BIM How BIM is changing the construction industry By Peter Ray Allison Source: http://www.computerweekly.com/feature/How-building-information-modelling-is-changing-the-construction-industry Sustainability Problem: The sustainability goal is to modernize the construction industry, with the aim of reducing costs in the construction and operation of new buildings. The employment of BIM is to create a more efficient construction sector. Technology Stakeholders: Construction value chain: […]
- Waste Reduction
- Transparency and Work Flow Efficiency
- Safer and Improved Patient Care Environment
“In healthcare today, the patient experience is of utmost importance. By accurately capturing where our delays were, we were able to identify our primary challenges and implement solutions to directly impact those areas.”
By: Kristen Brown, Clinical Manager of Children’s National Health System
Children’s National Health System is a pediatric care provider in Washington, D.C. For over 140 years, Children’s National has pioneered new therapies and treatments across a wide array of medical specialties, from neonatal services to cancer care.
The Children’s National Cancer Center is a very busy outpatient clinic, with 100+ providers, seeing 200+ patients each day. At Children’s National, successful cancer treatment is not just about delivering medication, but also about providing a friendly, comfortable environment where patients can feel safe for the duration of their treatment. This includes providing art and music therapy to patients while they wait.
When a child comes in for cancer treatment, the visit often is a multi-step process that takes hours. Accompanied by their parents or other caregivers, patients must sign in, give vital signs, have blood drawn, wait for lab results, see clinicians, and perhaps sit through lengthy chemotherapy infusions. There were so many moving parts going on at one time. Lab results might take an hour or two and patients would get bored and wander. Or, they might leave the unit for radiology or some ancillary service and would need to be tracked down at every turn. Children’s National spent too much time simply looking for their patients.
The excessive wait times, and a general lack of information made for a less than pleasant patient experience. The clinical processes had become inefficient and there was no data to track the patient flow to find and fix bottlenecks. Children’s National wanted to make the system more transparent to families, making it possible for everyone to know where they stood in line to be seen by their providers.
Children’s National tackled the challenges inherent in paper-based information flows—and in the process also increased its own staff efficiency. The Savance Health Staff Tracking solution was used to improve communication and workflow, and healthcare team organization. This significantly decreases patient wait times and increases patient satisfaction.
- Healthcare Institutions (Children’s National Cancer Center)
- Healthcare Providers (Primary Care Technician, Clinic Operations Manager Doctors, Nurses, Clinicians, etc)
- Patients (children) and their parents, other caregivers/family members
Savance Health deployed customized solutions: Patient Self Check-In, Waiting Room Display, and Patient Tracking & Flow solutions, helping Children’s National completely transform the workflow of its cancer and blood disorders unit so that when a patient arrives at the clinic, their adult caregiver signs them in at an easy-to-use touch-screen kiosk.
Savance Health Patient Self Check-In can pull information straight from an ID card, a driver’s license, or an insurance card, and easily fill out the patient’s address, phone number, current doctor, current medications, insurance, and date of birth. The solution delivers two key benefits: accurate and complete patient information – acquired through a patient-friendly process.
Once the patient has signed in, Savance’s Patient Tracking & Flow solution takes the mystery out of clinical workflows and patient location. The software tracks where patients are at any given time, and how much time they spend in each area. A display screen in the waiting room —with patient names symbolized by pictures of animals to maintain confidentiality— tells families how many patients are ahead of them to see their specific provider.
Another screen in the clinic workroom shows where patients stand in the day’s workflow. This allows Children’s Health not only to find patients quickly without searching the building, but also to see where process breakdowns occur and take steps to increase workflow efficiency.
- Simplify patient sign-in with self-service check-in kiosk
- Ability to time-stamp patient flow though clinic to monitor detail
- Free staff from physically tracking down patients
- Optimize patient and staff scheduling
- Leverage patient flow data to alleviate bottlenecks during peak demand
- Improve patient experience through better communication and shorter wait times
The looming cost and labor crises impact the healthcare industry. 1 From the back office to the doctor’s office, how can we deliver more effective, efficient and affordable healthcare?
