How to Successfully Plan Actionable Large-Scale Healthcare Projects: Architecture, Medical Planning, and Innovation

Damir Vukovljak, Principal at Jensen Partners, has been with the firm for over a decade. We sat down with Damir to learn about healthcare planning, mental health, and the future of care in hospital systems.

Damir holds a Master of Architecture from Rhode Island School of Design and was part of the Sheridan Teaching Program at Brown University. He is a IASSC Certified Lean Six Sigma Green Belt professional who received organizational leadership training at the University of Chicago’s Booth School of Business. A native of Chicago, he received his Bachelor of Science degree in Architecture from UIC.

How did you start your work in healthcare planning?

I’ve always wanted to do large scale work, and when I joined Jensen Partners almost eleven years ago, I knew more about architecture than planning. With Frances and Sarah’s mentorship, I quickly learned that planning means thinking thoroughly about a project before getting into the design. It starts with evaluating whether a project should or can happen, as well as how it could happen. I noticed I was more interested in generating a project from nothing than how to construct a building. I stuck around with Jensen Partners, because I’m still interested in that.

Tell us about what it’s like to work in healthcare master planning as an architect.

You have to learn two languages. First is the language of architecture, which some of us on the team went to school for. Then, you have to develop a shared language with folks that didn’t go to architecture school and learn their language, because most likely they’re going to speak healthcare. We need to be bilingual and make sure we know planning, operations, architecture, and healthcare very well in order to execute the type of work we’re doing, which is embedded in the operations of a hospital, but executed on a physical level.

Fascinating! How have you grown during your time at Jensen Partners?

I grew from an architect to a healthcare planner. Since doing almost exclusively healthcare projects, I thoroughly learned how to speak healthcare. Even though I’m not a physician, I can tell you a lot about an operation room or the makeup of a hospital. Understanding the client is important in any work, and for us, that client is pretty complex.

Certainly, our most successful projects are the ones that have strong user group participation and stakeholder engagement from the C-level. Communication with the C-suite is crucial to the success of the project. The way we refer to success is when the hospital stops referring to a plan as a Jensen Partners plan and starts referring to it as their own plan, because that’s when their ownership can be translated into implementation. We value that they own the process, so it’s not another project that just sits on the shelf.

The wraparound services we provide is different from the work of our architecture colleagues. Our clients hire us to answer a very difficult question about their present and future. Sometimes the answer is operational; other times it’s physical, and most of the time it’s both. Once that solution has been disseminated and presented to various stakeholders on the project, the implementation phase is what we look forward to, which is when we hire an architect to execute on some of the physical operations and projects. That operational preparation is often a culture shift, and we help clients prepare for it.

Could you talk about a project that or a hospital system that you’ve helped transform? What has been the impact of your work?

The impact of our work has been apparent to me since the first project I worked on upon joining Jensen Partners in 2009. We worked with a county hospital, a level one trauma center serving the underserved in the Midwest. This project was very much embedded into the county’s authority, so we wanted to make sure that the county could afford the plan and that it would be successfully implemented. After the master plan, they went ahead and implemented the phases we proposed, which was very rewarding to see. All of our plans take a long time to implement; hospital systems are not simple, nor cheap.

Hospital systems may be cost effective but they are large in nature and large take time to implement. I mentioned that project, because since 2009, I’ve worked on many projects in over 15 states with different enterprise healthcare systems, each of which offers different challenges that we overcome. I continue to work with institutions that serve a mission and take mission care seriously.

At Jensen Partners, we are familiar with underserved communities and public facilities. Working on these projects is extremely rewarding to me and our team, because we see how our work with our clients transform campuses and provide care that offers more value for the buck. This is especially crucial in healthcare today, since we are coming to a pretty large crossroads here with COVID-19. Hopefully, we will get leaner and get more successful in the coming years to provide more and better services at a better value-to-cost scale.

These are excellent insights. To dive deeper into COVID-19, what do you see as the challenges and opportunities for decision makers at healthcare systems today?

I think the greatest opportunity is clarity for decision making. That’s what we offer, which is a major differentiator of Jensen Partners. Anybody can have access to a lot of data. Data is very important and serves as a tool, but data in and of itself is not going to produce decisions that a hospital leader will consider. We translate data into decision making tools that shed light on the right solution for a specific client.

