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Why is Functional Programming Important in Healthcare?

by Jamie Cook | July 16, 2020

A good plan is like a road map; it shows the final destination and the best way to get there. The same can be said about a functional program.

A functional program is a detailed, multi-purpose document that serves as an interface between a physical space and the activities, programs and services the space will support. It reduces risks such as scope creep by working through and capturing all of the metrics to be provided in the final state.

For example, imagine you are working on a hospital expansion that requires several existing departments to relocate to another area of the hospital. A functional program will document each component of those relocations, and the relationships between them. The functional program will also reference smaller operational details such as where the mail for each department will be redirected, where linen will now be stored, and whether existing telephone extensions can be retained. These details are minor – but necessary – items that might otherwise get overlooked and cause project delays or operational confusion further on in the project.

It’s all in the details

In essence, functional programs detail all the human, technical and building resources needed for services to function optimally in a refurbished, expanded or newly created space.

In a healthcare environment, human details refer to the clinical or support staff working within a space and how they flow through it while they work. The functional program will include a workflow diagram illustrating staff movement from the nursing station to patient rooms, waiting areas to reception, etc. and the efficiencies that could be applied. Through the process of creating the Functional Program, the future state is envisioned and developed, and can be quite different from the current state.

Human details also include clients or patients and how they transition or move within the space during an appointment.

Human details also include clients/patients and how they transition or move within the space during an appointment. A functional program will include diagrams illustrating client/patient transport from an Emergency Department, for example, to a unit/clinic area, as well as how materials flow to and from the unit/clinic area.

The technical details are the regulations and applied space standards that the design should adhere to. The functional program will also describe the equipment required for the space and state the regulations that must be followed, such as Infection, Prevention and Control (IPAC), provincial accessibility standards, and CSA Z8000-18 for healthcare facility design.

The building resources are a combination of the physical space that will be used, the structural, mechanical and electrical requirements that are informed by CSA Z8000-18, and how this new project will impact the current building infrastructure.

In addition, a functional program describes the linkages between program/service elements and costs by using the above information to develop a preliminary operational management plan (e.g. staff and facility) and budgets for each unit or clinic area and the overall operational cost impact.

A functional program generally consists of the following:

  • Assumptions
  • Scope of program and service elements
  • Objectives to be achieved
  • Projected workload
  • Projected staffing
  • Operational workflow and procedures
  • Design and spatial considerations
  • Functional relationships
  • Space list
Functional program 3

When are functional programs used?

A functional program is usually mandated by a provincial health ministry/authority before a healthcare organization can receive project approval and/or capital funding. While functional programs are not typical in non-government funded projects, they arguably should be, as it’s important for projects with any complexity to have a proper and well thought out plan. This is where a functional program becomes an asset.

The process of developing the functional program brings together all the multidisciplinary groups that will function within the new space.

For non-government funded projects, a functional program can be the difference between executive leadership or board support or the project being cancelled. It serves as a business case of sorts, with extra details regarding the impact on spaces, operations and other resources. When done properly, the exercise of developing the functional program brings together all the multidisciplinary groups that will function within the new space. These groups are internal stakeholders from all areas of the organization including clinical directors, program managers, frontline staff and support services (e.g. facilities, IT, environmental services, etc.).

Bringing these groups together in the development of the functional program ensures that the future state is fulsome and improves upon the current state. It also leverages the expert knowledge of these groups, helping departments to justify the project scope and to secure annual operational funding and additional resources for the services/programs being proposed.

A functional program is the blueprint for project design because it provides instruction to the architectural and engineering teams for the preparation of design documentation and is a roadmap for the future. If a project doesn’t have a functional program or a well thought out plan there is a potential impact to the scope, schedule, budget and other unforeseen risks.