Guidance for Reopening Decommissioned Healthcare Facilities to Accommodate COVID-19

Healthcare organizations across the country are facing an unprecedented need for safe and additional spaces for COVID-19 care. Many are experiencing capacity challenges due to the swell in patient volume, especially those with existing space deficiencies. As the situation continues to rapidly evolve, ensuring adequate care capacity to handle all incoming patients is imperative.

While the evolving situation and challenges are daunting, there is a significant opportunity to reopen previously closed healthcare facilities to handle the increased need for care capacity. Governing bodies at the federal, state and local level, as well as private healthcare providers, often own many decommissioned or vacant facilities well-positioned to handle a surge in patient volume. A prudent and expedited recommissioning strategy must be developed that considers facility condition, safety and capability to handle new patients.

As the need for space and equipment to care for COVID-19 patients grows, healthcare administrators need accurate data and sound guidance to make immediate decisions. Quickly developing a recommissioning or repurposing strategy quickly takes the right people and the right tools.

To help, the Facility Optimization of Solutions of CannonDesign team is volunteering its services to organizations with immediate needs within New York State or within driving distance of Denver, Colorado or Houston, Texas.

Facility Optimization Solutions of CannonDesign is a group purpose-built to provide strategic physical asset management consulting for clients in all markets. Based on the group’s experiences, they’ve outlined a number of best practices for understanding a facility prior to recommissioning or repurposing.

Collect the right data

Relevant and accurate data is the foundation of decision making. Architects, engineers, former healthcare facility managers and other professionals should be deployed for field data collection on any assessment engagement. This blend of experience creates a comprehensive understanding of facility assets ensuring that stated issues, recommendations, and action prioritizations reflect the as-observed existing conditions.

Tablets or smartphones with software built for facility assessments are a data collection necessity. They ensure a consistent process in the field, a database for information storage and analysis and a platform for conducting cost estimating and quality assurance.

Focusing on critical facility systems and components is key to understanding the feasibility and associated costs of recommissioning or repurposing. Electrical distribution and mechanical equipment, including backup power generation and plumbing including fire protection, should be completely analyzed to ensure safe and reliable facility operation can continue while occupied.

Accurate cost estimates and consistent reporting

Following the initial data collection steps, asset deficiencies should be assigned probable costs for mitigation. Estimating the direct costs of the deficiency—whether it be maintenance, renewal or replacement—is critical for later analysis and comparison of assets. Once deficiencies are fully developed with recommendations and costs, they should be compiled into an asset summary report that contains relevant information for both administrators and facility managers.

Part of finalizing the assessment is developing a facility condition index. An industry-standard metric, the FCI is a simple ratio that compares the cost to fix divided by the cost to replace. A powerful comparison tool between like and unlike assets, the FCI is the first-glance view of an asset’s condition. FCI tranches may be developed to make quick and accurate yes-or-no decisions regarding the viability of facility recommissioning or repurposing.

Strategic actionable plan execution

Once all the data is gathered, an actionable execution strategy may be initiated. Lists of assets to be recommissioned or repurposed are built followed by developing projects based on the deficiency recommendations and costs. These projects can be easily bundled using capital planning software where project costs including contractor mobilization and overhead is added to understand the total cost implications and schedule, then finally procured through the proper channels.

Strategic facility recommissioning and repurposing may help health organizations increase their testing capacity, dedicated and isolated space for COVID-19 treatment or for other necessary functions critical to slowing the spread and optimizing care.

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Posted April 1, 2020

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