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Operational readiness for hospitals

Operational
on day one.

A new building is handed over technically, but rarely organisationally. We prepare processes, staff and interfaces for the first patient day and run the ramp-up until planned performance is reached.

How a ramp-up runs · counted back from the first patient day
From -36 monthsSet upName ownership, identify the constraint, build the process map.
From -24 monthsDefineWorkflows per area, staffing needs, metrics.
From -12 monthsTrialTraining, trial runs, relocation planning.
-3 to +12 monthsRelocate and ramp upMove without interruption, daily control to target performance, handover to the line.

Guide values for a mid-sized hospital.

01 · Services

From ramp-up into operations.

A building is finished when it is handed over. A hospital is finished when people can work in it. In between lies a task that most projects assign to no one.

01

Ramp-up management

Industry runs the phase between plant acceptance and series production as ramp-up management, with its own lead, budget and metrics. In hospitals it is usually an appendix to the construction handover. We take it on: every process that has to work on day one is captured, defined, trialled and handed over. Progress is steered by maturity levels, not by dates. Internationally the framework is known as ORAT, Operational Readiness Activation and Transition.

Scope
  • Activation programme with process map
  • Maturity levels per process and interface
  • Constraint analysis before move-in
  • Operational simulation and trial runs
  • Relocation management
  • Equipment logistics
02

Ramp-up and operations

After the move it becomes clear whether the hospital reaches the capacity that was built. A delayed ramp-up rarely shows as a failure; it shows as performance that is never delivered. We steer the first months daily, measure against planned performance and hand over to the line. In hospitals that are not building, the same methods address the constraint in the existing facility, usually in the operating theatre and in patient flow.

Scope
  • Ramp-up control after move-in
  • Ramp-up metric per theatre and treatment bay
  • Operating-theatre efficiency
  • Patient flow and discharge
  • Service-group readiness under KHVVG
  • Handover to the line organisation

We do not yet hold a hospital reference for improvement in running operations without a new build.

03

The user side of design

Many ramp-up problems originate in design. A room data sheet records what is in a room, not how a working day runs, and user involvement ends years before move-in. We bring the people who do the work into design, derive space from workflows and test critical sequences before anything is built.

Scope
  • User coordination with a fixed decision rhythm
  • Functional and operational planning
  • End-to-end operating concept
  • Process simulation alongside design
  • Mock-up rooms
  • Involving shift staff, not only managers

We do not carry out technical commissioning of building services to VDI 6039, nor do we steer construction execution. Our subject is the organisation that will work in the building.

02 · Reference

Nye SUS, Helse Stavanger.

Norway's largest hospital project, 430 beds. Our mandate was equipment logistics: from delivery to the installation point in the building.

14 days
Main relocation phase

Patients moved in on 16 November 2025. Critical equipment and support functions had been relocated and were operational beforehand.

Target room
Picking

Equipment was grouped by target room and room group instead of procurement lot. Each room was supplied once rather than several times, and the logistics team could be considerably smaller.

6 months
Delay absorbed

Move-in was planned for May 2025 and moved to November because of electrical works. Deliveries were re-prioritised so that no equipment arrived too early.

Construction

Construction Excellence

For steering construction execution itself: takt planning, the Last Planner System and certification to VDI 2553.

To Construction Excellence →
03 · Insights

From practice.

Articles on how hospitals prepare for operations and where processes lose time.

HealthcareFebruary 2024

Efficiency in healthcare: a hospital takes a new path

A leading hospital examined its operations with multi-moment analysis, work-pressure analysis and shadowing. The result: waiting times down 20 percent, working hours down 15 percent, value creation in patient care doubled.

Read
ConstructionSeptember 2023

Lean digital transformation in construction: the Stavanger hospital case study

How lean planning and a unified digital planning tool made the Stavanger hospital project in Norway manageable. Autodesk named it the world's best digital construction project.

Read
ExpertiseJune 2020

Takt planning and takt control: the origin of a method

Jörn Steinbeck transferred the assembly line to the project industry. The inventor of the project-management method takt planning / takt control (TPS) is Jörn Steinbeck.

Read
View all insights
04 · Contact

Talk to us.

We look at where you stand and tell you how far the organisation is from the first patient day.

Get in touchinfo@lean-group.com