Technology Article: Accenture transforms nursing practice with digital technologies and process innovation.
Source: IDC Health Insights, “Business Strategy: How Third-Party Consultants Helped Unify Communications in a Major U.S. Hospital Organization,” by Sven Lohse, June 2015.
This report describes how Trinity Health (Trinity) and Accenture identified and remedied challenges to hospital communications, to remove impediments to care delivery in terms of both cost and quality. The case study supports enterprise-wide efforts to improve and standardize communications processes, implement business rules to prioritize communications, and make better use of technology tools that manage communications across stakeholder groups.
Failures in communication is among the top three root causes of sentinel events. A typical 500-bed acute care hospital will average an annual economic burden of about $4 million due to wasted communication time.2
Technology that was supposed to be linking people was sometimes creating redundancies, interruptions, and getting in the way of quality care delivery. One clinician might interrupt workflows by responding to every interruption immediately, while another might not respond immediately to any messages, impairing clinical decision-making and team communications.
Uncoordinated communications channels in use included landline and mobile phones, voicemail, text messages (SMS), pagers, email, patient-tracking systems, geo-location technology, digital signage, whiteboards, and even hand-carried notes. As a result, cascades of redundant messages followed clinicians to and from the office by phone, text, voicemail, and pager. Unstandardized, uncoordinated communications caused unnecessary interruptions to workflows, misidentified the priority of specific work-related information, and created negative compensatory behaviors, feedback loops, and process workarounds.
- Trinity Health (hospital)
- Patients (residents, tourists, visitors)
Trinity Health worked with Accenture to plan and implement new processes and technology across their healthcare organization.3
- Accenture investigated Trinity’s network to explore similarities and differences that might exist in processes, technologies, and organizational cultures between different hospital departments and their associated technology platforms.
- Accenture evaluated and benchmarked communications technology and processes, developed a road map to a future strategy and used cases, and advised on technology and process reorganization to achieve Trinity’s organizational goals.
- Through situational observation and shadowing of nurses, Accenture studied separate hospital facilities to identify and remove impediments to coordinated communications.
- Accenture documented and analyzed the frequency and duration of communications and technology contacts, categorized the different types of contacts, and determined the impacts of these contacts on care delivery.
- The resulting data was organized to expose findings related to patient safety and quality of care (e.g., turning and repositioning), hourly rounding, and patient/caregiver experiences, especially in the operating room and intensive care unit.
- Clinicians and Accenture observed the wide range of information technologies that were used in uncoordinated way and identified suboptimal practices as contributing factors in the interruption of workflows, degradation of the quality of information being communicated among clinicians, and delays during unit and shift handoffs.
- Accenture studies supported enterprise-wide efforts to standardize communications processes, implement business rules to prioritize communications, and make better use of technology tools that manage communications across modalities and stakeholder groups. The key benefits that Accenture and Trinity are working toward include:
- Optimizing clinical workflows with improvements to cost and quality of care;
- Improving the quality of hand-offs between units and shifts, with reduction in time lags and interruptions;
- Streamlining and prioritizing provider workflows;
- Improving patient/patient caregiver satisfaction ratings.
- Trinity is taking steps at the enterprise level to empower local decision makers to streamline stakeholder communications.
- The communications priorities of the organization are now under review and reorganization to facilitate better integration of communication needs at centralized and local levels. More business rules and automated technology are implemented to better manage and prioritize communications across modalities.
- Trinity integrated technology into their operations and leveraged digital communications into planning for future patient satisfaction initiatives and into the architectural plans for new hospital facilities.
- Health Care Costs: A Primer, Key Information on Health Care Costs and their Impact, Henry J. Kaiser Family Foundation. May 2012
- The Complexities of Physician Supply and Demand: Projections from 2013 to 2025, American Association of Medical Colleges, March 2015
IoT: Public lighting is everywhere but connected lighting is not.
