“the big top” – an innovative approach to design driven by families and providers presented by...

“The Big Top” – An Innovative Approach to Design Driven by Families and Providers

Presented byHelen DeVos Children’s Hospital

Jonathan Bailey AssociatesSmith Hager Bajo, Inc.

Grand Rapids, Michigan

Presentation Outline

Introductions Process Overview Design Integration Design Analysis Implementation Plan Key Measures for Success From a Parent’s Perspective

Introductions

Michele Pietras Curtis Qualls Judy Hager Rhonda Hoyle

Overview

Project Scope Planning Process

“Making the Case” for a Children’s Hospital Market Analysis & Volume Projections Bed Need Analysis Board Support

Operational Process Analysis/Redesign Space Planning/Programming Site Analysis/Conceptual Nursing Unit Schematic Design

User Group & Space Planning Group StructureCORE TEAM

USER GROUPS

SUPER USER GROUP

SPACE PLANNINGGROUPS

CARE BEARS

PROCEED WITH CARE

CARE NECESSITIES

ITCOMM/FINANCE

PATIENT ROOMFAMILY AMENITIES

FAMILY/PUBLICSPACES

OR/ENDOSCOPYSEDATION

TREATMENTSERVICES

LAB/IMAGINGPHARMACY/RT

NUTRITIONSERVICES

ENVIRONMENTALSERVICES

SECURITY

MAT MGM’TSTERILE PROC.

INFRASTRUCTURE

ED SERVICESAMBULATORY

CLINICS

Process Overview

Vision developed for future experiences Idealized a floor to would include the Emergency

Department, Diagnostic Imaging Services, Outpatient Lab Draw Services and a Day Hospital

Centralized Support Space Family Space Staff Support Space Scheduling Check-In Process

“The Big Top”

Design Integration

Design Integration

fast trackobservation

acute

emergency

departurelounge elevator

publicelev

patient/staffelev

edambulanceentry

edwalk-inentry

valetdrop-off

lobby

Design Integration

valet parkingvalet carpick-up

departure lounge

Design Integration

dayhospital

publicelev

patient/staffelev

edambulanceentry

edwalk-inentry

valetdrop-off

Design Integration

diagnosticimaging

publicelev

patient/staffelev

edambulanceentry

edwalk-inentry

valetdrop-off

Design Integration

staff facilities

publicelev

patient/staffelev

edambulanceentry

edwalk-inentry

valetdrop-off

reception/admit

Design Integration

publicelev

patient/staffelev

edambulanceentry

edwalk-inentry

valetdrop-off

departurelounge elevator

trauma

lobby

workstationsupport

checkout

workstation

support

workstation

supportx-ray

isoexam

triage

triagesecurity

Design Integration

publicelev

patient/staffelev

check-in

lobbyplayroom

recovery

workstation/support

endoendo

prep/procedure/recovery

Design Integration

mri

mri

ct

ct

reading room office

office

nucmed

future

radrad/flouro

ultrasound

support

Design AnalysisKey Measures for Success

Space Efficiencies Wait Space/Check-In Holding Rooms/Observation Staff Lounge/Lockers Conference Room

Staffing Efficiencies ED/Observation Consolidation Global Sedation – one location Transport (time and distance)

ED -> Imaging Units -> Sedation/Imaging

Patient and Family Satisfaction ED Imaging Sedation

Design AnalysisSpace EfficienciesWhen evaluating the space efficiencies, a comparison was madebetween the shared space plan of “The Big Top” and individual spaces

foreach area. The spaces included:

Shared wait space Shared check-in space Shared public toilets Staff lockers and lounge The nine-bay holding area shared by sedation and imaging Observation rooms (moving observation patients to the ED versus

an inpatient unit reduced the size of the observation rooms)

Design Analysis

    Separate     Big Top    

    Program     Program    

Description Qty. NSF Total Qty. NSF Total Difference

Waiting Area/Play Area 3 500 1875 1 880 1100 775

Public Toilet 6 260 1950 2 260 650 1300

Check In 2 120 300 1 240 300 0

Staff Lounge 3 300 1125 1 600 750 375

Staff Lockers 3 400 1500 1 960 1200 300

Nine-Bay Holding Room 2 1089 2450 1 1089 1089 1089

Observation/Patient Room Diff. 10 370 5550 10 140 2100 3450

TOTAL DGSF     14,750     7,189 7,561

Space Efficiencies

Design Analysis

Staff Efficiency

Locating the observation patients in the Emergency Department rather than on nursing units.

Placing sedation services in a single location. Check-in/registration planned process that will be shared

by Day Hospital, Outpatient Lab Draw and Diagnostic Imaging.

Design Analysis

Patient and Family Satisfaction

The final analysis involves comparing patient and family

satisfaction in the current facilities with that found in “The

Big Top”, once opened. It is planned that satisfaction will

be measured (before and after the move) for the

Emergency Department, Diagnostic Imaging, Day Hospital

Services and the Outpatient Lab Draw Services.

Implementation Plan

From a Parent’s Perspective

Faith-based, family-centered community

Supportive environment for diagnostic procedures

Services will come to the patient and family

The Emergency Department Parent will be able to stay

and focus on child Quick access to the most

commonly used resources Overall, decreased stress

and anxiety is expected