Hospitals Emphasize Hospitality

High-Tech and High-Touch Changing Hospital Design

By Debra Wood

Health-care construction continues at a brisk pace throughout the Southeast, with hospitals incorporating the latest technologies and healing features proven to enhance patient safety and satisfaction.
"Obsolescence is a major factor," said Robert Levine, senior vice president of Turner Healthcare in Brentwood, Tenn., near Nashville. "Baby boomers, 78 million of them, are hitting the years when they are using hospitals, and they are demanding consumers."

Technologies that can detect illness early and treat it effectively tops boomers' requirements in a hospital. But they also are attracted to facilities with amenities that make the stay more pleasant.

Technology

To accommodate new technologies, hospitals with aging structures typically must build new because it's too expensive to retrofit. James Kukla, director of health care, Florida for HLM Design-Heery International in Orlando, said floor-to-floor heights or structural columns in older facilities often will not allow installation of the new equipment hospitals need for interventional radiology or other services.

HLM designed a $53 million, four-story, 130,000-sq.-ft. addition for the Shepherd Center in Atlanta, which broke ground in 2004. Choate Construction of Atlanta is building the pavilion, scheduled for completion in late 2007.

"We are building a lot of flexibility into the new buildings," Levine said. "Technology changes so quickly, you don't want to be doing major remodeling in two or three years. We use modular bay sizes."

When HuntonBrady Architects of Orlando designed a new 600,000-sq.-ft. bed tower with a cardiovascular institute for Florida Hospital Orlando, it planned second-floor catheterization labs with future modifications in mind.

"We're planning them to function more like operating rooms, with high-tech diagnostic equipment like MRIs," said Chuck Cole, president and principal in charge of health-care design for HuntonBrady. "And we're beefing up the structure."

Brasfield & Gorrie's Lake Mary, Fla., office has begun foundation work on the Florida Hospital project.

Many hospitals are putting in universal utilities, so lines for power and medical gases will be available wherever they're needed. Wireless technology and electronic medical records on computers and hand-held devices have grown in popularity. Hospitals also are installing systems for wireless tracking of patients and monitoring of vital signs.
Patient safety

The universal trend continues in patient care areas, where private rooms and universal beds have come in vogue. With a universal model, patients stay in one room as their condition changes, rather than moving from intensive care to a step-down unit to a regular floor.

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Turner broke ground in December on a six-story, concrete cast-in-place addition at Cape Fear Valley Medical Center. The plan developed by HDR of Alexandria, Va., calls for 260-sq.-ft., private, universal rooms.

Overall, rooms have grown dramatically larger, Levine said. Larger rooms allow for family members to sleep in, help the patient to the bathroom and assist in other ways, he added.

"Rooming in is good for patient recovery," Levine said. "Patients tend to have a lower length of the stay when family members help."

The private room trend carries over to neonatal intensive care units. New Hanover Medical Center in Wilmington, N.C., recently broke ground on a $190 million expansion that includes a 149-bed women's and children's center with private NICU rooms. The unit will feature a family zone within the room with a sleep bed and wardrobe for moms and dads.

Families feel more comfortable staying in private rooms, and studies show private rooms can decrease the risk of infection, medication errors and the chance of falling.

The 2006 Guidelines for Design and Construction of Hospital and Health Care Facilities, released by the American Institute of Architects and the Facility Guidelines Institute, call for only private rooms in newly constructed hospitals.

"This code will make semiprivate rooms obsolete in new construction," said Sam W. Burnette, senior project designer/principal with Earl Swensson Associates of Nashville.

ESA designed The Villages Regional Medical Center in The Villages, Fla., now undergoing a $65 million expansion, and Trinity Medical Center, a replacement facility for Community Hospital in New Port Richey, Fla. Both have private rooms.

The Robins & Morton Group of Orlando is building The Villages, and Bovis Lend Lease of Tampa the Trinity project.

To promote safety, hospitals are switching to nonmirrored rooms, even though they are more expensive to build. That makes every room identical, with supplies in the same place, to increase nurse productivity and decrease the risk of errors.

Hospitals are adding more grab bars and ceiling-mounted lift devices to eliminate patient falls and cut down on staff injuries. Also with patients weighing more, some hospitals are adding bariatric wings, with floor-mounted toilets reinforced to hold additional weight, bigger beds and wider doorframes. Hospitals are also requesting more isolation rooms, Burnette said.

These features all come with additional cost. For instance, Turner research shows building with all private rooms increases the cost of construction in a 100-bed hospital by 7 to 8 percent.

"If you haven't got the money to do it up front, you end up settling for something different, and that's dramatic in health care," said Levine, adding that rural hospitals seem the only entities building semiprivate rooms.

Healing environment

More hospitals are adopting healing environments, with more natural light, gardens, fountains and soothing colors. HuntonBrady used evidence-based principles, such as windows with interesting views and bedside controls for the blinds, when designing Florida Hospital.

"Evidence indicates patients with views to the exterior heal faster, and it reduces their stay in the hospital," Cole said.

Evidence-based design refers to concepts that have been proven effective at achieving positive results.

"Several studies have determined that atmosphere can improve outcome," Heery International's Kukla said. "And it has some business sense, both attracting patients or consumers in a competitive marketplace and reducing lengths of stay."

Wireless communication systems with personal devices for staff members allow hospitals to cut down on overhead pages, creating a quieter environment, Burnette added.

The Center for Health Care Design in Concord, Calif., received a grant earlier this year to develop evidence-based design resources for health-care executives and design professionals.

"Evidence-based design is really catching on," Burnette said. "Clients are intelligently versed on what is happening with this movement."

Useful sources:

Center for Health Care Design
http://www.healthdesign.org