To complement these architectural initiatives, Andy Parker and Becky Hayward of Buro Happold outlined how they have developed computer modelling software to analyse the utilisation and efficiency of circulation and waiting spaces on the RUH and other hospital sites with a view to informing the briefing and design processes.

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AfH 2015

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Approach
RUH Pharmacy
RUH OPD Utilisation
AG ENDA

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SMART H E ALTH C ARE
BENEF ITS/AP P ROAC H TH RO U G H
P ROJ EC T/BU ILDING LIF E C YC LE

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SMART H E ALTH C ARE
EVIDENC E BASED MO DELLING
Experience Costs
Key outcomes
Registry Triage
00
Facility
Design
Operational
Management
Patient
Pathways/Demand

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Gather
data
Journey
analysis
Activity
analysis
Identify
scenarios
Test
options
O U R AP P ROAC H

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Case Study 1:
OPD Utilisation

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GETTING MORE FOR LESS
Royal United Hospital, Bath

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We’re too
busy!
Need more
space!!
Opthalmalogy
Gastro Pain
Diabetes

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U NDERSTANDING F LO WS AND DEMAND
DATA G ATH ERING
Historical data
Automated technologies
for capturing data
Site visits, staff
interviews and surveys

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• Average 34% observed utilisation during peak
• Average 16% observed utilisation during off peak
Waiting room usage – Max. no. people
Outpatient departments

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Waiting room usage – Max. no. people
Outpatient departments

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TESTING F U TU RE O P TIO NS AG AINST KP IS
DY NAMIC MO DELLING

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Case Study 2:
Pharmacy

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P H AR M AC Y
People Movement Study
• Tracking of staff movements and
behaviour
• Assess current performance
• Layout optimisation to enhance efficiency

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Gather
data
Journey
analysis
Activity
analysis
Identify
scenarios
Test
options
Deliveries
Robot area
Corridor Unpacking area
Stores area
Key scenarios
Mon – bulk deliveries
Weds – deliveries throughout the day
O BJ EC TIVES AND KEY SC ENARIO S
Key areas
Key metrics
Walking distances
Time spent walking between locations

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Gather
data
Identify
scenarios
Test
options
Journey
analysis
Activity
analysis
DATA G ATH ERING AND KE Y ME TRIC S
Stores areaRobot & Dispensary

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Gather
data
Identify
scenarios
Test
options
Journey
analysis
Activity
analysis
Ward
boxes
Main
Dispensary
Robot Shelves
Terminals
Fridge
Unpacking
area
Deliveries
To aseptic
suite
IV store
Pigeon
holes
Pull-out
shelves
Origin of incoming deliveries
Flow of staff
Processing point of incoming
drugs
Storage point of incoming
drugs
J O U RNEY ANALYSIS – P RIMARY F LO WS – STO RES STAF F

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Gather
data
Identify
scenarios
Test
options
Journey
analysis
Activity
analysis
Deliveries
Staff movements
Deliveries
Staff movements
Monday Wednesday
AC TIVIT Y ANALYSIS – F REQ U ENC Y O F AC TIVITIE S

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09:48:20
Camera 1
09:49:04
Camera 1
09:49:08
Camera 2
09:51:27
Camera 3
AC TIVIT Y ANALYSIS – TRAC KING STAF F MO VEME NTS
Frequencies Dwell times
Order of
movements

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Back of
Robot
Robot
Terminal Ward Boxes
Pull out
shelves
Main
Dispensary Pigeon holes Store shelves
Store
terminals (1) Fridge
Store
terminals (2)
Unpacking
area
Out of
bounds
Back of
Robot 7 10 14 1 4 12 7 6 2 6 7 3
Robot
Terminal 25 12 28 6 3 3 3 1 3 4 1 3
Ward Boxes 8 30 11 2 1 4 6 2 0 0 2 5
Pull out
shelves 0 5 2 1 21 0 4 0 0 0 1 0
Main
Dispensary
2 6 2 18 7 19 6 7 5 9 5 13
Pigeon holes 7 4 5 3 18 6 11 23 0 1 1 4
Store shelves 5 5 5 0 4 19 54 24 2 7 18 10
Store
terminals (1) 8 8 2 0 5 12 30 43 2 5 7 17
Fridge 2 1 1 0 2 1 2 2 21 23 18 9
Store
terminals (2) 7 5 0 1 10 0 8 6 19 40 48 18
Unpacking
area
2 1 0 0 7 0 17 9 19 51 55 37
Out of
bounds
6 3 3 1 18 7 3 17 9 17 37 187
From
To
Many movements between :
Store shelves
↔
pigeon holes
Stores terminals
↔
pigeon holes
A high number of trips between any
stores area and:
• Back of robot
• Dispensary area
• Pigeon holes
F REQ U ENC Y O F TRIP S BE T WEEN ARE AS
Stores staff
MON

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This analysis shows, stores staff spend:
• In total 307 minutes
• On average 26 minutes (per staff
member)
each day walking between functions
Stores staff
MON
TIME SP ENT WALKING BE T WEEN AC TIVITIE S

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CO M PAR IN G P E R F O R M AN C E
Original proposed layoutExisting layout
Original proposed layout offers good access to the robot
but
No significant improvement in walking distances and times
0 10 40m 0 10 40m

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DY N AM IC M O DE L L IN G O F P E R F O R M AN C E
Final proposed layoutExisting layout
Proposed layout offers a compact and efficient footprint for the majority of movements

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Benefit of Evidence
• Enables informed conversations with consultants and staff
• Enables designs to be optimised with measurable efficiencies
CO NC LU SIO N

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smart.burohappold.com
Shrikant.Sharma@burohappold.com
Becky.Hayward@burohappold.com