San Francisco General Hospital Medical Center

SPACE PROGRAM SAN FRANCISCO GENERAL HOSPITAL MEDICAL CENTER

MAY 31, 2007 City and County of San Francisco Department of Public Health Fong & Chan Architects

SPACE PROGRAM SAN FRANCISCO GENERAL HOSPITAL MEDICAL CENTER

Table of Contents Section 1

Executive Summary Introduction Overview Development Process Space Program Objectives and Assumptions Findings Recommendations Program Summary

Section 2

Site Review Introduction Site Review Stacking Floor Plans

Section 3

Space Program Tables Introduction Program Summary Inpatient Medical/Surgical ICU/Step-Down Obstetrics Pediatrics NICU Diagnostic and Treatment Perioperative Diagnostic Imaging Ancillary Services Emergency Support Administration and Public Auxiliary Support Plant Services Program Allocation by Floor

SFGHMC | Space Program – May 2007

Section 4

Statement of Probable Construction Cost (Issued under separate cover)

Section 5

Acknowledgments Steering Committee Inpatient ICU/Step-down Women & Children Diagnostic Emergency Perioperative Ancillary Support DPH Program Management/Administration DPW Project Management Fong & Chan Architects Forell/Elsesser Engineers, inc. Gayner Engineers TBD Consultants Herrero Contractors

Section 6

Appendices Appendix A – Space Program Work Plan Appendix B – Bed Projections Appendix C – Meeting Minutes


Section 1

Executive Summary Introduction This space program report provides the basis for the development of the design and eventual construction of the new acute care hospital building at San Francisco General Hospital Medical Center (SFGHMC). The report includes a comprehensive written space program and a preliminary site review.

Overview In 1994, California Senate Bill (SB) 1953 was passed as an amendment to and furtherance of the Alfred E. Alquist Hospital Seismic Safety Act (Alquist Act) enacted in 1973. The intent of the original act was to ensure that acute care hospitals remain functional shortly after a major earthquake. The Alquist Act requires all general acute care hospital buildings to meet explicit seismic safety standards by either retrofitting existing buildings or electing the option, provided by SB 1801 (Speier) adopted in 2000, to rebuild a new hospital building by 2013.

Fig. 1-1

Aerial View of SFGHMC

In 2000, SFDPH commissioned a seismic evaluation study which concluded that the Main Hospital building at SFGHMC has significant seismic deficiencies and that it may not be capable of providing health care services to the public after a major seismic event.1 The SFGHMC Main Building was categorized as a Structural Performance Category 1 (SPC-1). Buildings categorized as a SPC-1 pose a significant risk of partial or total collapse and a danger to the public. In 2001 the San Francisco Health Commission adopted resolution 1-01 supporting the construction of a new general acute care hospital by 2013. In May 2005, Mayor Gavin Newsom and Public Health Director Mitch Katz established a Blue Ribbon Committee to study San Francisco General Hospital’s future location. In October 2005 the Blue Ribbon Committee issued a report to Mayor Newsom recommending rebuilding the new hospital on the existing Potrero Campus instead of at the new UCSF Mission Bay Campus as had been suggested.2 The Blue Ribbon Committee found that the Mission Bay Campus was not feasible from a cost, long-term financing or site acquisition perspective. In


1-1

Section 1 Executive Summary

addition, the Committee found that coordinating care between the Mission Bay Campus and the Potrero Campus would create operational challenges not readily overcome. In the final Blue Ribbon report issued to Mayor Gavin Newson, two locations within the Potrero Campus were acknowledged as potential viable sites to build the new acute care hospital. One option was to locate the new acute care hospital to the north and abutting the existing hospital, the other option was to locate the new acute care hospital west of the existing hospital on the west lawn in between two existing masonry buildings, the site of a former hospital building demolished in 1972. Proposed site for west option Proposed site for north option* Proposed site for south parking lot * North option requires the demolition of Bldg 100 and M-wing

The Blue Ribbon Committee recognized that the option to build to the north would require the demolition of Building 100 and M-wing which currently houses the majority of the ambulatory services and the clinical lab. The option to build to the west would have significantly less overall impact on the existing acute care hospital and would not likely require the demolition of existing structures. Even though the Blue Ribbon Committee did not consider where on Potrero Campus the new acute care hospital should be built, it suggested that the west option should be “further examined as a potential alternative to the more disruptive North option”. 3 Of note, prior to the establishment of the Blue Ribbon committee the option to build the new acute care hospital on the existing south parking lot adjacent to the existing hospital was reviewed. This option was rejected by the members of the Community Advisory Committee due to the site’s proximity to the nearby residential neighborhood, specifically highlighted were both noise and bulk concerns. In addition, the ongoing operations of the existing emergency and psychiatric emergency services would be severely impacted by the construction due to their direct adjacency to the site. Relocation of these services was considered not to be a workable or practical option.

Fig. 1-2

Aerial View of SFGHMC showing the various building site options

In Spring 2006 the San Francisco Department of Public Health (DPH) commissioned a site feasibility study to determine if a new hospital building could be constructed on the west lawn. The site feasibility study prepared by Anshen + Allen and issued on September 25, 2006 concluded that a compliant 428,003 sq. ft. hospital building could be constructed on the west lawn without demolishing any buildings. The study also stressed that the assumed program could be accommodated within the existing zoning height limits but the bulk limits may be exceeded.


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In November 2006, Fong & Chan Architects started the programming effort to determine the space requirements for the new acute care hospital and to validate the feasibility of the west lawn site. The contents of these items are described in detail in this report.

Development Process The essential data used to develop the space program was collected through the implementation of a work plan. This work plan involved a series of workshops and meetings with hospital staff and Fong & Chan Architects under the guidance of the Steering Committee. Hospital staff participated in seven distinct user groups: Inpatient, Women & Children, Diagnostic, ICU/Step-down, Emergency, Perioperative and Ancillary Support representing a broad cross section of healthcare expertise at SFGHMC. Refer to Appendix A for a copy of the Work Plan.

Space Program Objectives and Assumptions In the course of the planning process the Hospital Administration and the Steering Committee identified the following space programming objectives and assumptions: OBJECTIVES


•

To develop and submit a space program for a new acute care Hospital to fit within the West Lawn of San Francisco General Hospital Medical Center (SFGHMC)

•

To maximize the number of patient rooms and exam rooms within the building envelope

•

To increase the number of ICU/CCU patient rooms to reflect current demand and to meet future projections

•

To look for cost saving opportunities throughout the development of the space program, including balancing the allocation of space between existing and new Hospitals to the extent that is practical in accomplishing established goals

1-3


•

To maximize facility flexibility by programming multifunctional spaces and flexible step-down nursing units

•

To update and submit a Statement of Probable Construction Cost reflecting the findings and conclusions reached in the space program

Potrero Avenue

ASSUMPTIONS

N

•

The building site will be located directly west of the existing main hospital building, over the West Lawn between Building 20 and Building 30

•

Demolition of existing buildings will not be required

•

The San Francisco Planning Code limits the overall mass of a building. If required, these “bulk” limitations can be exceeded by applying for a conditional use permit

•

The San Francisco Planning Code also limits the overall height of a building, however the height of the new acute care building should not exceed these limits

•

Allocation of space in the new Hospital will be limited to those functions that are required to be in a new acute care hospital and to those functions that are required to meet operational adjacency requirements

•

The following major departments (not an complete list) will not be part of the new hospital program, but will stay in the existing hospital building:

Fig. 1-3

Site Plan showing building site

Acute Psych SNF Clinical Labs (except for the blood bank and specific functions that by code are required to be in a compliant acute care facility) Cafeteria Kitchen Rehab Nuclear Medicine •


Departmental gross square footages (DGSF) will be derived from the examination and analysis of SFGH census data; regulatory requirements; best practices in Health Care design; and suggestions from user groups, administrative personnel and industry leaders

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Space Program will be developed with the assumption that the new acute care hospital will begin providing services to the public in the year 2015.

Findings This report describes a space program for a 284 bed new acute care hospital to be located in the west lawn of SFGHMC with an assumed building massing of 8 stories (including basements) and an area of 420,260 square feet. The principal findings of the space program study are as follow: •

A code compliant acute care hospital can be built on the west lawn without demolishing any existing buildings

•

The assumed building massing as described in this report can be accommodated within the established zoning height limits however the portion of the building massing above 65 feet in elevation will likely exceed the bulk limits. A conditional use permit may be required

•

The new acute care hospital should be linked to the existing hospital building by means of a 2nd floor bridge connection and a basement tunnel connection to improve the movement of supplies and personnel

•

The total number of acute care beds can be expanded from 230 to 284 without significantly increasing the total building gross square footage. The assignable square footage of each patient room was thoroughly discussed with each respective user group and the final agreed upon area was deemed appropriate for a public teaching hospital

Fig. 1-4

Aerial view looking south of building site


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Recommendations In the course of the space programming effort the various User Group Committees and the Steering Committee identified project goals and objectives to be considered in the design phase of this project. These committees envisioned the creation of a modern healthcare facility that embodied the Hospital’s Mission to deliver humanistic, cost-effective, and culturally competent health services to the residents of the City and County of San Francisco. The following recommendations should be used as a foundation for the development of the design of the new acute care Hospital: •

Design a state-of-the-art acute care hospital with safe, secure, efficient and user-friendly patient and work environments to promote access to services, quality of care, patient safety, customer satisfaction, staff morale, resource management, effective partnership, and academic excellence

•

Design flexible and efficient spaces able to handle technological advances and allow for program changes

•

Incorporate emerging green building technologies and sustainable design principles

•

Consider the architectural context of the existing campus in the development of the new acute care hospital

•

Create spaces that support collegial professional interchange and discussion and promotes educational interaction

•

Perform cost management studies such as earn-value analysis, life-cycle costs analysis and value engineering throughout the planning and design process to improve the performance of the new acute care hospital without exceeding the budget

Degenkolb Engineers/ Structus Inc., SB1953 Seismic Evaluation Report, December 2000 2 Blue Ribbon Committee on San Francisco General Hospital’s Future Location, October, 2005 3 Blue Ribbon Committee on San Francisco General Hospital’s Future Location, October, 2005 1


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PROGRAM SUMMARY

Beds/Rm

DGSF

Remarks

Inpatient Acute Medical Medical/Surgical Medical/Surgical - Forensic Unit ICU/CCU Step-Down Obstetrics Pediatrics NICU Subtotal

144 8 40 46 22 12 12 284

72,466 6,744 31,086 27,287 21,427 9,194 7,830 176,032

Perioperative Surgery Gastroenterology Patient Intake and Recovery

15 5 57

23,369 4,158 17,914

Diagnostic Imaging Cardiology Radiology

6 8

4,606 15,425

Ancillary Services Sterile Processing Pharmacy Clinical Laboratory Pulmonary Function Biomed Morgue and Autopsy Subtotal

91

6,774 6,139 2,344 2,071 1,019 1,920 85,738

60

36,668

4 units - each 36 beds 4 units - each 10 beds 20 beds flex up & 26 beds flex down 13 postpartum + 9 LDRP beds

Diagnostic & Treatment 14 OR & 2 IR

Inpatient only Blood bank + Urinalysis

Emergency Emergency Clinical Care

54 exam + 6 trauma rooms

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PROGRAM SUMMARY

Beds/Rm

DGSF

Administration and Public Entry Area Admitting Administration

-

5,755 2,801 621

Auxiliary Support Material Management Messenger/Mailroom Environmental Services Information Technology PBX Dietary Subtotal

-

8,250 2,544 1,294 2,731 719 828 25,544

18% 9%

323,982 58,317 34,407 416,706

Remarks

Support

DGSF Total Circulation/ Exterior Wall Plant Services BGSF Total

Most Dietary Services to remain in Bldg. 5

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Section 2

Site Review Introduction San Francisco General Hospital Medical Center is located in the southeast quadrant of San Francisco, at the junction between the Mission and Potrero Hill Districts.

101 1

Financial District

SFGHMC 101 280

Fig. 2-1

Map of San Francisco

Potrero Hill Mission District

SFGHMC

101

208

Fig. 2-2

Enlarged map of San Francisco


2-1

Section 2 Site Review

EXISTING CAMPUS DESCRIPTION The hospital campus occupies an area of approximately 24 acres bordered on the west by Potrero Avenue, on the south by 23rd street, and on the east and north by U.S. Highway 101 and Vermont Street. The existing buildings were constructed throughout the last century. Dept. of Public Health (Built after 1987) Dept. of Public Health (Built before 1987) Dept. of Parking and Traffic A

Building 90

C

Service Building

D

Building 1

E

Avon Center (Building 4)

F

Volunteer Center

G

Building 3

H

Building 10/20

I

Building 5 (Main Hospital Building)

J

Building 100

K

Building 30/40

L

Building 9 Trailer

M

Building 9

N

Parking Structure

O

D

B

C

01

B

y1 wa

Building 80

21st Street

gh Hi

A

S. U.

Behavioral Health Rehabilitation

22nd Street

E

F

H

G 22nd Street

I

K

J L 23rd Street

M

23rd Street Vermont Street

O

San Bruno Avenue

Utah Street

Potrero Avenue

Fig. 2-3

Existing campus

N

On its north-south axis the campus is approximately 1700 feet long, and from the east to west about 750 feet wide. Moving east from Potrero Avenue, the terrain slopes upward by approximately 20 feet over street level, while the portion of the site occupied by the main hospital building is relatively level. Approaching the northeast, the campus continues to slope upwards, gaining another 25 feet in elevation as it reaches the freeway. SFGHMC | Space Program – May 2007

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Site Review BUILDING SITE The West Lawn building site was established by SFGHMC prior to this space program study. The buildable area on this building site is approximately 72,100 square feet, defined on the west by Potrero Avenue, on the north by Building 20, on the south by Building 30 and on the east by Building 5. The buildable area was determined using planning and building code best practices.

21st Street S. U. Hi y1 wa gh 01

22nd Street

Fig. 2-4

22nd Street

Aerial photo of SFGHMC campus map

West Drive

23rd Street

23rd Street Vermont Street

San Bruno Avenue


Utah Street

Buildable area

Potrero Avenue

Fig. 2-5

SFGHMC campus map

2-3


SETBACKS The following assumptions were made in determining the extents of the buildable area: Along the west the buildable area is defined by a plane created by the alignment of Buildings 20 and 30. Along the north/south/east the buildable area is defined by an assumed property line located 20-feet from existing adjacent structures to eliminate the need to fire rate the exterior walls and windows of these existing structures.

Building 20 20'

20'

Building 5

20'

Building 30 Fig. 2-6

Site plan indicating location of assumed property line Buildable area Assumed property line Alignment plane


2-4


Similarly the distance between the assumed property lines and the new acute care hospital is greater than 20-feet, eliminating the need to fire rate exterior walls and windows of the new acute care hospital, except at the first floor along the east side where the exterior wall is aligned with the assumed property line. The first floor east exterior wall will be of 4-hour fire resistive construction and openings within that wall assembly will not be allowed.

Building 20 20' 20'

20'

Building 5

20' 20'

Building 30

Fig. 2-6

Site plan indicating location of assumed property line Assumed property line Alignment plane

The below grade basement floors are not limited by setback requirements and extend to within 21-feet of Building 20, 20feet of Building 5 and 34-feet of Building 30. These distances were determined by balancing the need to maximize the program area and the need to protect these existing structures during construction. SFGHMC | Space Program – May 2007

2-5


Fig. 2-7

Aerial photo highlighting the 40’ separation between the new acute care hospital and adjacent buildings 20 & 30

Along the first floor the east exterior wall is aligned with the assumed property line, on the floors above the east exterior wall shifts 20-feet west to avoid opening protection requirements due to proximity to assumed property line.

Assumed Property Line Plane

Fig. 2-8

Perspective sketch showing the property line plane between the new acute care hospital & the existing hospital


2-6


ASSUMED BUILDING MASSING The assumed building massing derived from the 2006 Site Feasibility Study was developed to determine the constraints on the space program resulting from site, planning and code limitations. The assumed building envelope was exercised with the space program in an iterative process to validate the feasibility of the space program assumptions. •

The assumed building massing descends one floor and rises 7 floors below and above grade respectively along Potrero Avenue. Along West Drive, which is at a higher elevation the building descends 2 floors and rises 6 floors below and above grade respectively

•

The designation of first floor was assigned to the floor that is level with grade along West Drive to match the floor designation of the existing hospital building. The footprint of the first floor is 53,092 square feet which represents approximately 78% of the buildable area

•

To reduce the bulk of the building massing the footprint of all floors above the first floor has been further reduced

Fig. 2-9

View of SFGHMC looking northeast


2-7


SITE CIRCULATION The suggested circulation on the SFGHMC campus is shown on the plan below. In general, ambulance and service vehicle access is from 22nd Street. Public vehicle access is from 23rd Street. Pedestrian access is from Potrero Avenue, 22nd Street and 23rd Street.

21st Street S. U. gh Hi 01 y1 wa

Fig. 2-10

View of SFGHMC looking northeast

22nd Street

22nd Street

23rd Street

Fig. 2-11

Suggested site circulation Vermont Street

San Bruno Avenue

Auto for public

Utah Street

Service

Potrero Avenue

Ambulance

Pedestrians Bus stop


2-8


ZONING CONSIDERATION The SFGHMC campus is zoned as 105 E, this zoning designation reveals building height and bulk limits. The height limit for the new acute care hospital is 105 feet with the following exemptions: •

Mechanical equipment and appurtenances necessary to the operation of the building itself, together with visual screening, limited to the top 16 feet of any such features.

•

Elevator, stair, and mechanical penthouses, fire towers, and skylights, limited to the top 16 feet of such features. Further exemptions for elevator penthouses may be granted if necessary to meet state or federal laws or regulation.

•

Unroofed recreation including tennis and swimming pools with and play equipment feet.

Property line Grade line Building height limit Elevator/mechanical penthouse height limit Helipad New hospital massing Existing hospital building Mechanical penthouse

Fig. 2-12

Section showing height of new acute care hospital massing and existing hospital building

facilities with open fencing, basketball courts at roof level, a maximum height of four feet with a maximum height of 10

The suggested new acute care hospital massing is within the prescribed height limit. NEW HOSPITAL

103'

105'

16'

159'

PLANT SERVICES

PLANT SERVICES

12,000 BGSF

BGSF

CLINIC/PSYCH/SNF

73,272

CLINIC

79,362

CLINIC

78,070

CLINIC

77,597

MED/SURG

43,428

MED/SURG

43,428

ICU/STEP-DOWN

45,588

STEP-DOWN/ MED/SURG FORENSIC UNIT/PHARMACY

45,588

CLINIC

84,432

OBSTETRICS/PEDIATRICS/NICU

47,096

CLINIC LAB/CAFETERIA/SUPPORT

87,804

RADIOLOGY

91,934

NUCLEAR MED/MAT'L MGMT/SUPPORT

82,407

ADMITTING/EMERGENCY

51'

EXISTING HOSPITAL (Building 5)

56' PERIOPERATIVE/CLINICAL LABORATORY CARDIOLOGY/RADIOLOGY/AUXILIARY SUPPORT/PLANT SERVICES


69'

53,092 59,547

69'

84'

69,303

2-8


The “E” Bulk district designation limits the bulk of the new acute care hospital above 65 feet in elevation to a maximum plan dimension of 110 feet in length and a maximum diagonal dimension of 140 feet in length.

Achievement of a distinctly better design, in both a public and a private sense, than would be possible with strict adherence to the bulk limits, avoiding an unnecessary prescription of building form while carrying out the intent of the bulk limits and the principles and policies of the Master Plan.

•

Development of a building or structure with widespread public service benefits and significance to the community at large, where compelling functional requirements of the specific building or structure make necessary such a deviation.

Property line Grade line Helipad Building massing above 65’ Building massing below 65’ Existing hospital building Mechanical penthouse Fig. 2-13

Section showing bulk of new acute care hospital massing and existing hospital building

PLANT SERVICES

65'

Floor plate above 65’

The suggested new acute care hospital massing exceeds the prescribed bulk limit, however a variance could be granted based on the exemptions listed above.

NEW HOSPITAL

7 15'-0" 6 15'-0" 5 15'-0" 4 15'-0" 3 15'-0" 2 15'-0" 1 15'-0" B116'-0" B216'-0"

Buildable area within bulk limit

Fig. 2-14

Floor plan showing “E” district bulk limits


PLANT SERVICES

12,000 BGSF

BGSF

CLINIC/PSYCH/SNF

73,272

CLINIC

79,362

CLINIC

78,070

CLINIC

77,597

MED/SURG

43,428

MED/SURG

43,428

ICU/STEP-DOWN

45,588


45,588

CLINIC

84,432


47,096


87,804

ADMITTING/EMERGENCY

53,092

RADIOLOGY

91,934

PERIOPERATIVE/CLINICAL LABORATORY

59,547


82,407

CARDIOLOGY/RADIOLOGY/AUXILIARY SUPPORT/PLANT SERVICES

69,303


Max 110'

•

Ma x1 40 '

Exemptions from the prescribed bulk requirements may be granted via a variance application under the following conditions:

8 13'-0" 7 13'-0" 6 13'-0" 5 13'-0" 4 13'-0" 3 15'-0" 2 15'-0" 1 16'-0" B1 13'-0"

2-9


MEDICAL HELIPAD SFGHMC is proposing to construct and operate a medical helipad on the roof of the existing hospital building in order to provide timely access to and from their Trauma Center.

500'

500'

250'

Because the helipad's proximity to trauma is critical, the City will be studying, as part of the SFGHMC Environmental Impact Report (EIR) effort, whether or not the helipad should be relocated to the new acute care hospital or whether it's adequate to just link the two buildings. If a decision is made to move the helipad to the new acute care hospital, the original helipad location would be decommissioned. There will only be one operational helipad at the SFGHMC Potrero Campus.

Helipad transitional surfaces Helipad New hospital massing Existing hospital building Mechanical penthouse Fig. 2-15

Section showing suggested helipad location

If the helipad is to be relocated to the roof the new acute care hospital this report suggests locating it along the east side of the building closer to the center of the campus. Assuming a north-south approach/departure path it appears that neither the transitional surface nor the approach/departure surface will be punctured by nearby structures.

NEW HOSPITAL

PLANT SERVICES

' 00 40

2:1 transitional surface 8:1 approach/departure surface Helipad Fig. 2-16

Illustration showing approach/departure surfaces and transitional surfaces

250' 500'


PLANT SERVICES

12,000 BGSF

BGSF

CLINIC/PSYCH/SNF

73,272

CLINIC

79,362

CLINIC

78,070

CLINIC

77,597

MED/SURG

43,428

MED/SURG

43,428

ICU/STEP-DOWN

45,588


45,588

CLINIC

84,432


47,096


87,804

ADMITTING/EMERGENCY

53,092

RADIOLOGY

91,934

PERIOPERATIVE/CLINICAL LABORATORY

59,547


82,407

CARDIOLOGY/RADIOLOGY/AUXILIARY SUPPORT/PLANT SERVICES

69,303


2-10


Stacking

Fig. 2-17

Stacking diagram


2-12


Basement 2 Floor Plan Basement 2 is located one story below grade along Potrero Avenue and has a footprint of approximately 69,300 square feet. This floor does not have direct access to grade. The floor plan below suggests one possible arrangement of the spaces programmed on basement 2:

Radiology (8 Imaging Rooms Total) Cardiology Environmental Services Material Management Morgue and Autopsy Messenger/Mailroom Plant Services Sterile Processing Dietary Pulmonary Function Lab

20' 10'

40' 30'


2-13


Basement 1 Floor Plan Basement 1 is located one story below grade along West Drive and has a footprint of approximately 59,500 square feet. This floor has a Potrero Avenue grade level entrance, a tunnel connection to existing hospital and a small loading dock. The floor plan below suggests one possible arrangement of the spaces programmed on basement 1:

Surgery (14 OR Total) PACU (35 Beds Total) Gastroenterology Unit (5 Rooms Total) Pre-OP Unit (22 Beds Total) Administrative/Staff Areas Entry Area Bronchoscopy Clinical Laboratory Loading Dock

20' 10'

40' 30'


2-14


First Floor Plan First floor is located one story above grade along Potrero Avenue and has a footprint of approximately 53,100 square feet. This floor has separate entrances for public, ambulance and loading to the grade. The floor plan below suggests one possible arrangement of the spaces programmed on the first floor:

ER - Shared Support Areas ER - Exam Unit (54 Rooms Total) ER - Trauma Unit (6 Rooms Total) Entry Area Admitting

20' 10'

40' 30'


2-15


Second Floor Plan Second floor has a footprint of approximately 47,100 square feet. This floor has a bridge connection to existing hospital building 5. The floor plan below suggests one possible arrangement of the spaces programmed on the second floor:

Obstetrics Unit (22 Beds Total) Pediatrics Unit (12 Beds Total) Administrative/Staff Areas Administration Public Areas NICU Unit (12 Bassinets Total)

20' 10'

40' 30'


2-16


Third Floor Plan Third floor has a footprint of approximately 45,600 square feet. The floor plan below suggests one possible arrangement of the spaces programmed on the third floor:

ICU Step-Down (26 Beds Total) ICU Step-Down (10 Beds Total) Information Technology Inpatient Pharmacy Med/Surg - Forensic Unit (8 Beds)

20' 10'

40' 30'


2-17


Fourth Floor Plan Fourth floor has a footprint of approximately 45,600 square feet. The floor plan below suggests one possible arrangement of the spaces programmed on the fourth floor:

ICU/CCU Unit ( 30 Beds Total) Trauma ICU Unit (10 Beds Total) Biomed Public Areas Administrative/Staff Areas Step-Down Unit (10 Beds Total) PBX

20' 10'

40' 30'


2-18


Fifth and Sixth Floor Plans Fifth and sixth floors each have a footprint of approximately 43,500 square feet. The floor plan below suggests one possible arrangement of the spaces programmed on the fifth and sixth floor:

Med/Surg Unit (36 Beds Total) Med/Surg Unit (36 Beds Total) Courtyard Public Areas

20' 10'

40' 30'


2-19


Penthouse Floor Plan Excluding the Helipad the Penthouse floor has a footprint of approximately 12,000 square feet. The floor plan below suggests one possible arrangement of the spaces programmed on the penthouse floor:

Helipad Plant Services Elevator Hoistway Sixth Floor Roof Courtyard

20' 10'

40' 30'


2-20

Section 3

Space Program Tables Introduction The following space program tables detail the program requirements for a new acute care hospital at SFGHMC. Each program space is listed in the table along with the type and number of rooms and the assignable square footage (ASF) required. The following definitions are used in these program tables: ASF represents the net assignable area measured from inside of walls and partitions. Department gross square footage (DGSF) is the sum of the total department ASF plus the estimated area for departmental infrastructure, such as interior partitions and intra-department circulation which are estimated based on a percentage of the total ASF. Building gross square footage (BGSF) is the sum of the total DGSF and estimated building services and building infrastructure, such as exterior walls and inter-department circulation which are estimated based on percentages of the total DGSF


3-1

Section 3 Space Program

PROGRAM SUMMARY

Beds/Rm

DGSF

Remarks

Inpatient Acute Medical Medical/Surgical Medical/Surgical - Forensic Unit ICU/CCU Step-Down Obstetrics Pediatrics NICU Subtotal

