Stakeholder Engagement and the 3-P Planning Process The success of the planning, programming, and design process for complex healthcare environments hinges upon authentic engagement with all stakeholders. Case in point: when designing for new models of care, such as the consolidation of hospital-based services with local physician-based practices, architects will find it vital to understand the diverse space needs and work flows of all team members in advance. New models of care have great potential to provide operational efficiencies for the providers while improving the patient experience; taking time to understand these multifaceted programs from a care provider’s perspective will yield the most effective design solution possible. In order to engage all stakeholders and provide the best design for a complex healthcare program, LS3P’s healthcare team leads clients in a series of 3-P planning charrettes. 3-P refers to “Production, Preparation, Process,” a component of Lean Design which optimizes the design process through rapid creation and testing of the operational model, program needs, and potential designs. Working closely with physicians, nursing and clinical staff, support services, administrative managers, hospital facilities personnel, specialty consultants, and the contractor, the design team leads a series of intensive design charrettes. The 3P process allows the building’s end users to develop the Program of Needs, enabling the design team to create an efficient work flow based on a new operational model. The team begins the process by analyzing the existing operational models and work spaces, highlighting the ways in which diverse operational models overlap or contrast. This shared understanding of work flows helps the team to develop new, patient-focused operational models with work flows and processes accommodating the needs of all entities based on shared goals and objectives. As part of the 3P process, the LS3P team encourages the solicitation of feedback from patients and their family members to ensure operations and design features are patient-focused. Without direct patient engagement, patient satisfaction questionnaires can provide valuable clues to needed enhancements in the operations and the built environment. Key stakeholders may also visit other “case study” facilities to discuss success factors and lessons learned. Following the initial charrettes, the design team will lead a series of design workshops with all stakeholders. These workshops help to refine the user-generated space program based on site visits, codes and standards, space constraints within an existing building, budget constraints, and recommendations based on the design team’s experience and expertise. During the process, much discussion and debate should focus on the patient experience. Elements such as greeting and registering patients and families, navigating a routine series of treatments, and wayfinding should be simple, friendly, and as non-intrusive as possible. During the workshops, the users work in teams and draw their own preferred layouts. Teams discover unanticipated challenges which always lead to better solutions. This process emphasizes the value of the users’ input, results in staff buy-in to the final solution, and is critical to the overall success of the project. Following the design workshops, LS3P will develop multiple plan options for review for program elements such as medical suites, ancillary services, reception/registration space, physicians’ offices, and education space. The options incorporate proven design elements that enhance healing and accelerate recovery. Emphasis is placed on patient and staff safety, operational efficiency, and flexibility. The design team may then develop detailed three-dimensional renderings or build mock-ups for specialized spaces such as medical exam pods, diagnostic and treatment bays, patient rooms, and the building exterior. These tools help the client and staff clearly visualize the working environment, and serve as one more step in meeting the desired project goals. “Designing in a vacuum” rarely leads to an effective solution; all relevant stakeholders will offer valuable insight as to how each group will interact with the healthcare facility. The 3-P process allows the entire team to gain a much clearer understanding of the needs, constraints, and opportunities for all entities, which is much more likely to result in very productive client engagement and a state-of-the-art design which will ultimately lead to better, safer care for patients and their families. About Todd Todd Reichard, AIA, LEED AP, is a Senior Healthcare Architect with more than 30 years of experience planning and designing healthcare facilities throughout the eastern region of the United States. Highly experienced in all stages of the design and construction process from master planning to final occupancy, Todd has a significant portfolio of new and replacement hospitals, renovations, and facility additions including all hospital treatment, diagnostic, support and administrative functions.