WRO Medical Support Center proposal on construction project



WROMSC_WRO Medical Support Center


Table of Contents


Executive Summary and Finance Application


1.0. Introduction

1.1. Healthcare in Evolution

1.2. Vision and Mission Statement

1.3. Background Information

1.4. The WROMSC Project

2.0. Structure and Approach

2.1. Organization

2.2. Departments

2.3. Scope of the Project

2.4. Human Resources

2.5. The Creation of New Facility

3.0. Site Details and Plans

3.1. WROMSC Site Details

3.2. Project/Facility Design and Construction

3.3. Construction Schedule and Budget

4.0. Planning for Services

4.1. Guiding Principles for Patient Services

4.2. Services to Patients and Research

4.3. Next Steps in the Planning Process

5.0. Project Financials

5.1. Budget Assumptions

5.2. Revenue Assumptions

5.3. Operating Expenses

5.4. Cash Flow and NPV Analysis



The Project


The WROMSC is a comprehensive community hospital providing the full range of primary and secondary appropriate to the needs of 21stcentury. WROMSC is a modern acute-care facility providing a vital care of inpatient, outpatient and emergency services in a caring and personal community setting in Seoul.


Number of Beds : 750, Number of Physicians and Staff : 500



The Organization


In Jun 2002, the Board make preparation by POSRI Development. As per the WROMSC Organization, major planning for organization has been completed and the composition and mandate were set out immediately.



The Facility


The functional evaluation focused on 37 clinical departments in each facility. The WROMSC facility concepts for future healthcare model are focused on creating a facility environment that is easily accessed, human in scale, genuinely addresses the needs of the patients and families, accommodates the special concerns of caregivers, and integrated the activities of clinical research with patient care.


Total building area is 86,691 square meters(26,224py) on the lot of 10,780.9m2(3,261py).



The Location


The Project, well located within the densely populated Yongdeungpo-gu of Seoul, will receive full support and cooperation from the City. The selected site is suitable for accessibility, the need to service the catchment area, services delivery considerations and community support.

Location: Seoul, Korea


Land titles and contract will be secured for new hospital redevelopment on the existing hospital site, and parking and residential areas.

The Project Design


The project aries from the urgent needs, felt throughout society, to modernize our local healthcare system so that advances in knowledge, technology, and communication can better meet the population's needs for quality, access, and cost-effective operation. This hospital building goes beyond health services proper to deal with concerns having to do with the heritage of buildings and the fabric of the urban environment.

The project will take approximately 28 months to construct and an additional 2 to 3 months to obtain land approval from the City of Seoul.

The WROMSC Services


All of the services which will be provided by the WROMSC, were carefully planned with a new vision of the future. The service profile provided details the capacity required at the WROMSC for each clinical specialty and provides for enhanced service provision in modern facilities complemented by advanced technology. This includes outpatient services, acute inpatient services, emergency department services, and sub-acute/aged care services.



The Project Financials


The project development budget, including design, management, construction, other facilities including medical equipment, and WROMSC pre-opening costs is $268,006,000 excluding land for the existing hospital. The projected building cost per square meter is $1,260.42.


The total project value is $297,025,000 and therefore the total loan required is $268,000,000 over 20 years, with a five-year grace period on principal repayments as scheduled in the Cash Flow Analysis.


Ensuring the feasibility of the WROMSC Project requires that the financing approach used be based on a realistic and even conservative model of revenues, payments and cash flow. The model adopted was flexible and allowed to predict the impact of changes in revenues or expenditures on the overall cash flow requirements. The Board should undertake a capital funding with a target of $ 29million for purchase/preservation of land/building. The balance of funding would be obtained from institutional lenders in the form of a mortgage to be repaid from operational savings.



1.0. Introduction


1.1. Healthcare in Evolution


The healthcare system is society's means to its sick and injured :


It also works to promote health and prevent illness. It is a complex tool that brings together all our scientific, humanistic, technological and organizational capacities. While it works remarkably well, on the whole, its many components are goal.