- Sustainability Problem
Lighting, beyond illumination, is an energy related asset. There are about 300 million street lights worldwide. On average, public lighting is more than 20 years old. Lighting can account for up to 40% of city’s total energy consumption. -1% of installed systems, are connected, expected to grow at 16% per year. Over the past year, we’ve seen IoT-enabled innovations enter our homes, cars, phones, and air space – and even appear on our bodies. Will they make our lives safer, simpler, healthier, and more environmentally responsible?
- Technology Article Summary
The Internet of Things: Turning $3 Lightbulbs Into A $60 Billion Opportunity1
From this article, we learn how connected public lighting can be a driver for the digital transformation of cities and join the Internet of Things (IoT) revolution. See how Dutch company Koninklijke Philips N.V. partners with SAP to empower the digital transformation of cities as they become safer and more livable and energy efficient.
The idea was a reimagined commodity that we all rely on, opening the door to a $60 billion market opportunity. Philips is refurbishing streetlights, parks, bus stops, buildings, and bridges around the world with LED lightbulbs. But these are not just standard $3 lightbulbs – they’re connected and controlled through a remote management system.
Cities can now keep their residents safer by monitoring storm drains during heavy rains. They can even adjust lighting levels to strike a balance between public safety and costs related to energy consumption and maintenance. More important, they’re making the world safer, brighter, and a little more beautiful.
- Technology Stakeholders
- Lighting Manufacturer: Koninklijke Philips N.V 3
- Database management system company: SAP HANA 4
- Government and Citizens
- Businesses and Residents
- Visitors and Tourists
- Public Sector Customers
- Arenas sports
- Roads and streets
- Parks and plazas
- Bridges monuments and facades
- Transportation hubs
- Municipal buildings
To set the stage for the connected lightbulb market while helping cities and towns benefit from digital transformation, the public segment leader at Philips Lighting discussed:
- Assets will need to communicate so their behavior can be flexibly adapted; therefore, verify on: How many assets are there? What state are they in? Are they working when they are supposed to or not working when they are not supposed to? How much energy do they use?
- Measure the energy used while monitoring lighting as they change the behavior of the environment over time to ensure energy efficiency and right amount of light at the right place at the right time. Connect assets to be able to manage them remotely. Two trends: (1) Switch from analog to digital (LED) light points with microchip for communication, tracking and connectivity; (2) Employ business model involving third party service provider. This needs:
- Connected lighting for transparency
- Create proprietary networks (i.e. RF or powerline networks)
- Deploy light points by embedding cellular network into the device now available publicly
- Measurement and verification systems in place such as EPC (Energy Performance Contracting)
- Connected lighting for transparency
- Unlock potential of IoT and think about the market opportunities in cities. More and more people will be living in cities which are close to innovation age.
- Need partnership: Philips partnered with SAP to use IoT technology for better outcome. Philips focused on the potential of IoT market while SAP focused on the future of city program for innovative, smart and digital city. Both focused holistically on how city can become digital, smart, green and resilient cities because 80% of the energy consumption, as well as GDP, are generated through cities.
To be successful, keep in mind cities core functions are: 3 Ps – Protection, Proviision of Services, Prosperity. Cities must deliver value and protection is a key aspect. Cities are the heart of the challenge we face in the future.
Looking in tech enabled value to enable value allows the understanding of how to monetize and unlock the potential of IoT in the cities market for urban resilience, and protection against climate change, terrorism, crime, shocks, etc.
Look into how IoT can improve the lives of the people in those cities such as by providing waste services, safety, water, lighting, etc.
For business outcome, how can IoT technology reduce risk of fire, flooding, and improving management of the infrastructure?
Some examples of implemented Philips CityTouch infrastructure:
- Kristiansund in Norway has 5,500 light points and outages are fixed in no time.
