1. FY09 Post-Occupancy Evaluation (POE) Study Godfried Augenbroe | Altug Kasali | Yi Lu Djuan Marshall | Patty Reyes | Hyun Bo Seo Jane Snecinski | Sharon Steele | Fei Zhao Craig Zimring | Julie Zook

2. Company Confidential/Proprietary © Noblis 2009 2 Contents  POE Overview  POE Study  Findings & MHS Gap  Recommendations –Types of POEs –Database Structure  Next Steps

3. Company Confidential/Proprietary © Noblis 2009 3 Definition 1995: Post Occupancy Evaluation is the process of systematically comparing actual building performance, i.e., performance measures with explicitly stated performance criteria (Preiser, 1995). 2009: …Emphasizing organizational goals and long-term systematic evaluation. (Zimring, 2009)

4. Company Confidential/Proprietary © Noblis 2009 Why Post Occupancy Evaluation (POE) within the MHS?  POE Goals and Drivers –Identify outstanding facility issues –Assist future design teams with lessons learned –Identify best practices as well as the causes of performance –Test specific design strategies 4 Overall Recommendation: Create and implement a standardized POE program based on 3 types of POE, supported by an accessible database, enabling broad dissemination of lessons learned to guide future design.

5. Company Confidential/Proprietary © Noblis 2009 5 POE Study Goals / Value  Create a structure to assess innovation impacts  Facilitate standardized data collection from all MHS facilities  Create a centrally available and usable database  Analyze and utilize accumulated findings to avoid duplication of past shortcomings Methodology  Literature review of over 120 resources and POE reports  Identified best practices in the industry  Modeled alternative approaches to create the optimal framework for the MHS  Created 3-tier POE model  Created POE data structure

6. Company Confidential/Proprietary © Noblis 2009 6 Case Studies and Interviews U.S. GovernmentOther Organizations U.S. Postal Service (USPS) Kaiser Permanente General Services Administration (GSA) Post-Occupancy Review of buildings and their Engineering (PROBE) (UK) Naval Facilities Engineering Command (NAVFAC) and the Medical Facilities Design Office (MFDO) University of South Wales (Australia) Center for the Built Environment (CBE) (Air Force) Health Facilities Office (Western Region) Commission for Architecture and the Built Environment (CABE) (UK) (Army) Health Facilities Planning Agency National Health System (UK) US Army Corps of Engineers (USACE) Department of State

7. Company Confidential/Proprietary © Noblis 2009 7 Best Practice Findings  A standardized POE process  Use of a multi-disciplinary team process for specific level(s) of POE  A multi-tier system, with specific criteria identified to differentiate one level of POE from another  A data base/repository to collect the input obtained from the POE process  Use of POE data to modify design guide plates, specifications, criteria

8. Company Confidential/Proprietary © Noblis 2009 MHS POE Gaps  Lack of standardized POE requirements across Services (including methods and metrics)  Findings/conclusions not widely accessible  Primary focus for Agents is technical building performance and not outcomes related to patient- centered care  Lessons learned not tied to the modification of the guideplates, design recommendations or other institutional processes 8

9. Company Confidential/Proprietary © Noblis 2009 9 Recommendations 1.Establish Infrastructure to support POE Program by creating POE oversight and coordinating group with resources 2.Create and implement 3 types of POE using standardized methodologies 3.Expand the scope of POE using standard metrics to capture healthcare and organizational outcomes, as expressed in the MHS principles 4.Develop and implement an accessible database with standardized processes to evaluate and archive data 5.Broadly disseminate lessons learned 6.Use ongoing POE information to modify guideplates, design guidelines and specification, building procure standards, EBD checklist tool and the POE process itself

10. Company Confidential/Proprietary © Noblis 2009 10 Standardized POE Process  Type 1: Quick Response Survey (QRS) –A rapid survey conducted while the facility is still under warranty  Type 2: Descriptive POE –Surveys + direct evaluation of the building coupled with closer inspection of user perceptions  Type 3: Causal POE –In-depth examination and analysis of the causal links between design and outcomes

11. Company Confidential/Proprietary © Noblis 2009 11 Case Example: Light in Patient Rooms Type 1 POE (QRS): Baseline reading based on stakeholder input. Can be rapidly fixed on site. Type 2 POE (Descriptive) : Identify performance by measuring phenomenon. Evaluate and compare; consider solutions. Type 3 POE (Causal): Well structured research to establish causality (e.g., light & average recovery period).

12. Company Confidential/Proprietary © Noblis 2009 12 POE Schema

13. Company Confidential/Proprietary © Noblis 2009 POE Diffusion 13 POE Database Hospitals Clinics Other types POE/Checklist Automatic outcome monitoring Designer POE Staff Researcher Management Commissioning Report Data Flow Other strategies: newsletters training, meetings

14. Company Confidential/Proprietary © Noblis 2009 Database – Development & Implementation 14 Conceptual ModelData SchemaPrototyping Demo Development Short-term Implementation Initial server hosted by GT Noblis / Georgia Tech Team MHS POE Taxonomy Testing & Feedback Maintenance Data Population Testing

15. Company Confidential/Proprietary © Noblis 2009 Next Steps 1.Establish Infrastructure to support POE Program by creating POE oversight and coordinating group with resources 2.Refine and develop Type 1 and Type 2 standardized methodologies 3.Develop Type 3 POE based on an MHS priority issue 4.Pilot Type 1 and Type 2 standardized POEs, and pilot Type 3 sample 5.Refine, populate, and test database 15

16. Company Confidential/Proprietary © Noblis 2009 Why We Are Committed To POE as a key component of Innovation…. 16