Request for Proposal - Harney District Hospital

Space Planning Request for Proposals - please respond before xxx
Harney District Hospital Family Care Clinic
Harney District Hospital Physical Therapy Clinic
559 W. Washington
Burns, OR 97720
Contacts: Denise Rose 541-573-5184 [email protected]
Stacie Rothwell 541-573-8870 [email protected]
Harney District Hospital would like to determine interest and qualifications of architectural
businesses available to propose evaluation and planning process for redesign and remodel of Family
Care Clinic spaces, currently housed in a building attached to Harney District Hospital. Enclosed is a
brief history of our medical services, the Harney County community and an overview of challenges in the
current space. Plans for expansion of services and provider group are already being implemented and a
description of our projected needs is also included. The final page of this document asks for your
responses regarding how the project would be managed and the outcomes we can expect.
Located in isolated, rural Burns Oregon, Harney District Hospital has been serving as the only
medical provider for over 50 years. In 2012, the hospital and adjacent Family Care Clinic joined together
to become one entity. In 2014, HDH Physical Therapy, also housed in the clinic building became a part
of the hospital. The Health District provides frontline service to a population of less than 7600 residents,
spread over 10,000 square miles. Currently, the clinic houses three FM physicians, two Nurse
Practitioners and two Physicians Assistants. We will be adding another physician, potentially two in
2015 and at least two mental or behavioral health professionals (counselor, case managers and similar)
in the next 18 months. Support staff will also increase and projections will be shown on the attached
staffing plan.
The current hospital facility was completed in early 2008 and the attached clinic building
housing both FCC and the Physical Therapy departments was completed in 1998. Because this is a
relatively new building (especially for our community) we feel remodel vs. replace is the most appealing
option. However, basic practice work flows have changed and the integration of behavioral health and
care management services have been challenging to fit into the current clinic areas. Further, the design
is not conducive to the new model of team based, integrated health care and preventative services we
feel is our future.
As a Rural Health Clinic, HDH FCC is dramatically changing their care model to align with the
tenets of Patient Centered Primary Care Home practices. The team based care concept calls for a very
different type of physical space than the clinic staff currently has. As a Tier 3 PCPCH, Family Care has
exceeded the highest standards in their practice, but cannot grow services in the current space.
Conversely, the HDH Physical Therapy areas of the building are adequate, with many features
staff feels still work well. But they are experiencing growing pains; they have added support staff, hope
to bring on an Occupational Therapist and incorporate more wellness offerings. They have creatively
made space for equipment, added desk and work space in close quarters and are at maximum capacity.
On the following pages please find the following document:
 HDH Family Care compilation of brainstorming sessions with key staff regarding challenges and
future plans for physical plant.
 HDH Physical Therapy same as above but also thoughts regarding what currently works in their
space and features they would like to retain or replicate.
 Combined staffing levels for both departments. Projected staffing in three years, based on
strategic plan growth goals.
HDH Family Care:
Challenges
Current general lack of space
Heating and Cooling System is dysfunctional. Consider
option to link to hospital pellet boiler system. Insulation
throughout is questionable
Future staff growth - where to put everyone and in an
organized functional fashion and still allow room for
potential growth beyond that
Need for reconfigured reception area; more privacy at
intake stage. Area is now large and poorly laid out. Flex
up space needed for visiting specialists
Lack of storage place - current space is not sufficient
Current shared positions aren't adjacent, efficiency of
work flow in business areas
Nurses station privacy is lacking in many ways
Exam Rooms 1 & 8 are not being used due to
functionality/location
Physician offices - at capacity now, can consider shared
areas/offices or a more open concept that allows for
growth and use by contracted specialists such as Gyn.
Nursing/provider areas should be restructured to
accommodate care team functionality / pods
Needed space to perform drug screens in privacy
Need restroom with no running water for drug screens
(potential split bathroom?)
INR (back nursing area) workstation privacy
Tight quarters in procedure room with patient and
sometimes guest, provider and nurse
Need for space for consults such as dietary, etc.
No kid friendly area in lobby currently - need access to
literacy rich reading areas for Reach out and Read
requirements. Possibly sections to separate contagion
Patient education center evaluate feasibility and
continuation
Outer wall expansion is limited with the exception of the
current patio area that is between HDH and the clinic
that is rarely used
Roof and flooring throughout need to be replaced
Additions, Growth of Services
Add new programs such as mental health
and care management.
