GS&P DIALOGUE - "Planning"

Crystal Balling Healthcare Reform

Fri, 04 May 2012 07:47:42 GMT

Sitting on pins and needles as you await the Supreme Court rulings associated with the constitutionality of the Affordable Care Act? Baby Boomers have been entering the Medicare program this year at a rate of around 7,000 each day. By 2014, millions of Americans will find themselves newly eligible for Medicaid or exchange-based private insurance due to the coverage expansion provisions of the Patient Protection and Affordable Care Act – providing the Act is enacted as planned. Meanwhile, the individual insurance mandate may or may not be found constitutional.

Improve Quality of Care While Reducing Operational Costs

Fri, 04 May 2012 07:47:21 GMT

Improve quality of care, reduce costs – does that sound familiar? These days, hospitals across the country are increasingly being asked to do more with less and are expected to improve their level of care while cutting expenses. I recently participated with a team of designers at GS&P in developing a design response to Kaiser Permanente’s Small Hospital Big Idea competition which challenged the design community to propose meaningful change in support of how this notion could become a reality.

How Can You Start to Implement Complete Streets In Your Community?

Mon, 06 Feb 2012 16:47:48 GMT

GS&P's Marshall Elizer, P.E., PTOE is guest blogging today on the National Complete Streets Coalition's blog. In his post, he offers suggestions for how others can start to implement Complete Streets in their communities.

Reflections on 2011: A Year In Healthcare

Mon, 19 Dec 2011 16:52:30 GMT

When asked to present reflections on 2011, I found my mind turning to my fine colleagues at GS&P and their many recent achievements. I have proudly watched my extraordinary colleagues repeatedly win competitions and awards such as the Healthcare Design 2011 International Architectural Showcase Citation of Merit Award presented to the Seoul National University Hospital Medical Mall team by the American Institute of Architects and Center for Health Design; the Kaiser Permanente Small Hospital Competition (shortlist of three finalist firms); and the Methodist Le Bonheur Healthcare Olive Branch Medical Center competition with its integrated project delivery approach; in addition to a host of others.

My mind also turned to the encouraging signs of economic recovery that are steadily emerging and of the dramatic change that is sweeping the national healthcare industry. During 2011, we've witnessed a healthcare revolution materialize in direct response to medical error rates and the costs of healthcare. We've listened as our federal legislators have called for healthcare providers to accept accountability for the quality of care and the costs. Federal legislation has encouraged the creation of accountable care organizations, where providers and payers are joining ranks to deliver higher quality, more efficient, lower cost care. We've observed the continued emergence of regional super powers who have acquired a number of the struggling, but promising hospitals who in many cases do not have the balance sheets to sustain.

Job Well Done; The Impact of Recognition

Thu, 28 Jul 2011 12:53:44 GMT

"Job well done!" What does reading those words do to you? Recognition causes a wide variety of emotional responses in people. To some it may lift spirits after several long weeks or months of hard work. To others it may reaffirm that the difficult project decisions that they had to make were the right ones. Maybe you realize how valuable another member of your team was in achieving success. As a designer, recognition of one of your projects could mean the culmination of several years of intense study, research, apprenticeship and teamwork into a single deliverable that is now recognized as good design.

The Gas Station of the Future

Thu, 21 Jul 2011 14:46:23 GMT

As construction of the new GS&P-designed solar-assisted vehicle charging stations at Nissan's facilities in Smyrna, TN comes to a conclusion, I was asked if we are looking at the "gas station of the future". At first glance, it certainly looks the part: several Nissan Leafs lined up beneath a futuristic PV panel-covered canopy and connected to a series of phase 2 chargers by cables.

The case for electric vehicles could be pretty strong. A previous GS&P Dialogue post (Electric Cars: Environmental Boon or Bust?) discussed the impact the movement towards electric vehicles will have on our electricity infrastructure, but what about the changes it may bring to our neighborhoods and streetscapes? Will fuel stations in the form of ubiquitous, multi-vehicle facilities with convenience store appendages occupying convenient and often prominent locations (read valuable real estate) on our cities' main boulevards continue to be the model for serving an electric vehicle fleet?

Sustainability and Livability on a Regional Scale

Wed, 01 Jun 2011 09:33:42 GMT

Being in New Orleans, this year’s AIA Convention placed a significant focus on sustainable community and regional development. In a seminar entitled "Sustainability and Livability on a Regional Scale" we heard from the leaders of three government sponsored organizations and how they work together to realize a cohesive plan for the San Francisco Bay Area.

The Bay Area is composed of nine counties and 101 communities of various sizes, and has seen a sustained explosion of growth over the past several decades. Until recently, each community maintained a degree of separation adequate to retain a sense of independence. But several challenges have arisen that have put an end to that illusion.

You Want HOW MUCH for a Gallon of Gas?

Thu, 21 Apr 2011 08:51:04 GMT

A holistic approach to sustainable transportation.

Anyone who’s spent much time behind the wheel of a motor vehicle lately has no doubt felt the pain associated with skyrocketing gas prices which, according to AAA, have risen an average of almost $1.00 per gallon over the last year. You’ve seen your monthly gas costs rise precipitously and will no doubt think twice before loading up the minivan and driving the family to the Grand Canyon this summer. The long term implications for family budgets are scary.

Across the nation, transportation professionals are wringing their hands at the task of building new roads and keeping existing ones in good repair to keep pace with growth in traffic demands, all while federal transportation dollars are shrinking. To wit: according to a recent report from the National Surface Transportation Infrastructure Financing Commission, over the period from 2008–2035, if current trends continue, there will be enough money to maintain only 44 percent of the of the current transportation system and to make only 36 percent of necessary improvements. Cities, regions and states simply can’t sustain their road programs into the future.

