Phyathai Hospital Group moves forward with major initiative focused on developing its hospital network

The Bangkok-based Phyathai Hospital Group, known as PYT, is exploring a reorganization of their main facilities that would foster major improvements in their ability to provide high-quality health care. In January, a four-member team from HMI joined HMI’s partners in Thailand for a site visit focused on facilities development, equipment planning, and nursing professional development.

Kraivin Srikraivin, PYT’s Deputy Managing Director, is part of the group’s leadership team working with HMI.

PYT’s alliance with HMI dates back to the late 1990s, when HMI assisted in the design and programmatic development of a cardiac center of excellence. The Phyathai Heart Center was inaugurated in late 1998, but an economic crisis in Southeast Asia thwarted further collaborations. Now, with an economic recovery well underway, Phyathai Hospital Group and its new management team have brought a renewed vigor to the partnership. The organization hopes that through its collaboration with HMI, it can create synergies across its eight-hospital network that will not only create a new standard for medical services in the region, but also achieve operational sophistication.

"Our partnership with HMI has been very rewarding, both in terms of the progress we have made in pursuing our vision for the Phyathai Hospital Group, and in the professional development of our team members," said Kraivin Srikraivin, PYT's deputy managing director. "Being exposed to centers of excellence in the Harvard Medical School system has helped us to clarify our own objectives and develop a strategy for building a world-class hospital network."

The most recent site visit was the fourth major collaborative session of the renewed partnership. In February 2005, the new PYT management team came to Boston for strategic planning meetings and site visits to multidisciplinary care clinics and centers of excellence at Harvard Medical School and its affiliates. In May 2005, a team from HMI traveled to Bangkok for a series of discussions focused on clinical program strategies and network development. During a subsequent visit the HMI team worked with PYT’s architecture and engineering resources to evaluate PYT’s existing facilities and begin exploring alternative designs aligned with PYT’s clinical programming needs. This was the beginning of the development of a master plan for one of the network’s major hospitals, known as PYT 2.

“The PYT group has a long tradition of excellence, and they are now looking to extend this to their entire hospital  group, with a focus on state-of-the-art facilities and equipment, quality management, and excellence in nursing,” said Harvey Makadon, MD, HMI vice president of health systems. “They have made great strides in less than a year, and I expect that with their visionary leadership they will be the leading hospital group in Thailand.”

Makadon added that PYT is working to address several challenges common to health care organizations of their size and longevity: updating of aging facilities and equipment, recruitment and retention of top medical staff, and intense market competition. Over the last several months, HMI has been helping PYT’s leadership team to define a strategic vision for the organization to guide them going forward.

Judy Mitchell discusses potential design strategies for PYT's hospital network with Harvey Makadon (left) and Albert Gillis.

The HMI team also includes architect Judy Mitchell, AIA, HMI director of planning, and Albert Gillis, RT, MBA, HMI director of health care facilities development. Elizabeth Brown, RN, MSN, HMI director of clinical services, has recently joined the team and begun working with the nursing leadership at PYT (see sidebar).

Perhaps the most complex piece of the project is the re-design of several hospitals in the network. The partners are looking at this re-organization at the levels of process development, service delivery, and architecture. If embracing a strategic vision is the first step in this process, then clinical program planning—determining the specific services the network will provide—is the second. As Mitchell pointed out, these first two steps will lead to the master plans for restructuring the physical facilities themselves.

“Clinical programs are the basis for facility design, so we are trying to use the facilities planning process to uncover and define elements of strategic planning,” said Mitchell. “PYT has been thinking strategically about how to redistribute clinical services appropriately and how to allow that thinking to guide the planning for facilities and equipment. We believe this is the right approach for PYT, because too often, hospitals think about their facilities as the wrappers around medical equipment.”

Currently, PYT and HMI are focusing on three hospitals that are in close proximity to one another. “We are looking at how these hospitals are related to one another and determining their clinical programming needs. Where we discover that there is a duplication of services, we have an opportunity to re-allocate clinical space to increase the hospitals’ growth potential and allow PYT to introduce new services in the near future,” said Makadon.

One element of this re-design being discussed is the idea of shifting ambulatory care services to older facilities in the network, setting the stage for the newer hospitals to develop state-of-the-art departments in specialties such as radiation oncology.

To offer these new services, and to update services throughout the network, PYT plans major investments in new medical technology. Gillis, who has been working a team from PYT focused on updating its medical equipment, said, “Developing sophisticated services are key to PYT gaining competitive advantages in the local health care market, and a big part of attracting the best medical staff as well. He added that facilities planning and equipment planning should work in parallel, once the clinical program planning process is complete.

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