In 2013, Stanford University began theprocess of modernizing and expanding their medical centers utilizing Building Information Modeling (BIM). While BIM is traditionally used during the design and construction process, Stanford wanted to explore the benefits of the software with respect to streamlining Facilities Management & Operationsand Maintenance (FMOM) tasks.
The pilot of this initiative was the Stanford University Neuroscience Health Center, located on the Hoover Medical Campus. This 92,000-square-foot facility spans five floors, and was opened in early 2016. The building is a hub for the comprehensive care of neuroscience patients. There are 21 neuroscience subspecialities at the center, along with a clinical PET/MRI machine and autonomic laboratory. Patients and their caregivers along with center personnel and university staff provided valuable feedback and insight into the development of the building’s design.
Prior to this pilot study, FMOM staff were using traditional methods to address shutdowns, respond to work orders, and address other facilities management issues. Looking up technical specifications and structural information required a good deal of time, as it had to be done manually and resulted in lowered productivity and a backlog of requests with respect to handling other FMOM work.
There were three main goals of this pilot study:
• Use BIM to improve patient care at the facility
• Use BIM to improve patient safety measured by Infection Control Risk Assessment (ICRA)/Patient Care Risk Assessment (PCRA)
• Reduce the daily cost per patient, with respect to FMOM
The role of Microdesk in this particular initiative was as a Technology and Process Advisor. As such, Microdesk reviewed the existing BIM models and accompanying data from a QA/QC (Quality Assurance/Quality Control) perspective and helped with the writing and execution of the pilot plan. Additionally, Microdesk developed and updated the BIM for the Facilities Management Guidelines for Stanford Healthcare, which was then incorporated into the Building Information Modeling Guidelines for Design and Construction. The BIM software used in this project was Autodesk Revit, a 3D modeling platform for the design and analysis of a building. The models produced in Revit are used in design work and for coordination during construction.
PROJECT SOLUTION AND IMPLEMENTATION
In accordance with the pilot plan, BIM was utilized in seven different use cases to determine whether it would lead to increased ROI, through increased efficiency and reduced work hours needed to complete tasks. Microdesk presented the pilot plan to the teams at Stanford and trained relevant employees how to use BIM and how to apply it to the use cases. Web training support was provided as needed as the software was tested in the field.
Over the course of a two-week time-frame in January 2016, the use cases were conducted with the current methodology (mostly manual) and the new system using BIM. Use cases included: major plumbing leaks, structural and fire safety analysis, asset information entry and updating, integration of design finish scheduling, engineering staff training, shutdown requests, and Infection Control Risk Assessment (ICRA)/Patient Care Risk Assessment (PCRA) Reviews. Baseline data was obtained from the maintenance staff (from Maximo) and asset data entry information was provided by the staff member responsible for this task. Users were also prompted for the feedback (through surveys) regarding the new process and whether or not it was an improvement of the existing procedures.
IMPACTS AND PLANS FOR THE FUTURE
In reviewing the seven use cases in this pilot study, three key areas experienced the greatest impact from the utilization of BIM in Facilities Management.
• Addressing reactive and proactive shutdowns
• Regulatory Compliance (ICRA/PCRA)
• Increased institutional (tribal) knowledge
The above outcomes had a direct influence on the project goals of increased patient care and safety as well as on the reduction of the daily patient cost.
Using BIM to address reactive and proactive shutdowns, users were able to use the BIM model to view patient rooms and other nearby structures to more effectively and efficiently locate shut-off valves. Quickly locating valves and related structures allowed the staff to easily determine which patient or procedural rooms would be affected by work.
One of the largest uses of time with respect to work orders was the search and retrieval of relevant information, primarily through as-built drawings or other manual tasks. Through BIM models accessed on iPads, workers could easily pull needed information to address work orders and answer questions regarding the building.
MEASURING THE BENEFITS OF IMPLEMENTING BIM FOR FACILITIES MANAGEMENT AND OPERATIONS
The combination of BIM with an Asset Management System allows for staff to see the asset’s context in a way that was previously not possible. Through the BIM model integration, facility staff have access to information that a traditional asset management system could not capture or was not easily accessible. This additional context for the assets is what allows for the significant increases in efficiency throughout the FMOM.
While the initial cost of BIM is born by the project, several financial benefits were achieved from using the software in Facilities Management. The projected cost per Patient Day over a five-year period was reduced by 4% (from $67.31 to $64.75). Additionally, a 4.5% decrease in cost was also realized in the Engineering Maintenance, Environmental Health and Safety, and Facilities Management departments (based on the annual budget).
Addressing Shutdowns (both reactive and planned)
As mentioned above, there were a number of areas impacted by the implementation and utilization of BIM for FMOM. Time savings per event was one of the most frequently noted outcomes. Since BIM can pinpoint exactly where valves are located, there is less time spent searching existing plans or making repeated attempts to locate a specific location. Additionally, the workers can better prepare with the exact tools needed to resolve a work order, as the information allows them to identify materials affected, height of the ceiling, placement of ceiling tiles, etc. This results in fewer trips to and from the work site, and further supports the power of BIM to increase both productivity and efficiency. In Use Cases 1 and 2 (both dealing with shutdowns), there was an 80% (2 hours saved) and 63% reduction (35 hours) in the number of hours needed to complete the task with BIM.
Regarding shutdowns specifically, there was a 60-70% reduction in time spent. Communication between systems engineers and field staff is also streamlined, as identification of necessary valves and other equipment can be quickly and easily shared. The reduction in time spent on shutdowns ultimately resulted in an increase in the work hours available for other FMOM tasks. Additionally, Stanford can take the BIM information assembled and use it in future regionalization of facilities, saving time and resources.
Time associated with events for regulatory compliance was decreased by 50%. Due to the portability of the technology, staff can also locate necessary information easily from work or home, expediting retrieval of information in emergency situations or off-hours. Resources needed for regulatory reviews were decreased and system and scope verification was performed more accurately and safely.
Increased Institutional (Tribal) Knowledge
Without the use of BIM, locating necessary information for managing repairs took a significantly longer amount of time. This requires knowledge that has been accumulated by facilities management employees over time regarding how the facility functions and operates (tribal knowledge). The pilot program explored how BIM supports the capturing and sharing of this tribal knowledge amongst the FMOM community. Using BIM provides detailed information on equipment (manufacturer, serial number, model, etc.) to be uploaded electronically to the Computerized Maintenance Management System (CMMS), Maximo, rather than manually input by a user. For example, in Use Case 7 there was a 98.5% (1,616 hours) reduction in the time needed for asset information entry and updating. Additionally, the ability to understand complex systems easily appeared to help staff to make decisions more quickly and plan accordingly in a more efficient manner.
Because the BIM for FM and BIM Guidelines for Design and Construction are integrated, design elements and finishes can be easily identified and maintained. Structural decisions can also be made by determining what areas and materials in the building will be impacted.
Stanford’s utilization of BIM information for Facilities Management & Operations and Maintenance produced positive outcomes in all measured categories of the pilot program. When implemented in additional medical centers, Stanford will realize future time and cost savings and improved productivity.
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