Would like to have an appointment
scheduling center / call center. Auditory
privacy.
Space for surgeon (office space, nursing staff
workspace, exam room space, procedure
room and EQ need to be updated)
Specialists/Outreach -need to provide work
and exam areas so multiple specialists
overlap.
Espresso Bar Location - currently fine but
need to consider moves due to
plumbing/power.
Future storage for eq such as NST or portable
Ultrasound.
Behavioral health services need to integrate
with providers and care manager, physical
adjacency important for warm hand off.
Growth of general district business functions,
education, outreach and community support
functions causing space issues in
administrative areas of hospital building.
Explore co-location potential?
Space for tele-health office/consult room and
patient education space.
Physical Therapy:
Works well Currently:
Challenges to Current:
Windows, open light area with
view
Need more overall space, now ~2000
need double, cramped now
Good equipment
Private rooms, but need
larger/more ~5
Central office area, able to keep
eye on pt.
Separate wait area, private from intake
More storage
Lockers, restrooms, showers,
and ADA
Restrooms don’t have private
entrance, open right onto treatment
areas
Therapists offices not private, people
walk in, consult space needed separate
from treatment rooms
Additional potential
programs/services:
Separate areas for treatment vs.
wellness exercisers
Need multiples of some EQ
Walking loop, stairs can be
hallways
OT especially cert. hand therapist,
missing referrals from Bend now
Anti-gravity treadmill, hi/low
treatment tables, wellness type
pool (reimbursement unknown)
Close and or adjacent to clinic
and hospital
No consult space, view test results,
care plan
Additional capacity for wellness
pt, expanded hours by card
access
ADA doors
Need open area for walking, gait belt
exercise
Partner with VA, who has started
to do some wellness; partner with
RT for pulmonary and cardiac
rehab set up, if space available to
expand
Classroom space for fitness, CPR,
dietary, cooking classes (demo
kitchen?) plus outreach meeting
space. Offices for wellness
coordination
Massage therapy area; especially
need for lymphedema massage,
highly requested here and most
insurance does cover
Harney District Hospital Family Care Clinic and
Physical Therapy Staffing
Current Departments / Positions
Business Office
Business Office Supervisor
Medical Records Clerk/Patient Asst
Coder
Insurance Biller
Receptionist
Data Entry/Indexer
Patient Financial Services
Business Office Float
Nursing Department
Department Supervisor/Care Manager
MA/LPN - Direct Provider Assigned
Coagulation Nurse
Float Nurse
Referral Coordinator (Pt Services)
Surgeon Nurse
Provider Staff
Physicians
FNP
PA-C
Surgeon
Specialist (Gyn)
Care Management Program
Care Manager
Mental Health Professional
Care Coordinator
Support Staff
Current Staff
8.5
1.0
1.0
1.0
1.0
1.0
1.5
1.0
1.0
Projected Staff <3
yr.
12.0
1.0
1.0
1.5
1.5
2.0
2.0
1.5
1.5
11.5
.25-.5
6.5
1.0
1.0
2.0
0.0
6 FTE
3.0
1.5
1.5
0.0
1-2 day/Mo
.5-.75
.5-.75
0.0
0.0
0.0
14.5
1.0
8.5
1.0
2.0
2.0
0.5
8.5 FTE
5.0
1.5
1.3
0.5
1-2 day/mo
4.0
1.0
2.5
2.0
4.0
Administration
Clinic Administrator
Admin Clerical
1.0
1.0
0
1.0
1.0
1.0
Physical Therapy
Physical Therapist
PT Assistant
Occupational Therapist
PT Aide and clerical
2
1
0
1.5
2
2
1
2.5
Response Section:
1. Describe your program planning process; who would be assigned to this project and
what are their qualifications?
2. Will you involve additional resources to determine (for example) engineering, HVAC,
abatement, environmental, work flow analysis and interior design needs? If so, who do
you generally work with?
3. Describe your background working in small or rural communities, outpatient clinics and
physical therapy facilities. Please provide links to work performed in the past 24 months
and at least three similar-work references.
4. What additional information do you need to respond to this proposal? What
involvement would you require from our staff?
5. Are you able to schedule this work in the next 2-5 months?
6. Are you available beyond the space planning phase to participate in the full
remodel/construction project?
7. What deliverables will you provide at the end of the planning process? Include cost
projections.

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