- Buenos Aires, has 91,000 light points, was a partnerships with Philips CityTouch and SAP Hana. Implemented by combining real time data from connected street lights with data from other assets and sensors in a single integrated city dashboard.
- Empire State Building of NY changes peoples’ state of mind through color transformation lighting. On the Commencement Day of Columbia University, lighting is turned to blue and white.
- Miami Tower in Florida is a business case that proves savings of $ 0.25 M per year.
- Bay Bridge in San Francisco implemented responsive lighting in which pattern is connected to city rhythm, i.e. traffic, wind, and they come together in algorithm to reflect the pattern of lighting in the bridge.
1. Sustainability Problem
Controllability of Systems – Thermal Comfort
In summer air-conditioning season, nothing is more divisive than when and where to set the temperature in workplaces. Some employees control the thermostat and it’s a daily battle of, “I’m cold. I’m hot. Turn it off. Turn it up.” Thermal comfort impacts worker productivity and company’s triple bottom line. New information and office productivity technologies are a driving force for innovation.
2. Technology Article Summary
An article from the Wall Street Journal: Cold War Over the Office Thermostat
By Sue Shellenbarger
Updated June 8, 2016 12:47 p.m. ET
- People dress to stay cool on the commute but freeze inside the office. Some wear sweaters or coat at work, while others strip down to a T-shirt and sandals.
- Some employees tamper with the thermostat without asking colleagues. According to a survey by the International Facility Management Association, many devise tactics to get the temperature they want inside offices.
- Building managers maintain temperatures in a range between 68 and 74 degrees Fahrenheit—comfort levels for most people.
- To placate complainers, some facility managers install dummy thermostats to give occupants an illusion of control, although with no connection to the air-conditioning system.
- Dummy thermostats make office workers happier because of the sense of control over the temperature. Office workers perform best when they have control over their physical environment.
- Many variables affect individuals’ basal body temperatures:
- Different circadian rhythms
- Diet and exercise
- People are using high tech approach to manage thermostat disputes:
- Comfy, a smartphone app that allows occupants to request one of the following: Warm My Space, Cool My Space, or I’m Comfy. It then sends a blast of hot or cool air to their area.
- View Dynamic Glass, a smart window that enables smartphone-app users to lighten or darken the shading to heat or cool the interior, without blocking the view of outdoors.
- Vector Occupant, an app that allows occupants use their smartphones to register complaints about the temperature with the building’s control system.
- CrowdComfort, a crowd-sourcing app that enables office occupants to send complaints via smartphone to the building manager; about 30% to 40% are from people who are either too hot or too cold.
- Using CrowdComfort app, facility managers quickly adjust temperatures that are out of the target range, or fix problems.
- By building a network of human sensors, CrowdComfort allows users to capture data related to the human sensory experience. With this data, people can influence comfort, safety, and operations, and collaborate to make a building’s environment more efficient and more effective.
- CrowdComfort’s Human Sensor Network platform leverages crowd-sourced occupant feedback to improve safety and operations in workplaces, unlock efficiencies in facilities management and preventative maintenance, increase employee productivity, and more.1
- Organizational Stakeholders
- Building Occupants
- Business Owners/Employers
- Management Executives: CEOs, CFOs, COOs
- Office Managers
- Office Workers
- Building/Operations Managers
How it works? 2
- Sign-up for CrowdComfort’s Software-as-a-Service (Saas) cloud platform – no hardware required.
- Install QR codes in rooms and assets throughout building.
- Customize what information you receive and where it goes; integrate with existing building’s system.
- Collect site-specific feedback in real time to fix problems before they escalate.
- Analyze building and team performance to improve operations, increase productivity, and reduce costs.
As we continue to strive to make the world healthier and more sustainable through technology, this blog focuses on hospitals as key stakeholders who are committed to improving the healthcare environments for the benefit of patients, staff and communities. This is the impetus to expanding the implementation of LED (light-emitting diodes) lighting technology in healthcare facilities.
