Healthcare Design - August 2017 - 44

A H E Y H O S P I TA L & Medical Center
(LHMC) in Burlington, Mass., opened
in 1980 with an emergency department designed for an annual capacity
of 17,000 patients; in 2016, 42,000 patients were treated there.
The high demand resulted in patients frequently lined up in hallways
on gurneys, waiting to receive care.
Additionally, an inefficient department layout
often caused nurses to make frequent trips between exam rooms and far-away supply closets
and forced first responders to bring trauma cases in through the main entrance. "EDs are very
public places, and we completely lacked private
spaces to care for patients in a dignified manner," says Dr. Malcolm "Mac" Creighton, chair
of emergency medicine at LHMC. "We had nowhere to put anything or anyone," adds Megan
Burns, a registered nurse at LHMC.
Creighton, Burns, and their colleagues advocated for a new department for years. But before the project eventually got the green light in
2013, Creighton visited numerous facilities to
check out modern ED designs and determined
exactly what he wanted: a department that supports the patient-nurse relationship and provides a calm and efficient care environment. A
new 45,000-square-foot space, which opened in
January, is just what the doctor ordered.
THE RIGHT DESIGN

Creighton says most of the EDs he toured fell
into one of two layout categories: small pods

AUGUST 2017

TOP: A nurses' station, as seen from the trauma room, features direct access from critical
care space and provides a work area for multiple caregivers in a single pod. ABOVE:
Exam rooms are marked by colored floor patterns and wood paneling around the doors.
The floor patterns lead directly to handwashing stations within the exam rooms, while
sliding glass doors provide wide openings and facilitate visibility. OPPOSITE: The family
waiting area includes a work counter, technology charging outlets, and clustered seating
arrangements.

HCDMAGAZINE.COM

DAVID ANDERS ON, COURTESY OF FREEMAN WHITE

of exam rooms located around decentralized
nurses' stations or exam rooms located around
a large central nurses' station. Through his observations, he noted that the use of small pods
made communication and patient flow difficult,
while the more open layouts became chaotic
and noisy during the day and weren't as private.
"The thing that struck me about so many of these
newly renovated spaces was, when I watched the
doctors and nurses in action, it seemed that they
were working around the design, rather than
having a design that worked for them," he says.
Looking for a different approach, Creighton
reached out to Jon Huddy, then managing principal at FreemanWhite, a healthcare consulting and design firm in Charlotte, N.C., who has
designed more than 300 EDs. (Huddy is now
president of Huddy HealthCare Solutions.) Together, they set out to redefine LHMC's future
ED operations, streamlining processes to align
with goals of improving nurse proximity to pa-

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Healthcare Design - August 2017

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