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



4.0. Planning for Services


4.1. Guiding Principles for Patient Services



WROMSC's services will be characterized by :


● A strong, unwavering focus on the needs of patients of all ages, as well as on the patient's family.



Patient care will :


- be provided close to the patient's community whenever appropriate.


- involve innovative delivery models.


- entail minimal disruption of patient and family.


- include support for the full range of patients healthcare need ;

  physical, psychosogical, cultural and spiritual.


● Leading-edge clinical expertise and technology.


● Coordination, continuity of care, and close cooperation among disciplines within a network of healthcare providers.



The WROMSC environment will be characterized by :


● Patients engaged in their own healing with :


- a full partnership between patient, family and healthcare providers.


- attention paid to patients' physical, phychosocial, cultural and spiritual needs.


- the support of caring healthcare workers.


- comfortable and inviting facilities.


● Information systems readily available for the use and support of patients and providers.


● Service locations within the WROMSC based on patient needs while recognizing the interdependency of services.


● Easily accessible facilities in terms of location, design, and service organization.


● An atmosphere that attracts, develops and retains the best healthcare workers.



To serve its community, the WROMSC will :


● Encourage and act on input from the community at all levels.


● Innovate and advocate to provide services that set standards for best performance across all levels of care.


● Promote services and research linkages to a network of healthcare providers.


● Work with a network of healthcare providers to ensure a seamless transition for patients.


● Ensure that services are most effective by maintaining the necessary clinical volumes.


● Implement changes based on continuous evaluation of outcomes.


● Promote the health of the population through advocacy and community education.


● Orient its services to make efficient use of public resources available for healthcare.



4.2. Services to Patients and Research


The WROMSC has undertaken a broad planning process to develop a blueprint of future for patient services and research. This planning involved healthcare professionals, patients, researchers, and partners. The vision for patient services and research that emerged was subsequently validated through internal consultation. The advisors comprised of experts in clinical epidemiology, healthcare economics, and health record and utilization management, advised on the appropriate analysis and applications of hospital and other healthcare data, such as forecasting future population needs for WROMSC services.



A New Vision of the Future


The vision for patient services that emerged from this study can be summarized in three themes :


● The patient and family are central to the organization of care.


- Patient and their families need to participate actively in the care process.


- Services will be provided to patients of all ages.


- Each patient's care will be coordinated, both within the WROMSC and across the network.


● The WROMSC will offer care and research of the highest quality.


- The most advanced technologies will be available.


- Many disciplines will contribute to the care of the patient.


- Ongoing research is the most powerful way of ensuring that new knowledge is developed to improve care.


● Strong network partnerships are essential.


- Community-based physicians will participate actively in the primary care network.


- Other kinds of community clinics will be developed.


- Community hospitals throughout Seoul will have a changing role.


- Rehabilitation hospitals/centers and long-term care facilities will have better links with the WROMSC.


- Birthing centers will become an increasingly important part of the network.



Utilization of Services


As mentioned early in Section 2.2. Scope of the Project, an important task of the patient services planning is to forecast service volumes. Utilization data for 1992-97(AppendixⅡ) were used as a baseline for the forecast. Taking into consideration expected changes in population and demographics, and using a combination of past utilization trends and the best judgement of clinicians, the forecast gives an estimate of utilization of in 2005, which is a key factor in planning the size of the new facility. The service profile provided in this report details the capacity required at the WROMSC for each clinical specialty and provides for enhanced service provision in modern facilities complemented by advanced technology.

Outpatient Services


The WROMSC will assist patients, transition between inpatient services and the community.



The WROMSC will provide :


- access to specialist ambulatory medical clinics to complement inpatient services ;


- and a system that draws on the expertise of medical, nursing and other health professionals to offer effective solutions.


Acute Health Inpatient Services


WROMSC is an entirely new facility. Based on research conducted into demand, it is estimated that the WROMSC will require ranging between 700 to 750 inpatient beds and 20 to 25 day only places in its first year of operation.



Emergency Department Services


An Emergency Department will be required to provide the local community with 24 hour emergency medical and surgical care that will cater to the size of the catchment population. The Emergency Department will be integrated with other emergency and after hours services available in the region. It is expected that the WROMSC will develop effective procedures to ensure ambulance transport services are provided seamlessly within its operations.



Sub-acute/Aged Care Services


The WROMSC will be required to develop a coordinated approach to delivery of sub-acute services and form effective linkages with acute health services, mental health services and community-based health and support services to ensure continuity of care.


Services will include :


- access to an extended range of allied health staff, include :


- counseling, physiotherapy and occupational therapy ;


- access to facilities which enable normal activities of daily living, mobility and functioning to be assessed ;


- access to orthotic and prosthetic services ;


- and established linkages and protocols with day care and domiciliary support services to permit prompt discharge and continuity of care.

Planning for Research


The committee is mandated to identify the concepts and means required for development and maintenance of research as an integral part of the WROMSC. Before functional programming can be undertaken for the new WROMSC research, a plan will be developed that describes in detail all the research programs to be housed in the WROMSC, as well as expected technologies, support services, storage needs, and administrative services. Particular attention is being given to developing thematic axes of research that clinical research in the patient care setting, epidemiologic research in the population, and basic research in the laboratory.



4.3. Next Steps in the Planning Process


Preparing for Functional Programming


While a great deal of planning has been carried out over the past 2 months, the WROMSC is not yet at the point from which it could proceed with functional programming for a facility. To understand the task ahead, the concept of functional programming must be reviewed simply put, before a facility can be designed, each of the functions carried out in that facility must be identified, the required resources(staff, equipment and environment, etc.) defined, the flow of people and processes well understood, and the relationships between that function and other clarified. Then, for each such functional area, a program is drawn up that details the space needs technical requirements(i.e. special ventilation, temperature controls, water and gases, lighting, etc.) adjacencies with other functions, with preliminary design.



Integration of Services


Since Jun 2002, the planning committee has been working of assess how the WROMSC should integrate its services in the transitional period leading up to new facility on one site in 2002. This planning has been focused on the short term, with the goal of short-term pretax income(PTI). The purpose has been to respond to an urgent and current need to centralize resources. Over this time, with the support of clinical heads under the leadership of the chairman, 37 clinical areas as shown in Section 2.1, are being assessed, and reports will be prepared for each, identifying in general terms the visions of each clinical program or department for how it would function during the transitional period. Then, a number of programs will be asked to participate in a second phase involving a more detailed feasibility study based on such criteria as advantages for patient care and cost efficiency. Subsequently, it will be decided to bring together a number of programs at the adult hospitals, which are in various stages of implementation.



Transition Planning


This exercise will prepare the WROMSC for an effective function programming and preliminary design process. In addition to this, some other activities required over this year include :


- impact studies, zoning negotiation, and public consultation related to the new site ;


- public consultation related to the overall project.


- further fine-tuning of assumptions underlying the financing strategy.


- working with the regional board and potential network partners to further develop networks of care and research.


- on-going development and implementation of a communications program to ensure continued internal and external support for the project.


To carry out the transition planning exercise will require extensive consultant support. WROMSC will require consultants with a detailed knowledge of how hospitals work, access to good information about best practices in every area of hospital activity, and administrative processed in a complex environment. Such consultants must also offer skills ranging from information systems expertise and knowledge of healthcare technologies, to conflict resolution and consensus-building.