TOP 10: Secrets to Successfully Integrating BIM in Hospital Construction
Building Information Modeling (BIM) is a process involving the generation of digital representations of physical and functional characteristics of a location. Of all the industries that benefit from BIM, the health care industry may be the leading one.
Hospitals are complex buildings, and the cost and schedule of a hospital’s design are crucial to the success of the end result. By integrating BIM strategies prior to construction, hospitals can streamline design, approvals and operations.
Here are the top 10 ways BIM can help your design team.
10. BIM is a Game Changer.
Adopting BIM in architectural practices is not the same as what the health care industry experienced with transitioning to computer-aided design (CAD) 20 years ago. CAD simply replaced hand drafting with computer drafting. The technology was different, but the process remained the same.
BIM is both a technology and a process. This forces firms to reevaluate how they produce their design services. The winners will differentiate themselves by focusing on producing services that their clients expect, such as those that impact time, money and quality.
9. BIM Adds Value to Your Project.
The process of BIM adds value in a number of ways. Three that often come to mind are:
- BIM helps the designers, constructors, regulators and owners visualize complex geometric and spatial information.
- BIM helps organize building elements into logical formats that can be more easily extracted and quantified. And probably most importantly,
- BIM allows the designers and constructors to find quality defects during the most cost effective time in the process to fix them, i.e., during design and preconstruction.
8. The ‘I’ in BIM is the Key.
Graphically-compelling images of a building go a long way to explaining an idea. But it’s the information that is associated with each building component – and the aggregate of all the information, associated with intent, time and cost – that is the key to unlocking the value that exists in architectural services (in addition to the other parts of the AEC ecosystem).
Three-dimensional modeling has been around for 50 years, but for the most part it has lacked any codified data, other than geometry and overlaid text. The “I” in BIM helps put the facts of not only one particular building together in new ways, but more importantly, all the buildings in our practices.
7. The ‘M’ in BIM Can Mean ‘Model’ or ‘Manager’
If you’re involved in helping the industry develop BIM best practices and protocols, you’ll know what I mean by the “Fluffy Kitten” issue (Google “fluffy kitten and BIM” to see what I’m talking about. The images are worth the effort.) But I feel the concern over saving fluffy kittens is quickly becoming misplaced. It would be wise for the AEC industry to let the “M” in BIM mean either “Model” or “Manage”. So the next time you hear someone say BIM Model, you don’t have to cringe. Just imagine they are saying “Building Information Management.”
6. BIM Is More Than Just Technology.
Building Information Modeling is more than just software tools. It is also a process that allows all professionals who are involved with a building project to organize their efforts as well as their data. The process allows everyone involved to organize their data around a virtual representation of the building.
This is completely logical and it is fascinating that it has taken us this long to do so. Of course, from this virtual framework we can reorganize the data in all of the other formats needed to clearly communicate what is important at any given place and time, for those who need it.
5. BIM is also VDC.
Many architects, engineers and even building owners/operators are getting familiar with what Building Information Modeling/Management is, but less so VDC. VDC means Virtual Design and Construction (the term actually predates BIM by many years). When we speak about BIM being a process, in addition to a tool, we are speaking about VDC. In this sense, at least to this advocate, the terms are practically interchangeable.
4. BIM is an Opportunity to Retool the Entire AEC Project Delivery Process.
BIM is a disruptive technology and process. It is a common trait to resist anything that disrupts what we are familiar with, even if the familiar is not optimal. As an advocate of improving the AEC project delivery process so it adds value to the designers, constructors, suppliers, owners, operators and occupants, I take every opportunity to use BIM as a conversation-starter to persuade others to look deeply at what they do and find ways to make it better.
Some changes will be small, while others have the potential to radically alter how we do business. It is then all project stakeholders’ job to leverage this potential in order to add value and profit by it.
3. BIM is for the Entire Project Team.
Building Information Modeling/Management is not only a tool and process for the architects, engineers and constructors, but for anyone involved in the AEC process. The key is to make the data accessible to everyone involved. At the start of projects, there is frequently a negotiation about sharing the model. This misses the point. The geometric model, while valuable to those who need to actually work with the BIM, can be a hindrance to others.
What is often more important to others on the project team are the details within the data. For example, the quantities, the specifications and the quality being requested are valuable even without the geometry. This data should be accessible to the entire project team.
The key to doing so is using BIM as the primary framework, but storing additional information about the project in accessible databases. This data can then be sliced, diced and represented in any format needed by any team member so they may add their knowledge and professional judgment at the appropriate point in the project life cycle. Let’s keep our collective fingers crossed that this continues to evolve. Better yet, get involved.
2. AHJs Must Adapt Their Processes to Leverage BIM.
Authorities having jurisdiction – i.e., building inspectors and municipal regulatory agencies – are a needed part of the design and construction process. They provide a checks and balance that should be a part of anything that involves the public’s health, safety and welfare.
In this advocate’s opinion, AHJs are the least-advanced component of the AEC industry in their use of technology to improve the process and add value to the built environment. Fortunately, there are many industry leaders that are involved with the work of Fiatech to help AHJs across the U.S. to modernize and transform the regulatory review process for building design and construction.
1. The Secret to BIM is Learning to Work with Project Data in New Ways.
Over the last couple of years, we’ve been bombarded with hype about how other industries are using big data to the point that we’re tired of the term, but what’s exciting is that the AEC industry is finally at the point where we can take advantage of our own big data.
By using BIM, we are collecting exactly the type of information we need to learn from our projects. The secret is a combination of a deep dive into one project for the project’s sake, and in aggregating the data of many projects to see what is truly happening. Both are possible with the data our BIMs provide, if you know how.
