1. Minimizing Built-in Waste in Michigan Medicine’s New Clinical Inpatient Tower
Final Presentation
Presented By: IOE 481 Team #3
Sarthak Jain Mary Owczarczak Katherine Sell Jennifer Wenger
April 19, 2017

2. Overview Introduction Key Issues Goals and Objectives Project Scope
Methods
Findings and Conclusions
Recommendations
Expected Impact

3. “Best Hospitals in Michigan”
Introduction
“Best Hospitals in Michigan”
-U.S. News and World Report
Improve colocation of similar services and patients
Facilitate the overall growth of adult services
Create an optimal patient experience

4. Introduction Current capacity constraints New Clinical Inpatient Tower
Michigan Medicine’s Ann Arbor Location
New Clinical Inpatient Tower

5. Key Issues Key issues driving the need for this project:
Care providers walk long distances during shifts
Time at the bedside is constrained due to motion and transporting activities
Key resources and destinations are not efficiently placed in current facility layouts

6. Goals and Objectives
Minimize built-in waste in the design of Michigan Medicine’s new Clinical Inpatient Tower
The team analyzed the:
Total distance traveled during a care provider’s shift
Mean distance traveled per hour of the shift
Destinations visited most frequently by care providers

7. Project Scope Includes Excludes
Doctors, nurses, technicians, pharmacists, and residents
University Hospital
Inpatient Units 4A, 4C, 4D
Pre-Op, PACU, Anesthesiology, Adult ED
All shifts during week days
Excludes
Employees with no patient interaction
All other Michigan Medicine buildings

8. Methods

9. Literature Search
The Effect of Hospital Unit Layout on Nurse Walking Behavior
Lean-Led Hospital Design: Creating the Efficient Hospital of the Future
A 36-Hospital Time and Motion Study: How do Medical-Surgical Nurses Spend Their Time?

10. Observations and Interviews
University Hospital: Pre-Op, PACU, Unit 4A, and Unit 4D
12 hours per team member
Deeper understanding of current flow and destinations frequently visited

11. RFID Tag Study - Data Collection
Tagged participants during work week
Surveyed participants after tagging

12. RFID Tag Study - Data Analysis
Software created visual of RFID pings
String method used to analyze data

13. RFID Tag Study- Data Analysis
Key Metrics:
Total distance traveled per shift
Mean distance traveled per hour
Epicenter and the most frequently visited destinations
Distances from the epicenter to these destinations

14. Time Studies Timed walk paths to key destinations using stopwatch
Used MODAPTS to convert between distance, steps, and time

15. Findings
&
Conclusions

16. Distances Traveled

17. Department Epicenters
Epicenter: Location visited most frequently per department

18. Unit 4A Findings and Conclusions

19. Walking Paths from Epicenter (Unit 4A) Unit

20. Distances and Trip Percentages (Unit 4A) Unit
Data collected with RFID tags from 2/20/17 - 3/28/17, n = 5 people
Percentage of Trips
→ Patient rooms are most frequented location and have the longest distance from epicenter

21. Times Studies and MODAPTS (Unit 4A) Unit

22. Unit 4A Subjects: Walking Paths Unit
Ping Rate = 1 minute

23. Unit 4C Findings and Conclusions

24. Walking Paths from Epicenter (Unit 4C) Unit

25. Distances and Trip Percentages (Unit 4C) Unit
Data collected with RFID tags from 2/20/17 - 3/28/17, n = 6 people
Percentage of Trips
→ Patient rooms are most frequented location and have the longest distance from epicenter

26. Time Studies and MODAPTS (Unit 4C) Unit

27. Unit 4C Subjects: Walking Paths Unit
Ping Rate = 1 minute

28. Unit 4D Findings and Conclusions

29. Walking Paths from Epicenter (Unit 4D) Unit

30. Distances and Trip Percentages (Unit 4D) Unit
Data collected with RFID tags from 2/20/17 - 3/28/17, n = 5 people
Percentage of Trips
→ Computer area is most frequented location and has the longest distance from epicenter