144 8 40 46 22 12 12 284

72,466 6,744 31,086 27,287 21,427 9,194 7,830 176,032

Perioperative Surgery Gastroenterology Patient Intake and Recovery

15 5 57

23,369 4,158 17,914

Diagnostic Imaging Cardiology Radiology

6 8

4,606 15,425

Ancillary Services Sterile Processing Pharmacy Clinical Laboratory Pulmonary Function Biomed Morgue and Autopsy Subtotal

91

6,774 6,139 2,344 2,071 1,019 1,920 85,738

60

36,668

4 units - each 36 beds 4 units - each 10 beds 20 beds flex up & 26 beds flex down 13 postpartum + 9 LDRP beds

Diagnostic & Treatment 14 OR & 2 IR

Inpatient only Blood bank + Urinalysis

Emergency Emergency Clinical Care

54 exam + 6 trauma rooms

3-2


PROGRAM SUMMARY

Beds/Rm

DGSF

Administration and Public Entry Area Admitting Administration

-

5,755 2,801 621

Auxiliary Support Material Management Messenger/Mailroom Environmental Services Information Technology PBX Dietary Subtotal

-

8,250 2,544 1,294 2,731 719 828 25,544

18% 9%

323,982 58,317 34,407 416,706

Remarks

Support


Most Dietary Services to remain in Bldg. 5

3-3


SERVICE

Beds/Rm

ASF

Remarks

Inpatient - Summary Acute Medical Medical/Surgical Medical/Surgical Unit Support Areas Administrative/Staff Areas Public Areas

144 144

42,280 500 2,080 1,880 46,740 72,466

8 8

3,000 1,350 4,350 6,744

ICU/CCU ICU/CCU Unit ICU/CCU Unit ICU/CCU Unit Trauma ICU Unit Shared Support Areas Administrative/ Staff Area Public Areas ASF Total DGSF

10 10 10 10 40

3,290 3,290 3,290 3,990 2,480 2,510 1,200 20,050 31,086

Step-Down Step-Down Unit - Flex Up Step-Down Unit - Flex Up Step-Down Unit - Flex Down Support Areas Administrative/ Staff Areas Public Areas ASF Total DGSF

20 10 26 46

6,760 3,370 6,540 2,000 1,300 1,000 17,600 27,287

ASF Total DGSF Medical/Surgical - Forensic Unit Medical/Surgical - Forensic Unit Administrative/Staff Areas ASF Total DGSF

3-4


SERVICE

Beds/Rm

ASF

Remarks

Inpatient - Summary Acute Medical Obstetrics Triage Post-Partum LDRP C-Section Support Areas Administrative/Staff Area Public Areas ASF Total DGSF

3 13 9 2 22

650 3,150 3,270 1,420 2,240 2,210 880 13,820 21,427

Pediatrics Pediatrics Unit Administrative/Staff Area Public Areas ASF Total DGSF

12 12

4,440 1,030 460 5,930 9,194

NICU NICU unit Administrative/Staff Area Public Areas ASF Total DGSF

12 12

3,670 1,260 120 5,050 7,830

DGSF Total

176,032

3-5


SERVICE

No. of Units ASF/ Unit

ASF

Remarks

Inpatient Acute Medical Medical/Surgical Medical/Surgical Unit 19

180

3,420

Toilet

17

30

510

Toilet - ADA

2

50

100

4

280

1,120

Toilet

2

30

60

Toilet - ADA

2

50

100

9

180

1,620

Toilet

7

50

350

w/ shower

Toilet - ADA

2

70

140

w/ shower

Anteroom

5

100

500

Nursing Station

1

300

300

Auxiliary Nursing Station

2

150

300

Physician Workroom/Charting

1

200

200

Medication

2

120

240

Clean Supply

1

100

100

Clean Utility

1

100

100

Nourishment

1

100

100

Linen

2

30

60

Equipment/Storage

2

200

400

Soiled Utility

1

100

100

Soiled Linen

1

60

60

Patient Shower - ADA

2

50

100

Custodian Closet

1

40

40

Office - Unit Manager

1

100

100

Office - Head Nurse

1

100

100

Office - Clinical Nurse Specialist

1

100

100

Toilet - ADA

1

50

50

Conference Room

1

200

200

4

10,570

2

250

Patient Room

Patient Room - Double Occupancy

Patient Room - Isolation

3 negative pressure rooms

Wall between two rooms to have an opening to allow for multiple patient observation

Support

Automated dispensing units

Administrative/Staff Areas

10,570

Medical/Surgical Unit ASF Medical/Surgical Unit Total ASF

Exterior window if possible

42,280

Support Areas Procedure Room Support Areas ASF

500

1 per Floor

500

3-6


SERVICE


ASF

Remarks

Inpatient Acute Medical Medical/Surgical Administrative/Staff Areas Office - Social Worker

2

200

400

Office - Chief Medical Resident

1

100

100

Medicine Resident Room

1

250

250

Dayroom

1

250

250

Staff Lounge

2

200

400

1 per floor

Women's Locker

2

120

240

40 Lockers (full height)

Toilet - ADA

2

50

100

2

120

240

2

50

100

Men's Locker Toilet - ADA

Team based Common room


2,080

Administrative/Staff Areas ASF

Public Areas Waiting

2

200

400

1 per floor

Multipurpose Room

2

200

400

Consultation

3

120

360

w/ divider-can serve as waiting room/rounds and as Emergency Response Center

Women's Toilet

2

180

360

Multi accommodation - 3 fixtures

Men's Toilet

2

180

360


1,880

Public Areas ASF

46,740

Total Department ASF Intra-Department Circulation

36%

16,826

Partition & Structures

14%

8,899

Medical/Surgical DGSF

72,466

3-7


SERVICE


ASF

Remarks

Inpatient Acute Medical Medical/Surgical - Forensic (Jail) Medical/Surgical - Forensic Unit Patient Room Toilet Patient Room Toilet - ADA Patient Room - Isolation

5

180

900

5

30

150

1

180

180

1

50

50

2

180

360

Toilet - ADA

2

70

140

Anteroom

1

100

100

Nursing Station

1

200

200

Medication

1

120

120

Physician Workroom/Charting

1

150

150

Consultation

1

120

120

Equipment/ Storage

1

120

120

Linen

1

30

30

Clean Utility/Supply

1

120

120

Nourishment

1

50

50

Soiled Utility

1

80

80

Soiled Linen

1

40

40


1

50

50

Custodian Closet

1

40

w/ shower

Support

Medical/Surgical - Forensic Unit ASF

40 3,000

3-8


SERVICE


ASF

Remarks

Inpatient Acute Medical Medical/Surgical - Forensic (Jail) Administrative/Staff Areas Office - Head Nurse

1

100

100

Office - Social Worker

1

100

100

Office - Sheriff

1

100

100

Interview Room

2

80

160

Visiting

2

60

120

Command Center

1

150

150

Conference Room

1

150

150

Toilet - ADA

1

60

60

Staff Lounge

1

150

150

Women's Locker

1

80

80

Toilet - ADA

1

50

50

1

80

80

1

50



50 1,350


Total Department ASF

4,350

Intra-Department Circulation

36%

1,566


14%

828

Medical/Surgical - Forensic (Jail) DGSF


6,744

3-9


SERVICE


ASF

Remarks

Inpatient Acute Medical Step-Down Step-Down Unit - Flex Up 8

210

1,680

Toilet

3

30

90

Toilet - ADA

1

50

50

2

210

420

Toilet - ADA

2

70

140

Anteroom

1

80

80

Patient Room


w/ shower

Support Nursing Station/Charting

1

300

300

Viewing Alcove

1

30

30

Medication

1

120

120


1

120

120

Linen

1

30

30

Nourishment

1

50

50

Equipment/Storage

1

200

200

1

80

Soiled Utility Step-Down Unit - Flex Up ASF

80 3,390

Step-Down Unit - Flex Down Patient Room

12

180

2,160

12

30

360

4

280

1,120

Toilet

2

30

60

Toilet - ADA

2

50

100

6

180

1,080

Toilet

4

50

200

w/ shower

Toilet - ADA

2

70

140

w/ shower

Anteroom

3

80

240

Toilet Patient Room - Double Occupancy


Sliding glass doors between two rooms for multiple patient observation

Support Nursing Station/Charting

1

300

300

Auxiliary Nursing Station

1

150

150

Viewing Alcove

1

30

30

Medication

1

120

120


1

120

120

Linen

1

30

30

Nourishment

1

50

50

Equipment/Storage

1

200

200

Soiled Utility Step-Down Unit - Flex Down ASF

1

80

80 6,540

3-10


SERVICE


ASF

Remarks

Inpatient Acute Medical Step-Down Support Areas Physician Workroom/Charting

2

150

300

Medical Equipment

1

200

200

Mobile Imaging

1

150

150

Biomed

1

150

150

Respiratory Therapy

2

150

300

Pharmacy

1

150

150

Physical Therapy

1

150

150

Storage

2

200

400

Soiled Linen

1

60

60


2

50

100

Custodian Closet

1

40

40

w/ 2 PACS stations in each room

2,000

Support Areas ASF

Administrative/ Staff Areas Office - Unit Manager

1

100

100

Office - Head Nurse

1

100

100


1

100

100


1

150

150

Toilet - ADA

1

50

50

Conference Room

1

150

150

Staff Lounge

1

200

200

Locker

Team based w/ 1 PACS station

1

250

250

Women's Toilet

1

70

70

w/ Shower

Men's Toilet

1

70

70

w/ Shower

Changing Room

2

30

60


1,300

Administrative/ Staff Areas ASF


2

200

400

Consultation

2

120

240

Women's Toilet

1

180

180


Men's Toilet

1

180

180


1,000

Public Areas ASF

14,230


36%

5,123


14%

2,709

Step-Down DGSF

22,062 3-11


SERVICE


ASF

Remarks

Inpatient Acute Medical ICU/CCU/Step-Down ICU/CCU Unit 9

210

1,890

5

30

150

1

210

210

Hopper Room

1

30

30

Anteroom

1

80

80

Nursing Station/Charting

1

300

300

Viewing Alcove

1

30

30

Medication

1

120

120


1

120

120

Linen

1

30

30

Nourishment

1

50

50

Equipment/Storage

1

200

200

Soiled Utility

1

80

80

3

3,290

9,870

9

280

2,520

Patient Room Hopper Room Patient Room - Isolation

1 Negative Pressure Room

Support

3,290

ICU/CCU Unit ASF ICU/CCU Unit Total ASF

Trauma ICU Unit Patient Room

5

30

150

1

280

280

Hopper Room

1

30

30

Anteroom

1

80

80


1

300

300

Viewing Alcove

1

30

30

Medication

1

120

120


1

120

120

Linen

1

30

30

Nourishment

1

50

50

Equipment/Storage

1

200

200

Soiled Utility

1

80

80

Hopper Room Patient Room - Isolation

1 Negative Pressure Room

Support

Trauma ICU ASF

3,990

3-12


SERVICE


ASF

Remarks

Inpatient Acute Medical ICU/CCU/Step-Down Step-Down Unit - Flex Up 8

210

1,680

Toilet

3

30

90

Toilet - ADA

1

50

50

2

210

420

Toilet

1

50

50

w/ shower

Toilet - ADA

1

70

70

w/ shower

Anteroom

1

80

80


1

300

300

Viewing Alcove

1

30

30

Medication

1

120

120


1

120

120

Linen

1

30

30

Nourishment

1

50

50

Equipment/Storage

1

200

200

Soiled Utility

1

80

80

Patient Room


Support

3,370

Step-Down Unit - Flex Up ASF

Shared Support Areas Mobile Imaging

2

150

300

Biomed

1

150

150

Respiratory Therapy

2

150

300

Satellite Pharmacy

1

300

300

Medical Equipment

1

150

150

Provider Workroom/Charting

3

150

450

Quiet Room

2

80

160

Storage

2

200

400

Soiled Linen

2

60

120


1

50

50

Custodian Closet

2

50

100

Shared Support Areas ASF

w/ 2 PACS stations in each room

One cart per ICU unit

2,480

3-13


SERVICE


ASF

Remarks

Inpatient Acute Medical ICU/CCU/Step-Down Administrative/ Staff Area Office - Director

1

100

100

Office - Head Nurse

3

100

300


1

150

150

Toilet - ADA

1

50

50

On-Call Sleep Room

8

80

640

Shared

Toilet - ADA

4

70

280

w/ shower

Conference Room

2

150

300

w/ 1 PACS station in each room

Staff Lounge

1

300

300

Locker

1

250

250

Women's Toilet

1

70

70

w/ Shower

Men's Toilet

1

70

70

w/ Shower

Changing Room

2

30

60


2,510



3

200

600

Consultation

2

120

240

Women's Toilet

1

180

180


Men's Toilet

1

180

180


1,200

Public Areas ASF

23,420


36%

8,431


14%

4,459

ICU/CCU/Step-Down DGSF

36,310

3-14


SERVICE


ASF

Remarks

Inpatient Acute Medical Obstetrics Triage 3

180

540

Toilet

2

30

60

Toilet - ADA

1

50

Patient Room

During high census use Postpartum rooms

50 650

Triage ASF

Post-Partum Patient Room Toilet Patient Room

9

180

1,620

9

50

450

2

180

360

2

70

140

2

180

360

Toilet - ADA

2

70

140

Anteroom

1

80

Toilet - ADA Patient Room - Isolation

w/ shower w/ shower w/ shower

80 3,150

Post-Partum ASF

LDRP Patient Room Toilet Patient Room

7

290

2,030

7

60

420

1

290

290

1

80

80

1

290

290

Toilet - ADA

1

80

80

Anteroom

1

80

80

Toilet - ADA Patient Room - Isolation

w/ tub w/ tub w/ tub

3,270

LDRP ASF

C-Section Operating Room

2

400

800

Resuscitation Room

1

200

200

Sterile Supply

1

100

100

Clean Supply/Utility

1

120

120

Sub-Sterile

1

120

120

Soiled Utility

1

80

80

C-Section ASF

Included in NICU

1,420

3-15


SERVICE


ASF

Remarks

Inpatient Acute Medical Obstetrics Support Areas Nursing Station

1

300

300

Well Baby

1

400

400

Medication

1

120

120


1

200

200

Anesthesia/Respiratory

1

120

120

Equipment/ Storage

2

300

600

Linen

2

30

60


1

120

120

Soiled Utility

1

80

80

Soiled Linen

1

90

90

Pantry

1

100

100

Custodian Closet

1

50

50

Five bassinets (80 SF per bassinet)

2,240

Support Areas ASF

Administrative/Staff Area 4

80

320

Toilet

1

40

40

Toilet - ADA

1

70

70


1

100

100

Office - Lactation Specialist

1

100

100

Office - Nurse Manager

1

100

100

Conference Room

1

300

300

Toilet - ADA

1

50

50

Staff Lounge

1

400

400

Shared w/ Pediatrics and NICU

Locker

1

250

250

250 total staff

Women's Toilet

1

180

180


Men's Toilet

1

180

180


Changing Room

4

30

120

On-Call Sleep Room


w/ shower

w/ divider

2,210

3-16


SERVICE


ASF

Remarks

Inpatient Acute Medical Obstetrics Public Areas Waiting

1

400

400

Consultation

1

120

120

Women's Toilet

1

180

180


Men's Toilet

1

180

180


880

Public Areas ASF

13,820


36%

4,975


14%

2,631

Obstetrics DGSF

21,427

3-17


SERVICE


ASF

Remarks

Inpatient Acute Medical Pediatrics Pediatrics Unit 8

180

1,440

Toilet

6

30

180

Toilet - ADA

2

50

100

2

180

360

2

30

60

Patient Room

Patient Room Toilet

2

180

360

Toilet - ADA

2

70

140

Anteroom

1

100

100

Nursing Station

1

300

300

Medication

1

120

120

Pantry

1

80

80


1

200

200

Treatment Room

1

120

120

Play Room

1

150

150

Equipment/Storage

1

300

300


1

100

100

Soiled Utility

1

80

80

Linen

1

30

30

Soiled Linen

1

60

60

Patient Tub/Shower - ADA

2

60

120

1

40


Sliding glass doors between two rooms for multiple patient observation w/ shower

Support

Custodian Closet Pediatrics Unit ASF

40 4,440

Administrative/Staff Area On-Call Sleep Room

2

80

160

1

70

70


1

100

100


1

100

100


1

150

150

Team based

Conference Room

1

400

400

w/ divider

Toilet - ADA

1

50

50

Staff Lounge

-

-

-

-

Toilet - ADA

Locker w/ Toilets Administrative/Staff Area ASF

w/ shower

-

Shared w/ Obstetrics and NICU

-


1,030

3-18


SERVICE


ASF

Remarks

Inpatient Acute Medical Pediatrics Public Areas Waiting

-

-

Consultation

1

120

120

Parent Lounge

1

200

200

2

70

140

Toilet - ADA Public Areas ASF

-

w/ shower

460


5,930


36%

2,135


14%

1,129

Pediatrics DGSF


9,194

3-19


SERVICE


ASF

Remarks

Inpatient Acute Medical NICU NICU unit Patient Room - Level II

7

150

1,050

Patient Room - Level III

4

170

680

Patient Room - Level III Isolation

1

190

190

1

100

100

Anteroom

w/ bathing sink and counter

Support Nursing Station

1

200

200


1

200

200

Respiratory Therapy

1

100

100

Treatment Room

1

100

100

Medication

1

120

120

Scrub

1

60

60

Linen

1

30

30

Soiled Linen

1

60

60

Breast Feeding

1

100

100

Equipment/Storage

1

400

400


1

120

120

Soiled Utility

1

120

120

1

40

40

Custodian Closet NICU Unit ASF

w/ sink

3,670

Administrative/Staff Area On-Call Sleep Room

2

100

200

1

70

70

Family Sleep Room

1

100

100

Toilet - ADA

1

70

70

1

400

400

Toilet - ADA

Mother Boarding Room

1

70

70


Toilet - ADA

1

100

100


1

100

100

Office - Neonatologist

1

100

100

Conference Room

-

-

Toilet - ADA

1

50

Staff Lounge

-

-

Locker w/ Toilets

-

-

Administrative/Staff Area ASF

-

w/ shower w/ shower 4 beds with visual separation & sink w/ shower

Shared w/ Pediatrics

50 -

Shared w/ Obstetrics and Pediatrics

-


1,260

3-20


SERVICE


ASF

Remarks

Inpatient Acute Medical NICU Public Areas Waiting

-

-

Consultation

1

120

Toilet

-

-

Public Areas ASF

-


120


5,050


36%

1,818


14%

962

NICU DGSF


120

7,830

3-21


SERVICE

Beds/Rm

ASF

Remarks

Diagnostic and Treatment - Summary Perioperative Surgery Surgery Unit Interventional Radiology Unit Shared Support Areas Administrative/Staff Areas ASF Total DGSF

14 1 15

9,130 2,670 3,000 320 15,120 23,369

Gastroenterology Gastroenterology Unit Administrative/Staff Areas ASF Total DGSF

5 5

2,440 250 2,690 4,158

Patient Intake and Recovery Pre-OP Unit PACU Shared Support Areas Administrative/Staff Areas Public Areas ASF Total DGSF

22 35 57

2,820 4,220 200 3,230 1,120 11,590 17,914

Cardiology Cath/EP Lab Unit Echo Lab Unit Support Areas Administrative/Staff Areas ASF Total DGSF

1 5 6

730 930 970 350 2,980 4,606

Radiology X-ray Unit CT Scan Unit MRI Unit Angiography Unit Ultrasound Unit Support Areas Administrative/Staff Areas ASF Total DGSF

3 2 1 2 1 9

900 1,180 850 1,310 400 3,680 1,660 9,980 15,425

Diagnostic Imaging

Can accommodate 3 cubicles

3-22


SERVICE

Beds/Rm

ASF

Remarks

Diagnostic and Treatment - Summary Ancillary Services Sterile Processing Decontamination Area Assembly/Sterilization Administrative/Staff Areas ASF Total DGSF

-

1,270 2,360 850 4,480 6,774

Pharmacy Storage Areas Manufacturing Areas Dispensary Administrative/Staff Areas ASF Total DGSF

-

640 1,230 970 1,220 4,060 6,139

Clinical Laboratory DGSF

-

1,550 2,344

Pulmonary Function Lab DGSF

4 4

1,340 2,071

Biomed DGSF

-

700 1,019

Morgue and Autopsy Morgue Autopsy Administrative/Staff Areas ASF Total DGSF

-

600 400 270 1,270 1,920

DGSF Total

85,738

3-23


SERVICE


ASF

Remarks

Diagnostic and Treatment Perioperative Surgery Surgery Unit Operating Room - Large

4

540

2,160

Operating Room - Medium

6

500

3,000

Operating Room - Small

4

420

1,680

Clean Core

2

1,000

2,000

Scrub

7

30

2

40

One OR to be fluro capable

Support

Custodian Closet Surgery Unit ASF

210 80 9,130

Interventional Radiology Unit 1

550

550

1

60

60

1

700

700

1

60

60

Control

2

200

400

PACS Viewing

1

200

200

Workroom

1

200

200

1

100

100

IR Operating Room Computer Storage IR Operating Room Computer Storage

w/ CT scan capability

Support

Sterile Supply Scrub

1

30

30

Equipment/Tube Storage

1

250

250

Electrical Room

1

120

120 2,670

Interventional Radiology Unit ASF

Shared Support Areas 1

350

350

1

150

150

Anesthesia Induction

1

220

220

Surgery Control Station

1

150

150

Satellite Pharmacy

1

300

300

Graft Freezer

1

60

60

Frozen Section Lab

1

100

100

Control/Video Equipment

1

100

100

Biomed

1

200

200

Equipment/Storage

4

250

1,000

Housekeeping Supplies

1

80

80

Decontamination

1

200

200

1

90

90

Anesthesia Workroom Storage

Soiled Linen Shared Support Areas ASF

Scheduling

w/ tray-veyor

3,000

3-24


SERVICE


ASF

Remarks

Diagnostic and Treatment Perioperative Surgery Administrative/Staff Areas Office - Surgery Manager

1

100

100

Office - Anesthesia

1

100

100

2

60

Toilet - ADA Administrative/Staff Areas ASF

120 320


15,120


38%

5,746


12%

2,504

Surgery DGSF

23,369

3-25


SERVICE


ASF

Remarks

Diagnostic and Treatment Perioperative Gastroenterology Gastroenterology Unit 1

350

350

Control Room

1

80

80

Toilet - ADA

1

50

50

Endoscopy Room

4

250

1,000

ERCP Room

Support pH Monitoring Room

1

150

150

Linen

1

30

30


1

120

120

Scope Closet

4

30

120

Scope Clean Room

1

80

80

Equipment/ Storage

1

200

200

Computer Room

1

80

80

Soiled Utility

1

80

80

Soiled Linen

1

60

60

1

40

Custodian Closet Gastroenterology Unit ASF

40 2,440

Administrative/Staff Areas Conference Room Toilet - ADA Administrative/Staff Areas ASF

1

200

1

50

200 50 250


2,690


38%

1,022


12%

445

Gastroenterology DGSF

4,158

3-26


SERVICE


ASF

Remarks

Diagnostic and Treatment Perioperative Patient Intake and Recovery Pre-OP Unit 22

80

1,760

Nursing Station

2

120

240


1

100

100

Equipment/Storage

1

200

200

Linen

2

30

60


1

120

120

Soiled Utility

1

80

80

Soiled Linen

1

60

60

Patient Toilet - ADA

2

50

100

Patient Toilet

2

30

60

1

40

40

Holding Cubicle Support

Custodian Closet Pre-OP Unit ASF

2,820

PACU Recovery Cubicle

34

80

2,720

Recovery Patient Room - Isolation

1

140

140

1

70

70

Nursing Station

2

120

240


1

120

120

Equipment/Storage

1

200

200

Nourishment

1

80

80

Medication

1

120

120

Linen

2

30

60


1

120

120

Soiled Utility

1

80

80

Soiled Linen

1

60

60


2

50

100


1

70

70

1

40

40

Toilet - Accessible

w/ shower

Support

Custodian Closet PACU ASF

w/ shower

4,220

Shared Support Areas Stretcher/Wheelchair Shared Support Areas ASF

2

100

200 200

3-27


SERVICE


ASF

Remarks

Diagnostic and Treatment Perioperative Patient Intake and Recovery Administrative/Staff Areas Office - PACU Manager

1

100

100

Office - Medical Director

1

100

100

Office - Nursing Director

1

100

100

Office - IS Clinical Staff

1

100

100

Office - CNS/Educator

1

140

140

Toilet - ADA

2

50

100

On-Call Sleep Room

4

80

320

Toilet

1

30

30

Shared

Toilet - ADA

1

50

50

Shared

1

80

80

Surgery

Toilet - ADA

1

50

50

Conference Room

2

200

400

Staff Lounge - Anesthesia

1

300

300

Staff Lounge

1

300

300

Women's Locker

On-Call Sleep Room

Shared Anesthesia (3 residents, 1 faculty)

1

300

300

75 Lockers (full height/purse)

Toilet

1

210

210

Multi accommodation - 3 fixtures w/ shower

Men's Locker

1

300

300

75 Lockers (full height/purse)

Toilet

1

210

210


1

40

40

Custodian Closet Administrative/Staff Areas ASF

3,230

Public Areas Reception

1

120

120

Waiting

2

200

400

Consultation

2

120

240

Women's Toilet

1

180

180


1

180

180


Men's Toilet Public Areas ASF

1,120


11,590


38%

4,404


12%

1,919

Patient Intake and Recovery DGSF

17,914

3-28


SERVICE


ASF

Remarks

Diagnostic and Treatment Diagnostic Imaging Cardiology Cath/EP Lab Unit Cath/EP Lab Room

1

500

500

Includes POCT

Control Room

1

150

150

w/ PACS station

1

80

80

Equipment Cath/EP Lab Unit ASF

730

Echo Lab Unit Echo Bays

4

150

600

Stress Echo Room

1

250

250

1

80

Equipment Cath Lab Unit ASF

w/ treadmill and crash cart

80 930

Support Areas Imaging Reading/Workroom

1

300

300

Equipment/Computer Storage

1

200

200

Stat Lab

1

100

100


1

100

100

Linen

3

30

90

Soiled

1

80

80

Soiled Linen

1

60

60

Contrast Media Storage

1

40

40

-

-

PACS Workroom Support Areas ASF

-

Shared w/ Radiology

970

Administrative/Staff Areas Office - Cardiology Manager

1

100

100

Office - Chief Sonographer

1

100

100

Office - Tech

1

100

100

Toilet - ADA

1

50

50

Conference Room

-

-

-

-

Locker Administrative/Staff Areas ASF

-

Shared w/ Radiology

-

Shared w/ Radiology

350


2,980


38%

1,132


12%

493

Cardiology DGSF

4,606

3-29


SERVICE


ASF

Remarks

Diagnostic and Treatment Diagnostic Imaging Radiology X-ray Unit X-ray Room Control Room Fluoroscopy Room Control Room Toilet X-ray Unit ASF