To do this, we need to learn how to work with the data. Fortunately, our data isn’t all that big in comparison to the data sets retailers, insurance companies and internet service providers manage on a daily basis. We would be amiss though, if we didn’t learn how they are capitalizing on the data flowing through their business and apply similar tactics to our data and businesses.
To do so will take some new skills that are not traditionally used in our industry, but aren’t too difficult to acquire. The knowledge needed includes expertise in statistics, predictive analytics, data mining and software development. Yes, architects, engineers, constructors and other building professionals will either need to learn these skills explicitly or implicitly by hiring or by partnering with experts who have them.
These additional skills, coupled with traditional design and engineering expertise, will allow us to sift through the data of our projects and present it in multiple ways which will provide insight that has never been easily obtainable, until now. The list could go on. I invite you to share your ideas about BIM and what it means to our industry.
Robert Mencarini, AIA, is Principal and Practice Area Leader – Design Technologies with Array Architects. He can be reached at [email protected] For more information, visit www.array-architects.com.
COVID-19 "causing mass trauma among world’s nurses"
Healthcare providers are facing ongoing nursing shortages, and hospitals are reporting high rates of staff turnover and burnout as a result of the COVID-19 pandemic. In June a report found that levels of burnout among staff in England had reached "emergency" levels.
Registered nurses Molly Rindt and Erika Haywood are nurse mentors on US recruitment platform Incredible Health. In this joint Q&A they tell Healthcare Global about their own experiences of burnout and what can be done to tackle it.
What does it mean to be suffering from burnout?
Some of the most common reasons for nurse burnout include long work hours, sleep deprivation, a high-stress work environment, lack of support, and emotional strain from patient care.
While every profession has its stressors, the nursing industry has some of the highest burnout rates. The massive influence on patients’ lives, the long hours, and many other factors put nurses at risk of severe burnout. And with the rise of COVID-19, many healthcare professionals feel the strain more than ever.
Burnout in nurses affects everyone — individual nurses suffer, patients are impacted, and employers struggle with enormous turnover. This is why it’s crucial for healthcare systems and management to watch for signs of nurse burnout and take steps to provide a healthier workplace. Employers should be careful to watch for burnout symptoms in their healthcare staff — and not ignore them.
Symptoms include constant tiredness, constant anxiety related to work, emotional detachment and unexplained sickness.
How widespread is this problem?
Unfortunately, burnout affects approximately 38% of nurses per year and even the WHO recently labelled burnout as an official medical diagnosis. To put this statistic into perspective, nearly 4 out of 10 nurses will drive to work dreading their shift. Burnout is a reason nurses leave their positions.
Other top reasons for leaving included a stressful work environment, lack of good management or leadership, inadequate staffing, and finding better pay or benefits elsewhere.
Even before the pandemic, demanding workloads and aspects of the work environment such as poor staffing ratios, lack of communication between physicians and nurses, and lack of organisational leadership were known to be associated with burnout in nurses.
Have either of you experienced burnout?
Rindt: I have experienced burnout as an RN. I was constantly fatigued, never felt like I was off work, and would frequently dream I was still at work taking care of patients. In my particular situation, I needed to take a step back and restructure my work schedule to allow for more time off. After doing this, I was able to reduce burnout by deciding to work two shifts back-to-back and then have 2-3 days off.
Haywood: I definitely experienced constant anxiety related to work - so much so it would impact the days I wasn’t at work. At one point, I was even on medication to help combat the anxiety and stress I was facing on the job.
I had heart palpitations, chest pain, and wouldn’t be able to sleep before working the next day, which slowly started to impact other aspects of my life. I knew I couldn’t continue to live this way, it wasn’t sustainable. Because of this, I began to focus on my needs and prioritising self-care, especially during the beginning of the pandemic. Putting my needs first and not feeling guilty were necessary for me to overcome burnout.
What impact is COVID-19 having on nurses' wellbeing?
Some nurses have suffered devastating health consequences. Many nurses have dealt with excessive on-the-job stress, fears of becoming infected, and grief over seeing patients succumb to COVID-19 while isolated from their families.
New evidence gathered by the International Council of Nurses (ICN) suggests COVID-19 is causing mass trauma among the world’s nurses. The number of confirmed nurse deaths now exceeds 2,200, and with high levels of infections in the nursing workforce continuing, overstretched staff are experiencing increasing psychological distress in the face of ever-increasing workloads, continued abuse and protests by anti-vaccinators.
However, other small silver linings that came from the pandemic include increased professional autonomy, leadership opportunities and career growth potential.
How much of the cause of burnout is due to the hospitals or healthcare providers, and what can they do to address it?
Nurse fatigue poses serious problems for healthcare organisations, and a recent survey from Kronos found 63% of nurses say their job has caused burnout. The survey also found that more than 4 out of 5 nurses think hospitals today are losing good staff because other employers offer a better work/life balance.
Nurse burnout not only contributes to staff turnover, but it can impact the facility’s quality of care, patient satisfaction, and even medical outcomes.
Strategies to address burnout include training improving nurse-to-patient ratios, include nurses in policy discussions, and prioritise fostering a healthy work culture in hospitals.
What does your role mentoring nurses on the Incredible Health platform involve?
Rindt: My role can vary based on the needs of the nurses. The nurses love knowing they have someone in their corner who can give interview preparation advice or provide suggestions on how to improve their resume. Knowing that there is someone who is well-versed in the job process and can help set expectations on what to anticipate, really helps to remove a layer of uncertainty.
Haywood: When screening nurses, it is customised to what their individual RN or nurse practitioner needs, and at a time that is most convenient for them. Nurses are busy and often aren’t thought of first. Being able to provide support from the very beginning of their career advancement journey helps tremendously. We also provide resources such as resume templates and tips that can help nurses be successful and feel supported.