In the middle 2002, WRO Medical Support Center(WROMSC) as a new model for healthcare in the 21stCentury, has been undergoing a far-


reaching reconceptualization, primarily due to progress in knowledge, enormous advances in technological capacity and the expanded understanding of an educated population. This work has been stimulated by the population's changing expectations, needs arising from a longer life expectancy, and the emergence of new diseases. We know, from our own reflection and from the experience of others, that it is possible to respond to people's healthcare needs in better ways, with higher quality and at a lower cost overall. But it has been the overwhelming need of our society to put its finances in order that provided the irresistible impetus to change. We at WROMSC foresaw that change is inevitable, necessary and possible. We undertook a feasibility study and a planning process which goal was to develop a blueprint for the future for patient services and research. We now have a concrete visionary, yet realistic plan for the future operation of WROMSC, within the framework of the vision being implemented by the acting board of directors.


The key elements of that plan, as described in the following paragraphs, are ; appropriate integration of services and research to serve the needs of the patients across the lifespan in our hospital ; partnership with other healthcare providers in a network to ensure a coordinated continuum of services to patients, along with related research ; and a new facility that is fully supportive of patient and their families, staff and researchers.



1.2. Vision and Mission Statement


The basic value system inherent to the mission and vision of WROMSC includes the following characteristics :


* Pursuit of Excellence


* Commitment of Healing and Health Promotion


* Respect for People


* Preservation of Organizational Strength


* Responsiveness to the Public


WROMSC's vision is that of partnership in an emerging healthcare delivery system that will provide and easily accessible emergency services, acute inpatient care, medical management, outpatient diagnostics, and therapeutic care locally within its own communities. WROMSC believes that new programs targeted at the promotion of wellness will bear equal value to those that already provide for the treatment of illness and thereby commits itself to working with the other community agencies in the promotion of community health. The WROMSC not only provides care, but is at the forefront of advancing and imparting knowledge to improve care and the health of the population it serves. WROMSC's clinical services will continue to be inextricably linked to enormous research capacity. Research is the process by which we discover fundamental knowledge about biological science that in turn leads us to develop and evaluate new and better diagnostic, treatment and rehabilitation methods. This linking of research and service is society's best guarantee of quality in healthcare, and of continued innovation and improvement.

Services Across The Lifespan


The WROMSC will represent the voluntary hospital serving adult patients and children together. The fact of unifying adult and pediatric services is an important innovation in WROMSC, although a growing trend in Korea. This is based on recognized advantages in terms of promoting continuity of care, especially from adolescence to adulthood, and of having concentrations of expertise, technology and services that are relevant to specialty care for all age groups. Underlying this trend is the fact that the same scientific basis of medicine is applicable to all ages. In addition, significant benefits arise when a critical mass of professionals work to solve problems together. The specific psychological, environmental, and technical needs associated met through careful attention to facilities planning, care processes, and selection of staff.



Network Partnerships


The WROMSC sees its role as a leader and an equal partner in a regional health care network which is the appropriate setting for the provision of much patient care. Within the network, our particular focus is on patients who require specialized expertise, complex treatments or scarce technologies. A wide array of telemedicine technologies and diagnostic tools is being developed today which will change fundamentally the way services are provided as well as the location. The WROMSC will build upon the opportunities created by computer-related matters.



A Fully Supportive Facility


Chief among the resources at our disposal to carry out mission are our facilities. The built environments of hospitals, as much as the technologies they house, are important tools in the process of treatment. Our planning process looked at the capacity of our buildings to serve the WROMSNC's mission into the 21stcentury, and to adapt further in the decades ahead ; the results of this planning are described further in this


report. Facilities with better infection control, ventilation, and lighting, with more circulation, are not only more welcoming to patients and their families, but lead to better care. Within this healing environment, patients will experience less stress and recover sooner, and the facility will be supportive of staff, who will be able to work more effectively and productively. To meet the population's needs and expectations for cost-effective, high-quality healthcare that respects the best standards in modern practice, we intend to build a new hospital. Our target date to achieve this is 2005.