2

250

500

1

50

50

1

250

250

1

50

50

1

50

50

ADA accessible

900

CT Scan Unit CT Scan Room

1

450

450

CT/Angio Scan Room

1

550

550

1

180

180

Control Room CT Scan Unit ASF

1,180

MRI Unit MRI Room Control Room Equipment MRI Unit ASF

1

520

520

1

180

180

1

150

150 850

Angiography Unit Angiography Room

2

500

1,000

Control Room

1

150

150

2

80

Equipment Angiography Unit ASF

160 1,310

Ultrasound Unit Ultrasound Room Toilet - ADA Ultrasound Unit ASF

1

350

1

50

350

Three cubicles

50 400

3-30


SERVICE


ASF

Remarks

Diagnostic and Treatment Diagnostic Imaging Radiology Support Areas Reading Room

1

150

Holding/Recovery

1

1,360

150

Reception

1

60

60

Waiting

1

150

150

Changing

2

40

80

Workroom

1

500

500

Imaging Control Station

1

150

150

PACS Workroom

1

300

300

Linen

3

30

90


1

100

100

Soiled

1

80

80

Soiled Linen

1

60

60

Equipment/Computer Storage

1

400

400

Contrast Media Storage

1

60

60

Patient toilet

2

50

100

Custodian Closet Support Areas ASF

1

40

40

1,360

17 Gurneys

Scheduling

ADA accessible

3,680

Administrative/Staff Areas Office - Imaging Director Office - Radiology Manager

1 1

100 100

100 100

Office - Tech

2

100

200

Conference Room

1

350

350

Toilet - ADA

1

50

50

Staff Lounge

1

200

200

Women's Locker

1

150

150

50 day use Lockers (full height)

Toilet

1

180

180


Men's Locker

1

150

150

50 day use Lockers (full height)

1

180

180


Toilet Administrative/Staff Areas ASF

1,660


9,980


38%

3,792


12%

1,653

Radiology DGSF

w/ divider

15,425

3-31


SERVICE


ASF

Remarks

Diagnostic and Treatment Ancillary Services Sterile Processing Decontamination Area Workroom

1

800

800

1

200

200

Cart Wash

1

120

120

Toilet - ADA

1

70

70

Supply Closet

1

50

50

1

30

30

Soiled Cart Staging area

Custodian Closet Decontamination Area ASF

w/ shower

1,270

Assembly/Sterilization Pass Through Sterilizers

1

150

150

Sterile Supply

1

400

400

Terminal Sterilizer

1

180

180

Sterile Storage/Cart Assembly

1

800

800

Cart Storage

1

200

200

Wrap and Pack Area

1

600

600

Custodian Closet

1

30

30 2,360

Assembly/Sterilization ASF

Administrative/Staff Areas Office - Manager

1

100

100

Office - Supervisor

1

100

100

Conference Room

1

150

150

Staff Lounge

1

200

200

Women's Locker

1

100

100

Toilet - ADA

1

50

50

1

100

100

1

50

50


20 Lockers (full height) 20 Lockers (full height)

850



4,480


35%

1,568


12%

726

Sterile Processing DGSF

Back to back w/ Staff Lounge

6,774

3-32


SERVICE


ASF

Remarks

Diagnostic and Treatment Ancillary Services Pharmacy Storage Areas Active Storage

1

400

400

Refrigerated Storage

3

30

90

Narcotics Vault

1

150

150 640

Storage Areas ASF

Manufacturing Areas Bulk Compounding

1

400

400

2 auto compounders

I.V. Prep Room (Chemo)

1

300

300

Positive air pressure

Anteroom/Storage

1

300

300

Walk-in Refrigerator

1

80

80

Packaging and Labeling

1

150

150 1,230

Manufacturing Areas ASF

Dispensary Pick-Up

1

120

120

Discharge

1

150

150

Compounding

1

300

300

Reviewing and Recording

1

320

320

Cart Staging

1

80

80

8 Workstations

970

Dispensary ASF

Administrative/Staff Areas Office - Director

1

100

100

Office

1

100

100

Open Office

1

320

320

Conference Room

1

200

200

Staff Lounge

1

200

200

Women's Locker

1

100

100

Toilet - ADA

1

50

50

1

100

100

1

50


20 Lockers (full height) 20 Lockers (full height)

50 1,220



4,060


35%

1,421


12%

658

Pharmacy DGSF

4 Workstations

6,139

3-33


SERVICE


ASF

Remarks

Diagnostic and Treatment Ancillary Services Clinical Laboratory Clinical Laboratory Blood Bank

1

1,200

1,200

Urinalysis Lab

1

150

150

Office - Senior Supervisor

1

100

100

Office - Supervisor

1

100

100 1,550

Clinical Laboratory ASF


Code min. 180 SF

1,550


35%

543


12%

251

Clinical Laboratory DGSF

6" Pneumatic Tube

2,344

3-34


SERVICE


ASF

Remarks

Diagnostic and Treatment Ancillary Services Pulmonary Function Pulmonary Function Lab Procedure Room

3

Equipment

1

80

80

1

200

200

1

80

Special Procedure Room Equipment

200

600

80 960

Pulmonary Function Lab ASF

Bronchoscopy Procedure Room

1

250

250

Equipment

1

80

80

Toilet - ADA

1

50

50

Negative pressure

380

Bronchoscopy ASF

Shared Support Areas Clean Supply/Utility

-

-

-

Shared w/ Cardiology & GI

Linen

-

-

-


Soiled

-

-

-


Soiled Linen

-

-

-


0

Support Areas ASF

Administrative/Staff Areas Toilet

-

-

-


Conference Room

-

-

-


Locker

-

-

-


0



1,340


38%

509


12%

222

Pulmonary Function DGSF

2,071

3-35


SERVICE


ASF

Remarks

Diagnostic and Treatment Ancillary Services Biomed Biomed Workshop

1

400

400

Storage

1

200

200

Office - Manager

1

100

100 700

Biomed ASF


700


30%

210


12%

109

Biomed DGSF

1,019

3-36


SERVICE


ASF

Remarks

Diagnostic and Treatment Ancillary Services Morgue and Autopsy Morgue Viewing Room

1

200

200

Mortuary Refrigerator

1

400

400

1

200

Vestibule

16'x25' can accommodate 6 gurneys

200 600

Morgue ASF

Autopsy Autopsy Tissue Storage Autopsy ASF

1

300

300

1

100

100 400

Administrative/Staff Areas Office - Supervisor

1

100

100

Locker

1

80

80

Changing Room

1

40

40

Toilet - ADA

1

50

50 270



1,270


35%

445


12%

206

Morgue and Autopsy DGSF


1,920

3-37


SERVICE

Beds/Rm

ASF

Remarks

Emergency - Summary Emergency Clinical Care Exam Unit

54

10,780

Trauma Unit

6

3,510

Support Areas

-

4,305

Administrative/Staff Areas

-

2,780

Public Areas ASF Total DGSF

60

Exam rooms are equipped w/ additional med gas consoles and are sized to accommodate two gurneys to handle mass casualty events

1,600 22,975 36,668

3-38


SERVICE


ASF

Remarks

Emergency Emergency Clinical Care Exam Unit Exam Room

46

140

6,440

Exam Room - Behavioral Health

4

140

560

w/ sound isolation control

Exam Room - RTC

1

180

180

Adjacent to consultation room

Toilet - ADA

1

70

70

3

140

420

Toilet

2

30

60

Toilet - ADA

1

50

50

Nursing Station

4

200

800

Provider Charting

4

150

600

Medication

4

120

480

Clean Utility/Supply/Equipment

4

170

680

Soiled Utility

4

80

320

Soiled Linen

2

60

120

Exam Room - Isolation

w/ shower

Support

10,780

Exam Unit ASF

Trauma Unit 6

350

2,100

3

120

360

Nursing Station

1

200

200

Provider Charting

1

250

250

Medication

1

120

120

Clean Utility/Supply/Equipment

1

200

200

Soiled Utility

1

80

80

Soiled Linen

1

60

60

Consultation/Quiet Room

1

100

100

1

40

40

Resuscitation Room Equipment Storage

w/ X-ray capability

Support

Custodian Closet Trauma Unit ASF

3,510

3-39


SERVICE


ASF

Remarks

Emergency Emergency Clinical Care Support Areas 1

350

350

2

120

240

POCT

1

100

100

CT Scan Room

2

450

900

Control Room

1

150

150

Workroom

1

100

100

2

250

500

Control Room

1

100

100

Satellite Pharmacy

1

400

400

Equipment/Storage

2

300

600

Provider Workroom

1

200

200

Toilet - ADA

3

50

150

Toilet

5

35

175

Shower/Decontamination

1

260

260

1

40

40

1

40

Central Triage Triage Room

X-ray Room

Storage Custodian Closet

Including reception

ADA accessible w/ washer & dryer

40 4,305

Support Areas ASF

Administrative/Staff Areas Office - Nursing Director

1

100

100


2

100

200

Office - CNS

1

150

150

Shared


1

150

150

Shared

Admitting/Registration

1

500

500

6 Workstations

Interview

1

80

80

Radio Room

1

80

80

Conference Room

2

200

400

Toilet - ADA

2

50

100

Staff Lounge

1

300

300

Women's Locker

w/ divider to accommodate 20 staff

1

150

150


Toilet

1

210

210


Men's Locker

1

150

150


Toilet

1

210

210


1

40

Custodian Closet Administrative/ Staff Areas ASF

40 2,780

3-40


SERVICE


ASF

Remarks

Emergency Emergency Clinical Care Public Areas Waiting

2

400

800

Waiting - Pediatrics

1

200

200

Consultation/Quiet Room

2

120

240

Women's Toilet

1

180

180


1

180

180


Men's Toilet Public Areas ASF

1,600


22,975


40%

9,190


14%

4,503

Clinical Care DGSF

36,668

3-41


SERVICE

Beds/Rm

ASF

Remarks

Support Services - Summary Administration and Public Entry Area Main Lobby Lobby ASF Total DGSF

-

3,360 1,000 4,360 5,755

Admitting DGSF

-

2,030 2,801

Administration DGSF

-

450 621

Material Management DGSF

-

6,250 8,250

Messenger/Mailroom DGSF

-

1,770 2,544

Environmental Services DGSF

-

900 1,294

Information Technology DGSF

-

1,900 2,731

PBX DGSF

-

500 719

Dietary DGSF

-

600 828

Auxiliary Support

DGSF Total

25,544

3-42


SERVICE


ASF

Remarks

Support Services Administration and Public Entry Area Main Lobby Waiting

1

3,000

3,000

Women's Toilet

1

180

180


Men's Toilet

1

180

180


Main Lobby ASF

3,360

To be located in First Floor

Lobby Waiting

1

1,000

Lobby ASF

1,000 1,000


To be located in Ground Floor

4,360


20%

872


10%

523

Entry Area DGSF

5,755

Administration and Public Admitting Administrative/Staff Areas Interview/ Admitting Room

12

80

960

Reception

1

250

250

Registration

1

200

200

Cashiers

1

300

300

Vault

1

40

40

Supply

1

200

200

Toilet

1

80

80

Custodian Closet

1

40

40


2,030


2,030


20%

406


15%

365

Admitting DGSF

2,801

3-43


SERVICE


ASF

Remarks

Support Services Administration and Public Administration Administrative Offices Office

1

200

200

Director of Nursing

Open Office

1

200

200

Including Reception

Toilet

1

50

Administrative Offices ASF

50


450


20%

90


15%

81

Administration DGSF

ADA accessible

450

621

3-44


SERVICE


ASF

Remarks

Support Services Auxiliary Support Material Management Material Management Storage

1

6,000

6,000

Medical Gas Storage

2

100

200

Toilet - ADA

1

50

50 6,250

Material Management ASF


6,250


20%

1,250


10%

750

Material Management DGSF

Code Min. 20 SF per Licensed Bed

8,250

3-45


SERVICE


ASF

Remarks

Support Services Auxiliary Support Messenger/Mailroom Messenger Office - Supervisor

1

100

100

Open Office

1

600

600

Toilet - ADA

2

50

100

Changing

1

40

40

Specimen Storage

1

80

80

Mailroom

1

200

200

Clothes Storage

1

300

300

One Workstation

Gurneys/Wheelchair Storage

1

350

350

10 Gurneys and 10 Wheelchairs

Two Refrigerators

1,770

Messenger ASF


1,770


25%

443


15%

332

Messenger DGSF

12 Workstations w/ 12 Lockers (half height)

2,544

3-46


SERVICE


ASF

Remarks

Support Services Auxiliary Support Environmental Services Environmental Services Office - Supervisor

1

100

100

Supply

1

400

400

Equipment

1

200

200

Linen

1

200

200 900

Environmental Services ASF


900


25%

225


15%

169


1,294

3-47


SERVICE


ASF

Remarks

Support Services Auxiliary Support Information Technology Information Technology 1

800

800

Lab/Test

1

800

800

Operator

1

300

Computer Server Room

300 1,900

Information Technology ASF


1,900


25%

475


15%

356

2,731

Information Technology DGSF

Auxiliary Support PBX PBX 1

300

350

Office - Supervisor

1

100

100

Toilet - ADA

1

50

50

PBX Room

500

PBX ASF


500


25%

125


15%

94

PBX DGSF

719

3-48


SERVICE


ASF

Remarks

Support Services Auxiliary Support Dietary Dietary Storage Refrigerator Freezer Dietary ASF

1

500

500

1

50

50

1

50

50

Code Min. 2 Cu FT per Licensed Bed

600


600


20%

120


15%

108

Dietary DGSF

Code Min. 400 sf + 1 sf per Licensed Bed over 200

828

3-49

Section 3 Space Program BASEMENT -2 Department

BASEMENT -1 Beds/Rm

ASF

Diagnostic Imaging Cardiology Cath/EP Lab Unit Echo Lab Unit Support Areas Administrative/Staff Areas ASF Total DGSF Radiology X-ray Unit CT Scan Unit MRI Unit Angiography Unit Ultrasound Unit Support Areas Administrative/Staff Areas ASF Total DGSF

Sterile Processing Decontamination Area Assembly/Sterilization Administrative/Staff Areas ASF Total DGSF Morgue and Autopsy Morgue Autopsy Administrative/Staff Areas ASF Total DGSF

FIRST FLOOR Beds/Rm

ASF

Perioperative 1 5 -

730 930 970 350 2,980 4,606

3 1 1 2 1 -

900 1,180 850 1,310 400 3,680 1,660 9,980 15,425

Ancillary Services Pulmonary Function Lab DGSF

Department

4

960 1,484

-

1,270 2,360 850 4,480 6,774

Surgery Surgery Unit Interventional Radiology Unit Shared Support Areas Administrative/Staff Areas ASF Total DGSF Gastroenterology Gastroenterology Unit Administrative/Staff Areas ASF Total DGSF Patient Intake and Recovery Pre-OP Unit PACU Shared Support Areas Administrative/Staff Areas Public Areas ASF Total DGSF

Department

SECOND FLOOR Beds/Rm

ASF

Emergency 14 1 -

9,130 2,670 3,000 320 15,120 23,369

5 -

2,440 250 2,690 4,158

22 35 -

2,820 4,220 200 3,230 1,120 11,590 17,914

Clinical Care Exam Unit Trauma Unit Support Areas Administrative/Staff Areas Public Areas ASF Total DGSF

Admitting DGSF

Plant Services

54 6 -

10,780 3,510 4,305 2,780 1,600 22,975 36,668

-

-

3,360 3,360 4,435 2,030 2,801

(For Reference Only)

Plant Services DGSF

562

Ancillary Services Bronchoscopy DGSF Clinical Laboratory DGSF

1

-

THIRD FLOOR Beds/Rm

ASF

Acute Medical

Administration and Public Entry Area Main Lobby ASF Total DGSF

Department Obstetrics Triage Post-Partum LDRP C-Section Support Areas Administrative/Staff Area Public Areas ASF Total DGSF Pediatrics Pediatrics Unit Administrative/Staff Area Public Areas ASF Total DGSF NICU NICU unit Administrative/Staff Area Public Areas ASF Total DGSF

600 400 270 1,270 1,920

Entry Area DGSF

Plant Services

-

Beds

ASF

Acute Medical 3 13 9 2 -

12 -

12 -

650 3,150 3,270 1,420 2,240 2,210 880 13,820 21,427

4,440 1,030 460 5,930 9,194

3,670 1,260 120 5,050 7,830

Step-Down Step-Down Unit - Flex Up Step-Down Unit - Flex Down Support Areas Administrative/ Staff Areas Public Areas ASF Total DGSF Medical/Surgical - Forensic Unit Medical/Surgical - Forensic Unit Administrative/Staff Areas ASF Total DGSF

10 26 -

3,390 6,540 2,000 1,300 1,000 14,230 22,062

8 -

3,000 1,350 4,350 6,744

-

640 1,230 970 1,220 4,060 6,139

-

1,900 2,731

Ancillary Services Pharmacy Storage Areas Manufacturing Areas Dispensary Administrative/Staff Areas ASF Total DGSF

Auxiliary Support

380 587

Administration and Public Administration Administrative Offices ASF Total DGSF

1,550 2,344

Information Technology DGSF -

450 450 621

Administration and Public -

Department

Plant Services

1,000 1,320

Plant Services


Plant Services DGSF

562


Plant Services DGSF

562


Plant Services DGSF

562

Auxiliary Support Material Management DGSF

-

6,250 8,250

Messenger/Mailroom DGSF

-

1,770 2,544


-

900 1,294

Dietary DGSF

-

600 828

Plant Services Plant Services Mechanical Electrical Miscellaneous Administrative/ Staff Areas ASF Total DGSF DGSF Total Interdepartmental & Vertical Circulation/ Exterior Wall BGSF Total (For this floor only) BGSF Available (For this floor only) BGSF Available/ Total Delta BGSF Delta %


-

7,000 2,800 1,100 610 11,510 15,193 58,318

18%

10,497 68,815

DGSF Total Interdepartmental & Vertical Circulation/ Exterior Wall BGSF Total (For this floor only)

69,303 488 1%

BGSF Available (For this floor only) BGSF Available/ Total Delta BGSF Delta %

50,253 18%

9,046 59,299


59,749 450 1%


44,467 18%

8,004 52,471


53,092 621 1%


39,633 18%

7,134 46,767


47,096 329 1%


38,238 18%

6,883 45,121 45,588 467 1%

3-50

Section 3 Space Program FOURTH FLOOR Department

FIFTH FLOOR Beds

ASF

10 10 10 10 10 -

3,290 3,290 3,290 3,990 3,370 2,480 2,510 1,200 23,420 36,310

Medical/Surgical Medical/Surgical Unit Medical/Surgical Unit Support Areas Administrative/Staff Areas Public Areas ASF Total DGSF

Plant Services

PENTHOUSE

SIXTH FLOOR Beds

ASF

Acute Medical

Acute Medical ICU/CCU/Step-Down ICU/CCU Unit ICU/CCU Unit ICU/CCU Unit Trauma ICU Unit Step-Down Unit - Flex Up Shared Support Areas Administrative/ Staff Area Public Areas ASF Total DGSF

Department

Department

Beds

ASF

Acute Medical 36 36 -

10,570 10,570 250 1,040 940 23,370 36,233


Plant Services DGSF

562

Medical/Surgical Medical/Surgical Unit Medical/Surgical Unit Support Areas Administrative/Staff Areas Public Areas ASF Total DGSF

Plant Services

Department


Rooms

ASF

Plant Services 36 36 -

10,570 10,570 250 1,040 940 23,370 36,233

Plant Services Mechanical Electrical Miscellaneous ASF Total DGSF

-

BUILDING 25 Services

Beds

ASF

Inpatient

284

113,540

7,000 300 300 7,600 10,032

Diagnostic and Treatment

10,032 1,806 11,838


12,000 162 1%

BGSF Available BGSF Available/ Total Delta BGSF Delta %

76,096

Support Services

18,760 208,396 323,982

ASF Total DGSF


Plant Services DGSF

562

Auxiliary Support Biomed DGSF

-

700 1,019

PBX DGSF

-

500 719

Plant Services


Plant Services DGSF

DGSF Total Interdepartmental & Vertical Circulation/ Exterior Wall BGSF Total (For this floor only) BGSF Available (For this floor only) BGSF Available/ Total Delta BGSF Delta %

562

38,610 18%

6,950 45,560


45,588 28 0%


36,795 18%

6,623 43,418


43,922 504 1%


36,795 18%

6,623 43,418


43,922 504 1%


18%

18% 9%

323,982 58,317 34,407 416,706 420,260 3,554 1%

3-51

Section 4

Statement of Probable Construction Cost A statement of probable construction cost based on this space program will be issued under separate cover.


4-1

Section 5

Acknowledgments The following people participated in the development of the San Francisco General Hospital Medical Center space program report and provided their labor, time and expertise toward the preparation of the final document:

Steering Committee Gene Marie O'Connell, MSN Roland Pickens Sue Currin, RN, MS, CNS Delvecchio Finley, MPP, FACHE Andre Campbell, MD Jeff Critchfield, MD John Luce, MD Sue Carlisle, MD Kathy Jung, MPH Carlos Villalva, RA Ron Alameida, RA Mark Primeau Sharon Kotabe, PharmD

Inpatient Sue Currin, RN, MS, CNS Yuhum Digdigan, RN, MS Ana Sampera, RN, MS Michael Daly, RN Lettie Miller, RN Leslie Dubbin, RN Sharon Wicher, RN, MS Piera Wong, RN, MS, CNS Bill Schecter, MD Jeff Critchfield, MD Talmadge King, MD Kevin Grumbach, MD Todd May, MD Elena Fuentes-Afflick, MD Richard Price, MD Morris Schambelan, MD Pat Skala


5-1

Section 5 Acknowledgments

ICU/Step-down Sue Currin, RN, MS, CNS Terry Dentoni, RN Vivian Curd, RN Genevieve Farr, RN Paul Koo, RN, MS, CNS Leslie Dubbin, RN Lettie Miller, RN Sue Carlisle, MD Jim Marks, MD John Luce, MD Shirley Stiver, MD Sheryl Calson, RN, MS, CNS Nora Goldschlager, MD Andre Campbell, MD Courtney Broaddus, MD Lisa Chen, MD Julin Tang, MD Rochelle Dicker , MD Cheryl Jay, MD Sandra Peterson

Women & Children Nela Ponferrada, RN Fe Hortinela, RN Louise Dimattio, RN Elizabeth Romero, RN Ocean Berg, RN, MS, CNS Phil Darney, MD Lee Learman, MD Tina Raine, MD Eleanor Drey, MD Chris Stewart, MD Susan Sniderman, MD Teresa Villela, MD Ronald Dieckmann, MD Shannon Thyne, MD Kathryn Roberts


5-2


Diagnostic Terry Dentoni, RN Patricia Coggan, RN, MS, CNS Maggie Rykowski, RN Terry Lynch, MD Mark Wilson, MD Geoff Manley, MD Claude Hemphill, MD Ebie Fiebig, MD Walt Finkbeiner, MD Hal Yee, MD Jim Genevro John Applegarth

Emergency Bob Sypher, RN Pat Carr, RN John Fazio, RN, MS, CNS Kathryn Fowler, RN Alan Gelb, MD Chris Barton, MD Jeff Tabas, MD Mark Leary, MD Eric Isaacs, MD Mitchell Cohen, MD Jan Allison, RN

Perioperative Sue Currin, RN, MS, CNS Terry Dentoni, RN Lawrence Nichols, RN Jane Cino, RN Patricia Coggan, RN, MS, CNS Renee Navarro, MD Bob Mackersie, MD Sue Carlisle, MD Rochelle Dicker, MD Ted Miclau, MD Jim Marks, MD John Inadomi, MD Courtney Broaddus, MD Winona Mindolovich


5-3


Ancillary Support Sharon Kotabe, PharmD Paul Cho Shirley Lee, PharmD Julie Russell Fred Hom, PharmD Eberhard Fiebig, MD Cora Nunez-Talens Lawrence Nichols, RN James Moore Bob Eggleston Delvecchio Finley, MPP, FACHE Johnson Gong Marijane Pierson

DPH Program Management/Administration Gene Marie O'Connell, MSN Kathy Jung, MPH Mark Primeau Carlos Villalva, RA John Hurley Anson Moon

DPW Project Management Ron Alameida, RA

Fong & Chan Architects Chiu Lin Tse-Chan, FAIA, CSI, LEED AP David Fong, AIA, SARA, LEED AP Paolo Diaz Nuno Lopes, AIA Samina Choudhry Connie Ma, LEED AP Jacopo Montalenti

Forell/Elsesser Engineers, inc. (Structural Engineers) Simin Naaseh, SE James B. Guthrie, SE


5-4


Gayner Engineers (Mechanical/Electrical Engineers) David Pang, PE, CIPE, MCIBSE

TBD Consultants (Cost Estimator) Gordon Bevridge

Herrero Contractors (Cost Estimator) Craig Braccia


5-5

Section 6

Appendices The following documents were prepared during the development of the San Francisco General Hospital Medical Center space program report and supplement the content of this report. Appendix A Space Program Work Plan Appendix B Bed Projections Appendix C Meeting Minutes


6-1

Appendix A

SPACE PROGRAM WORK PLAN Organizational Chart STEERING COMMITTEE COMPOSITION • • • • • • • • •

Fig. Exhibit A-1

View of SFGHMC

Executive Hospital Administrator Chief Nursing Officer Executive DPH Admin. Representative SFGH Associate Hospital Administrators Chief Medical Officer Chief of Service (current and elect) SFGH/UCSF Dean Campus Executive Architect DPW Project Manager

USER GROUP COMMITTEE COMPOSITION • • •

•

Chief Nursing Officer SFGH Associate Hospital Administrators Department Managers Inpatient Ambulatory Emergency Facilities Support Services Physician Representatives

Activity I: Engagement Initiation (2 Weeks):


•

Receive authorization to proceed with work

•

Identify San Francisco General Hospital Medical Center (SFGHMC) Objectives and Assumptions

•

Tour SFGHMC and project site

•

Compile project data: Institutional Master Plan, site survey, plot plans (topographic and site utilities), legal site descriptions, soil reports, EIR documentation, City of San Francisco planning regulations, City of San Francisco Master Plan (if applicable), SFGHMC space standards, etc

•

SFGHMC to provide patient population projections

•

Develop and present preliminary project schedule Appendix A-1

Appendix A Space Program Work Plan

•

Assemble Steering Committee, appoint AChair@ and identify “User Groups” for the services to be programmed

Activity II: Develop “Draft” Space Program (12 Weeks): •

Document planning assumptions and space requirements, including scope of services to be included in the building, operating systems, functional relationships, organizational structure and staffing, hours of operation, major equipment, major intraand inter-departmental relationships, and anticipated facility or operational changes

•

Translate planning assumption and space requirements into the following service categories: à à à à à

•

Forward “Draft” document to user representatives prior to meeting

•

Meet with Steering Committee

•

Review planning assumptions and space requirements

•

Workshop #1 with User Groups: à à à à à


Inpatient Diagnostic and Treatment Emergency Support Plant Services

Meet with User Groups Review patient population projections, assumptions and space requirements Review site and building constraints Review work progress in Activity I Identify and document outstanding issues

planning

Appendix A-2

Appendix A Space Program Work Plan

Activity III: Weeks)

Preliminary “Draft” Space Program (7

•

Document “Draft” Space Program based on Workshop #1 input.