Healthcare facilities are one of the highest consumers of energy in commercial building types and lighting alone represents about 42% of electricity consumption. Based on Graybar case study, the economic burden of old lighting represents $8.8 billion on energy each year to meet patient needs. A 200,000 sq. ft., 50-bed hospital in the U.S. spends approximately $680,000 annually, or roughly $13,611 per bed on energy costs.1 The “Graybar Lights the Way” case study suggests that healthcare facility saves 33% by using LED lighting technology as a cost-effective solution.2
A comprehensive evaluation requires a holistic approach. An economic assessment must be integrated with environmental and social analysis before LED lighting technology can be valued as sustainable. LED life of 50,000–100,000 hours suggests cost savings as LEDs minimize lamp replacement and maintenance costs. LEDs are deemed efficient because of an extended working life, significant reduction on CO2 emissions and electricity bills.
A downstream benefit to using LED lights is that LEDs generate significantly less heat than old lighting sources, which reduces costs on cooling and adds up to considerable energy savings. According to EPA’s 2008 assessment, lighting retrofits can save as much as 30%–50% of lighting energy, plus 10%–20% of cooling energy. Retrofits generally have shorter payback times than other building system retrofits.3
The LED technology as a retrofit solution not only yields economic and environmental benefits but also fosters social well-being. Lighting impacts caregiver performance and patient care outcome. Poor lighting impacts accuracy, reaction times and even a person’s mood. Graybar study suggests that average medication dispensing error rate in healthcare facilities is 3.8%. Nurses say constant exposure to artificial light is draining. Poor lighting compromises visibility and can lead to accidents. The study indicates 99% of patients in hospitals are age 65+ and cited “an eye that is 65+ years reduces incoming light by 65%.”4 Good lighting improves mood, reduces anxiety and depression, and decreases the length of a hospital stay. It decreases the likelihood of errors, injuries and patient falls. More comfortable surroundings help make hospitals safer, improve patient outcomes and reduce potential liability.
Other stakeholders of LED lighting technology in healthcare facilities are: caregivers, nurses, patients, facilities’ staffs and hospital operations managers; the architects and engineers who design environment for patients’ comfort and health, and caregivers’ well-being and performance; the installers of LED who require technology know-how in building green hospitals. The commitment of manufacturers and supply chains that are also stakeholders is essential to support the common goal of producing environmentally safe and economically effective LED lighting products.
LED technology offers a marketing advantage to all stakeholders. As in many other facilities, healthcare with old lighting could give the perception of poorly maintained and outdated facility. This could impact the reputation of the stakeholders and the hospital organization as a whole.
To boost energy efficiency, automatic lighting controls turn lights off when space is unoccupied, and turn lights on when triggered by occupancy sensors. Lighting controls can improve energy conservation by lighting only the space needed and configured individual fixtures or lighting zones.
To support the business case, Graybar established a four-step process composed of the following:5
Step 1: Assess
Graybar assesses current building and collected data.
Step 2: Propose
Graybar presents recommendations with ROI projections.
Step 3: Deploy
Graybar implements recycle replaced items, financed and installed LED retrofitted lighting.
Step 4: Capture
Graybar captures the benefits out of rebates/incentives. Graybar handles and processes the paperwork, documents ROIs and Environmental Impact Assessment reports.
For continuous improvement, additional steps 5 and 6 below are suggested for LED lighting technology implementation:
Step 5: Rate and Rank
Graybar shall employ bench-marking to evaluate hospitals’ lighting performance, then rate and rank hospitals based on their environmental, economic and societal impacts.
Step 6: Reward
Graybar can influence societal behavior to encourage less consumption on electricity and take proactive measures to conserving energy by using a reward system. Highly acclaimed publication to laud the hospitals as champions can promote sustainability. Graybar’s Green Certification Award can help maximize energy efficiency in healthcare facility.
Environmental impact and corporate social responsibility effect reputation to work to the advantage of the healthcare organizations. This affects the economic bottom line.