1.3. Background Information



1.4. The WROMSC Project


The WROMSC will be a comprehensive community hospital providing the full range of primary and secondary services appropriate to the needs of the community and will work with other hospitals to ensure effective linkages and referral arrangements. WROMSC is a modern acute-care facility providing a vital core of inpatient, outpatient and emergency services in a caring and personal community setting in Seoul. Advanced technology and a hight number Board certified physicians offer strengths in the areas of Surgery, Ambulatory Care, Maternity, Critical Care, MRI, Radiology, Dental Care and Laboratory. Specialty programs in such as Heart & Lung, Mammography, Spinal Clinic, Pain Clinic, Childcare/ Counseling, Physical and Occupational Therapy, Oncology, and Social Services, enhance WROMSC's wellness programs. Affiliation with tertiary care facilities provide additional sophisticated services to patients while the paramedic program and healthcare programs bring medical services out into the communities WROMSC serves.


Number of beds : 750, Number of physicians and staff : 500


The WROMSC operator will be free to apply to collocate with the WROMSC fully private health services establishment providing fully private admitted patient care, including fully private medical care and accommodation, to patient who choose to be admitted to that establishment. The government will not be prescriptive about the extent and manner in which the fully private patient services are provided as long as they do not in any way derogate the delivery of the required private hospital services for the WROMSC and designated services outcomes. The construction of a new, 21stcentury hospital, based of the most recent design concepts and building technologies, would engage partly some sectors of the


Seoul economy and could lead to the development of expertise which would put local companies in an advantageous in the market.



The WROMSC Project should :


● deliver a comprehensive hospital/health service which meets the majority of identified needs of the regions of Seoul ;


● ensure the effective integration of services with other hospital/health services provided in the region and other regions ;


● ensure that the services are delivered from state-of-the-art facilities in a cost efficient and effective manner ;


● establish a model for participation by the private sector in the delivery hospital/health services ;


● ensure that the Project meet Government policy objectives and is implemented in accordance with other principles ;


● ensure that the Project meets health policy objectives and supports private sector investment in the local healthcare system ;


● and ensure that all the services and facilities of the WROMSC are available for professional training of doctors, nurses and other health professionals.


By stating only the management specification and a few facility specifications, this Project Brief aims to encourage innovative planning for the delivery of services to patients. The project brief proposes an infrastructure project established on a Build, Own, and Operate basis. Under the Board, the planning and steering committee is to assume responsibility for design, construction, ownership, financing, operation and maintenance of the WROMSC.

Our planning process looked at the capacity of new building to serve WROMSC's mission into the 21stcentury, and to adapt further in the


decades ahead ; the result of this plan are described further in this report. The original design of building will be modified to incorporate new diagnostic and treatment modalities.


Our intention is to provide Seoul and the vicinity with a facility designed to produce the best healthcare outcomes.


● provide a true healing environment for our patients and satisfying work environment for our staff :


● are easily accessible to patients, staff and visitors:


● make it possible to organize services in the most effective ways, and especially by bringing related services closer to each other for the benefit of


patients and staff :


● are flexibly designed to respond to changes in needs over the coming decades :


● and encourage and facilitate excellence in service in service and research activities :


Located so as to be easily accessible, the facility will incorporate construction features that make it both cost-effective to operate and easily adaptable to modification in the future. Such a facility will be a tangible symbol of progress and security, not only will this make possible a more cost-effective operation, but it will fit in perfectly with Seoul's continuing development as a center for biotechnology and other health related industries. As outlined in this report, the search for a new site has proceeded with rigor and discretion, and according to criteria established during this feasibility study. The process we are using to conduct this matter is conscientious, and respects the principles of public accountability and fiscal responsibility. To build this facility will require the support of the support of the stakeh olders(the Board), including the long-term borrowings. An initial capital is expected to raise one-quarter of the funds required. The steering committee will be asked to contribute to the construction of WROMSC. The remainder of the cost of construction will be financed through foreign institutional lenders(overseas loan) and paid from operating savings generated by the new facility. In Jun, 2002, the steering committee was formed, agreed and signed a memorandum of understanding setting out their commitment to this project.