31. Time Studies and MODAPTS (Unit 4D) Unit

32. Unit 4D Subjects: Walking Paths Unit
Ping Rate = 1 minute

33. Pre-Op Findings and Conclusions

34. Walking Paths from Epicenter (Pre-Op) Unit

35. Distances and Trip Percentages (Pre-Op) Unit
Data collected with RFID tags from 2/20/17 - 3/28/17, n = 4 people
Percentage of Trips
→ Bay stations are most frequented location

36. Time Studies and MODAPTS (Pre-Op) Unit

37. Pre-Op Subjects: Walking Paths Unit
Ping Rate = 5 minute

38. PACU Findings and Conclusions

39. Walking Paths from Epicenter (PACU) Unit

40. Distances and Trip Percentages (PACU) Unit
Data collected with RFID tags from 2/20/17 - 3/28/17, n = 4 people
Percentage of Trips
→ Bay stations are most frequented location and have the longest distance from epicenter

41. Time Studies and MODAPTS (PACU) Unit

42. PACU Subjects: Walking Paths Unit
Ping Rate = 5 minute

43. Anesthesiology Findings and Conclusions

44. Walking Paths from Epicenter (Anesthesiology) Unit

45. Distances and Trip Percentages (Anesthesiology) Unit
Data collected with RFID tags from 2/20/17 - 3/28/17, n = 5 people
Percentage of Trips
→ PACU is most frequented location

46. Time Studies and MODAPTS (Anesthesiology) Unit

47. Anesthesiology Subjects: Walking Paths Unit
Ping Rate = 5 minute

48. Adult ED Findings and Conclusions

49. Walking Paths from Epicenter (Adult ED) Unit

50. Distances and Trip Percentages (Adult ED) Unit
Data collected with RFID tags from 2/20/17 - 3/28/17, n = 5 people
Percentage of Trips
→ Patient rooms are most frequented location and have the shortest distance from epicenter

51. Time Studies and MODAPTS (Adult ED) Unit

52. Adult ED Subjects: Walking Paths Unit
Ping Rate = 1 minute

53. Recommendations
Unit
Patient rooms: placed as close to department epicenter as possible
Distance savings: Up to 54 feet per trip
Time savings: Up to 12 seconds per trip
Anesthesiologists’ offices: placed between the Pre-op and PACU departments
Distance savings: 180 feet per trip
Time savings: 39 seconds per trip
Pre-op department: include break room for department
Distance savings: Up to 195 feet per trip
Time savings: Up to 42 seconds per trip

54. Recommendations: Adjacencies
Department Epicenter
Primary Adjacencies
Secondary Adjacencies
Unit 4A: Charge Station
Conference Room
Computer Room
Med Room
Equipment Room
Unit 4C: Charge Station
Team Room / Computers
Computer Desk
Clean & Sterile Supply Room
Unit 4D: Charge Station
Computer Area
Staff Room
Clean Holding Room
Soiled Holding Room

55. Recommendations: Adjacencies
Department Epicenter
Primary Adjacencies
Secondary Adjacencies
Pre-Op: Charge Station
Computer Area
Clean Room
Break Room
PACU: Charge Station
Supply Room
Anesthesiology Department: Office Region H
PACU
Equipment Room
Operating Room
Conference Room
Logistics Room
Pre-Op
Adult Emergency Department: Computer Area
Equipment Hallway
EMS Linens Room
Computers

56. Innovative Recommendations
Two computer areas: one on each end of inpatient unit
Moderate spacing between med rooms and patient rooms
Saves up to 60 feet and 13 seconds per trip
Saves a minimum of 12 feet and 3 seconds per trip

57. Innovative Recommendations
Two-way access for frequented locations
Improves department flow
Saves up to 70 feet and 15 seconds per trip

58. Innovative Recommendation

59. Recommended Future Studies
Additional analysis of walking distances of Michigan Medicine’s care providers
Pedometer as additional measurement tool

60. Expected Impact
Decrease distance traveled by care providers per shift/hour
Increase time at the bedside
Increase employee morale
Decrease square footage of inpatient tower
Increase Michigan Medicine’s operational efficiency

61. Questions?