•

Develop site plan and floor plan block diagrams

•

Workshop #2 with Steering Committee and User Groups: à à à à à

Meet with Steering Committee and User Groups Review “Draft” Space Program Review site plan and floor plan block diagrams Review work progress in Activity II Resolve and document outstanding issues

Activity IV: Refine “Draft” Space Program (6 Weeks) •

Refine “Draft” Space Program based on Workshop #2 input

•

Develop general room layouts

•

Workshop #3 with User Groups: à à à à

Meet with User Groups Review refine “Draft” Space Program Review general room layouts Review work progress in Activity III

Activity V: Review and Refinement of “Draft” Space Program (6 Weeks) •

Refine “Draft” Space Program based on Workshop #3 input and submit for review

•

Steering Committee and User Groups to review and comment on “Draft” Report

Activity VI: Final Space Program (5 Weeks) •


Make minor revisions and complete final Space Program

Appendix A-3

Appendix B

Bed Projections Introduction The number of beds included in this space program have been derived from the examination and analysis of several variables: census trends at SFGHMC, current and expected demands on services, the range of services provided at SFGHMC, rates of occupancy, and services provided by other area hospitals now and in the future. There is no prescribed formulary for establishing bed projections.

Daily Census and Average Daily Census (ADC) Daily Census for this report includes all acute medical patient days. The daily census is a snap shot in time taken at midnight each day. Midnight census is the community standard for counting patient days. Excluded from the data provided for this report are normal newborn nursery days, acute psychiatric patient days, and skilled nursing patient days. Normal newborns are not considered acute patients and nursery bassinets are never included in bed counts. Acute psychiatric and skilled nursing days are excluded because these patient care areas will not be relocated into the new hospital building. Average Daily Census (ADC) is the average number of patients in the hospital on a single day. An ADC for the past four years was calculated for each bed type. The ADC can then be used as one variable to project future bed needs by multiplying each bed category by a chosen occupancy rate. There is no fixed prescribed community standard for occupancy rates. Each hospital must assess the needs of its own patient population along with their particular service capabilities to determine an appropriate rate. The Society of Critical Care Medicine in their “Guidelines for Intensive Care Unit Design” state that “The development team should assess the expected demands on the proposed ICU based on an evaluation of its sources of patients, admission and discharge criteria, expected rate of occupancy, and services provided by other area hospitals. The ability to provide specific levels of care must be determined by analyzing physician resources, staff resources (nursing, SFGHMC | Space Program – May 2007

Appendix B-1

Appendix B Bed Projections

respiratory therapy, etc.) and the availability of support services (laboratory, radiology, pharmacy, etc.)” This guidance is equally applicable to acute care beds. According to the National Center for Health Statistics the average occupancy rate for Community Hospitals from 1998 thru 2001 was 64%. SFGHMC’s occupancy rate has frequently gone to nearly 100% of its capacity. You cannot operate efficiently at that occupancy level. Time is required for the discharge of patients and the cleaning of beds by housekeeping services. Operating at levels that exceed 80% means patients will often have to wait for beds. Based on the factors described above and known demands for services, SFGHMC has applied an occupancy factor of 80% for all acute patient bed categories and a factor of 70% for intensive care (adult and neonatal) and step-down beds. Generally a lower rate is applied when utilization of a particular service is more unpredictable (in the case of intensive care and step-down – which is closely associated with ICU use). In terms of services provided by other area hospitals, SFGHMC is the only designated trauma center (Level 1) serving San Francisco and northern San Mateo County, SFGHMC is required to maintain bed capacity for trauma patients. Nontrauma facilities do not have this same level of responsibility. SFGHMC and St. Luke’s Hospital are the only two hospitals that serve the southern quadrant of the City. There is some concern that in the near term, St. Luke’s will not continue to provide acute care services. Other variables that artificially lower the census data and that skews the actual demand for services include:


•

Census is limited by the number of available, staffed beds.

•

Census does not always reflect the patients that have been admitted but are being held in the emergency department or PACU awaiting a bed to become available. Patients are required to be in a bed at midnight to be counted in the midnight census.

Appendix B-2


Summary The bed projections provided in Table have been derived from an examination of all the above variables. Bed flexibility is built into the program by the number of planned step-down beds. Step-down beds can either go from intensive care to step-down; or step-down to acute care levels of care.


Appendix B-3


ADC

Daily Census

Projected Bed Needs

CY 02-03

CY 03-04

CY 04-05

CY 05-06

4 Year Total

Over 4 Years

Occupancy rate

Based on Census Data*

Based on Actual Needs**

Medical/Surgical

47,469

45,083

49,001

47,687

189,240

129.5

80%

162

144

Medical/Surgical - Forensic

1,939

1,425

1,066

1,031

5,461

3.7

80%

5

8

ICU

8,000

7,915

8,167

8,647

32,729

22.4

70%

32

40

Step-Down

6,844

7,679

8,805

12,037

35,365

24.2

70%

35

46

Obstetrics

4,197

4,076

4,119

3,952

16,344

11.2

80%

14

22

Pediatrics

1,069

1,082

991

1,093

4,235

2.9

80%

4

12

NICU

2,864

2,729

2,707

3,421

11,721

8.0

70%

11

12

Total

72,382

69,989

74,856

77,868

295,095

202.3

262

284

Average Daily Census (ADC)

198.3

191.8

204.5

213.3

202.3

SERVICE

Notes: Census is limited by the number of beds available. Lack of available beds artificially reduces the census and does not reflect actual demand. Census numbers do not always reflect the patients that have been admitted but are being held in the emergency department or PACU awaiting a bed to become available. Patients need to be in a bed at midnight to be counted in the midnight census – which is the community standard for establishing daily census numbers. SFGHMC's occupancy rate has frequently gone to nearly 100% of its capacity. Hospitals cannot operate efficiently at that occupancy rate. SFGHMC operates beds beyond their budgeted capacity in order to care for as many patients as possible. SFGHMC is the only trauma center in San Francisco. As a designated trauma center SFGHMC is required to maintain bed availability in ICU for trauma patients.

Appendix B-4

Appendix C

Meeting Minutes The following meeting minutes will serve as the approved record of matters discussed and conclusions reached during the space programming effort for the new acute care hospital at San Francisco General Hospital Medical Center.


Appendix C-1

MINUTES OF MEDICAL/ SURGICAL MEETING NO. 1 PROJECT:

San Francisco General Hospital 1001 Potrero Avenue San Francisco, CA 94110

MEETING LOCATION:

San Francisco General Hospital, Room 2A6

MEETING DATE:

December 1, 2006 2:00 pm : 4:00 pm

ISSUE DATE:

December 4, 2006

ATTENDEES:

Kathy Jung (KJ) Sue Currin (SC) Yuhum Digdigan (YD) Ana Sampera (AS) Michael Daly (MD) Lettie Miller (LM) Leslie Dubbin (LD) Sharon Wicher (SW) Piera Wong (PW) Jeff Critchfield (JC) Todd May (TM) Elena Fuentes-Affl. (EF) Richard Price (RP) Pat Skala (PS) Mark Jacobson (MJ) Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:

All Attendees Gene O’Connell Mark Primeau

San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH -Nursing Admin SFGH -Nursing Admin SFGH -Nursing Admin. SFGH -Nursing Admin. SFGH -Nursing Admin. SFGH -Nursing Admin. SFGH -Nursing Admin. SFGH -Oncology SFGH -Medicine SFGH -Family & Comm. Med. SFGH -Pediatrics SFGH -Neurology SFGH -Information System SFGH Fong & Chan Architects (FCA) FCA FCA FCA FCA

SFGH, Executive Administrator Department of Public Health (DPH)

FCA FONG & CHAN ARCHITECTS

ARCHITECTURE ▪ PLANNING ▪ INTERIOR DESIGN 1361 BUSH STREET, SAN FRANCISCO, CALIFORNIA 94109 TEL: (415) 931-8600 FAX: 9415) 931-4601 E-MAIL [email protected]

This meeting was held to initiate the programming effort with the Medical/ Surgical User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Space Programming Objectives and Assumptions, dated December 1, 2006 3. Project Schedule dated November 20, 2006 4. SFGHMC Rebuild Program Subcommittee Focus Groups, 5. Average Daily Census FY 00-01 – FY 04-05 6. Preliminary Summary Space Program, dated December 1, 2006 7. Med/Surg User Group Questionnaire, dated December 1, 2006

ITEMS DISCUSSED: Item

Description

Action

NEW BUSINESS: PROGRAM ISSUES

A. 1.01

Nuno Lopes (NL) of FCA noted that the primary goal of this effort was to develop a Detailed Space Program for the new Acute Care Hospital. The new Acute Care Hospital is to be built on the West Lawn of the Campus and will not require the demolition of any of the existing buildings currently on the Campus. NL noted that there were several major constraints and drivers that would direct the development of the Space Program. 1. Operations – The User Groups and the Leadership committee need to provide input to help develop a space program that will adequately meet the operational needs of SFGHMC for the foreseeable future. 2. Costs – NL noted that a Site Feasibility Study was recently completed which validated the feasibility of the West Lawn site and set some parameters and costs for the project. FCA has been instructed to assume a preliminary construction cost budget of 622 million dollars for a new building with approximately 230Page 2 of 7

Due Date

Item

Description

Action

267 beds. Kathy Jung (KJ) of SFGHMC noted that this maximum target includes construction costs only and is what has been determined to be politically feasible as a bond measure. This figure does not include the estimated 160 million dollars required for equipment and furnishings or for any renovation work of the existing hospital building. 3. Site Limitations- NL noted that the Site Feasibility Study established parameters for the maximum size of the new building. Code and Planning requirements have determined the maximum area for each floor and the maximum number of floors for the new facility. All new required program elements need to be accommodated within this envelope. 1.02

FCA reviewed some current trends in Med/Surg Nursing Unit Design per the request of the user group. FCA noted that some of the major trends that may impact the program of the Nursing Units include the following: 1. Increased use of technology for patient /asset tracking and allowing decentralizing of nurses away from a Central Nurse Station towards auxiliary nurse stations and in-room charting stations. 2. Greater patient privacy. Rooms provided with more amenities such as multimedia options to increase patient comfort. 3. Development of Patient rooms with the same configuration and orientation. This helps reduce staff error by standardizing the room layouts. 4. Greater use of mobile equipment to allow exams, therapies and imaging to take place in patient rooms rather than transporting patients around the hospital.

1.03

FCA noted that the preliminary space program assumptions for Med/Surg beds were for a total of 120 beds divided into 2 nursing units per floor with 32 & 28 beds per unit. This assumption was developed in conjunction with SFGH and is based on a combination of the census figures and previous utilization studies commissioned by SFGH.

DEPARTMENTAL ISSUES

B. 1.04

Nuno Lopes (NL) of FCA asked whether the Nursing Units are specialized or generalized units. The user group noted that there was a distinction between the medical nursing units and Page 3 of 7

Due Date

Item

Description

Action

the surgical nursing units that should be maintained. Otherwise there should be no planned specialization of Nursing Units for maximum flexibility. 1.05

Elena Fuentes-Affl. (EF) of SFGH noted that the Pediatric Nursing Unit should be located in a separate unit adjacent to Obstetrics and noted that separation of the general adult patient population from the Pediatrics and Obstetrics units as an important planning consideration. EF also noted that patient rooms in the Pediatrics Nursing Unit should be designed to be large enough to accommodate sleeping facilities for a family member.

1.06

Nuno Lopes (NL) of FCA noted that the Forensic Inpatient Unit was located with the new Hospital Building but that the Forensic – Psych unit was to remain within the existing Hospital. The user group noted that while it was desirable to keep the two units together for operational efficiency, it was preferable to separate the units in order to increase the overall number of licensed beds in the new Hospital building.

1.07

Mark Jacobsen (MJ) of SFGH expressed his concern that no patient beds were currently allocated for the General Clinical Research Center (GCRC) and noted the importance of the GCRC within the facility. Kathy Jung (KJ) of SFGH acknowledged that the GCRC had not yet been addressed as part of the Space Program and that it needed to be discussed and evaluated by SFGH in a separate meeting. NURSING UNIT ISSUES

C. 1.08

Nuno Lopes (NL) of FCA noted that the current assumptions were for 2 nursing units per floor with 32-28 beds per unit. The user group confirmed that this was generally acceptable and that the workability of the 36 bed unit would depend on the layout of the unit for workflow efficiency. The user group generally agreed that either a centralized or decentralized nursing unit concept would be feasible but that actual plan layouts would need to be reviewed. The user group noted that the past patient census is not a good indication of the actual patient beds required by the Hospital since occupancy is usually over 100% and there is significant diversion of patients that takes place. Whatever the maximum number of beds feasible given the other constraints of space and cost would be preferred by the User Group. After further discussion, it was agreed that a maximum of four units of 36 beds for a total of 144 licensed beds would be preferable. FCA to exercise this option for feasibility within the building Page 4 of 7

Due Date

Item

Description

Action

envelope 1.09

The user group noted the importance of sufficient storage space required for printers and other equipment that needs to be easily accessible. The current storage space in the existing nursing units have not been sufficient. NL stated that the storing mobile equipment in alcoves along the corridor could be provided in the design of the unit. Currently FCA has allocated 400 square feet per unit for storage not including the possible additional alcove spaces.

1.10

The user group emphasized the importance of having one (1) conference and one (1) consultation room within each unit. The user group would also prefer to have at least one (1) sleep room within the unit in addition to the on call facilities that will stay in the existing building. NL noted that any additions to support and service areas may reduce the number of patient beds as there is a limited amount of floor area per nursing unit. The user group agreed that patient beds are the priority and that the work of the group would be to find the optimal balance between maximizing bed capacity and staff / support areas.

1.11

The user group confirmed that a separate medicine room might not be required as a Pyxis/Omnicell automated system will probably be provided. PATIENT ROOM ISSUES

D. 1.12

Nuno Lopes (NL) of FCA confirmed that in the current programming all patient rooms are single occupancy patient rooms and asked whether shared patient rooms should be considered to increase the number of licensed beds. The user group confirmed that all patient rooms should be designed as single patient rooms with the exception of two (2) patient rooms per unit which should be designed for the possibility of two beds in each room with a sliding door within the shared wall that can open up the rooms into one large room. This will allow the rooms to be used for monitoring purposes and as a mini-ward and will provide the nursing staff with flexibility for patient care. NL asked the user groups whether the rooms be reduced in size to maximize the number of beds in the unit. The user group noted that patient rooms should be designed for medical reasons and not to squeeze in the maximum capacity. Although the number of patient beds is a prime consideration, Page 5 of 7

Due Date

Item

Description

Action

Due Date

the size, comfort and quality of patient rooms should not be compromised just to maximize capacity. 1.13

Nuno Lopes (NL) of FCA confirmed that in the current programming three (3) patient rooms per nursing unit are ADA accessible units as required by code. The user group agreed to 3 accessible patient rooms per unit was acceptable. Paolo Diaz (PD) of FCA noted that these rooms would also be appropriate for bariatric patients. SFGH to review their current and projected needs for bariatric rooms and will provide data to FCA at the next meeting.

1.14

Nuno Lopes (NL) of FCA confirmed that in the current programming one (1) patient room per nursing unit is an isolation room as required by code. The user group noted that because of the prevalence of TB and other communicable diseases within the patient population there is a need for 30-35% of the rooms to be negative pressure isolation rooms. FCA clarified that the current isolation rooms within the hospital were not code compliant isolation rooms which require an anteroom but rather just negative pressure rooms.

1.15

The user group agreed that two isolation rooms with a shared anteroom per unit would be acceptable and the remainder of the required isolation rooms could be negative pressure rooms without anterooms. The isolation rooms should be equally distributed among all the nursing units. Nuno Lopes (NL) of FCA confirmed that in the current programming each patient room has a private toilet. The user group agreed that all patient rooms should have private toilets. Shared bathrooms are not considered to be an option due to infection issues. A shower for each bathroom is not required apart from the Obstetrics unit. Shared showers on each unit (2 showers per unit) are sufficient.

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Medical-Surgical\Minutes_06.12.01_Medical - Surgical.doc Page 6 of 7

MINUTES OF MEDICAL/ SURGICAL MEETING NO. 1

PROJECT:


MEETING LOCATION:


MEETING DATE:

December 1, 2006 2:00 pm : 4:00 pm

ISSUE DATE:

December 4, 2006

ATTENDEES:

Kathy Jung (KJ) Sue Currin (SC) Yuhum Digdigan (YD) Ana Sampera (AS) Michael Daly (MD) Lettie Miller (LM) Leslie Dubbin (LD) Sharon Wicher (SW) Piera Wong (PW) Jeff Critchfield (JC) Todd May (TM) Elena Fuentes-Affl. (EF) Richard Price (RP) Pat Skala (PS) Mark Jacobson (MJ) Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH -Nursing Admin SFGH -Nursing Admin SFGH -Nursing Admin. SFGH -Nursing Admin. SFGH -Nursing Admin. SFGH -Nursing Admin. SFGH -Nursing Admin. SFGH -Oncology SFGH -Medicine SFGH -Family & Comm. Med. SFGH -Pediatrics SFGH -Neurology SFGH -Information System SFGH Fong & Chan Architects (FCA) FCA FCA FCA FCA




This meeting was held to initiate the programming effort with the Medical/ Surgical User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Space Programming Objectives and Assumptions, dated December 1, 2006 3. Project Schedule dated November 20, 2006 4. SFGHMC Rebuild Program Subcommittee Focus Groups, 5. Average Daily Census FY 00-01 – FY 04-05 6. Preliminary Summary Space Program, dated December 1, 2006 7. Med/Surg User Group Questionnaire, dated December 1, 2006

ITEMS DISCUSSED:

Item

Description

Action


A.

1.01

Nuno Lopes (NL) of FCA noted that the primary goal of this effort was to develop a Detailed Space Program for the new Acute Care Hospital. The new Acute Care Hospital is to be built on the West Lawn of the Campus and will not require the demolition of any of the existing buildings currently on the Campus. NL noted that there were several major constraints and drivers that would direct the development of the Space Program. 1. Operations – The User Groups and the Leadership committee need to provide input to help develop a space program that will adequately meet the operational needs of SFGHMC for the foreseeable future. 2. Costs – NL noted that a Site Feasibility Study was recently completed which validated the feasibility of the West Lawn site and set some parameters and costs for the project. FCA has been instructed to assume a preliminary construction cost budget of 622 million dollars for a new building with approximately 230Page 2 of 7

Due Date

Item

Description

Action

Due Date

the size, comfort and quality of patient rooms should not be compromised just to maximize capacity. 1.13

Nuno Lopes (NL) of FCA confirmed that in the current programming three (3) patient rooms per nursing unit are ADA accessible units as required by code. The user group agreed to 3 accessible patient rooms per unit was acceptable. Paolo Diaz (PD) of FCA noted that these rooms would also be appropriate for bariatric patients. SFGH to review their current and projected needs for bariatric rooms and will provide data to FCA at the next meeting.

1.14

Nuno Lopes (NL) of FCA confirmed that in the current programming one (1) patient room per nursing unit is an isolation room as required by code. The user group noted that because of the prevalence of TB and other communicable diseases within the patient population there is a need for 30-35% of the rooms to be negative pressure isolation rooms. FCA clarified that the current isolation rooms within the hospital were not code compliant isolation rooms which require an anteroom but rather just negative pressure rooms.

1.15

The user group agreed that two isolation rooms with a shared anteroom per unit would be acceptable and the remainder of the required isolation rooms could be negative pressure rooms without anterooms. The isolation rooms should be equally distributed among all the nursing units. Nuno Lopes (NL) of FCA confirmed that in the current programming each patient room has a private toilet. The user group agreed that all patient rooms should have private toilets. Shared bathrooms are not considered to be an option due to infection issues. A shower for each bathroom is not required apart from the Obstetrics unit. Shared showers on each unit (2 showers per unit) are sufficient.


Item

Description

Action

267 beds. Kathy Jung (KJ) of SFGHMC noted that this maximum target includes construction costs only and is what has been determined to be politically feasible as a bond measure. This figure does not include the estimated 160 million dollars required for equipment and furnishings or for any renovation work of the existing hospital building. 3. Site Limitations- NL noted that the Site Feasibility Study established parameters for the maximum size of the new building. Code and Planning requirements have determined the maximum area for each floor and the maximum number of floors for the new facility. All new required program elements need to be accommodated within this envelope. 1.02

FCA reviewed some current trends in Med/Surg Nursing Unit Design per the request of the user group. FCA noted that some of the major trends that may impact the program of the Nursing Units include the following: 1. Increased use of technology for patient /asset tracking and allowing decentralizing of nurses away from a Central Nurse Station towards auxiliary nurse stations and in-room charting stations. 2. Greater patient privacy. Rooms provided with more amenities such as multimedia options to increase patient comfort. 3. Development of Patient rooms with the same configuration and orientation. This helps reduce staff error by standardizing the room layouts. 4. Greater use of mobile equipment to allow exams, therapies and imaging to take place in patient rooms rather than transporting patients around the hospital.

1.03

FCA noted that the preliminary space program assumptions for Med/Surg beds were for a total of 120 beds divided into 2 nursing units per floor with 32 & 28 beds per unit. This assumption was developed in conjunction with SFGH and is based on a combination of the census figures and previous utilization studies commissioned by SFGH.

DEPARTMENTAL ISSUES

B. 1.04

Nuno Lopes (NL) of FCA asked whether the Nursing Units are specialized or generalized units. The user group noted that there was a distinction between the medical nursing units and Page 3 of 7

Due Date

Item

Description

Action

the surgical nursing units that should be maintained. Otherwise there should be no planned specialization of Nursing Units for maximum flexibility. 1.05

Elena Fuentes-Affl. (EF) of SFGH noted that the Pediatric Nursing Unit should be located in a separate unit adjacent to Obstetrics and noted that separation of the general adult patient population from the Pediatrics and Obstetrics units as an important planning consideration. EF also noted that patient rooms in the Pediatrics Nursing Unit should be designed to be large enough to accommodate sleeping facilities for a family member.

1.06

Nuno Lopes (NL) of FCA noted that the Forensic Inpatient Unit was located with the new Hospital Building but that the Forensic – Psych unit was to remain within the existing Hospital. The user group noted that while it was desirable to keep the two units together for operational efficiency, it was preferable to separate the units in order to increase the overall number of licensed beds in the new Hospital building.

1.07

Mark Jacobsen (MJ) of SFGH expressed his concern that no patient beds were currently allocated for the General Clinical Research Center (GCRC) and noted the importance of the GCRC within the facility. Kathy Jung (KJ) of SFGH acknowledged that the GCRC had not yet been addressed as part of the Space Program and that it needed to be discussed and evaluated by SFGH in a separate meeting. NURSING UNIT ISSUES

C. 1.08

Nuno Lopes (NL) of FCA noted that the current assumptions were for 2 nursing units per floor with 32-28 beds per unit. The user group confirmed that this was generally acceptable and that the workability of the 36 bed unit would depend on the layout of the unit for workflow efficiency. The user group generally agreed that either a centralized or decentralized nursing unit concept would be feasible but that actual plan layouts would need to be reviewed. The user group noted that the past patient census is not a good indication of the actual patient beds required by the Hospital since occupancy is usually over 100% and there is significant diversion of patients that takes place. Whatever the maximum number of beds feasible given the other constraints of space and cost would be preferred by the User Group. After further discussion, it was agreed that a maximum of four units of 36 beds for a total of 144 licensed beds would be preferable. FCA to exercise this option for feasibility within the building Page 4 of 7

Due Date

Item

Description

Action

envelope 1.09

The user group noted the importance of sufficient storage space required for printers and other equipment that needs to be easily accessible. The current storage space in the existing nursing units have not been sufficient. NL stated that the storing mobile equipment in alcoves along the corridor could be provided in the design of the unit. Currently FCA has allocated 400 square feet per unit for storage not including the possible additional alcove spaces.

1.10

The user group emphasized the importance of having one (1) conference and one (1) consultation room within each unit. The user group would also prefer to have at least one (1) sleep room within the unit in addition to the on call facilities that will stay in the existing building. NL noted that any additions to support and service areas may reduce the number of patient beds as there is a limited amount of floor area per nursing unit. The user group agreed that patient beds are the priority and that the work of the group would be to find the optimal balance between maximizing bed capacity and staff / support areas.

1.11

The user group confirmed that a separate medicine room might not be required as a Pyxis/Omnicell automated system will probably be provided. PATIENT ROOM ISSUES

D. 1.12

Nuno Lopes (NL) of FCA confirmed that in the current programming all patient rooms are single occupancy patient rooms and asked whether shared patient rooms should be considered to increase the number of licensed beds. The user group confirmed that all patient rooms should be designed as single patient rooms with the exception of two (2) patient rooms per unit which should be designed for the possibility of two beds in each room with a sliding door within the shared wall that can open up the rooms into one large room. This will allow the rooms to be used for monitoring purposes and as a mini-ward and will provide the nursing staff with flexibility for patient care. NL asked the user groups whether the rooms be reduced in size to maximize the number of beds in the unit. The user group noted that patient rooms should be designed for medical reasons and not to squeeze in the maximum capacity. Although the number of patient beds is a prime consideration, Page 5 of 7

Due Date

MINUTES OF OBSTETRIC/ PEDIATRIC MEETING NO. 1

PROJECT:


MEETING LOCATION:


MEETING DATE:

December 5, 2006 2:00 pm : 4:00 pm

ISSUE DATE:

January 5, 2007

ATTENDEES:

Kathy Jung (KJ) Ocean Berg (OB) Jon Barash (JB) Holly Cost (HC) Ronald Dieckmann (RD) Alma Martinez (AM) Nela Ponferrada (NP) Tina Raine-Bennett (TRB) Kathryn Roberts (KR) Elisabeth Romero (ER) Susan Sniderman (SS) William Taeusch (WT) Juan Vargas (JV) Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH Fong & Chan Architects (FCA) FCA FCA FCA FCA




This meeting was held to initiate the programming effort with the Women & Children User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Space Programming Objectives and Assumptions, dated December 1, 2006 3. Project Schedule dated November 20, 2006 4. SFGHMC Rebuild Program Subcommittee Focus Groups, 5. Average Daily Census FY 00-01 – FY 04-05 6. Preliminary Summary Space Program, dated December 1, 2006 7. Women & Children Program Questionnaire, dated December 5, 2006

ITEMS DISCUSSED:

Item

Description

Action


A. 1.01

Nuno Lopes (NL) of FCA noted that the primary goal of this effort was to develop a Detailed Space Program for the new Acute Care Hospital. The new Acute Care Hospital is to be built on the West Lawn of the Campus and will not require the demolition of any of the existing buildings currently on the Campus. NL noted that there were several major constraints and drivers that would direct the development of the Space Program. 1. Operations – The User Groups and the Leadership committee need to provide input to help develop a space program that will adequately meet the operational needs of SFGHMC for the foreseeable future. 2. Costs – NL noted that a Site Feasibility Study was recently completed which validated the feasibility of the West Lawn site and set some parameters and costs for the project. FCA has been instructed to assume a preliminary construction cost budget of 622 million dollars for a new building with approximately 230267 beds. Kathy Jung (KJ) of SFGHMC noted that this maximum target includes construction costs only and is what has been determined to be politically Page 2 of 5

Due Date

Item

Description

Action

feasible as a bond measure. This figure does not include the estimated 160 million dollars required for equipment and furnishings or for any renovation work of the existing hospital building. 3. Site Limitations- NL noted that the Site Feasibility Study established parameters for the maximum size of the new building. Code and Planning requirements have determined the maximum area for each floor and the maximum number of floors for the new facility. All new required program elements need to be accommodated within this envelope. 1.02

FCA reviewed some current trends in OB/GYN Nursing Unit Design per the request of the User Group. FCA noted that some of the major trends that may impact the program of the Nursing Units include the following: 1. Increased use of technology for patient /asset tracking and allowing decentralizing of nurses away from a Central Nurse Station towards auxiliary nurse stations and in-room charting stations. 2. Greater patient privacy. Rooms provided with more amenities such as multimedia options to increase patient comfort. 3. Development of Patient rooms with the same configuration and orientation. This helps reduce staff error by standardizing the room layouts. 4. Greater use of mobile equipment to allow exams, therapies and imaging to take place in patient rooms rather than transporting patients around the hospital.

