYOUT SERVICES FOR EASE OF EXPANSION

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PLANNING FOR EXPANSION

• LOCATE EASY TO RELOCATE SERVICES ADJACENT TO
  SERVICES THAT SHOULD REMAIN STATIONARY
• PLAN FOR PLUG-IN MOBILE SERVICES
• USE VACANT SPACE TO AID WITH EXPANSION
• LOCATE IMMOVABLE ELEMENTS SO EXPANSION OF OTHER
  STRUCTURES IS NOT BLOCKED

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Emergency Entrance
Main Entrance
Circulation Network Establishes Growth Pattern
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• EXPANSION CHARACTERISTICS OF SERVICES

• INPATIENT UNITS
• Whole Units are Added or Replaced
• DIAGNOSTIC TREATMENT SERVICES
• Incremental
• Space for New Equipment
• Building Systems are Modified
• SUPPORT SERVICES
• Expansion Delayed Until Substantial Expansion is
  Required
• ADMINISTRATIVE SERVICES
• Miscellaneous Available Space is Filled Until
  Consolidation is Required
• CLINCS
• Support Space is Converted Into Clinical Space
• Whole Modules are Added

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Emergency Entrance
EMERGENGY
SURGERY
RADIOLOGY
CONF.
PATIENT SERVICES
DT
MED/ SURG NURSING UNIT
ICU
Main Entrance
DT
DT
MECH.
ADMIN.
Large High-Tech Services on Exterior Wall
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Layout Services for Ease of Expansion
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Emergency Entrance
EMERGENGY
SURGERY
RADIOLOGY
CONF.
PATIENT SERVICES
DT
MED/ SURG NURSING UNIT
ICU
Main Entrance
DT
DT
MECH.
ADMIN.
Soft Space Provides Expansion for High-Tech
Services
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PLANNING FOR EXPANSION
Design and Construction Considerations
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PLANNING FOR EXPANSION

• STRUCTURE FOR VERTICAL EXPANSION
• LOCATE MAJOR BUILDING EQUIPMENT, SO THAT
  ADDITIONAL EQUIPMENT CAN BE ADDED
• DESIGN BUILDING SYSTEMS FOR EASE OF EXPANSION
• DESIGN AND CONSTRUCT TO MINIMIZE THE DISRUPTION
  OF EXPANSION
• CONSIDER BUILDING LIFE-CYCLE SHORT TERM,
  MID-TERM, LONG TERM

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PLANNING FOR ADAPTABILITY
Programming and Planning Considerations
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PLANNING FOR ADAPTABILITY

1. USE STANDARD PLANING MODULES
2. MAXIMIZE OPEN SPACE, DO NOT ENCUMBER WITH FIXED
   ELEMENTS
3. POSITION SOFT SPACE WHERE FUTURE HIGH TECH ROOMS
   WILL BE NEEDED
4. SHARE OR SWING SPACE WITH LOW UTILIZATION
5. DEVELOP DESIGN CONCEPTS TO ACCOMMODATE EXPECTED
   FUTURE OPERATONAL CHANGES
6. ENCOURAGE OPEN SPACE PLANS
7. DOCUMENT PLANNED FLEXIBILITY

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Standard Planning Module - Room
EXAM ROOM
ADMIN. OFFICE
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Standard Planning Module - Clinic
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Clinics Swing Exam Rooms to Meet Demand
Fluctuations
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Fixed Elements Encumber Open Space
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Fixed Elements on Perimeter
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Soft Space Becomes Future High-Tech Room
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Nurse Station
(12) Bed Acute Care Pod Becomes an ICU
Acute Care Unit Converts to Intensive Care
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PLANNING FOR ADAPTABILITY
Design and Construction Considerations
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PLANNING FOR ADAPTABILITY

• SIZE STRUCTURAL BAYS FOR FLEXIBILITY
• FLOOR TO FLOOR HEIGHT THAT ALLOW FOR ADDITIONAL
  OR NEW SYSTEMS
• DESIGN BUILDING SYSTEM SPACE FOR ACCESS AND
  ADDITIONAL SYSTEMS
• ZONE BUILDING SYSTEMS
• USE BUILDING COMPONENTS THAT CAN BE RECONFIGURED
• USE CHANGEABLE, MOVEABLE, AND PORTABLE EQUIPMENT
• PROVIDE ADDITIONAL OUTLETS SO ROOM FURNISHINGS
  CAN BE RECONFIGURED

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Building Section with Interstitial Space
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VALUE OF FLEXIBILITY

• First Cost Premium Operating Cost Premium
• -VS-
• Future Cost Savings Mitigated Disruption
• First Cost Premium Additional Cost of
  Flexibility
• Operating cost Premium Additional Operating
  Cost
• Future Cost Savings Savings Derived from
  Flexibility at Time of Modifications
• Mitigated Disruption Disruption not Experienced
  due to Build-in Flexibility

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• WHERE IS FLEXIBILITY IMPORTANT TODAY?

ABILITY TO ADD HIGH-TECH DIAGNOSTIC EQUIPMENT
EXPANSION OF OUTPATIENT SERVICES
EXPANSION FOR INPATIENT BEDS
INSTALLATION OF COMMUNICATION/ INFORMATON SYSTEMS
ABILITY TO ADAPT FOR ACTIVITY
ABILITY TO SURGE FOR UNEXPECTED HIGH VOLUMES
ABILITY TO ADD INCREMENTALLY
EXPANDING SERVICES
DOWN-SIZING SERVICES
EVERYWHERE