We work with data and benchmarks in great detail, but it is not the data alone that leads to successful outcomes. Success is determined by the filter data goes through and how easy it is to put data into work for you. How do you use these tools so that a CEO or a member of the C-suite can use them to make an informed decision easily? Our clients are busy, and we understand they’re busy. We want to be mindful of their time and direct their attention to where it’s necessary, and our clients appreciate that.

We also look at whether a hospital or system is positioned to provide care into the future. A lot of facilities are aging, and many services are provided in locations that might not offer the best patient experience. We are very focused on providing care in the appropriate setting. We tailor strategy based on a future model of care.

The questions need to be: Are we able to provide the care that we want? What are the service lines that are looking to grow, and how do we focus our attention to that? The goal is to competitively provide care that a community needs. Leaders need clear information to consider service lines that they may not be so competitive in and decide whether to continue those programs.

In light of that, could you share with us how you’re leveraging technological developments in your recommendations?

First, our projections and utilization benchmarks are getting more and more sophisticated. I think it’s nearly impossible to recommend anything without the technology to project what any service will look like in the future. Again, I think you have to be mindful of asking the right questions about technology, data, or anything else. That’s where I think a good filter makes the whole difference.

For instance, answers around telehealth will be completely different for physical therapy than primary care or ontology. The ability to ask questions around value and decipher what the information is telling you are crucial. And that’s where I think speaking the language of healthcare comes into handy.

How do you see the growth of Jensen Partners in the upcoming years?

In some aspects, healthcare is very unique, and in others, it’s not. There are plenty of services in other industries encumbered by similar challenges especially around scale. There’s a wealth of knowledge and experience in Jensen Partners that we can apply to a wider range of projects. We have worked on higher education projects successfully, for instance, because of our depth of expertise in large scale work with extremely complex, high stakes healthcare systems. We can and do apply our knowledge to other industries that need these solutions in private and public arenas.

Could you share with us a bit more about behavioral health projects you’re working on and how you see that area growing?

Behavioral health, or mental health in the US and across the world, is something that has received greater understanding and investigation recently. We are right at the cusp of planning for a wraparound service for mental health. For a long history of healthcare, mental health has piggybacked on acute services and trauma services.

Let me give you an example. When you look into an emergency department network, whether it be an urgent care all the way up to a level one trauma center in a hospital, they are all geared towards whether or not you have a bodily injury, the level of significance of that injury and the appropriate treatment triage. Historically, healthcare has treated mental health in quite a bit of the same way. If someone has mental health issues and they’re acute, they go to the emergency room because of having no other choice.

In the current scenario for healthcare, that’s not working. Many emergency departments are overwhelmed with psychiatric patients that would be better served or best served in a different setting, where you would have a psychologist or psychiatrist available, a social worker that understands conditions, such as psychosis. We need to find solutions that are better than having somebody be restrained in an emergency department waiting to be seen by a provider who may or may not be on call at that time, as that’s a disservice to patients. Behavioral health is a big component of healthcare, and I am hopeful that it has started to have the focus that it deserves. It’s a growing field that is being more and more understood, and it’s helping a whole lot more people now that more attention has been paid to it. Our work is very cognizant of this at every stage.

Very true. What makes you so committed to healthcare and improving how people receive care?

For me, architecture has always been rooted in providing the people we serve with a shelter, which is an extension of how we humans protect ourselves from the elements. Healthcare is an expansion of that in a profound way, for we are providing shelter for the most vulnerable. I see architecture and healthcare as each other’s extensions and deeply value them both.

We work with clients serving communities with a wide variety of socioeconomic resources. Some of our clients are profit-focused; others are highly specialized or provide a niche service, and some provide safety nets to patients with very limited financial resources. I find this instrumental for the high quality of services we provide, as we have the advantage of learning from the differences. Not one case fits all; our solutions are very uniquely tailored to our clients and understanding their situation and needs.

We cast a broad net when we ask the question about who the stakeholders are. It’s instrumental for not only getting buy in, but also learning from everyone who wants the hospital to provide better care. We surround ourselves with folks who do their jobs well, and in seeking expertise, we speak with everyone, whether it be the folks in the laundry room or in the operating room. Experts are folks that are the boots on the ground. We take pride in asking questions and considering the input from EDS services to the CEO, because I think it’s very important to consider the people that are going to be living in the space. We can’t make recommendations void of those perspectives, and this is a major factor differentiating us and making our master plans actionable and implemented.

Thank you, Damir! We look forward to your continued success with your team at Jensen Partners.