1.03

KJ confirmed that the time limit for a new hospital is 2013. An extension for the planning of the new hospital has been approved; an additional extension while the hospital is in construction will be necessary.

1.04

The User Group raised the question if the planning of the OB/GYN and PED departments is considering a move to Mission Bay. KJ noted that the decision to move OB/GYN and PED departments to Mission Bay is outside the mandate of this programming effort. For now the programming effort will assume the OB/GYN and PED departments will remain in the Potrero Campus.

B.

DEPARTMENTAL ISSUES Page 3 of 5

Due Date

Item

Description

Action

1.05

The User Group requested the programming effort to address pediatric patient needs in the Emergency and ICU departments.

1.06

The User Group agreed that a total of three Triage rooms are necessary. The Triage rooms should be the same size as the Postpartum rooms. The User Group also commented that if necessary during high census the postpartum rooms could also be used for triage.

1.07

The User Group agreed that the current and future philosophy is to follow the LDRP model- the mother and child stay in one room during labor, delivery, recovery and postpartum (LDRP). The average duration for a patient in a LDRP room is 2 days, in case of a C-Section patient the average duration increases to 4 days. The User Group confirmed there are currently: 7 LDRP 12 Postpartum The User Group requested: • 9 LDRP rooms • 13 Postpartum rooms, which includes 9 single rooms, 2 ADA rooms, 2 isolation (ADA). • 1 well baby nursery with 5 well baby bassinets • 1 Procedure / Treatment room

1.08

The User Group noted that providing a movable partition between 2 single patient rooms to allow for observation of two patients by a single nurse was acceptable.

1.10

All LDRP rooms should have a toilet with a birthing tub. All Postpartum rooms should have a toilet with a shower.

1.11

The User Group requested four on-call sleep rooms to accommodate Obstetrics. They emphasized that the on-call sleep rooms should be on the same floor as the Obstetrics unit, preferably within the unit. The User Group agreed that 2 on-call sleep rooms for Pediatrics could be located in the existing hospital preferably on the same floor with a bridge connection.

1.12

The User Group requested 2 C-Section rooms sized similarly to an operating room with a resuscitation room in between. This is similar to the current layout, which has proven to work well.

1.13

The User Group stated their preference to locate approximately 12 GYN Med/ Surg beds in the same floor as Page 4 of 5

Due Date

Item

Description

Action

Due Date

Obstetrics. FCA noted that due to space constraints this would likely not be possible. FCA also noted that staffing issues would have to be addressed if a partial Med/ Surg unit was to be programmed on a separate floor. STAFF ISSUES

C. 1.14

The User Group requested the following revisions from the original program: • Delete office for social worker. • Increase size of the staff lounge from 300 sf to 400 sf. • Provide only one 400 sf waiting room for Obstetrics, Pediatrics and NICU.

1.15

The User Group requested lockers for a total of 125 staff (75 female and 50 male)

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Medical-Surgical\Minutes_06.12.01_Medical - Surgical.doc

Page 5 of 5

ICU / STEP-DOWN NO. 1

PROJECT:


MEETING LOCATION:


MEETING DATE:

December 8, 2006 2:00 pm : 4:00 pm

ISSUE DATE:

January 11, 2007

ATTENDEES:

Kathy Jung (KJ) Courtney Broaddus (CB) Andre Campbell (AC) Vivian Curd (VC) Terry Dentoni (TD) Leslie Dubbin (LD) Genevieve Farr (GF) Nora Goldschlager (NG) Cheryl Jay (CJ) Paul Koo (PK) John Luce (JL) Jim Marks (JM) Lettie Miller (LM) Sandy Peterson (SP) Shirley Stiver (SS) Julin Tang (JT) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH Fong & Chan Architects (FCA) FCA FCA FCA




This meeting was held to initiate the programming effort with the Medical/ Surgical User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Space Programming Objectives and Assumptions, dated December 1, 2006 3. Project Schedule dated November 20, 2006 4. SFGHMC Rebuild Program Subcommittee Focus Groups, 5. Average Daily Census FY 00-01 – FY 04-05 6. Preliminary Summary Space Program, dated December 8, 2006 7. ICU / Stepdown User Group Questionnaire, dated December 8, 2006

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

PROGRAM ISSUES

1.01

General Nuno Lopes (NL) of FCA noted that the primary goal of this effort was to develop a Detailed Space Program for the new Acute Care Hospital to be designated as Building 25. The new Acute Care Hospital is to be constructed on the West Lawn of the Campus and will not require the demolition of any of the existing buildings currently on the Campus. NL noted that there were several major constraints and drivers that would direct the development of the Space Program. 1. Operations – The User Groups and the Leadership committee need to provide input to help develop a space program that will adequately meet the operational needs of SFGHMC for the foreseeable future. 2. Costs – NL noted that a Site Feasibility Study was recently completed which validated the feasibility of the West Lawn site and set some parameters and costs for the project. FCA has been instructed to assume a preliminary construction cost budget of 622 million dollars for a new building with approximately 230Page 2 of 6

Due Date

Item

Description

Action

267 beds. Kathy Jung (KJ) of SFGHMC noted that this maximum target includes construction costs only and is what has been determined to be politically feasible as a bond measure. This figure does not include the estimated 160 million dollars required for equipment and furnishings or for any renovation work of the existing hospital building (Building No. 5). 3. Site Limitations- NL noted that the Site Feasibility Study established parameters for the maximum size of the new building. Code and Planning requirements have determined the maximum area for each floor and the maximum number of floors for the new facility. All new required program elements need to be accommodated within this envelope. 1.02

Building Connections NL noted the current assumption is that Building 25 and the old Hospital Building (Building No. 5) will be connected on three levels; at basement level through a tunnel, at street level and with a bridge connection at Level 2. KJ confirmed that connections between all levels will not be possible since it would be too costly.

1.03

Helipad Currently the proposed location for a new helipad is the C wing of Building 5. The feasibility of relocating the helipad to the top of Building 25 will be studied as part of the Building Design.

1.04

Building 5 Envelope Limitations John Luce (JL) and Andre Campbell (AC) of SFGH explained that the space available in the established envelope is limited and cannot be increased. They both emphasized the important goal is to achieve the maximum efficiency within the established envelope. JL noted that the assumptions made for the new hospital are based on previously proposed space programming figures that were not considering any building envelope limitations. Now that the decision regarding the site to be on the existing campus between buildings 20 and 30 is made, the current space programming is more precise and represents a realistic possible scenario. FCA noted that there will be a net overall increase in program areas because Building 5 will be retained for outpatient, clinic and support functions. There may be limitations in the size of inpatient, diagnostic and treatment functions because of the limitations of the new building envelope, but the overall available space will be increased. Page 3 of 6

Due Date

Item

Description

Action

B.

DEPARTMENTAL ISSUES

1.05

Space Adjacencies The user group noted the following spaces are desirable to be adjacent to the ICU unit:: • Post Anesthesia Care Unit (PACU) • Operating Rooms (OR) • Cath Lab Given the building limitations, it was agreed that it will not be possible to locate all related departments on the same floor. Dedicated elevators assigned to connect these spaces was considered an acceptable solution to address adjacency requirements. The user group agreed that the final layout will depend on the optimal allocation within the building envelope.

1.06

Location of Operating Rooms The user group expressed concern that the Operating Rooms were located in the basement and did not have any natural daylight. FCA explained that the Patient rooms are required by code and practice to have access to natural daylight and that they are given priority in their location above grade. Other departments, such as Emergency are required to be located at grade level. This limitations lead to the location of the Peri-Operative Services and Imaging Department in the basement levels. The user group generally agreed with this approach and understood the rationale.

1.07

On-Call Sleep Rooms The user group expressed concern about the initial proposal to locate all the on-call sleep and conference rooms in Building No. 5. FCA noted that this was done to maximize the amount of space for patient bedrooms and support services but agreed that a minimum number of sleep and conference rooms per unit are required for the operational efficiency of the ICU/CCU in the new building.

1.08

Quantity of Isolation Rooms The user group expressed concern that one (1) isolation room per unit would not be sufficient to meet operational needs. FCA clarified that an isolation room built to the current code has an anteroom and specific requirements and is not comparable to what is currently designated as isolation rooms in the existing hospital, which generally only have negative pressure systems. It was agreed that one (1) isolation room per unit would be provided and one (1) negative-pressure room.

Page 4 of 6

Due Date

Item

Description

1.09

Support & Staff Area The user group requested the following support and staff areas to be included in the ICU department: • • • • • •

1.10

Action

3 Nurse manager offices 1 ICU director office 2 Workrooms 2 Consultation rooms. (100 square feet (sf) each) Staff lounge (does not need to be located within the unit, can be located in Building No. 5.) Staff lockers (50 male / 50 female)

Patient Rooms The user group confirmed that the 2005/06 census has been extremely high. More beds for the ICU and Step-down are currently needed. These numbers are also expected to increase in the future. The increase in patient number is dependent on the development of the city’s health care policies and are unpredictable. The user group agreed that the programming should provide the maximum flexibility possible regarding the current and future use of the units. The number of ICU/Step-down was discussed. The user group agreed to the following ICU/Step-down bed breakdown: •

40 licensed ICU beds in 4 units.

•

10 licensed ICU beds in one unit that will also function as a Step-Down Unit.

•

One 32-36 bed Med/Surg Unit that will also function as a Step-Down Unit.

Subsequent to this meeting, the Emergency Department user group noted that it was desirable that one ICU unit be designated as a Trauma ICU unit. 1.11

Patient Room Toilets The user group confirmed that the ICU Patient rooms do not need separate toilets. Step-down rooms need separate or shared toilet facilities.

Page 5 of 6

Due Date


Page 6 of 6

MINUTES OF DIAGNOSTIC MEETING NO. 1

PROJECT:


MEETING LOCATION:


MEETING DATE:

December 12, 2006 2:00 pm : 4:00 pm

ISSUE DATE:

January 15, 2007

ATTENDEES:

Kathy Jung (KJ) Patricia Coggan (PG) Doug Eckman (DE) Genevieve Farr (GF) Walt Finkbeiner (WF) Jim Genevro (JG) Claude Hemphill (CH) Richard Hollingsworth (RH) Gene O’Connell (GOC) Roland Pickens (RP) Hal Yee (HY) Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:

All Attendees Mark Primeau

San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH, Executive Administrator SFGH SFGH Fong & Chan Architects (FCA) FCA FCA FCA FCA

Department of Public Health (DPH)



This meeting was held to initiate the programming effort with the Diagnostic User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Space Programming Objectives and Assumptions, dated December 1, 2006 2. Project Schedule dated November 20, 2006 3. SFGHMC Rebuild Program Subcommittee Focus Groups, 4. Average Daily Census FY 00-01 – FY 04-05 5. Preliminary Summary Space Program, dated December 1, 2006

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

PROGRAM ISSUES

1.01

General Paolo Diaz (PD) of FCA noted that the primary goal of this effort was to develop a Detailed Space Program for the new Acute Care Hospital. The new Acute Care Hospital is to be built on the West Lawn of the Campus and will not require the demolition of any of the existing buildings currently on the Campus. PD noted that there were several major constraints and drivers that would direct the development of the Space Program. 1. Operations – The User Groups and the Leadership committee need to provide input to help develop a space program that will adequately meet the operational needs of SFGHMC for the foreseeable future. 2. Costs – PD noted that a Site Feasibility Study was recently completed which validated the feasibility of the West Lawn site and set some parameters and costs for the project. FCA has been instructed to assume a preliminary construction cost budget of 622 million dollars for a new building with approximately 230267 beds. Kathy Jung (KJ) of SFGHMC noted that this maximum target includes construction costs only and is what has been determined to be politically feasible as a bond measure. This figure does not include the estimated 160 million dollars required for Page 2 of 6

Due Date

Item

Description

Action

equipment and furnishings or for any renovation work of the existing Hospital Building. 3. Site Limitations- PD noted that the Site Feasibility Study established parameters for the maximum size of the new building. Code and Planning requirements have determined the maximum area for each floor and the maximum number of floors for the new facility. All new required program elements need to be accommodated within this envelope. B.

DEPARTMENTAL ISSUES

1.02

Radiology & Endoscopy Rooms The user group noted that the use of diagnostic imaging in the future is anticipated to increase with a focus on a wider use of CT scanning and MRI scanning facilities. It was noted that there is a need to increase the current number of Endoscopy procedure rooms. The user group agreed to the following numbers of rooms: 2 X-Ray Rooms 1 Fluoroscopy Room 1 Interventional Radiology Room (adjacent to OR’s) 3 CT Scans (1 CT Scan for Emergency, 2 CT Scans for Diagnostic Imaging) 2 MRI 2 Angiography Rooms 2 Ultrasound

1.03

Location - Inpatient Imaging The user group agreed to locate the Inpatient Imaging in the basement of the new hospital with dedicated elevators connecting the department to the surgery and emergency.

1.04

Outpatient/Inpatient Split – Radiology & Endoscopy (GI) Paolo Diaz (PD) of FCA asked whether the Endoscopy Procedure Rooms should be separated between outpatient radiology located in the existing Hospital Building (Building No. 5) and inpatient radiology located in the new hospital building (Building No. 25). The user group raised concerns that splitting the Endoscopy procedures between Outpatient and Inpatient would result in additional staff required in 2 different locations. The user group agreed that each nursing unit floors should have either a procedure room or a larger patient room where Endoscopies could be performed. Outpatient Endoscopies would remain in the existing Hospital Building. This solution would increase the availability of Endoscopy procedure rooms Page 3 of 6

Due Date

Item

Description

Action

and would reduce the amount of intra-hospital transportation for the patient. The comfort of the patient is an important concern. The user group agreed that the GI department and the Outpatient Imaging should be maintained in the existing Hospital Building. (Building No. 5). It was understood that there will be additional operational costs in separating Outpatient and Inpatient Imaging. 1.05

Adjacencies The user group noted that ideally the ICU/CCU should be located closer to the Diagnostic Imaging department but that it was acceptable to have a dedicated elevator provide access between the departments. The user group agreed that the IR rooms should be located adjacent to the Operating Rooms as a swing room to be accessible for both Diagnostic Imaging and Perioperative departments. Subsequent to this meeting, Dr. Andre Campbell also noted that a wall mounted Fluoroscopy unit be provided in one of the OR rooms for use during Trauma Surgery.

1.06

Cardiology The user group noted that an Angiography Room is not required within the Cath Lab. 2 Angiography Rooms in the Inpatient Radiology department will be sufficient. The user group agreed that one (1) Cath lab in the new hospital building will be sufficient and that all other Diagnostic Cardiology functions can be kept in the existing Hospital Building (Building No.5). The user group recommended four (4) Echo/EKG rooms and two (2) Stress Testing Rooms.

1.07

Mammography The user group confirmed there is no need for Mammography in the new building. These services are provided in the Avon Breast Center.

1.08

Nuclear Med. The user group confirmed that the Nuclear Med. Department should remain in the existing Hospital Building (Building No. 5).

1.09

Further Departments located in Old Hospital FCA confirmed that the following departments remain in the existing Hospital Building: Page 4 of 6

Due Date

Item

Description • • • • • • • •

1.10

Action

Cardio Echo Rehab Dialysis Respiratory Bronchoscopy Main storage Psych SNF

Pathology- Morgue The user group recommended that the Pathology department should be relocated from Building No. 3 into the existing Hospital Building. This will move it adjacent to the clinical labs. FCA confirmed that there is a frozen section room within the OR area. The user group noted that this was acceptable. The user group requested one centralized morgue for the SFGHMC to be located with the new Hospital Building. Size of the morgue facility to be determined. The user group recommended that an autopsy area be provided next to the morgue that can also be used for tissue transplant. The user group agreed that pathology offices and faculty rooms do not need to be next to the morgue and autopsy facilities in the new Hospital Building. They can be located in a separate location.

1.11

Clinical Lab The user group agreed that the main clinical labs and blood bank could stay in the existing hospital building if each unit is supplied with the necessary equipment and rooms to perform point of care testing. Satellite labs in each department/unit need to be connected to the clinical labs in the existing Hospital Building through a new 6 inch pneumatic tube system that can accommodate IV bags. The user group confirmed that point of care testing can also be used in the ICU/CCU and Emergency. FCA confirmed that a Building Code requires a minimum amount of Clinical Lab space to be located within the new Hospital Building as part of the critical facilities. FCA to provide the exact requirements. Subsequent to this meeting, FCA clarified that the following Clinical Lab functions need to be available within the new Hospital Building to meet minimum code requirements. 420A.17 Clinical Laboratory Service Space. Page 5 of 6

Due Date

Item

Description

Action

Due Date

420A.17.1 General requirements. All hospitals shall provide space and equipment to perform urinalysis, complete blood counts, hemoglobin blood typing and cross matching. If laboratory facilities for bacteriological, serological, pathological and additional hematological procedures are not available in the community, then space, equipment and supplies for such procedures shall be provided. 420A.17.2 Size. The minimum clinical laboratory area shall be 180 square feet (16.7 m2). 420A.17.3 Blood storage. Blood storage facilities shall be provided.

1.12

Storage Space The user group is concerned about sufficient and appropriate storage space for diagnostic equipment and addressed the importance for it to be accessible at all times. FCA confirmed that the storage in the basement is for general storage purposes and that there will be additional storage space allocated for each department. A detailed breakdown of the programming will be presented in the next meeting.

1.13

Mobile Imaging Equipment The user group noted that it was desirable to provide provisions for Mobile Imaging equipment on each nursing unit.


Page 6 of 6

MINUTES OF PERI-OPERATIVE MEETING NO. 1

PROJECT:


MEETING LOCATION:


MEETING DATE:

December 15, 2006 2:00 pm : 4:00 pm

ISSUE DATE:

January 17, 2007

ATTENDEES:

Kathy Jung (KJ) Andre Campbell (AC) Jane Cino (JC) Sue Currin (SC) Terry Dentoni (TD) Renee Navarro (RN) Lawrence Nichols (LN) Winona Mindolovich (WM) Gene O’Connell (GOC) Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH, Executive Administrator Fong & Chan Architects (FCA) FCA FCA FCA FCA


This meeting was held to initiate the programming effort with the Peri-Operative User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents:



1. Agenda of Meeting 2. Space Programming Objectives and Assumptions, dated November, 2006 3. Project Schedule dated November 20, 2006 4. SFGHMC Rebuild Program Subcommittee Focus Groups, 5. Average Daily Census FY 00-01 – FY 04-05 6. Preliminary Summary Space Program, dated December 15, 2006 7. Peri-Operative User Group Questionnaire, dated December 15, 2006

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

PROGRAM ISSUES

1.01

General Nuno Lopes (NL) of FCA noted that the primary goal of this effort was to develop a Detailed Space Program for the new Acute Care Hospital. The new Acute Care Hospital is to be built on the West Lawn of the Campus and will not require the demolition of any of the existing buildings currently on the Campus. NL noted that there were several major constraints and drivers that would direct the development of the Space Program. 1. Operations – The User Groups and the Leadership committee need to provide input to help develop a space program that will adequately meet the operational needs of SFGHMC for the foreseeable future. 2. Costs – NL noted that a Site Feasibility Study was recently completed which validated the feasibility of the West Lawn site and set some parameters and costs for the project. FCA has been instructed to assume a preliminary construction cost budget of 622 million dollars for a new building with approximately 230267 beds. Kathy Jung (KJ) of SFGHMC noted that this maximum target includes construction costs only and is what has been determined to be politically feasible as a bond measure. This figure does not include the estimated 160 million dollars required for equipment and furnishings or for any renovation work Page 2 of 5

Due Date

Item

Description

Action

of the existing hospital building. 3. Site Limitations- NL noted that the Site Feasibility Study established parameters for the maximum size of the new building. Code and Planning requirements have determined the maximum area for each floor and the maximum number of floors for the new facility. All new required program elements need to be accommodated within this envelope. 1.02

A. 1.03

NL encouraged all attendees to hold separate internal space program discussions and forward any comments and/or questions to KJ prior to the next Peri-Operative User Group meeting . NL also noted that the high census of 05/06 will be taken into account with the space program once those figures are made available.

DEPARTMENTAL ISSUES Outpatient/Inpatient Split – Peri-Operative The feasibility of locating Inpatient Peri-Operative services in the new hospital building and Outpatient Peri-Operative services in the existing hospital building was discussed. Paolo Diaz (PD) of FCA described the following 2 possible programming scenarios to be studied. 1. Entire Peri-Operative Department to be located in the new hospital building – Sixteen (16) OR/IR rooms with adjacent sterile processing facility. 2. Inpatient Peri-Operative Services to be located in the new hospital building - Outpatient PeriOperative Services to remain in the existing hospital building – Ten (10) OR/IR rooms with adjacent satellite sterile processing facility in the new hospital building. The main sterile processing and Outpatient Surgery services to use existing spaces. The user group preferred the option of having the entire PeriOperative Department in the new hospital building. The consensus was that splitting the Outpatient and Inpatient PeriOperative services was not desirable as this would have significant impact on operational costs.

1.04

Sterile Processing & Distribution Dr. Andre Campbell (AC) of SFGH noted that ideally the Sterile Processing & Distribution (SPD) should be located adjacent to the OR to keep crucial transportation time of Page 3 of 5

Due Date

Item

Description

Action

required surgery items during surgery to a minimum. 1.05

Quantity & Size of Operating Rooms (OR) Nuno Lopes (NL) of FCA noted that currently there are ten (10) OR’s in the existing hospital building. The OR room size varies between 380sf- 550sf. The user group confirmed that the number of OR’s definitely needed to be increased. The user group discussed whether it is better to pursue an increased number of medium/small (450-480sf) sized OR rooms rather than working with a smaller number of large OR rooms (550-650sf). Dr. Andre Campbell (AC) of SFGH questioned the need for very large OR rooms and noted that the small OR rooms (450480sf) are sufficient for the majority of operations if operation equipment is installed within the OR; if mobile equipment is shared between OR s, bigger OR rooms are better. He also noted that it would be better if all OR rooms are the same size. The user group concluded that the program should include: Sixteen (16) OR rooms in total, including 2 IR room for Surgery. All OR rooms to be around 520sf in size. If it is not possible to accommodate the large sized OR rooms within the given floor plan, the room size and number should be reduced to only: Ten (10) large OR rooms (520sf) Four (4) smaller OR rooms (minimum 400sf) Two (2) IR rooms (520-600 sf) including Fluoroscopy equipment for Surgery The user group confirmed that orthopedic surgery rooms need to be the larger OR Rooms and require a laminar flow mechanical system. Subsequent to this meeting, Dr. Andre Campbell also noted that a wall mounted Fluoroscopy unit be provided in one of the large OR rooms for use during Trauma Surgery.

1.06

Inpatient Bed Ratio Gene O’Connell (GOC) of SFGH inquired about data showing the relation between the amount of surgeries performed to the amount of inpatient beds required and questioned if there were sufficient inpatient beds to accommodate the amount of surgeries performed in the OR. FCA noted that the number of ICU beds has been increased from 40 to 50 licensed ICU/CCU beds and that an additional Page 4 of 5

Due Date

Item

Description

Action

Due Date

10 Step-down beds are considered as flex up ICU/CCU beds, which gives a total of 60 ICU/CCU beds. 1.08

Lockers The user group requested for locker space for a total of One Hundred and Fifty (150) staff members. Surgery and Anesthesia can share the locker rooms. Female- male ratio is 50-50. The user group agreed that the small personal lockers for individuals and shared full-height day-use lockers be provided.

1.09

On-Call Sleep Rooms The Anesthesia users requested 4 separate sleep rooms, 2 rooms with separate toilets and 2 rooms sharing a toilet. The Surgery user group noted to confirm detailed requirements in the next meeting. FCA to provide one (1) sleep room for Surgery until the requirements can be confirmed.

1.10

Miscellaneous The user group noted the following items: • Viewing rooms are not required • Provide Anesthesia Workroom with 350sf and 100sf storage • Provide One (1) Isolation room in the PACU Recovery Area • Pantry area needs more space • One (1) shower is sufficient in the PACU Recovery Area • There should be 1 OR Staff lounge and 1 Anesthesia lounge. The anesthesia lounge could be used as a conference room as well.


Page 5 of 5

MINUTES OF EMERGENCY MEETING NO. 1

PROJECT:


MEETING LOCATION:


MEETING DATE:

December 18, 2006 2:00 pm : 4:00 pm

ISSUE DATE:

January 22, 2007

ATTENDEES:

Kathy Jung (KJ) April Clock (AC) Mitchell Cohen (MC) Rochelle Dicker (RD) John Fazio (JF) Kathryn Fowler (KF) Angela Hackenschmidt (AH) Michelle Lin (ML) Gene O’Connell (GOC) Kristan Staudenmayer (KS) Bob Sypher (BS) Chiu Lin Tse-Chan (CLTC) David Fong (DF) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH, Executive Administrator SFGH SFGH Fong & Chan Architects (FCA) FCA FCA FCA


This meeting was held to initiate the programming effort with the Emergency User Group. The following is a record of the items discussed.



FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Space Programming Objectives and Assumptions, dated November, 2006 3. Project Schedule dated November 20, 2006 4. SFGHMC Rebuild Program Subcommittee Focus Groups, 5. Average Daily Census FY 00-01 – FY 04-05 6. Preliminary Summary Space Program, dated December 18, 2006 7. Med/Surg User Group Questionnaire, dated December 18, 2006

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

PROGRAM ISSUES

1.01

General Nuno Lopes (NL) of FCA noted that the primary goal of this effort was to develop a Detailed Space Program for the new Acute Care Hospital. The new Acute Care Hospital is to be built on the West Lawn of the Campus and will not require the demolition of any of the existing buildings currently on the Campus. NL noted that there were several major constraints and drivers that would direct the development of the Space Program. 1. Operations – The User Groups and the Leadership committee need to provide input to help develop a space program that will adequately meet the operational needs of SFGHMC for the foreseeable future. 2. Costs – NL noted that a Site Feasibility Study was recently completed which validated the feasibility of the West Lawn site and set some parameters and costs for the project. FCA has been instructed to assume a preliminary construction cost budget of 622 million dollars for a new building with approximately 230267 beds. Kathy Jung (KJ) of SFGHMC noted that this maximum target includes construction costs only and is what has been determined to be politically feasible as a bond measure. This figure does not Page 2 of 6

Due Date

Item

Description

Action

include the estimated 160 million dollars required for equipment and furnishings or for any renovation work of the existing hospital building. 3. Site Limitations- NL noted that the Site Feasibility Study established parameters for the maximum size of the new building. Code and Planning requirements have determined the maximum area for each floor and the maximum number of floors for the new facility. All new required program elements need to be accommodated within this envelope. B. 1.02

DEPARTMENTAL ISSUES Emergency Rooms The user group commented that the current number of 25 exam rooms is inadequate. The user group requested 40 exam beds to be programmed in the new hospital with the following breakdown • 27 private exam rooms • 3 private isolation exam rooms • One ‘open space’ exam area capable of holding 10 beds. The user group also inquired whether additional space in the corridor would be available to accommodate additional gurneys in case of a catastrophic event. KJ noted that gurneys in hallways should be avoided. David Fong (DF) of FCA noted that each of the 27 private exam rooms, currently programmed at 120 sf, are capable of holding two beds in case of a rapid patient surge. DF however cautioned that this approach is not ideal and would likely not be acceptable as a means to address normal daily patient fluctuations.

