HEALTHCARE QUALIFICATIONS CONTENTS SECTION 1 INTRODUCTION HEALING SPACES CONTEMPORARY HEALTHCARE CAPABILITIES+OFFICE LOCATIONS SECTION 2 EXPERIENCE KMD HEALTHCARE PROJECTS SECTION 3 PERSONNEL KMD HEALTHCARE TEAM LEADERS 1 The Imperial College of London Diabetes Centre, Al Ain, Abu Dhabi, UAE 2 SECTION 1 INTRODUCTION Healing Spaces Contemporary Healthcare KMD Capabilities+Office Locations 3 HEALING SPACES KMD Architects Approaches Healing Design with People in Mind KMD designed El Camino Hospital in Mountain View, California, to be the “Hospital Community of the Future.” The people at KMD Architects commit their lives to designing and planning for the future of healthcare in contemporary America and worldwide. KMD is more than just an architecture and planning firm. Our ideas are what truly define us and our passion is great architecture. We approach each project asking, “Now, what if…?” We do not confine ourselves to norms, instead combining our creativity with reality to innovate. KMD often partners with local architecture firms, including the majority of our healthcare projects. Our healthcare planning, programming and design expertise paired with local presence allows for greater personal service to our clients, and a larger contribution of ideas to the project. This collaboration is central to KMD’s ethos as a planning and design firm. 4 As planners and designers, we strive to absorb the cultural context and unique demands that shapes each design opportunity. We continually learn from our experience and the world around us, which informs our creativity, innovation and individuality. Our work reflects great variety because each project is a unique challenge calling for a specific solution. This approach has led to great advances in healthcare planning and inspired designs. During the last 25 years, KMD has been recognized with more than 250 project awards, including more than 40 from the American Institute of Architects. Evidence-Based Design For almost 50 years, since KMD’s founding on a grant from the U.S. National Institutes of Health (NIH), we have been pioneers in the healthcare field. Before Evidence-Based Design existed as a term, evidence and research-based design has been a standard for KMD’s healthcare practice. We performed the first post-occupancy evaluation in our profession for Marin General Hospital, and have continued to perform post-occupancy evaluations on our healthcare facilities. Our research has led to other pioneering achievements including family-oriented birthing centers, interactive environments for pediatric centers, triangular nursing units and universal or flex rooms. Based on our research, KMD’s advances in healthcare planning and our flexible designs have ensured client and user satisfaction. Understanding how hospital staff and visitors use healthcare facilities enables us to design and plan more efficient and flexible buildings. Increased operational efficiency translates into cost savings for healthcare systems, allows them to accommodate growth or changes in care, and leaves them with happier and healthier employees and patients. Throughout our history KMD has used our research and experience – or evidence – to design and plan our hospitals and healthcare facilities, making us a leader in the field. To date, KMD has approximately nine KMD performs post- occupancy evaluations team members on staff who have Evidence-based Design Accreditation and for our healthcare Certification (EDAC). facilities and hospitals, and have The Human Connection recently completed one for John Muir Patient and family participation in the process of care and healing requires a Health’s Hofmann process of education and willingness of staff to participate. KMD believes that Tower in Concord, California. is the responsibility of the architect to provide a supportive environment where these delicate partnerships can be forged. To that end, we approach healing design with people in mind. Whether our designs allow users a connection with nature, as seen in our Yonsei University Cancer Hospital, or offer retail and other spaces to help people manage personal details during times of stress as seen in El Camino Hospital, KMD’s solutions are forever mindful that these spaces have a direct impact on the staff’s and patients’ health. 5 CONTEMPORARY HEALTHCARE State of the Art Medical Facilities KMD’s recent UCSF Osher Center is among the new wave of outpatient facilities. KMD focuses on how best to plan and design for the future of healthcare. We perform research so we can inform our clients about anticipated future trends, and provide insight into how facilities can accommodate change over time. • We are one of two architectural firms that serve as advisors to the Health Technology Center • A guest member of the Institute for the Future and its subsidiary Health Horizons • Active in the Adaptive Business Leaders (ABL) Healthcare Executives Roundtable and its annual Innovations in Healthcare Awards program • Exploring how technologies we are using in our non- healthcare sustainable buildings can be applicable to healthcare facilities design 6 • Partnered with HealthWorks, a healthcare management consultancy, to refine a jointly developed methodology for Integrated Business and Facilities Master Planning, and integrate that methodology with HealthWorks Big Improvement! approach to rapid process improvement • Regularly perform pre and post occupancy studies to test impacts on staff efficiency and patient/staff safety of same- handed rooms for interventional procedures, surgery, and inpatient nursing units • Working with clients abroad exploring new concepts and testing new technologies not yet applicable in the United States While no one knows exactly what the future may bring, KMD listens to the projections of a variety of highly regarded sources and seeks to provide master planning and facility design that will perform exceptionally well for the future scenario deemed most likely and that will also be robust if other, less likely but none the less plausible scenarios should come to pass. Achieving Operational Efficiencies Through Design Operating costs for buildings, particularly healthcare facilities, usually significantly exceed all capital costs associated with construction and equipment. This is most dramatic for hospitals where annual operating costs are typically eight to 15 times annualized capital costs due to 24 hour services, multiple shifts, high staff costs and demanding infection control requirements for heating, ventilating and air conditioning (HVAC) and electrical, communication and information systems. For ambulatory care facilities, the ratio of operating costs to capital costs is still significant, ranging from eight to ten depending on services and hours of operation. We focus on operational impacts when making planning and design decisions. Technology is rapidly This allows us to plan for operational efficiencies of diagnostic, treatment, advancing and will reinforce and support and administrative services and also for energy efficiency. influence changes in the healthcare field. We can achieve some efficiencies without the need for greater capital investment or leverage additional investment for operational savings over time. Decisions made at every stage of planning and design affect operational efficiency, from master planning, to programming, to design and interior design. For example: • The orientation of buildings, configuration of building massing, size and placement of windows, landscape design and choices of materials affect the requirements for heating, cooling and electrical consumption • Rainwater collection, pervious paving, and storm-water retention areas can reduce initial capital costs and operating costs • Integration of cost effective alternative energy systems can reduce utility costs and a development’s carbon footprint 7 • Connections between buildings, sometimes at multiple floor levels, and planning for connections with future buildings can reduce user travel distances and productivity • Credible evidence suggests that access to daylight and views of the external world improves staff productivity, enhances wayfinding, reduces anxiety and, properly arranged, reduces the levels of interior lighting required for visual comfort and acuity • Choices of interior materials, furniture, equipment and lighting affect productivity, user health, absenteeism, staff workplace satisfaction and patient/family satisfaction with facilities and providers • Application of “Process Improvement” planning techniques can lead to more efficient use of space KMD uses various approaches to identify opportunities for process improvements and ways to achieve them and integrate them into building programs, planning and design. At the simplest level KMD provides benchmark data, facility models, flow diagrams and trends from similar buildings and services to which clients can compare their performance and projected facility needs. This information assists in decisions about what to plan, build and “build-out.” We have also worked with clients who employ Lean Design and 6 Sigma techniques and have brought team members to clients for Rapid Process Improvement. The Rapid Process Improvement approach, which can often be completed in a few weeks time, has helped clients achieve greater “through-put,” increased revenue and margin, and reduced projected program areas for new facilities. Design For Flexibility The pace of medical and technological advancements, in conjunction with market, staff, and regulatory uncertainties,