April 16, 2020 // Romano Nickerson

Rural Hospitals and the overlooked fight against COVID-19

Dr. Neil Nickerson, Dr. Roger Nickerson, and Dr. Harold Williamson  My grandfather was an internist in a small town in rural Minnesota. In the 1950s, he formed a practice with his brother, a general surgeon, and his cousin, a general practitioner. Together, they bought out a physician named Dr. Hunt, who owned a building called the Lakeside… more

March 31, 2020 // Michael Oswald

How can we increase lab testing throughput without upgrading equipment or infrastructure?

There was great news from Roche this past week announcing they were approved to run Covid-19 testing on their platform.  The current difficulty for labs is that they are swamped with a significant increase in non-coronavirus flu swabs and new testing adds to the demand going through the lab. Fortunately, there are often operational improvements that labs can make to improve… more

March 23, 2020 // Romano Nickerson

Can we increase capacity in the healthcare system by adapting hotels for quarantine?

As our nation continues to struggle with the coronavirus, two strategies have emerged to deal with the crisis. We have all heard about flattening the curve to prevent sick patients from overwhelming our healthcare providers. Another strategy involves increasing the capacity of healthcare systems. As Covid-19 spreads across our country,… more

January 28, 2020 // Romano Nickerson

What Do Pull Planning in Design and IKEA Have in Common?

  If you are like most people, you’ve bought flat-pack furniture from IKEA at some point in your life. You return home, unpack the pieces and start wondering how on earth it is all going to come together. Luckily, IKEA gives you a picture of the final piece that comes with… more

October 29, 2019 // Romano Nickerson

Get Hands-On Lean Training with our Mobile Learning Lab

Developed during the second half of the 20th century, the Toyota Production System (TPS) is one of the most celebrated methods for quickly identifying and correcting issues that could lead to faulty production. It has benefited from years of continuous improvement which allow for increased quality and efficiency while eliminating… more

October 15, 2019 // Romano Nickerson

Lean Training Goes Portable With Our Toyota Production System Dojo

My colleagues and I recently debuted our Toyota Production System (TPS) Dojo at the 21st LCI Congress in Fort Worth, TX on Monday. With former Toyota teammate Mike Oswald at the helm, we taught TPS basics and put them into immediate action on our portable assembly line. Starting with standard… more

September 30, 2019 // Michael Oswald

Not Enough Time? When Unnecessary Distractions Keep Overloaded Staff from Patient Care

One thing I see most health care organizations struggle with is the amount of time that RNs, Mas, and techs are distracted from patient care because they must look for supplies, equipment, and meds. In fact, I have seen up to three hours of an RN’s shift consumed by these types… more

July 26, 2019 // Michael Oswald

Plan Ahead: Are You Operationalizing Your New Space Before or After You Move In?

If you have a TI or a new healthcare facility that’s 9-12 months from move-in, you have a choice to make regarding operationalizing your new space. Do you develop your process flows and work instructions and train your teams before or after move-in? If you want to ensure a smooth… more

July 2, 2019 // Romano Nickerson

Be A Lean Construction Leader

   I’m an architect. I went the route of getting a master’s degree in architecture. I have worked for almost two decades for a firm here in the states that does work on healthcare facilities. I’ve been very passionate about that. I come from a family of doctors, nurses,… more

June 22, 2019 // Michael Oswald

Lean Leadership Development Can Tackle the Trouble of the “I’m Too Busy” Response

The key to any continuous improvement in a work culture is leadership’s ability to be available to develop and support their team. However, in many organizations, employees are often told by leaders: “I am too busy. My schedule is already overloaded!” This not only puts a block on improvement but… more

April 26, 2019 // Romano Nickerson

How Lean IPD Thinking Can Fix the Problem You Didn’t Know You Had

I’m going to share a dirty little secret. It’s a secret that the design and construction industry frequently hides from the public, from the owner, and worst of all, from itself. So, what is this secret? In the industry, many projects touted as “successes” really should be considered failures. Within… more

March 9, 2018 // Meredith Banasiak

Bridging the Gap: Integrating behavioral health and primary care is more than just bringing providers together

Moving from a traditional to an integrated care delivery model requires a systemic investment aligning operational, cultural, technological, and physical processes to effectively deliver team-based care. Read more about our work on designing for integrated care in Healthcare Design Magazine.

September 8, 2017 // Meredith Banasiak

When can we EBD? Anytime!

We’ve translated the Evidence-Based Design (EBD) process into a designer-friendly tool: The “When can we EBD” diagram prompts designers to consider opportunities for integrating EBD at any point across design and delivery by mapping EBD processes with familiar project cycle phases and practices. Like the design process, it is set… more

April 26, 2015 // Romano Nickerson

Design Within a Lean IPD Team

I had the honor of presenting about IPD at Tallinn University in Estonia for their Project Manager Day to discuss the experiences of an architect working in an integrated project delivery team. In the above video of the presentation, you’ll learn the importance of: Working in a Big Room The… more