1.03

Trauma Rooms The user group requested 6 trauma rooms and noted that when considering work flow an open floor plan layout for the trauma rooms is preferred. NL noted that from an acoustical, turnover and infectious control standpoint an open floor plan layout for the trauma rooms may not be desirable. These issues could be partially mitigated if an opening in the partition separating the trauma rooms is provided. The User Group agreed to this approach. The user group also requested 3 equipment storage rooms.

1.04

Imaging Contrary to the existing condition, the user group confirmed Page 3 of 6

Due Date

Item

Description

Action

that a dedicated x-ray room for each trauma room is not required. Instead the user group requested a separate imaging suite consisting of 2 CT scan rooms and 2 X-ray rooms, located within the Emergency department preferably adjacent to the trauma suite. Subsequent to this meeting, the Steering Committee questioned this approach and requested this issue be reconfirmed in the next Emergency user group meeting. 1.05

Department Adjacencies The user group expressed some concern regarding the distance between the Radiology and Emergency departments and noted that ideally Emergency, Surgery and Radiology departments should all be collocated on the same floor. NL noted that given the site constraints collocating all three departments in the same floor is not possible, however each department is currently programmed to be located directly above or below each other, vertically linked with dedicated service only elevators. NL explained that currently Radiology is located in the Basement Floor, Surgery is located in the Ground Floor and Emergency is located in the First Floor. Kathy Jung (KJ) also pointed out that the Emergency department will be equipped with two X-ray rooms and two CT scan rooms to handle any urgent imaging needs. Given the limited size of each floor area, the user group confirmed that the proposed concept would be operationally feasible.

1.06

Storage The user group expressed concern that an 8’-6” corridor would not provide adequate storage space for equipment. NL noted that currently two 300 sf storage rooms have been programmed and that during the building design phase the user group could request alcoves within the corridor to provide for additional storage areas. The user group conquered with this approach.

1.07

Medication Room The user group requested larger medication rooms to facilitate 4 automated medication machines. The user group noted that a decision needs to be made whether all 4 machines should be located centrally in 1 room or in 4 separate rooms distributed within the department depending on the floor plan layout. Page 4 of 6

Due Date

Item

Description

Action

1.08

Meeting and Consultation Area NL noted that 2 conference rooms of 200 sf each and 2 consultation rooms of 120 sf each for staff meetings and patient consultations have been programmed. The user group conquered with the proposed space allocation.

1.09

Stat. Lab The user group requested a small 100 SF Stat. Lab to be located in the Emergency department.

1.10

Centralized Monitoring Area The user group noted that a centralized monitoring area is not desirable, since that would require additional dedicated nursing staff. Nursing stations should be sized to accommodate all necessary monitoring equipment.

1.11

Custodian Closets The user group requested 1 custodian closet inside the Trauma suite and two additional custodian closets to service the remaining Emergency department.

1.12

Linen The user group mentioned that in the existing Emergency department the accumulation of soiled linen has become an issue and requested a dedicated 800 sf soiled linen room.

1.13

Manager/Director Offices The user group requested separate offices for the manager and director positions.

1.14

Security Staff Area The user group pointed out that a dedicated security room adjacent to the emergency lobby area is not desirable. The user group preferred to allocate space for a workstation inside the Emergency Entry lobby to increase the visibility of security personnel.

1.15

EMS Dispatch The user group confirmed that the EMS Dispatch can be reduced to 80 sf.

1.16

On-Call Sleep Rooms The user group agreed that the residents do not require a sleep room in the Emergency department.

1.17

Viewing Room The user group confirmed that a separate viewing room for family members to view a deceased patient before taken to the morgue is not required.

Page 5 of 6

Due Date

Item

Description

Action

1.18

Lockers The user group requested a mix of medium and large sized lockers to be shared with a total of 160 staff members.

Due Date

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Emergency\Minutes_06.12.18_001 Emergency.doc

Page 6 of 6


PROJECT:


MEETING LOCATION:


MEETING DATE:

January 5, 2007 2:00 pm : 4:00 pm

ISSUE DATE:

February 5, 2007

ATTENDEES:

Kathy Jung (KJ) Ronald Alameida Iran Blanco Sue Currin Elena- Fuentes-Afflick Kevin Grumbach Fred Hom Sharon Kwong Todd May Katie Murphy Ana Sampera Morris Schambelan Chris Stewart Bill Taeusch Sharon Wicher Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services Bureau of Architecture, Project Manager SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH Fong & Chan Architects (FCA) FCA FCA FCA FCA




This meeting was held to review the programming effort with the Medical/ Surgical User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Preliminary Detail Space Program, dated January 5, 2007 3. Preliminary Summary Space Program, dated January 5, 2007 4. New Hospital Space Program, dated January 5, 2007

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

PROGRAM ISSUES

2.01

Building Bulk & Clearances Nuno Lopes (NL) of FCA introduced the bulk of the new building and noted that the distance at the first and second floor levels to the existing hospital building is 25’ and to the adjacent brick buildings 20 and 30 is 40’. The floors above the second floor have additional setbacks to address planning and exterior wall fire rating concerns. The distance at the basement 1 and 2 to the existing hospital building is 14’ and to the adjacent brick buildings 20 and 30 is 12’. NL emphasized that the bulk study is only an exercise to examine the maximum mass possible within the designated site. It does not represent any design features. The final layout, building and façade design are to be determined at a later stage.

B.

DEPARTMENTAL ISSUES

2.02

Forensic Unit The user group requested if it was possible to configure the Forensic unit to allow it to be used as a regular Med/Surg unit during low census of forensic patients. Currently the existing forensic unit cannot accept non-forensic patients and is required to shut down if the number of patients is lower than 3. The average census for forensic beds was 2.3 last year, 3.4 this year. NL commented that a Forensic Unit has unique security Page 2 of 4

Due Date

Item

Description

Action

requirements and may not be possible to convert to a regular Med/Surg unit. NL and PD noted that a meeting with the forensic group will determine the requirements and possibilities for a flexible Forensic – MedSurg unit. 2.03

New and Existing Bed Capacity NL introduced the revised space program and confirmed that a total of 4 Med/Surg units each with 36 beds have been programmed for the 5th and 6th floors. The following distribution of patient rooms was proposed and agreed by the user group. • 19 Patient Rooms - Single Occupancy • 4 Patient Rooms - Double Occupancy • 9 Patient Isolation Rooms The user group expressed concerns that the total number of patient beds currently being proposed is too low. The user group estimated that currently 186-196 beds are being used. The user group requested if an additional Med/Surg unit could be added in the currently allocated shell space on the 3rd floor. NL noted that FCA would analyze the available space on the third floor and confirm whether an additional Med/Surg unit could be accommodated.

2.04

Pharmacy - Medication Room The user group explained that the medication room needs to accommodate 9 nurses per Med/Surg unit. Currently one 80sf medication room per Med/Surg unit has been programmed. The user group requested FCA to program two 120sf medication rooms per Med/Surg unit.

2.05

Lockers The user group expressed concerns that the number of lockers might not be sufficient. KJ confirmed a shared day-use policy for the lockers has been agreed for the new hospital.

2.06

Conference Rooms - Teaching Rooms - Rounds The user group mentioned the importance of providing sufficient space for conference/consultation rooms, predominantly to be used for: • Patient rounds and teaching • Seminars / lectures Page 3 of 4

Due Date

Item

Description

Action

Due Date

The user group agreed that seminars/lectures could take place in existing conferences rooms in Building 5, but all patient rounds and teaching should be conducted in conference/consultation rooms located on the same floor as the Med/Surg unit. 2.07

Isolation The user group requested 30% to 35% of all patient rooms to be isolation rooms. NL confirmed that the current available space only allows for 25% of all patient rooms to be true isolation rooms, but additional negative pressure rooms, which are similar to isolation rooms minus the anteroom, would be programmed to make up the difference.

2.08

Computer Terminals in Corridors The user group requested that sufficient space be provided within the corridors for computer terminals, so that they are easily accessible and evenly distributed. CLTC noted that details such as computer terminal locations in the corridor layout are going to be addressed at a later design stage. The floor layout currently shown is only representing one of many layouts possible to demonstrate that the planned space program fits into the designated square footage of the building envelope.

2.09

Social Worker Offices The user group confirmed that one 200sf office per floor would be required to accommodate 2-4 social workers.

2.10

Summary NL summarized the following points at the end of the meeting: • Any feedback regarding the space program spreadsheet should be forwarded to FCA to be addressed in further planning. • There is no more available space for additional program on the 5th and 6th floors. Any additional program on these floors will have to replace space that has already been allocated.


MINUTES OF OBSTETRIC/ PEDIATRIC MEETING NO. 2 PROJECT:


MEETING LOCATION:


MEETING DATE:

January 9, 2006 1:45 pm : 4:00 pm

ISSUE DATE:

February 8, 2007

ATTENDEES:

Kathy Jung (KJ) Beg Ocean Sue Carlisle Phil Darney Louise Dimattio Fe Hortinela Colin Partridge Nela Ponferrada Tina Raine-Bennett Kathryn Roberts Chris Stewart Cathryn Thurow Cam Tran Teresa Villela Juan Vargas Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH Fong & Chan Architects (FCA) FCA FCA FCA FCA




This meeting was held to initiate the programming effort with the Obstetric/Pediatric User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Preliminary Detail Space Program, dated January 9, 2007 3. Preliminary Summary Space Program, dated January 9, 2007 4. New Hospital Space Program, dated January 9, 2007

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

BUILDING ISSUES

2.01

Relocation to Mission Bay The user group raised the question whether the Obstetric/Pediatric (Ob/Peds) department is going to be relocated to Mission Bay. KJ noted that the program effort should continue with the assumption that Ob/Peds is going to remain in the Potrero campus.

2.02

Building Bulk & Clearances Nuno Lopes (NL) of FCA introduced the bulk of the new building and noted that in order to address planning and exterior wall fire rating concerns specific distances to the existing buildings need to be kept on all levels. The distance at the first and second floor levels between the existing and new hospital building is 25’. The distance between the new hospital building and the adjacent brick buildings 20 and 30 is 40’. The floors above the second floor have additional setbacks to address planning concerns and to eliminate the need to have fire rated walls and windows along the east facade. The distance at the basement 1 and 2 to the existing hospital building is 14’ and to the adjacent brick buildings 20 and 30 is 12’. NL emphasized that the bulk study is only an exercise to Page 2 of 6

Due Date

Item

Description

Action

examine the maximum mass possible within the designated site. It does not represent any design features. The final layout, building and façade design are to be determined in the subsequent design phases. B.

PROGRAM ISSUES

2.03

OB/PEDS Location NL noted that the Ob/Peds department is currently programmed to be located on the 2nd Floor of the new hospital building. The user group raised concerns with collocating the OB/Peds department on the same floor as the bridge connection to the existing building, since this may result in higher than usual human traffic which could pose a security concern given the patient population of the department. FCA discussed several options ranging from either relocating the Ob/Peds department or the bridge connection to the 3rd floor or to layout the floor plan in a way that provides a direct and dedicated connection from the elevators to the bridge connection without passing through the OB/Peds department. It was agreed that a final decision will be made after examining and reconsidering the floor plans and program.

2.04

Quantity & Size of Rooms The user group agreed to the following number of patient rooms in Obstetrics, Pediatrics and NICU: Obstetrics

3 Triage Rooms @ 180 sf 13 Post Partum Rooms @ 180 sf 9 LDPR Rooms @ 250 sf Pediatrics

12 Patient Rooms @ 180 sf NICU

1 Level II Patient Room @ 720 sf (6 bassinets) 1 Level III Patient Room @ 900 sf (6 bassinets) The user group noted that the layout of the patient rooms in Pediatrics should accommodate a sleeping area for family members. The user group commented that unlike the current Pediatric Department the new Pediatrics Department should be family friendly in terms of its program and layout.

Page 3 of 6

Due Date

Item

Description

Action

2.05

Triage Rooms The user group questioned if the current number of triage rooms being programmed is sufficient. FCA noted that currently 3 triage rooms have been programmed. FCA added that during high census post partum rooms and LDRP rooms can serve as additional triage rooms. The user group agreed to the above arrangement. KJ also added that how the rooms are going to be utilized is an internal discussion dealing with operational issues to be addressed at a later point.

2.06

C-Section / Resuscitation The user group noted that the C-Section and Resuscitation rooms are not adequately sized. FCA proposed to increase the size of the C-Section room to 400 sf and the Resuscitation room to 200sf. FCA to review the impacts the additional space will have on the program.

2.07

Patient Toilets Obstetric

NL confirmed that toilets in LDPR rooms are equipped with bath tubs. Pediatric

The user group requested Pediatrics patient rooms to be sized similarly to Med/Surg patient rooms in order to provide for future flexibility and be equipped with showers. FCA confirmed that Pediatrics patient rooms, including the toilets are sized similarly to Med/Surge patient rooms. FCA however noted that like Med/Surg patient rooms, Pediatric patient rooms are not equipped with showers, instead several patient shower rooms are provided throughout the unit. The user group agreed to this concept and requested 2 shared patient showers to be programmed in the Pediatric Department. 2.08

ICU and Emergency services for Pediatric patients The user group noted that provisions for pediatric patients in the ICU and Emergency Departments need to be provided. The user group noted that in the Pediatric Department certain high acuity pediatric patients require direct visual monitoring. To increase nurse efficiency FCA proposed to provide a sliding door between 2 Pediatric patient rooms to allow for Page 4 of 6

Due Date

Item

Description

Action

the visual monitoring of two patients by a single nurse. The user group agreed to this approach. 2.09

Isolation FCA noted that currently 25% of the Med/Surg patient rooms are isolation rooms and inquired if the Ob/Peds departments would want the same isolation room ratio. The user group confirmed the following isolation room distribution: Obstetrics

2 Post Partum Isolation patient rooms 1 LDPR isolation room Pediatrics

2 Isolation patient room 2.10

Anesthesia Workroom The user group requested one 120 sf Anesthesia/Respiratory workroom and one adjacent 300 sf storage room. FCA to review the impacts the additional space will have on the program.

2.11

Equipment Storage Pediatrics

The user group noted that more space is required for equipment storage room in Pediatrics, since this is a major shortcoming in the current department. The user group requested the Equipment storage to increase to 300 sf. FCA to review the impacts the additional space will have on the program. NICU

The user group requested the NICU storage room to be increased to 400 sf and requested a separate 100 sf storage room for Respiratory Therapy. FCA to review the impacts the additional space will have on the program. 2.12

Lockers KJ noted that a policy needs to be established by the hospital and should be applied to all departments. The user group would be agreeable to a concept of providing small personalized lockers for personal belongings and shared day-use lockers for coats and larger items. Page 5 of 6

Due Date

Item

Description

Action

Due Date

The user group also suggested that if necessary additional lockers could be provided in the existing hospital. The user group pointed out that the majority of nursing staff are female and agreed to the idea of having unisex locker rooms with separate adjacent changing rooms. 2.13

Social Worker Office The user group confirmed that only one 150 sf social worker office be provided in the Pediatric department to service OB/Peds Departments.

2.14

On-Call Rooms The user group revised the number of on-call rooms as follows: • • • • •

2 On-call rooms for Peds 3 On-call rooms for OB 1 On-call room for Medical Nurse 1 On-call room for Family Attending 1 On-call room for Anesthesiologist

FCA to review the impacts the additional space will have on the program.

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Obstetrics - Pediatrics - Nursery\MIN.02_ObGynPed.doc

Page 6 of 6

`. MINUTES OF ANCILLARY-CLINICAL LAB MEETING NO. 1 PROJECT:


MEETING LOCATION:

San Francisco General Hospital, Cafeteria Conference Room 3

MEETING DATE:

January 10, 2007 3:00 pm : 4:00 pm

ISSUE DATE:

May 25, 2007

ATTENDEES:

Kathy Jung (KJ) Eberhard Fiebig (EF) Chiu Lin Tse-Chan (CLTC) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH, Clinical Labs Fong & Chan Architects (FCA) FCA FCA FCA


This meeting was held to initiate the programming effort with the Ancillary-Clinical Lab User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Space Programming Objectives and Assumptions, dated November, 2006 2. Project Schedule dated November 20, 2006 3. Preliminary Detail Space Program, dated January 10, 2007 4. Preliminary Summary Space Program, dated January 10, 2007 5. New Hospital Space Program, dated January 10, 2007



ITEMS DISCUSSED:

Item

Description

Action

Due Date

NEW BUSINESS: B.

DEPARTMENTAL ISSUES

1.01

Clinical Lab Location The user group confirmed that the Clinical Lab Department will remain in the existing hospital building with the exception of the Blood Bank and any other space required by code to be located in a compliant acute care hospital .

1.02

Space Program FCA proposed the following spaces to be included in the space program: • • • •

Blood Bank – 1200 sf Urinalysis Lab – 150 sf Office Senior Supervisor – 100 sf Office Supervisor – 100 sf

The user group agreed to the proposed space program revisions and added that the Blood Bank should be located in close proximity to the Resuscitation rooms and the Operating Rooms to facilitate the immediate delivery of blood supplies. The user group also requested the Blood Bank to have direct access to a shipping and receiving area to facilitate the distribution of blood products. 1.03

Point of Care Testing (POCT) The user group requested a 80 sf POCT room with a sink, bench space, storage for supplies and a location for a specimen refrigerator in the Emergency Department.

1.04

Pneumatic Tube System The user group requested a 6” pneumatic tube system be provided with a direct connection to the Emergency Department.

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Ancillary - Auxiliary\MIN.01_Ancillary-Clinical Lab.doc Page 2 of 2

`. MINUTES OF ANCILLARY- PHARMACY MEETING NO. 1 PROJECT:


MEETING LOCATION:

San Francisco General Hospital, Cafeteria Conference Room 3

MEETING DATE:

January 10, 2007 2:00 pm : 3:00 pm

ISSUE DATE:

May 25, 2007

ATTENDEES:

Kathy Jung (KJ) Sharon Kotabe (SK) Paul Cho (PC) Shirley Lee (SL) Julie Russel (JR) Fred Hom (FH) Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH, Pharmacy SFGH, Materials Management/Purchasing SFGH, Pharmacy SFGH, Pharmacy SFGH, Pharmacy Fong & Chan Architects (FCA) FCA FCA FCA FCA


This meeting was held to initiate the programming effort with the Ancillary-Pharmacy User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Space Programming Objectives and Assumptions, dated November, 2006 2. Project Schedule dated November 20, 2006 3. Preliminary Detail Space Program, dated January 10, 2007



4. Preliminary Summary Space Program, dated January 10, 2007 5. New Hospital Space Program, dated January 10, 2007

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: B.

DEPARTMENTAL ISSUES

1.01

Pharmacy Location The user group confirmed that the Pharmacy Department will remain in the existing hospital building with the exception of the Inpatient Pharmacy and any other space required by code to be located in a compliant acute care hospital. The user group confirmed that the Inpatient Pharmacy does not require to be adjacent to any specific department.

1.02

Satellite Pharmacy The user group requested a Satellite Pharmacy in the following departments: • Emergency Department (400 sf) • Operating Rooms (300 sf) • ICU (300 sf)

1.04

Shipment and Receiving Area The user group requested that a shipment and receiving area be provided in the new hospital building, principally to accommodate smaller pharmaceutical deliveries. KJ agreed that a shipment and receiving area will be required as using the main public entrance for deliveries would not be acceptable. NL acknowledged that a shipment and receiving area would be advantageous and would identify possible locations in the new hospital building.

1.05

Receiving Logistics The user group agreed to receive and unpack most pharmacy deliveries in the existing hospital building and use the tunnel and elevator connections for distribution of goods to supply the inpatient and satellite pharmacies.

Page 2 of 4

Due Date

Item

Description

1.06

Pharmacy Equipment

Action

Robotic Processing Chiu Lin Tse-Chan (CLTC) of FCA recommended to consider robotic processing equipment for the new inpatient pharmacy because it saves space and reduces human errors. It has become the current trend in pharmacy design. PD also noted that storage capacity can be improved by using vertical storage systems. Compounders The user group requested the inpatient pharmacy area to be able to accommodate 2 compounders. Automated Dispensing The user group confirmed that the automated pharmacy dispensing system (Sure-Med) cannot be located in the nurse stations because licensing requires dispensers to be located in a lockable room. Subsequent to the meeting during a pharmacy walk- through (1/23/07) FH and SK requested the impatient pharmacy to be able to accommodate 2 automated carrousel dispensing machines. 1.08

Dispensary The user group requested the Reviewing and Recording room to accommodate 6-8 workstations (40 sf each). Each workstation should consist of a countertop work surface large enough to accommodate a computer, a fax and a scanner.

1.09

Medication Room The user group requested one medication room per nursing unit and 2 medication rooms for each 36-bed Med/Surg Nursing Unit (120 sf each).

1.10

Narcotics Vault The user group requested the area assign to Narcotics Vault to increase to 150 sf.

1.11

Staff Lounge The user group requested a staff lounge in the inpatient pharmacy. NL confirmed that currently a 200 sf staff lounge has been programmed. The user group agreed to the proposed staff lounge size.

Page 3 of 4

Due Date

Item

Description

Action

1.12

Lockers The user group confirmed that lockers for inpatient pharmacy staff can remain in the existing hospital.

Due Date


Page 4 of 4


PROJECT:


MEETING LOCATION:


MEETING DATE:

January 12, 2007 2:00 pm : 4:00 pm

ISSUE DATE:

February 12, 2007

ATTENDEES:

Kathy Jung (KJ) Andre Campbell Sue Carlisle Lisa Chen Sue Currin Terry Dentoni Leslie Dubbin Genevieve Farr Cheryl Jay Paul Koo John Luce Sandy Peterson Shirley Stiver Ron Alameida Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH Fong & Chan Architects (FCA) FCA FCA FCA FCA




This meeting was held to initiate the programming effort with the ICU / Step-down User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Preliminary Detail Space Program, dated January 12, 2007 3. Preliminary Summary Space Program, dated January 12, 2007 4. New Hospital Space Program, dated January 12, 2007

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

BUILDING ISSUES

2.01

Building Bulk - Clearances & Height Nuno Lopes (NL) of FCA introduced the bulk of the new building and noted that in order to address planning and exterior wall fire rating concerns specific distances to the existing buildings need to be kept on all levels. The distance at the first and second floor levels between the existing and new hospital building is 25’. The distance between the new hospital building and the adjacent brick buildings 20 and 30 is 40’. The floors above the second floor have additional setbacks to address planning concerns and to eliminate the need to have fire rated walls and windows along the east facade. The distance at the basement 1 and 2 to the existing hospital building is 14’ and to the adjacent brick buildings 20 and 30 is 12’. NL emphasized that the bulk study is only an exercise to examine the maximum mass possible within the designated site. It does not represent any design features. The final layout, building and façade design are to be determined in the subsequent design phases.

B.

PROGRAMM ISSUES

2.02

Number of ICU and Step-Down Beds NL reviewed the total number and distribution of ICU and Page 2 of 4

Due Date

Item

Description

Action

Step/down beds based on the previous meeting: Fourth Floor:

• 3 ICU units (10 beds each) • 1 Trauma ICU unit (10 beds) • 1 Step-down unit – flex up (10 beds) Fifth Floor:

• 1 Step-down unit – flex down (36 beds) The user group noted that the presented number of ICU and Step-down beds will not be sufficient to meet the future needs of the hospital. After discussing several different options the user group agreed to the following number and distribution of ICU and Step-down beds: Third Floor:

• 1 Step-down unit – flex up (10 beds) • 1 Step-down unit – flex down (26 beds) Fourth Floor:

• 3 ICU units (10 beds each) • 1 Trauma ICU unit (10 beds) • 1 Step-down unit – flex up (10 beds) Fifth Floor:

• Med/Surg units only The user group acknowledged that the hospital needs to examine whether financial resources would be available to operate 86 ICU and Step/ down beds. 2.03

Procedure Rooms Paulo Diaz (PD) of FCA asked if a procedure room is required in the ICU floor. The user group confirmed that a dedicated procedure room is not required because procedures can be performed in the proposed 270 sf Trauma patient rooms. The user group however requested one Trauma patient room to be equipped with wall led protection to accommodate fluoroscopic procedures.

2.04

Showers The user group confirmed that showers are not required in the ICU patient rooms.

2.05

Waiting Room Given the potential for rival gang members to be in the ICU Page 3 of 4

Due Date

Item

Description

Action

Due Date

and Step-down floors at the same time, the user group requested two separate waiting rooms to be programmed in each floor. The user group also suggested to provide glass windows in the waiting rooms to provide for greater transparency and improve security.

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\ICU - Step-Down\MIN.02_ICU-Step-Down.doc

Page 4 of 4

MINUTES OF DIAGNOSTIC MEETING NO. 2

PROJECT:


MEETING LOCATION:


MEETING DATE:

January 16, 2007 2:00 pm : 4:00 pm

ISSUE DATE:

February 15, 2007

ATTENDEES:

Kathy Jung (KJ) Sue Carlisle Mary Clancy Pierre-Alaine Cohen Terry Dentoni Doug Eckman Genevieve Farr Eberhard Fiebig Walt Finkbeiner Rafael Ibarra Roland Pickens Hal Yee Ronald Alameida Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH DPW Fong & Chan Architects (FCA) FCA FCA FCA FCA


This meeting was held to initiate the programming effort with the Diagnostic User Group. The following is a record of the items discussed.



FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Preliminary Detail Space Program, dated January 16, 2007 3. Preliminary Summary Space Program, dated January 16, 2007 4. New Hospital Space Program, dated January 16, 2007

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

BUILDING ISSUES

2.01


Page 2 of 5

Due Date

Item

Description

Action

2.02

Building Connections NL confirmed the program currently assumes the following three connections between the existing and new Hospital buildings: • Tunnel connection at the basement level • Street connection at the 1st floor • Bridge connection at the 2nd floor

B.