The Pros and Cons of Single Family NICU Rooms

Wed, 30 Mar 2011 10:30:12 GMT

For no apparent reason my son, Noah, was born five weeks early. That may seem like no big deal, but when you’re a first-time parent and your tiny baby is in the neonatal intensive care unit (NICU) attached to all sorts of devices… it's a REALLY big deal. I gave birth in what is known as the “baby factory”, a metropolitan hospital in the southeast which delivers approximately 18,000 babies each year. The care we received was outstanding. The neonatologists and NICU nurses were incredible. I’ll never forget Nurse “Q” as she cuddled my son and affectionately called him Boo Boo.

In spite of the high quality of care we received, I was uncomfortable in the NICU environment. As I passed by, I glanced at the other NICU babies (although I knew I shouldn’t stare), some much smaller than my own. I was intimidated by the tubes and needles and beeping alarms all around. I felt uncomfortable trying to breastfeed with just a privacy curtain separating me from the others in the room. The nurses recommended we provide our baby with skin-to-skin contact (known as “kangaroo care”), but that too felt awkward given the limited privacy, so I didn’t do it much. As my son’s condition improved over the next several days, he was moved into a room that housed only three infants, and I was more comfortable in that environment. Of course Noah was healthier too, so that eased my mind.

Are You There Airport Director? It's Me, the Terminal

Fri, 25 Mar 2011 19:05:02 GMT

Dear Airport Director,

Excuse me, but have you seen me lately? I'm not exactly a spring chicken any more. Us boomers have to look after ourselves you know. A few upgrades would go a long way to bridging the gap between today and retirement. I think you should really consider a few investments in this terminal body.

Have you seen my friends CHO and TPA? Wow, are they looking good! Refurbished terrazzo, no more spalling, no more dull spots. Good to go for many more years and the updates help them to become easier to maintain too.

Have you heard the talk about how energy efficient I could become? New energy efficient light fixtures would almost pay for themselves. And the cost to keep me conditioned? An upgrade here or there could save energy and lower some bills. It wouldn't hurt to save some money now to put into my retirement account.

The Hype and Fervor Over Accountable Care Organizations (ACOs)

Wed, 23 Feb 2011 08:46:37 GMT

In a recent interview for a keynote speaking opportunity, a State Hospital Association VP quickly moved to their desired agenda. “It’s all about ACOs! What are all the magic numbers? What is the required size (covered lives) of the community? How many primary care providers do we need? How do we measure risk?” The hype and fervor over Accountable Care Organizations is undeniable, but for most unwarranted.

For the vast majority of hospitals, planning for your transition to an Accountable Care Organization is like a high school coach planning on taking his team to the Olympics. While there may be one or two individuals with the potential to compete at that level, they are years away from being ready. The journey will require more training, new measures of performance and the ability to accept some loses.

'Twas the end of my patience and all through the lot, in the worst holiday traffic I found myself caught.

Tue, 28 Dec 2010 10:21:32 GMT

As I muddled through what seemed like an endless disarray of traffic this past Saturday evening, two things occurred to me: 1.) I’m not the only one that waits until the last minute to Christmas shop; and 2.) driving can often be a very frustrating experience.

Surely others must feel this way, too. The question is, have we reached a tipping point such that people will shun their cars for different, better options?

Leveraging Form-Based Codes

Tue, 07 Dec 2010 13:26:52 GMT

The competition among regions, cities and neighborhoods to attract and retain employers, residents and visitors has arguably never been greater. And, this in turn is driving many communities to reexamine their planning policies and regulations. Whether it’s greenfield development or urban redevelopment, a corridor or a neighborhood, cities and towns across the nation are increasingly asking, “How can we implement our community’s vision and compete in today’s economy?”

Health Care Reform: If You Fail to Plan, You Plan to Fail

Tue, 29 Jun 2010 12:43:32 GMT

Too many hospital administrators continue to squander the precious present, while they wait for some documentation or signal from Washington, D.C. that the future of health care has been decided. These are the same individuals who were waiting for clarity with the passage of the healthcare reform bill. It has now been longer than three months since Vice President Biden sent up a flare and notified us what a big deal this truly is. By now we have had the opportunity to read numerous interpretations and insightful implications of the bill. The challenges are significant and for many unsettling, but the direction is clear. The sooner we get past the anger and fear, the sooner we can arrive at responsibility and intention.

Can You Handle It?

Tue, 16 Jun 2009 10:24:36 GMT

Baggage Handling Systems (BHS) continue to evolve with a focus on creating a better staff and passenger experience, greater efficiencies and increased safety. Automation and self-service options have long been utilized as ways of improving services and increasing productivity.

The advent of "no-lift" designs at ticket counters has improved the level of automation in recent years. As installed in the Alaska Airlines terminal at Anchorage International Airport (ANC), the ticket counter take away belt runs perpendicular to the main take away. The passenger sets a bag on the belt to be weighed; when complete the belt advances to the main take away and from there to the BHS matrix for level 1 screening. This process helps to reduce the repetitive strain injury associated with such tasks typically performed by an airline or TSA agent, thus reducing workers compensation claims and operational costs. Recently this "no-lift" design approach has evolved to the baggage inspection rooms, where such devices allow the TSA to perform trace detection without the need to lift and carry the bag from alarm line to ETD table, and then to a cleared bag line.