Engineering Inc. - September/October 2008 - 27

I t’s ultimately a question of what a hospital desires, what it actually needs flexibility and expandability are essential. A New Standard of Care GRanT SCHMIDT kJWW fact that many facilities, originally built in the 1950s or 1960s, are in desperate need of renovations and upgrades. As a result, some owners are completely rebuilding facilities, while others choose to remodel existing buildings and infrastructure. Patient rooms typically have doubled in space—many of them built to accommodate one, rather than two, patients. Sinai Hospital in Baltimore has gone a step further and built a guesthouse—complete with cable TV, private baths, sitting areas and a telephone—for families of long-term patients. A growing number of facilities also include private showers, sophisticated windows and lighting systems (capable of providing everything from actual daylight to specialized blue light designed to minimize disruptions to circadian rhythms) and sound-absorptive materials that reduce noise and disruption. In addition, computer systems and patient portals increasingly offer quick and easy access to medical data, interactive educational materials and point-to-point communication tools that connect directly to medical professionals within a facility. Networks—with wireless Internet access— accommodate everything from laptop computers and personal digital assistants to mobile medical equipment. In many instances, hospitals even are tying patientfacing systems into room-installed TVs, providing a central place to view treatment calendars, order meals and discuss medication regimens. “Architects and design professionals must keep up with cutting-edge trends,” says Liebert. Indeed, as hospitals migrate from multiple, independently run systems to a central IP-based approach, administrators are learning that it’s essential to design and build work and patient areas to accommodate the various tools and technologies of the trade. Some hospitals even are turning to peerreviewed scientific journals to provide clues about how to adapt and change hospital settings. Medical professionals are learning that it is vital to standardize operating rooms (in order to minimize the risk of errors); construct nursing stations that keep nurses deployed rather than congregating at central administrative areas; and design common areas so as to minimize worker fatigue and speed access to records, supplies and equipment. For design and construction professionals, this evolving approach means understanding how facilities—and the patient environments and workflows they create—contribute or inhibit the spread of infections, potential injury, facility transfers and even staff turnover. It’s a concept that Mercy’s Gilbert understands well. The 304-bed facility is undergoing a major rebuilding and renovation project spearheaded by ACEC Member Firm KJWW that involves the construction of a new emergency center and an outpatient surgery department, the redesign of rooms, more efficient use of public spaces and the integration of advanced lighting and climate controls. Project managers are scrutinizing industry best practices and soliciting feedback from focus groups and patients. Ultimately, Gilbert says, the success of the project, slated for completion in 2011, is dependent upon “the entire team and the expertise that it brings to the table.” Balancing current practices with emerging design trends and technology systems is essential. “We have tried to look beyond what’s available today and understand what will likely be necessary in the future,” says Gilbert. That means understanding feasibility and cost issues necessary to complete the project. Getting a handle on the data means being able to work closely with con- Here are some of the major changes in modern hospital design: • Larger rooms designed for a single patient. These spaces increasingly include windows and private showers. • Replacing harsh fluorescent lighting with softer fluorescent or incandescent lighting. • Patient portals offering hospital information, treatment schedules, video on demand, music, games, Web access, e-mail and more. a growing number of facilities are installing high-definition TVs and home theater components. • additional space for robotic surgery units. • More efficient and ergonomic corridors and public areas, optimized for electronic records. sultants and design firms with deep technical knowledge of lighting, acoustics, electrical systems, mechanical systems, ergonomics, IT and more. KJWW’s Schmidt says it’s best to use a detailed matrix that leads executives, project managers and engineers through the entire analysis and planning process. “It’s ultimately a question of what a hospital desires, what it actually needs, what the infrastructure can support and what its budget is,” he says. “Flexibility and expandability are essential.” It’s also wise to assemble a strong core team—including outside consultants and subcontractors, if necessary—that truly understand a hospital’s unique situation. Bringing in expertise early and conducting a thorough analysis “can have a huge domino effect by building a solid foundation,” says Schmidt, who adds that an 18- to 26-month construction process isn’t unusual. One thing is certain: Hospital design is evolving, and firms that work with these facilities are being forced to upgrade their internal expertise and offerings. This new environment serves up its share of opportunities and challenges. “It is an exciting time to work with health care organizations,” says Sparling’s Duncan. “Hospital design and engineering now require a strong balance between knowledge, skills and creativity. It’s an entirely different world than a few years ago.” n Samuel Greengard is a freelance business writer based in West Linn, Ore. september / october 2008 eNGINeerING INc. 27

Engineering Inc. - September/October 2008

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