PROGRAM ISSUES

2.03

Gastroenterology NL noted that currently the programming assumption is for the Gastroenterology department to remain in the existing Hospital building. NL explained that endoscopic procedures in the new Hospital could be performed in patient rooms on the ICU/ Step-down floors and in procedure rooms in the Med/Surg floors. Additional storage space for equipment has also been programmed in the ICU/ Step-down and Med./Surg floors. The user group agreed with this approach, however stated that the Gastroenterology department in the existing Hospital would also require to be modernized and expanded. KJ emphasized that funds from the upcoming bond measure could only be used for work related to the new Hospital. Funds to modernize and/or expand departments in the existing Hospital would have to come from a different source. KJ reiterated that the programming effort should not assume funding to modernize and/or expand departments in the existing Hospital will be available. The user group commented that a lack of guaranteed funding warrants a reassessment of the current approach. Subsequent to the meeting the Perioperative user group confirmed that while the Gastroenterology department could remain in the existing Hospital an Endoscopy Suite with the following spaces should be included in the new Hospital Program: • • • • •

2.04

4 Endoscopy Procedure Rooms 1 ECRP Room 1 Monitoring Room Required Ancillary Space 10 patient intake and recovery beds

Percentage of Inpatient procedures in the GI Unit CLTC noted that if the percentage of inpatient procedures in the GI unit is less than 20%, then these services could remain in the existing Hospital. The user group agreed to verify this Page 3 of 5

Due Date

Item

Description

Action

information. Subsequent to the meeting the Mr. Hal Yee confirmed in an email that the percentage of inpatient procedures performed in the GI unit is predicated to be less than 20%. 2.05

Emergency Evacuation The user group expressed some concerns with the proposed 4th & 3rd floor locations of the ICU/ Step-down units. The user group commented that in the event patients require to be evacuated following a major catastrophe and elevators are decommissioned, hospital staff would have to physically transport these patients down several flights of stairs. The user group predicted that this scenario would result in a high number of a patient casualties. Subsequent to the meeting, this issue was raised with the Steering Committee and the consensus was that from an operational standpoint it was important to locate the Emergency Department at grade level and given the limited footprint of the building it would not be possible to collocate two large departments on the same floor. The Steering committee also noted that an emergency evacuation procedure plan would have to be developed since transporting patients in the ICU and Step-down floors and perhaps certain Med/Surg patients down several flights of stairs would not be a viable option.

2.06

Size of Imaging Rooms NL reviewed the following imaging room sizes with the user group. • • • • • • • •

Radiology X-ray Rooms CT Scan Rooms MRI Room IR with 2 adjacent storage rooms each Angiography Room Ultrasound Room Cath Lab Room Cath Lab Control Room

250 sf 450 sf 520 sf 600 sf 60 sf 500 sf 150 sf 500 sf 150 sf

The user group took no exceptions. 2.07

Cardiology The user group requested a point of care testing area within the Cardiology department. The point of care testing area should include a workbench with a sink and some storage space.

Page 4 of 5

Due Date

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Diagnostic\MIN.02_Diagnostic.doc

Page 5 of 5

MINUTES OF STEERING MEETING NO. 1 PROJECT:


MEETING LOCATION:


MEETING DATE:

January 18, 2007 12:00 pm : 2:00 pm

ISSUE DATE:

February 28, 2007

ATTENDEES:

Kathy Jung (KJ) Ronald Alameida Andre Campbell Sue Carlisle Jeff Critchfield Sue Currin Gene O’Connell Delvecchio Finley Sharon Kotabe John Hurley John Luce Roland Pickens Mark Primeau Carlos Villalva Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services Bureau of Architecture, Project Manager SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH Fong & Chan Architects (FCA) FCA FCA FCA FCA


This meeting was held to present, discuss and validate the space programming process for the new



hospital building at San Francisco General Hospital Medical Campus. The following is the list of items to be discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Hospital Comparison Chart, dated January 18, 2007 3. Preliminary Summary Space Program, dated January 18, 2007 4. New Hospital Space Program, dated January 18, 2007

ITEMS DISCUSSED:

Item

Description

NEW BUSINESS: A.

BUILDING ISSUES 1.01

Actio n

Clearances to Existing Buildings Nuno Lopes (NL) of FCA introduced the bulk of the new building and noted that in order to address planning and exterior wall fire rating concerns specific distances to the existing buildings need to be kept on all levels. The distance at the first and second floor levels between the existing and new hospital building is 25’. The distance between the new hospital building and the adjacent brick buildings 20 and 30 is 40’. The floors above the second floor have additional setbacks to address planning concerns and to eliminate the need to have fire rated walls and windows along the east facade. The distance at the basement 1 and 2 to the existing hospital building is 14’ and to the adjacent brick buildings 20 and 30 is 12’. NL emphasized that the bulk study is only an exercise to examine the maximum mass possible within the designated site. It does not represent any design features. The final layout, building and façade design are to be determined in subsequent design phases.

1.02

Bulk Dr. Andre Campbell (AC) questioned the need to reduce available floor area on the upper levels. Page 2 of 6

Due Date

Item

Description

Actio n

FCA responded that the San Francisco Planning Department would likely not approve a building where the maximum floor area is maintained on every floor, such building would be considered bulky. FCA assumed a 15% reduction of the maximum floor area on the upper floors to address this concern, however this is still well short of the prescribed Planning Department bulk requirements, which would require an 80% reduction. The user group agreed to the proposed floor area reduction in the upper floors. 1.03

Building Cost KJ explained that the $622 Million probable construction cost estimate in the Site Feasibility study is for a 230 bed 385,000 sf hospital building, however the consensus was that additional beds would be required. NL noted that after meeting with all the user groups the total number of beds has increased to 284 beds and the new hospital square footage has increase to 405,000 sf. NL noted that even though the total number of beds has increased by 23% the overall square footage of the building has only increased by 5%. This is due in part with our initial assumption to reduce the spacing of each column bay from 29’x 29’ to 26’x 29’, to note each column bay can accommodate 2 patient rooms. This adjustment resulted in the addition of an entire row of column bays without increasing the size of the building. CLTC also explained that using code concepts such as horizontal exits and suites the net to gross ratio could be further reduced, resulting in a more compact and efficient building. CLTC concluded that since the overall square footage of the building has only increased by 5%, and since healthy cost contingencies were assumed in the probable construction cost estimate, the overall project cost should not substantially increase.

1.04

Bridge Connection NL noted that in the space program the following floors in the existing and new hospital buildings are assumed to be connected: • Basement Floor - Tunnel connection • 1st floor - Street level connection • 2nd floor - Bridge connection KJ noted that the Ob/Peds/NICU departments have Page 3 of 6

Due Date

Item

Description

Actio n

expressed concerns with the proposed second floor bridge connection. They are concerned that the additional pedestrian traffic induced by the bridge connection will make Ob/ NICU less secure. The user group suggested examining the possibility of relocating Ob/Peds/NICU departments to another floor or relocating the bridge to another floor. FCA to investigate. Subsequent to this meeting the Women & Children user group agreed that the preferred solution was to keep both the Ob/Peds/NICU departments and the bridge connection on the second floor provided a layout with a dedicated pathway from the elevator core to the bridge connection and a single point of entry into these departments could be devised. 1.05

Loading Dock The lack of a loading dock in the new hospital building was discussed. The user group agreed that due to site constraints an appropriately sized loading dock for the new hospital would not be possible. The user group concluded that the existing loading dock could be used to facilitate the movement of materials for both existing and new hospital buildings. FCA noted that the Auxiliary user group requested at a minimum a small loading dock be provided to facilitate the movement of blood into the Blood Bank and cadavers from the Morgue. The user group requested FCA to review site conditions and to propose locations where a small loading dock could be incorporated into the building design. DEPARTMENTAL ISSUES

B. 1.06

Distribution of Patient Beds FCA presented the following patient bed distribution: 6th Floor 5th Floor 4th Floor -

2 x 36 bed unit - Med/Surg 2 x 36 bed unit - Med/Surg 3 x 10 bed unit - ICU 1 x 10 bed unit - Trauma ICU 1 x 10 bed unit - Step-Down-Flex Up rd 3 Floor - 1 x 10 bed unit - Step-Down-Flex Up 1 x 26 bed unit - Step-Down-Flex Down 8 bed unit - Med/Surg Forensic 2nd Floor 22 bed unit -Obstetric (excl. 3 Triage Rooms) 12 bed unit - Pediatric Page 4 of 6

Due Date

Item

Description

Actio n 12 bed unit - NICU

Total of

284 beds

The user group agreed with the proposed quantity and distribution of patient beds. 1.07

Morgue NL noted that due to several unresolved operational concerns the final location of the Morgue has not yet been determined. Currently the Morgue has been programmed in Basement 1 in close proximity to the tunnel connection. The user group agreed to review this issue internally and provide FCA with direction in the next user group meeting.

1.08

Resuscitation Rooms NL noted that contrary to the existing condition, the Emergency user group had confirmed that a dedicated xray room for each Resuscitation room was not required. The user group questioned this approach and requested this issue be reconfirmed in the next Emergency user group meeting. Subsequent to this meeting the Emergency user group requested X-ray capability in each Resuscitation room and two X-ray rooms inside the Emergency Department.

1.09

Patient Rooms NL noted that in the space program all patient rooms are assumed to be single handed rooms. FCA explained that this layout concept has proven to minimize nursing errors. NL also noted that in the space program 25% of all patient rooms are assumed to be true isolation rooms with an anteroom. The user group took no exceptions.

1.10

Linen NL explained that the Auxiliary user group requested alcoves for clean linen and dedicated rooms for soil linen. The user group took no exceptions.

1.11

Dietary Page 5 of 6

Due Date

Item

Description

Actio n

Due Date

NL explained that in the space program dietary services are assumed to remain in the existing hospital building, however a dietary storage room has been programmed in the new hospital to meet minimum code requirements.

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Steering\MIN.01_Steering.doc

Page 6 of 6

MINUTES OF PERI-OPERATIVE MEETING NO. 2

PROJECT:


MEETING LOCATION:


MEETING DATE:

January 19, 2007 2:00 pm : 4:00 pm

ISSUE DATE:

January 20, 2007

ATTENDEES:

Kathy Jung (KJ) Terry Dentoni Jim Marks John Inadomi Ronald Alameida Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH DPW Fong & Chan Architects (FCA) FCA FCA FCA FCA


This meeting was held to initiate the programming effort with the Diagnostic User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Preliminary Detail Space Program, dated January 19, 2007 3. Preliminary Summary Space Program, dated January 19, 2007 4. New Hospital Space Program, dated January 19, 2007



ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

BUILDING ISSUES

2.01


2.02

Building Connections NL confirmed the program currently assumes the following three connections between the existing and new Hospital buildings: • Tunnel connection at the basement level • Street connection at the 1st floor • Bridge connection at the 2nd floor

B.

PROGRAM ISSUES

2.03

Gastroenterology NL noted that currently the programming assumption is for the Gastroenterology department to remain in the existing Hospital building. NL explained that endoscopic procedures in the new Hospital could be performed in patient rooms on the ICU/ Step-down floors and in procedure rooms in the Page 2 of 4

Due Date

Item

Description

Action

Med/Surg floors. Additional storage space for equipment has also been programmed in the ICU/ Step-down and Med./Surg floors. The user group suggested that the proposed approach may reduce patient care efficiency and increase operational costs. The user group also stated that in a prior Diagnostic user group meeting it was noted that funding to make the necessary improvements in the existing building to modernize and expand the GI department may not be available. Based on the above discussion the user group determined that while the Gastroenterology department could remain in the existing Hospital an Endoscopy Suite with the following spaces should be included in the new Hospital Program: • • • • • 2.04

4 Endoscopy Procedure Rooms 1 ECRP Room 1 Monitoring Room Required Ancillary Space 10 patient intake and recovery beds

Patient Intake and Recovery NL stated the following number of patient holding and recovery beds currently programmed: • Holding - 24 beds • Recovery - 32 beds (including 1 isolation) The user group determined that the proposed number of beds is generous. However the user group highlighted that 10 beds had been requested to accommodate the Endoscopy suite. In view of that the user group decided that only 5 additional beds should be added to the proposed total number of patient holding and recovery beds. The number of patient holding and recovery beds were revised as follows: • Holding - 26 beds • Recovery - 35 beds (including 1 isolation)

2.05

Soiled & Clean Linen/Equipment The user group noted that space needs to be programmed to accommodate 2 carts for clean linen supply within each unit. The user group requested to provide separate rooms for soiled linen and soiled equipment. NL noted that detailed information for soiled/clean linen pick up and delivery areas will be discussed during the next Material Management user group meeting. Page 3 of 4

Due Date

Item

Description

2.06

On-Call Sleep Rooms The user group confirmed the following arrangements for oncall sleep rooms to be within immediate adjacency to the OR: • For Anesthesia: 3 rooms for residents 1 room for faculty • For Surgery:

2.07

Action

Due Date

1 room (final requirements to be confirmed by the Surgery user group at next meeting)

Lounge The user group requested a separate lounge for the anesthesia staff. FCA programmed a total of 2 staff lounges, each 300 sf.

2.08

Trauma Waiting Room Given the potential for rival gang members to be in the Trauma floor at the same time, the user group requested two separate waiting rooms to be programmed for security reasons. The user group also suggested to provide glass windows in the waiting rooms to provide for greater transparency and improved security.

2.09

Morgue NL noted that due to several unresolved operational concerns the final location of the Morgue has not yet been determined. Currently the Morgue has been located on the ground floor in close proximity to the tunnel connection.

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Perioperative\MIN.02_Perioperative.doc

Page 4 of 4

MINUTES OF EMERGENCY MEETING NO. 2

PROJECT:


MEETING LOCATION:


MEETING DATE:

January 23, 2007 2:00 pm : 4:00 pm

ISSUE DATE:

February 23, 2007

ATTENDEES:

Kathy Jung (KJ) Pat Carr (PC) Kathryn Fowler KF) Alan Gelb (AG) Eric Isaacs (EI) Bob Sypher (BS) April Clock (AC) Ron Alameida (RA) Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH SFGH SFGH SFGH DPW Fong & Chan Architects (FCA) FCA FCA FCA FCA


This meeting was held to initiate the programming effort with the Diagnostic User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents:



1. Agenda of Meeting 2. Preliminary Detail Space Program, dated January 23, 2007 3. Preliminary Summary Space Program, dated January 23, 2007 4. New Hospital Space Program, dated January 23, 2007

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

BUILDING ISSUES

2.01


B.

PROGRAM ISSUES

2.02

Program Assumptions NL clarified that initial program assumption have been derived from SFGHMC current and past census figures, previous SFGHMC commissioned studies and comparative data from other hospitals. The user group explained that this past year the Emergency Page 2 of 4

Due Date

Item

Description

Action

Department has experienced higher than usual census and believed this trend will continue in subsequent years. The User group also noted that a needs assessment study would be helpful in determining the size of the Emergency Department in relation to other Hospital services. PD noted that needs assessment studies are typically performed during the Design Development phase where program and building information is more reliable and can take up to 6-9 months to complete. Currently a needs assessment study is not being considered during the programming phase. The user group agreed to clarify the goals, requirements and operational issues for the Emergency department in an internal meeting and provide FCA with updated information at the next user group meeting. C.

DEPARTMENTAL ISSUES

2.03

Exam Rooms NL presented the following distribution of exam rooms: • 27 Exam Rooms • 3 Isolation Exam Room • 1 Semi Private Room with 10 beds The user group agreed with the following exam room distribution however they’ve request that one of the exam rooms be designated as a SART exam room. The SART Exam room should be sized to accommodate all required equipment and have a dedicated toilet with a shower.

2.04

Urgent Care KJ confirmed that Urgent Care is remaining in the existing hospital.

2.05

X-ray Rooms The user group requested X-ray capability in each Resuscitation room and two X-ray rooms inside the Emergency Department.

2.06

Meeting Rooms NL confirmed the following number of meeting rooms: • 3 Consultation/ Quiet Rooms • 2 Conference Rooms The user group requested a space capable of accommodating 20 staff members for patient rounds. NL proposed to locate the two conference rooms next to each other separated by a movable partition that can be opened to provide 400 sf of Page 3 of 4

Due Date

Item

Description

Action

Due Date

space. The user group agreed to this proposal. 2.07

Resuscitation Rooms The user group requested the Resuscitation rooms to be located near the ambulance entrance and service elevators.

2.08

CT Scan Rooms The user group requested the CT Scan rooms to be located adjacent to the Resuscitation rooms with access from the corridors as well as from a Resuscitation room.

2.09

Pediatric Emergency The user group discussed the need for a dedicated Pediatric Emergency area with a separate waiting area. A final conclusion was not made.

2.10

Toilets The user group requested additional toilets in the Emergency Department. The user group agreed to the following distribution: • 6 private patient toilets (incl. 2 ADA) • 2 private ADA staff toilets • 2 multi-accommodation public toilets (3 fixtures each) NL noted that in addition staff toilets have been programmed in the staff locker area.

2.11

Social Worker Office The user group requested one social worker office to be shared by two social workers. FCA added one 150 sf social worker office.

2.12

Security The user group confirmed that security does not need a dedicated enclosed space inside the Emergency department. A visible workstation near the emergency entrance is preferred.

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Emergency\MIN.02_ Emergency.doc

Page 4 of 4

MINUTES OF AUXILLARY-SUPPORT MEETING NO. 1 PROJECT:


MEETING LOCATION:

San Francisco General Hospital, Cafeteria Conference Room 3A, Surgery

MEETING DATE:

January 26, 2007 300 pm : 400 pm

ISSUE DATE:

May 25, 2007

ATTENDEES:

Kathy Jung (KJ) James Moore Bob Eggleston Delvecchio Finley Johnson Gong Marijane Pierson Chiu Lin Tse-Chan (CLTC) David Fong (DF) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH – Messenger/Mailroom/Laundry SFGH – Food Services SFGH - Support Services SFGH - Environmental Services SFGH - Material Management Fong & Chan Architects (FCA) FCA FCA FCA


This meeting was held to initiate the programming effort with the Ancillary-Sterile Processing User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Preliminary Detail Space Program, dated January 26, 2007 3. Preliminary Summary Space Program, dated January 26, 2007



4. New Hospital Space Program, dated January 26, 2007 ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: B.

DEPARTMENTAL ISSUES

2.01

Messenger/Mail Services The user group noted that Messenger services should be located in the new acute care hospital building since most of their work is related to inpatients services. They also added that since Mail services is staffed by the same personnel as Messenger services Mail services should also be located in the new acute care hospital. FCA revised the space program to include the following spaces: • Supervisor Office @ 100 sf • Open Space Office @ 600 sf (12 workstations and 12 half height lockers) • Women’s Toilet @ 50 sf • Men’s Toilet @ 50 sf • Changing room @ 40 sf • Specimen Storage @ 80 sf (incl. 2 commercial grade refrigerators) • Storage Area @ 350 sf (10 gurneys and 10 wheelchairs) • Clothes Storage @ 300 sf • Mailroom @ 200 sf

2.02

Material Management The Receiving and Administrative areas were discussed. The user group noted that since the main loading dock will remain in the existing hospital the Receiving and Administrative areas should also remain in the existing hospital. The user group did request to increase the material management Storage area in the new acute care hospital from 5000 sf to 6000 sf .

2.03

Dietary NL explained that dry and refrigerated storage space for emergency supplies is required by code to be included in the new acute care hospital. The user group acknowledged this code requirement however confirmed that the supervisor’s office included in the Dietary storage area is not required. Page 2 of 4

Due Date

Item

Description

Action

2.05

Custodian Closets The user group commented that based on the programmed area in general two 40 sf custodian closets on each floor would be required. The user group agreed to the following custodian closet arrangement for each department: Med/Surg

• 4 closets @ 40 sf. (2 per floor) Med/Surg - Forensic

• 1 closet @ 40 sf. ICU

• 2 closets @ 50 sf (to accommodate a total of 5 carts, one per ICU unit) OB/GYN

• 1 closet @ 50 sf Peds

• 1 closet @ 40 sf. NICU

• 1 closet @ 40 sf. Surgery

• 3 closet @ 40 sf. Gastroenterology

• 1 closet @ 40 sf. Pre-Op

• 1 closet @ 40 sf. PACU

• 1 closet @ 40 sf. Emergency

• 3 closets @ 40 sf. 2.06

Linen The user group noted that in general one 30 sf alcove for a clean linen cart and one 60 sf room for two soiled linen carts is required for each inpatient unit. The user group also commented that the Emergency Department needs three soiled linen rooms.

Page 3 of 4

Due Date

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Ancillary - Auxiliary\MIN.01_Auxillary Support.doc

Page 4 of 4

MINUTES OF ANCILLARY- STERILE PROCESSING MEETING NO. 1 PROJECT:


MEETING LOCATION:

San Francisco General Hospital, Cafeteria Conference Room 3A, Surgery

MEETING DATE:

January 26, 2007 2:00 pm : 3:00 pm

ISSUE DATE:

May 25 2007

ATTENDEES:

Kathy Jung (KJ) Cora Nunez-Talens Lawrence Nichols Chiu Lin Tse-Chan (CLTC) David Fong (DF) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH Fong & Chan Architects (FCA) FCA FCA FCA


This meeting was held to initiate the programming effort with the Ancillary-Sterile Processing User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Preliminary Detail Space Program, dated January 26, 2007 3. Preliminary Summary Space Program, dated January 26, 2007 4. New Hospital Space Program, dated January 26, 2007 ITEMS DISCUSSED:



Item

Description

Action

NEW BUSINESS: B.

DEPARTMENTAL ISSUES

2.01

Sterile Processing FCA proposed to locate the entire Sterile Processing (SP) in the new acute care hospital. SP would sterilize all equipment for both existing and new hospitals and distribute sterile equipment directly to the ORs. The user group concurred with the proposed arrangement, noting that the current breakdown of SP services to the various departments is as follows: • 5% Clinics (existing hospital) • 5% ER (new acute care hospital) • 70% OR (new acute care hospital) • 20% Labor & Delivery (new acute care hospital) The user group also noted that operating and maintaining two separate SPs would be inefficient and costly.

2.02

Central Processing and Distribution FCA suggested keeping most of Central Processing and Distribution (CPD) in the existing hospital and only included approximately 5,000 sf of storage in the new acute care hospital. CPD would be responsible for the distribution of supplies and sterile equipment for both existing and new hospital with the exception of sterile equipment to the ORs, which would be managed by SP. The user group agreed to the proposed arrangement, however suggested increasing the Material Management storage in the new acute care hospital from 5,000 sf to 6,000 sf.

2.03

Dumbwaiter FCA proposed locating SP directly below the OR’s and to receive and distribute clean and soiled equipment by way of dumbwaiters. The user group agreed to this arrangement however requested that in addition to providing separate clean and soiled dumbwaiters a third dumbwaiter should be provided as backup.

2.04

Decontamination room The user group requested a Decontamination room to be included in the OR suite off the peripheral corridor (patient corridor). The soiled dumbwaiter should be located in the Decontamination room. Page 2 of 3

Due Date

Item

Description

Action

2.05

Soiled Cart Staging Area The user group noted that the soiled staging area should be large enough to accommodate a total of 18 carts. Assuming each cart is approximately 48”x30” the Soiled Cart Staging Area should be increased to 200 sf.

2.06

Decontamination Area The user group requested a toilet with shower to be included inside the Decontamination Area.

2.07

Sterile Supply The user group requested to increase Sterile Supply from 250 sf to 400 sf.

2.08

Offices FCA included in the space program three offices. An office for a supervisor to be located in the Assembly/Sterilization Area and two additional offices in the Administration and Staff Areas.

Due Date

The user group requested to locate the office for the supervisor in the Administrative and Staff Areas and to only provide one additional office for a manager. FCA to revise the space program to include two offices one for a manager and one for a supervisor in the Administrative and Staff Areas.

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Ancillary - Support\MIN.02_Ancillary-Sterile Proc..doc

Page 3 of 3


PROJECT:


MEETING LOCATION:


MEETING DATE:

February 6, 2007 2:00 pm : 4:00 pm

ISSUE DATE:

February xxx, 2007

ATTENDEES:

Kathy Jung (KJ) Ronald Alameida Todd May Susan Sniderman Sue Carlisle Morris Schambelan Edgar Pierluissi Yuhum Digdigan Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services Bureau of Architecture, Project Manager SFGH - Family Medicine SFGH - Pediatrics SFGH - Dean’s Office SFGH SFGH SFGH - Nursing Admin Fong & Chan Architects (FCA) FCA FCA FCA FCA


This meeting was held to review the programming effort with the Medical/ Surgical User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting



2. Preliminary Detail Space Program, dated February 6, 2007 3. Preliminary Summary Space Program, dated February 6, 2007 4. New Hospital Space Program, dated February 6, 2007

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

PROGRAM ISSUES

3.01

Patient Room Size Validation FCA presented several images of a three dimensional computer model and floor plans of a possible Med/Surg patient room to confirm that the proposed 180 Assignable Square Footage (ASF) was adequate. The user group commented that the size of the exterior window should be maximized but agree that the proposed 180 ASF for the Med/Surg patient room was adequate.

3.02

Same-Hand Room Designs for Private Patient Rooms The user group agreed that same-hand room designs for all private Med/Surg patient rooms should be assumed in the space program report. CLTC noted same-hand room designs will increasing material and installation costs since unlike mirror-reverse patient room designs the plumbing chase and oxygen and gas drops cannot be shared. The user group noted that if conclusive evidence supports the argument that same-hand room designs are safer than mirror room designs the additional costs are justified.

3.03

Charting Work Areas The user group discussed the benefits of charting inside patient rooms vs. in the corridor. The user group agreed that creating a charting work area inside each patient room was beneficial in fostering better communications between patient and nurse/physician. However the user group agree that charting inside the room is not always beneficial and requested that in each unit three charting work areas be programmed in the corridor.

Page 2 of 4

Due Date

Item

Description

Action

3.04

Nursing Station Instead of programming a centralized nursing station, the user group suggested to split the nursing station into nursing pods to improve workflow. FCA noted that a primary nursing station is required by code, but stated that currently two additional auxiliary nursing station have been programmed. The user group agreed to this arrangement.

3.05

Nursing Lounge The size of the nursing lounge was discussed. The user group requested one 200 sf staff lounge per floor to serve two Med/Surg units.

3.06

Meeting Rooms The user group noted that during morning rounds, 7 teams approximately 6-8 members each would require a private space to meet on each floor. FCA noted that currently 12 meeting rooms in total on 2 floors have been programmed. The user group acknowledged that the number of meeting rooms currently programmed is an improvement to the current existing condition and requested that these meeting rooms not be eliminated.

3.07

Forensic Beds NL confirmed that Forensic Med/Surg patients are required to be treated in a compliant acute care hospital. The user group discussed whether it would be more efficient to treat forensic patients in the Med/Surg units rather than creating a dedicated Forensic Med/Surg unit. KJ noted that this concept would require security guards to monitor each forensic patient outside their room, which during high census would significantly increased the total number of security guards required. KJ commented that this concept needs to be discussed with the sheriff’s department.

3.08

Public Toilets in Waiting Rooms The user group noted that the existing lockable single accommodation public toilets in waiting rooms have encouraged drug and other inappropriate use and requested multi-accommodation public toilets be provided in all waiting rooms.

