CAD system impresses Joint Commission

Hospital wins commendation as result

When the Joint Commission rolls into town, savvy hospital administrators know exactly what to do -- point and click.

Computer technology is helping hospitals across the country prepare for surveys by the Joint Commission on Accreditation of Healthcare Organizations by making the triennial event more efficient, technology experts claim.

In fact, in January 1996, the 486-bed Shadyside Hospital in Pittsburgh garnered a Joint Commission commendation with the help of its Aperture Visual Information Manager, a Windows-based computer-aided design (CAD) system produced by Aperture Technologies in Valhalla, NY. The commendation was given for making the Joint Commission surveyor's task much easier.

Aperture's software system displays in detail the physical layout of Shadyside's 1.2 million square feet, says Tom Schwartzmier, PE, the hospital's assistant director of facilities planning and construction, who is responsible for preparing documentation for the Joint Commission inspection.

In addition to helping with the Joint Commission inspection, Aperture is used for the hospital's facilities planning and construction department overall, he says.

Besides being able to view the architectural drawings of each department, the user can click into another hospital database to obtain, for example, information on a piece of furniture. The drawing of the furniture can be overlayed inside the drawing of the department. The user can then click on the furniture to obtain information about the piece, such as when it was purchased, how much it cost, the last time it was fixed, the invoice number, and any other pertinent information, Schwartzmier says.

But mainly, Aperture and similar systems deliver fast and handy details of the location of fire walls, exits, sprinkler systems, and other information pertinent to a Joint Commission inspection, note Schwartzmier and others who have used the system.

"It's definitely made life easier," notes John Burkhardt, manager of office space management at Cornell University Medical College in New York City. Burkhardt used Aperture to help with the college's recent inspection by the Liaison Committee on Medical Education (LCME), the accreditation review committee for medical colleges, he says.

"It facilitated getting information, from measuring spaces to compiling the data, and doing the analysis and breakdowns," Burkhardt says.

In addition, LCME inspectors reacted very favorably to the medical college's demonstrated control over the use of its facilities, he adds.

Troubleshooting before the survey

Before the Joint Commission surveyors crossed Shadyside's threshold, Schwartzmier and his staff used Aperture to ensure there were no glitches in their life safety plans, Schwartzmier says. Aperture indicates the location of fire-rated walls and other critical barriers, he says.

"Before they [the Joint Commission] arrived, we gave our own people the life safety plans, and they used the information to check on barriers," he says.

Aperture also helped identify potential trouble spots, Schwartzmier says. For example, it pointed out where a maintenance worker may have run a pipe through a wall and neglected to seal the wall afterwards. "They may not realize when they're installing something that they're going through these protective spaces. This [software] gives them a way to check and make sure everything is in compliance," Schwartzmier says.

With the hospital's floor plans installed in Aperture, the software allowed Schwartzmier and his staff to superimpose layers of drawings that designated where the fire walls were. So when the Joint Commission surveyor came in, he was handed a binder with 81Ž2 x 11-inch prints that contained the drawings, which were much easier to carry and faster to read than blueprints, Schwartzmier says.

"Normally, they [the surveyors] would take blueprints and lug them around, and the maintenance worker would say, 'I think this is the right wall,'" he says.

The inspector was impressed, Schwartzmier says. "He said he'd never seen anyone show this to him so clearly and simply." It also showed the Joint Commission that the hospital was prepared, Schwartzmier says. "If you're prepared and somebody knows you're prepared, they have a level of comfort that you're ready," he says.

Aperture also helped Schwartzmier and his staff prepare the statement of conditions, which identifies all the known areas where the hospital does not meet life safety requirements. That life safety information was given to the inspector along with the statement of deficiencies, which, along with the Aperture graphs, helped point the inspector to any problems, Schwartzmier says.

Point-and-click use rising

The use of systems such as Aperture to assist with Joint Commission surveys is rapidly increasing, notes John Brock, AIA, principal with the architectural firm of Burt, Hill, Kosar, Rittelmann Associates in Butler, PA. Brock's firm recommended Aperture to Shadyside and built its architectural database, he says.

Over the past three years, Brock has been in the business of building database tools for his clients, which are hospitals and health care facilities. Finding a good CAD system takes some careful searching because they all function a little differently, he says. "Some of them require the owner also own CAD software, and the facility software is installed alongside the CAD software," Brock says.

Aperture has also facilitated locating blueprints quickly, notes Schwartzmier. "Every time we go in to look at a space or redesign a space, we don't have to pull out paper files," he says. "We can pull it out on a computer screen, print it out, play what-if games with it, see if an area is underutilized, so much more quickly than sitting there with paper and white-out and a Xerox machine," he says.

Aperture is only one of a growing number of point-and-click programs helping hospitals manage their facilities. For example, Drawbase Software in Cambridge, MA, makes Drawbase, a full-function CAD software system and built-in database, says Bill Westerman, the company's vice president of sales and marketing. Drawbase is a Windows-based program that creates CAD drawings in two- or three-dimensional views, and can interface to external databases. Drawbase is easy enough to use that entering floor plans can be done by the user or an outside architect, Westerman notes.

Drawbase can also code floor plans to show open work orders for maintenance and where the work needs to be performed. The system is open-ended and comes with sample drawing databases that the user can modify to fit individual requirements. "You don't have to buy a different module to do a different application," Westerman says.

Drawbase costs from $500 to $5,500, depending on capabilities, but most hospitals using Drawbase for Joint Commission inspections spend about $4,400 to $5,500, he says. Training is $300 per day per student and generally lasts four days, Westerman notes. Aperture ranges in cost from $495 to $11,500, says Rene Wood, Aperture market manager. The top package like the one used at Shadyside costs $11,500, which includes training for two people.

Brock's firm customizes Aperture with architectural plans for an additional 3.5 cents per square foot of facility, he says.

[Editor's note: For more information on Aperture, contact Rene Wood at Aperture Technologies, 100-3 Summit Lake Drive, Valhalla, NY 10595; (914) 769-7800, ext. 324.

For information on Drawbase, contact Bill Westerman at Drawbase Software, 222 Third St., Suite 2300, Cambridge, MA 02142; (617) 868-6003.] *