Communications Plans Unite Stakeholders in Facility Construction

One in 5 American adults suffers from mental illness, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). The administration adds that the rate is likely higher following the onset of the COVID-19 pandemic. While treatment for mental illness is effective, a sufficient number of accessible, well-equipped behavioral health facilities is a prerequisite for meeting patients’ needs countrywide. Accordingly, nearly half of the hospitals surveyed in the American Society for Health Care Engineering’s (ASHE) 2022 Hospital Construction Survey are planning or executing a behavioral healthcare facility construction project.

However, behavioral health facilities require a different approach than more traditional healthcare projects. For example, behavioral health facilities feature unique design and construction constraints, such as strict anti-ligature and tool management requirements, in addition to the constraints associated with other medical building projects, such as large hallways and doors for ease of patient and medical equipment transport. Behavioral health facilities also include a variety of subtypes with many differences and requirements—e.g. psychiatric inpatient facilities, outpatient offices, drug and alcohol rehabilitation centers, and behavioral units in detention centers. To deliver behavioral health projects, owners must assemble a project team with appropriate experience and expertise. All of these factors can make behavioral health facility construction projects challenging, especially for owners without direct experience managing a behavioral health project.

One tool that can help teams overcome behavioral health construction’s unique challenges is a communications plan. From project pre-planning through design, construction, and closeout, communications unite professionals, align a project team’s efforts, and create the conditions needed for project success.

Visualizing the Benefits

Very simply, a communications plan is a way to manage communications on a project or program. It defines lines of communication, both formal and informal, with all project stakeholders. Often, communications plans distinguish between internal and external communications and provide guidelines for both. In this way, a communications plan reduces confusion about who reports to whom, how frequently, by what means, and where information of a certain type should go. This is especially valuable on complex, multi-phase projects. Some advantages of robust communications on behavioral healthcare projects are briefly described, broken down by the major project phases, below.

Pre-Planning. Owners do not undertake projects in a vacuum. Even when, as now, new federal and state funding streams are creating opportunities for healthcare organizations to take on behavioral health projects, leadership must plan such a project in context. Required maintenance, capital planning, the existing project pipeline, operations, and the changing needs of stakeholders and patients are just some of the many considerations an owner must weigh against any new project.

A formal communications plan helps owners pre-planning a behavioral health project systematically navigate the web of interests that impact project planning. For example, formal and informal lines of communication with the public help healthcare organizations prioritize projects targeting community needs. This helps ensure capital funding goes to community-oriented medical resources. If it is determined that a community is in need of enhanced behavioral health support, continued community engagement can help owners plan a behavioral health project with the greatest potential impact.

Design. Behavioral health facility design requires input from healthcare leadership, a team of experienced designers, healthcare professionals, other stakeholders, and the public. Project managers/construction managers (PM/CM) can review drawings and other design documents to help ensure an owner’s and other stakeholders’ expectations are captured in the design. Contractors can provide additional design review, helping assess ligature risk and other material hazards to provide for patient safety. Toward the end of this phase, stakeholders and healthcare professionals should review near-final design documents to make sure all parties are comfortable with the design.

A robust communications plan can bridge gaps and facilitate design input from the multiplicity of sources inherent on behavioral health projects. This helps the team capture and report all feedback and preferences in a timely fashion, reduces the likelihood of changes, and helps ensure a project in line with the owner’s vision.

Construction. The value of a communications plan is perhaps most evident during construction. Through this phase, all requirements established during pre-planning and design must be accessible to the contractor and subcontractors. The builders must also generally adhere to regulations regarding safety, tool management, and noise and dust levels, especially in occupied facilities. As a part of an overall communications strategy, PM/CMs can document all project requirements and make them accessible to the project team using a project management information system (PMIS).

The construction phase of a behavioral health project will generate large quantities of technical data. The team must order and track long-lead items and medical equipment, monitor material prices, audit safety practices, and regularly evaluate the project’s cost, schedule, and quality performance. Expert subconsultants often provide anti-ligature walkthroughs or safety audits to help reduce risk to patients following handover. Likewise, doctors, nurses, and technician staff should visit the site to help ensure spaces are appropriate for practice. PM/CMs can work with the team to identify and codify best practices and lessons learned in the PMIS. A communication plan helps an owner keep control over these streams of information and helps get data into the right hands at the right time. This facilitates cooperation, promotes transparency, reduces risk, and leads to better outcomes.

Implementing a Communications Plan

A communications plan on your behavioral health project starts with the communication culture at your healthcare organization. Prior to any project, an owner should evaluate the communication culture at their organization in preparation for efficiently onboarding a variety of designers, builders, and consultants. At the very least, owners identify individuals at their organization who will play a large part in the planned project, specify their expected roles, and reflect upon the best ways of communicating within that group. This can serve as a foundation for a projectwide communication approach.

As a project moves from pre-planning through design and construction, the communication web becomes more complex. A PM/CM can work with an owner to establish a formal project communications plan based on management consultancy best practices and tailored to the healthcare organization’s preferences. The earlier a PM/CM is brought onboard, the better the communications throughout the project’s life cycle. As discussed above, strong communications will help project teams overcome the unique challenges associated with behavioral health construction and help healthcare organizations better meet the needs of their communities.

Steven Walker is a Project Executive at Hill International Inc.

The views expressed in Perspectives are solely those of the author and do not necessarily reflect the views of Behavioral Healthcare Executive, the Psychiatry & Behavioral Health Learning Network, or other Network authors. Perspectives entries are not medical advice.