Page 3 of 4

Due Date

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Medical-Surgical\MIN.03_MedSurg.doc

Page 4 of 4

MINUTES OF OBSTETRIC/ PEDIATRIC MEETING NO. 3 PROJECT:


MEETING LOCATION:


MEETING DATE:

February 9, 2007 2:00 pm : 4:00 pm

ISSUE DATE:

May 25, 2007

ATTENDEES:

Kathy Jung (KJ) Cathy Duran Alma Martinez Colin Partridge Susan Sniderman Elisabeth Romero Ronald Alameida Eleanor Drey Abner Korn Cathryn Thurow Fe Hortinela Louise Dimattio Bill Tausch Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH Fong & Chan Architects (FCA) FCA FCA FCA FCA


This meeting was held to initiate the programming effort with the Obstetric/Pediatric User Group. The following is a record of the items discussed.



FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Preliminary Detail Space Program, dated February 9, 2007 3. Preliminary Summary Space Program, dated February 9, 2007 4. New Hospital Space Program, dated February 9, 2007

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

PROGRAM ISSUES

3.01

Patient Room Size Validation FCA presented several images of three dimensional computer models and floor plans of possible LDRP and Postpartum patient rooms to confirm that the proposed Assignable Square Footages (ASF) were adequate. The following room sizes were depicted in the images presented. • LDRP patient room – 290sf • Postpartum patient room – 180sf

The user group agreed to the proposed patient room sizes. 3.02

NICU Bassinets The user group noted that in 2006 the average daily census for NICU was between 7-11. They also commented that in 2006 a total of ten days the daily census for NICU was between 1517. Based on this information the user group requested to increase the NICU area to accommodate 5 additional bassinets, with the following distribution: • 10 Level II bassinets • 6 Level III bassinets • 1 Level III isolation bassinet Medication Room

A Medication room was requested and added to the NICU. Mother Boarding Room

The user group noted that a sink with counter will be required for the Mother boarding room. FCA acknowledged the Page 2 of 4

Due Date

Item

Description

Action

requirements in the program. Showers

Showers for the NICU were requested and added to the on-call sleep rooms, family sleep room and the mother boarding room. 3.02

Provider Workroom/Charting The user group requested to increase Workroom/Charting in the NICU to 200 sf.

the

Provider

3.02

Medication Room The user group requested to add a 120 sf Medication room in the NICU.

3.02

Mother Boarding Room The user group requested a counter with sink to be included in the Mother Boarding room.

3.02

Toilet Room Showers The user group requested the following Toilet rooms to be equipped with showers: • • •

At least one On-call room Toilet per department Toilet in Family Sleep room Toilet in Mother Boarding room

3.03

Alcove for Resuscitation Equipment in LDRP The user group requested an alcove to accommodate resuscitation equipment within the LDPR patient rooms.

3.04

Adjacency Requirement between LDRP and C-Section The user group requested LDPR rooms to be located in close proximity to C-Section operating rooms to insure immediate patient transfer during emergencies.

3.04

Lactation Room The user group noted that the Lactation room currently programmed is not required and can be eliminated.

3.06

Conference Rooms The user group noted that the proposed 200 sf conference rooms for Pediatrics and NICU are too small to accommodate large gatherings. FCA suggested combining both the Pediatrics and NICU Conference rooms into one large 400 sf Conference room separated by a movable room divider. This arrangement can accommodate large gatherings and preserve the same number of meeting spaces. The user group agreed to the above arrangement and Page 3 of 4

Due Date

Item

Description

Action

Due Date

suggested to also include a movable room divider in the Obstetric Conference room. 3.07

Lockers The user group requested to combine separate male and female Locker rooms into one unisex Locker room with multiple toilet and changing facilities as indicated below: • 1 Unisex Locker room – 250 sf • 2 multi-accommodation separate male and female Toilet

rooms – 180 sf • 4 Changing rooms – 30 sf

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Obstetrics - Pediatrics\MIN.03_ObPeds.doc

Page 4 of 4


PROJECT:


MEETING LOCATION:


MEETING DATE:

February 13, 2007 2:00 pm : 4:00 pm

ISSUE DATE:

February xx, 2007

ATTENDEES:

Kathy Jung (KJ) Andre Campbell Cheryl Jay Sheryl Calrson Genevieve Farr Terry Dentoni Vivian Curd Charlotte Bobek Shirley Stiver Ron Alameida Nuno Lopes (NL) Paolo Diaz (PD) David Fong (DF) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH Fong & Chan Architects (FCA) FCA FCA FCA


This meeting was held to initiate the programming effort with the ICU / Step-down User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting



2. Preliminary Detail Space Program, dated February 13, 2007 3. Preliminary Summary Space Program, dated February 13, 2007 4. New Hospital Space Program, dated February 13, 2007

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

PROGRAM ISSUES

3.01

Patient Room Size Validation FCA presented several images of three dimensional computer models and floor plans of possible ICU/CCU and Step-down patient rooms to confirm that the proposed programmed Assignable Square Footages (ASF) were adequate. The following room sizes were depicted in the images presented. • • • •

ICU/CCU trauma patient room – 280sf ICU/CCU patient room – 210sf Step-down patient room (flex up) – 210sf Step-down patient room (flex down) – 180sf

The user group agreed to the proposed patient room sizes. 3.02

Nourishment/Clean Supply The user group requested separate Nourishment and Clean Supply rooms. FCA proposed programming 50 sf for a Nourishment room and 120 sf for a Clean Supply room. The user group agreed to the proposed space allocation.

3.03

On-Call Sleep Rooms The user group requested 4 private On-call sleep rooms to be located in the same floor as the ICU units.

3.04

Physical Therapy The user group confirmed the proposed 150 sf Physical Therapy room is not required in the ICU floor, instead the user group requested FCA to program a Medical Equipment room of equal size.

3.05

PACS Viewing Stations The user group requested that all patient care units be Page 2 of 3

Due Date

Item

Description

Action

Due Date

provided with PACS viewing stations. The user group requested 2 PACS viewing stations in each Provider Workroom/Charting, 1 PACS viewing station in each Conference room and 1 PACS viewing station inside each ICU/CCU and Step-down unit. FCA confirmed that a total of 20 PACS viewing stations have been added. 3.06

Public Toilets in Waiting Rooms Based on user group comments made in previous meetings FCA suggested changing all lockable single accommodation public toilets in Waiting Rooms to multiaccommodation public toilets to discourage drug and other inappropriate use. The user group agreed to the proposed suggestion.

3.07

Lockers The user group requested to combine separate male and female Locker rooms into one unisex Locker room with multiple toilet and changing facilities as indicated below: • 1 Unisex Locker room – 250 sf • 2 single accommodation Toilet rooms w/ shower – 70 sf • 2 Changing rooms – 30 sf

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\ICU - Step-Down\MIN.03_ICU-Step-Down.doc

Page 3 of 3

MINUTES OF DIAGNOSTIC MEETING NO. 3 PROJECT:


MEETING LOCATION:


MEETING DATE:

February 16, 2007 2:00 pm : 4:00 pm

ISSUE DATE:

May 25, 2007

ATTENDEES:

Kathy Jung (KJ) Nora Goldschlager Dough Eckman Richard Hollingsworth Hal Yee Eberhard Fiebig Jeff Critchfield Terry Lynch Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH SFGH SFGH SFGH SFGH Fong & Chan Architects (FCA) FCA FCA FCA FCA


This meeting was held to initiate the programming effort with the Obstetric/Pediatric User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Preliminary Detail Space Program, dated February 16, 2007



3. Preliminary Summary Space Program, dated February 16, 2007 4. New Hospital Space Program, dated February 16, 2007

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

DEPARTMENTAL ISSUES

3.01

Cardiology NL noted that currently only the Cath Lab is located in the new hospital building. The user group emphasized that with the exception of EKG and Dialysis the Cardiology Department should be located in the new hospital building since 50% of the services provided are inpatient services. The user group requested the additional following spaces to be included in the space program: • 4 Echo bays • 1 Stress Test

3.02

Pulmonary Function The user group requested the following Pulmonary Function rooms to be included in the space program: • Pulmonary Function Lab • Special Procedures • Bronchoscopy

3.03

@ 150 sf each @ 250 sf

600 sf 220 sf 230 sf

Holding/Recovery The user group requested to increase the number of bays in the Holding/Recovery room to accommodate a total of 17 gurneys, with the following distribution: • Radiology • Cardiology

15 gurneys 2 gurneys

3.04

Equipment/Computer Storage FCA noted that a large Equipment/Computer Storage room for Cardiology and Radiology has been programmed and inquired if multiple smaller rooms are more practical. The user group confirmed that one large Equipment/Computer Storage room for each department is preferred.

3.05

Linen Page 2 of 3

Due Date

Item

Description

Action

Due Date

The user group requested Cardiology and Radiology to have dedicated alcoves capable of accommodating 3 linen carts each. 3.06

Contrast Media Room The user group requested Cardiology and Radiology to have separate Contrast Media Rooms. FCA made the following revisions to the space program: • Radiology – 1 Contrast Media Room – 60 sf • Cardiology –1 Contrast Media Room – 40 sf

3.07

Resuscitation Rooms – X-Ray The user group reiterated that x-ray equipment in the Resuscitation rooms should be hard wired. They explained that mobile x-ray equipment requires frequent charging of batteries and is not suitable for use in Emergency situations.

3.08

Elevators The user group noted that the service elevators should be equipped with double acting doors.

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Diagnostic\MIN.03_Diagnostic.doc

Page 3 of 3

MINUTES OF PERIOPERATIVE MEETING NO. 3 PROJECT:


MEETING LOCATION:


MEETING DATE:

February 20, 2007 2:00 pm : 4:00 pm

ISSUE DATE:

May 25, 2007

ATTENDEES:

Kathy Jung (KJ) Bill Chun… Ted Miclau Sue Carlisle Jens Krombach Jane Cino Terry Dentoni Andre Campbell Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:








ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

DEPARTMENTAL ISSUES

3.01

Operating Rooms (ORs) The number and square footage of OR was discussed. FCA noted that currently the following is currently programmed: • 10 OR (large) @ 520 sf • 4 OR (small) @ 420 sf • 2 IR The user group agreed to make the following revisions to the space program: • • • •

3.02

4 OR (large) @ 540 sf 6 OR (medium) @ 500 sf 4 OR (small) @ 420 sf 2 IR

Clean Core FCA stated that the existing ORs were designed around a clean core room and bounded by a peripheral corridor. FCA proposed to program the new OR suite using a similar approach, however given the total number of OR rooms currently programmed two surgical suites rather than one large surgical suite maybe more practical. The user group agreed to the proposed surgical suite arrangement.

3.03

IR Room FCA noted that 550 sf has been programmed for each IR room and 60 sf for associated computer/equipment storage, matching the size of the existing IR room. The user group noted that the existing IR room did not provide enough space at the end of the patient table for the anesthesiologist and the required anesthesia equipment. FCA confirmed that the current IR room proportions were not Page 2 of 4

Due Date

Item

Description

Action

ideal, however recently FCA has successfully designed 550 sf IR rooms using more efficient proportions. The user group agreed to keep the square footage of the IR rooms at 550 sf but stated that they will re-examine the size of the IR room once a room layout and IR equipment is known. 3.04

Anesthesia Induction Room The addition of an Anesthesia Induction room was discussed. The user group commented that certain anesthesia induction procedures could last up to 2-hours before a patient is ready for surgery. Administering these procedures in the ORs would be inefficient. The user group also mentioned that certain anesthesia induction procedures should not be administered in a Pre-Op Unit cubicle, citing privacy, noise and safety concerns. FCA suggested adding one 220 sf Anesthesia Induction room to the space program to accommodate longer procedures and those requiring special equipment. The user group agreed to this proposal.

3.05

Toilets in Pre-Op Unit FCA stated that 2 ADA toilets are currently programmed in the Pre-Op unit. The user group pointed out that since the GI department has been recently added to the space program additional toilets should be added to accommodate GI patients in the Pre-Op unit. FCA revised the space program to include two additional toilets in the Pre-Op unit.

3.06

Lockers The size of both women’s and men’s Locker rooms were discussed. The user group noted that the current locker room setup is not adequate. FCA confirmed that the existing men’s locker room was divided into two rooms measuring approximately 260 sf and 130sf and the women’s locker room was approximately 320 sf. FCA noted that the lockers in the rooms were poorly layout creating an inefficient and uncomfortable space. FCA reintegrated that a well layout 300 sf locker room could easily accommodate a combination of 75 full height and purse lockers and still offer a comfortable space for changing. Certain members of the user group were still concern with the proposed locker room size, however they agreed to defer their opinion until they’ve had the opportunity to review a detail locker room layout.

Page 3 of 4

Due Date

Item

Description

Action

3.07

OR with Fluoroscopy Capability The user group requested 1 large OR to have fluoroscopy capability.

Due Date

FCA to add note in space program to address this request. 3.08

Office The user group requested to replace the Material Management office with a IS Clinical Staff office. FCA to revise the space program as requested.

3.09

Scope Clean Room The user group requested to add a 80 sf scope clean room. FCA to revise the space program as requested.

3.10

Square Footage Revisions The user group agreed to revise the square footage of the following spaces: • • • • • • •

Clean Core Equipment/Tube Storage Biomed Housekeeping Supplies ECRP Endo Holding (from 26 to 22 cubicles)

from 1400 sf from 300 sf from 250 sf from 120 sf from 400 sf from 280 sf from 2080 sf

to 1000 sf to 250 sf to 200 sf to 100 sf to 350 sf to 250 sf to 1760 sf

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Perioperative\MIN.03_Perioperative.doc

Page 4 of 4

MINUTES OF EMERGENCY MEETING NO. 3 PROJECT:


MEETING LOCATION:


MEETING DATE:

February 23, 2007 2:00 pm : 4:00 pm

ISSUE DATE:

May 25, 2007

ATTENDEES:

Kathy Jung (KJ) Alan Gelb Eric Isaacs Bob Sypher Angela Hackenschmidt April Clock Linda Garcia Ron Alameida Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:








ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

DEPARTMENTAL ISSUES

3.01

Exam Rooms Number of exam rooms

The number of exam rooms was discussed. The user group stated that the proposed 40 exam rooms would not be sufficient. The user group argued that not enough inpatient beds were being programmed to accommodate the total volume of patients requiring admissions, resulting in an average length of stay similar to what is currently being observed in the existing ED. Given those parameters the user group presented the following statistics: • The average ED census in January and February 2007, at

midnight was 50 patients. • During that period on two occasions the midnight census

was over 60 patients. • The average length of stay was 4-6 hours • Waiting time for a transfer to Step-down was 12 hours • Waiting time for a transfer to a Med/Surg bed was 10 hours

In addition the user group commented that the number of ED visits will increase by the time the new hospital is built due primarily to San Francisco’s growing aging population and the likely closure of St. Luke’s ED. FCA proposed to increase the number of exam rooms to 54, the user group agreed. They noted however that they wanted to continue to evaluate all known data and would reconfirm the final number of exam rooms. Subsequent to the meeting Dr. Alan Gelb distributed an email requesting “at least 60 private exam rooms.” Size of exam rooms

The size of exam rooms was discussed. FCA noted that 140 sf exam rooms are currently programmed. The user group noted that preferably the dimensions for exam rooms in a teaching Page 2 of 4

Due Date

Item

Description

Action

hospital should be 11’-6” x 14’ (161 sf). The increased area would better accommodate the multiple staff and students common in teaching hospitals. Further the user group highlighted that the trend is to let friends and family members stay with the patients in the exam rooms. FCA explained that the First Floor where the ED is currently programmed can not accommodate both an increase in the number and square footage of exam rooms. The user group recognized these limitations and acknowledged that their priority was to increase the number of exam rooms. Subsequent to the meeting Dr. Alan Gelb distributed an email clarifying that ED exam rooms should be 160 square feet. Behavioral Health

The user group requested 4 exam rooms with sound control for chemically restraint patients to be included in the program. Rape Treatment Center Room (RTC)

The user group requested 1 exam room with shower for RTC patients to be included in the program. The RTC room should be located in close proximity to a Consultation room. Summary

During the meeting the following exam room revisions to the space program were agreed to: • • • • 3.02

46 Exam Rooms 4 Exam Rooms – Behavioral Health 1 Exam Room – RTC 3 Exam Rooms – Isolation

@ 140 sf @ 140 sf @ 180 sf @ 140 sf

Exam Room Pods The user group suggested dividing the total number of exam rooms into 4 pods each servicing around 13 exam rooms with separate Nursing Station, Provider Charting, Clean Utility/Supply, Soiled Utility, Soiled Linen and Medication rooms. The user also noted that in addition to the above support spaces the Resuscitation rooms also require a Consultation room and a dedicated Custodial closet.

3.03

Resuscitation Rooms Open Space Layout

The user group confirmed that an open space layout for the resuscitation rooms is not desirable citing infection control, Page 3 of 4

Due Date

Item

Description

Action

Due Date

patient privacy and noise concerns. Preferred Layout

The user group noted that a layout incorporating an anteroom that leads to the resuscitation room is preferred to a layout where a separate equipment storage room is provided at the rear of the resuscitation room. The anteroom would provide the necessary space for storage and preparation of equipment, allowing staff to get prepared before entering the resuscitation room and reducing inefficient circulation. FCA noted that the layout of the resuscitation rooms will be discussed during the design phase but enough area has been programmed for either an Equipment Storage room or a Vestibule/Equipment room. Location

The user group requested the resuscitation rooms to be in close proximity to the service elevators as well as the emergency entrance. 3.04

Pediatric – Waiting Room The user group requested a separate waiting room for Pediatric patients and family members. The user group agreed to the following distribution of waiting rooms in the ED: • 2 Waiting Rooms • 1 Waiting Rooms – Pediatrics

@ 400 sf each @ 200 sf

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Emergency\MIN.03_ Emergency.doc

Page 4 of 4

MINUTES OF STEERING COMMITTEE MEETING NO. 3 PROJECT:


MEETING LOCATION:


MEETING DATE:

March 5, 2007 9:00 am : 11:00 am

ISSUE DATE:

April 25, 2007

ATTENDEES:

Kathy Jung (KJ) Ronald Alameida Andre Campbell Sue Carlisle Jeff Critchfield (JC) Sue Currin Gene O’Connell (GOC) Delvecchio Finley Sharon Kotabe John Hurley John Luce Roland Pickens Mark Primeau Carlos Villalva Chiu Lin Tse-Chan (CLTC) David Fong (DF) Paolo Diaz (PD) Nuno Lopes (NL) Samina Choudhry (SC) Connie Ma (CM)

DISTRIBUTION:

San Francisco General Hospital (SFGH), Facilities/ Support Services SF Bureau of Architecture SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH SFGH Department of Public Health (DPH) SFGH Fong & Chan Architects (FCA) FCA FCA FCA FCA FCA

All Attendees



This meeting was held to review the overall programming effort with the Steering Committee. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Preliminary Summary Space Program, dated March 2, 2007 3. New Hospital Space Program, dated March 2, 2007

ITEMS DISCUSSED:

Item

Description

Action

NEW BUSINESS: A.

PROGRAM ISSUES

2.01

Nuno Lopes (NL) of FCA noted that after meeting with all user groups the overall program has increased 20% compared to the initially proposed program. This will cause an increase in cost. A revised cost estimate is being prepared to determine whether the overall building construction budget is acceptable or if program areas need to be reduced to meet the budget. NL noted that the construction budget would not increase linearly with the increase of the program areas.

B.

DEPARTMENTAL ISSUES Overview of Current Space Program NL presented the currently proposed space program for each floor of the new hospital building as follows. Items in bold italics are areas that were added since the previous Steering Committee meeting: Basement 2

• • • • • • •

Cardiology Radiology Sterile Processing Morgue and Autopsy Material Management Messenger/Mailroom Environmental Services

Basement 1

• • • •

Surgery Gastroenterology Patient Intake and Recovery Entry Area Page 2 of 6

Due Date

Item

Description

Action

First Floor

• Entry Area • Clinical Care – Emergency • Admitting Second Floor

• Obstetrics • Pediatrics • NICU Third Floor

• • • •

Step-Down Medical / Surgical – Forensic Unit Pharmacy Information Technology

Fourth Floor

• • • •

ICU/CCU/Step-Down Administration Dietary Biomed

Fifth Floor

• Medical / Surgical / Step-Down Sixth Floor

• Medical / Surgical 2.02

Additions and Changes to the Space Program NL noted that the input from meetings with all user groups have resulted in the following additions and changes been made since the previous steering committee meeting: Cardiology

FCA noted that the Cath/EP Lab, Echo Lab and Pulmonary Function have been included in the basement 2 level of the new hospital. The steering committee agreed to the proposed arrangement however noted that if cuts need to be made the Pulmonary Function could remain in the existing building. Morgue and Autopsy

FCA noted that the morgue and autopsy in the basement 2 level of the new hospital has moved to the north side of the new hospital building. This location would allow for a small delivery and pick up area requested by the user groups to service the morgue as well as the blood bank and pharmacy.

Page 3 of 6

Due Date

Item

Description

Action

FCA suggested examining the possibility of providing a dedicated elevator to directly connect the morgue with the loading area. The steering committee agreed with the proposed arrangement and welcomed the option of a delivery and pick up area dedicated to the new hospital. Messenger / Mailroom

FCA noted that the messenger and mailroom departments have been included in the basement 2 level of the new hospital. The steering committee agreed to the above arrangement. Gastroenterology

FCA noted that the Gastroenterology (GI) department has been included in the new hospital. The steering committee agreed to the above arrangement. It was noted that Bronchoscopy should be located adjacent to the GI department. Emergency

FCA and the steering committee discussed the Emergency user group’s request to increase the total number of exam rooms from 40 to 60, each room preferably to be sized at 160 sf in order to accommodate family members and teaching staff. FCA suggested the following 3 options: • Increase the number of exam rooms from 40 to 56 @ 140 sf each. Area dedicated to admitting would remain in the First Floor level as programmed. • Increase the number of exam rooms from 40 to 47 @ 160 sf each. Area dedicated to admitting would remain in the First Floor level as programmed. • Increase the number of exam rooms from 40 to 60 @ 160 sf each. Area dedicated to admitting would move elsewhere in the building. The steering committee discussed different admitting procedures options such as splitting the department onto different floors however they concluded that relocating admitting from the First Floor either partially or completely is not desirable. The steering committee decided to increase from 40 to 56 exam rooms @ 140 sf each and to keep the space dedicated to Page 4 of 6

Due Date

Item

Description

Action

admitting on the First Floor as programmed. NICU

FCA noted that the Women & Children user group has requested the number of NICU bassinets to increase from 12 to 17. Gene O’Connell (GOC) of SFGH noted that currently the NICU is budgeted for only 8 bassinets. 2.03

Med/Surg Forensic The steering committee and FCA discussed whether the Med/Surg Forensic beds could be used as regular Med/Surg beds instead of having to close down the Med/Surg Forensic unit during times of low census. FCA noted that converting a Forensic Med/Surg unit to a regular Med/Surg unit is not recommended, and advised against it. The steering committee noted that forensic beds could be integrated into the Med/Surg unit if dedicated security guards are assigned to each forensic patient room. This option however needs to be discussed with the sheriff department. GOC noted that a meeting with the sheriff department needs to be established during the design phase to discuss the issues for this area.

2.04

Med/Surg – Conference Rooms JC asked if sufficient space has been provided in the Med/Surg unit to accommodate meeting rounds. FCA noted that the following number of meeting rooms per floor are currently programmed: • 2 Consultation Rooms • 2 Conference Rooms • 2 Physician Workrooms Jeff Critchfield (JC) of SFGH noted that given the proposed Med/Surg floor configuration there will be 8 medicine teams with 7 members each meeting in the mornings from 10am12am and noted that additional space to accommodate this arrangement would be needed. FCA noted that currently 2 waiting rooms are programmed per floor, and suggested to convert one of the waiting rooms into a multi purpose room with dividers to be used as meeting rooms in the morning and as waiting room later in the day.

Page 5 of 6

Due Date

Item

Description

Action

Due Date

This would provide the following distribution per floor: • • • •

2 Conference Room 2 Consultation Rooms 2 Physician Workrooms 1 Multi-purpose Room (can be divided into 2 meeting rooms during morning hours)

The steering committee agreed to the above arrangement. Subsequent to this meeting NL, KJ and JC agreed to reduce the total number of consultation rooms on the 5th and 6th floors from 4 consultation rooms to 3 (120 sf each), to reduce the physician workroom/charting from 300 sf to 200 sf and to reduce the waiting room from 250 sf to 200 sf. These reductions afforded the following rooms to be added: • 1 Office – Chief Medical Resident • 1 Medical Resident Room • 1 Dayroom

@ 120 sf @ 250 sf @ 250 sf

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Steering\MIN.02_Steering.doc

Page 6 of 6

MINUTES OF DIAGNOSTIC MEETING NO. 4 RADIOLOGY PROJECT:


MEETING LOCATION:

San Francisco General Hospital, Radiology Library

MEETING DATE:

March 8, 2007 9:00 am : 10:30 am

ISSUE DATE:

May 25, 2007

ATTENDEES:

Kathy Jung (KJ) Mark Wilson Roland Pickens Richard Hollingsworth Chiu Lin Tse-Chan (CLTC) Nuno Lopes (NL) Samina Choudhry (SC)

DISTRIBUTION:


San Francisco General Hospital (SFGH), Facilities/ Support Services SFGH SFGH SFGH Fong & Chan Architects (FCA) FCA FCA


This meeting was held to initiate the programming effort with the Obstetric/Pediatric User Group. The following is a record of the items discussed. FCA presented and discussed the following attached documents: 1. Agenda of Meeting 2. Preliminary Detail Space Program, dated March 7, 2007 3. Preliminary Summary Space Program, dated March 7, 2007 4. New Hospital Space Program, dated March 7, 2007



ITEMS DISCUSSED:

Item

Description

Action

Due Date

NEW BUSINESS: A.

DEPARTMENTAL ISSUES

4.01

Interventional Radiology (IR) NL noted that 2 IR rooms have been currently programmed in the Surgery Department. The IR room in the existing hospital building will remain and be used for outpatient services. The user group requested the imaging equipment in one of the IR rooms to have integrated CT scanning capability. FCA increased one of the IR rooms to 700 sf to accommodate integrated CT scanning capability.

4.02

Ultrasound In lieu of two ultrasound rooms the user group requested one large room with 3 separate bays and one dedicated toilet. FCA revised the space program to include one 350 sf ultrasound room with one 50 sf toilet.

4.03

Reading Rooms The number of Reading rooms was discussed. FCA confirmed that separate Reading rooms for Cardiology (300 sf) and Radiology (150 sf) have been programmed. In addition FCA confirmed that a shared 300 sf PACS room was also included in the space program. The user group expressed some concern that not enough space was being provided for image reading. FCA suggested increasing the shared Conference room from 200 sf to 350 sf and adding a movable partition allowing the room to be divided in half. This flexible Conference room could be used as additional image reading or meeting room depending on the user needs. The user group agreed to the proposed approach.

FONG & CHAN ARCHITECTS will rely on these minutes as the approved record of matters discussed and conclusions reached. Should there be a different understanding of the issues described in the meeting notes, a written notice should be sent to Fong & Chan Architects within five working days of receipt of these minutes. Prepared by Nuno Lopes of Fong & Chan Architects F:\Proj338\Doc\Minutes\Diagnostic\MIN.04_Diagnostic.doc Page 2 of 2

San Francisco General Hospital Medical Center

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