Case Study: Children’s Services Moves & Improvements

A Deeper LookIn addition to experiences, quality and safety, adjacencies and future space requirements need to be considered when Pediatric spaces are being moved and improved. The completeness of planning scenarios and phasing is of the utmost importance when the projects will affect many departments across several floors of more than one bed tower.

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CHILDREN’S HOSPITAL OF NEW YORK OvERvIEW

Located at New York Presbyterian’s (NYP) Columbia Campus, the Morgan Stanley Children’s Hospital of New York (CHoNY) is comprised of three buildings, ranging in age from 10 to 90 years. The owner chose to embark on a series of feasibility studies to map out the most effective plan to implement modernization projects in four key areas of the two older buildings and one location in the newest tower building.

Critical care bed demand and surgical services growth were key drivers along with maternity capacity and the creation of single family rooms. The projects are donor-funded with defined funding schedules. Each department’s improvement plan is phased to accommodate the domino-effect of planning multiple moves within occupied spaces. Implementation is also dependent on timing of new infrastructure installation.

Feasibility studies were prepared with input from a diverse group of stakeholders and user groups to confirm volumes, census levels and operations. A program of requirements was prepared and test fits developed to ensure that each unit would meet current codes, incorporate evidence-based design tenets and respond to volume projections. The team worked closely with hospital personnel to ensure continuity of identity and wayfinding with the goal of maintaining system-wide parity and compatibility with the Hospital’s design of interior finishes and construction standards.

NYP provided equipment budgets and institutional approvals at the end of the Analysis and Creation phases. At the conclusion of the feasibility studies, a construction management firm provided pre-design and pre-construction services to ensure accurate, detailed cost estimating.

PEDIATRIC PLANNING

CHALLENGE

Aging infrastructure, increased demand and im-portant adjacencies require meticulus planning and systematic implementation.

SOLUTION

Phased project delivery and a knowledge of infrastruc-ture priorities will allow for long-overdue upgrades to essential diagnostics, inpatient and clinic spaces.

Five Floors of Pediatric Improvements

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FEASIbILITY STuDIES YIELD AN EFFECTIvE PLAN

With the feasibility studies complete and approved, the projects are now in various stages of design, documentation and construction.

In the Central Building, inpatient spaces on floors 10 and 11 address expansion of the Pediatrics Intensive Care Units and Antepartum services. The new cardiac NICU is proposed for the 9th floor of the North Building, adjacent to the current PICU, including the Tower Building’s Cardiac ICU. The planning drivers for these essential service lines revolved around the need for all-private rooms, with family space accommodating two-person day beds; decentralized nursing units with central team communication spaces; integrated child life support; and deliberately-sized support spaces reflective of the hospital’s lean operations.

For the Central Building’s Antepartum Unit, adjacent to the existing LDR suite in the Tower Building, an enhanced monitoring capability in support of the high risk patient population is essential. The new Unit, currently under construction, will add maternity bed capacity in NYP Sloane Hospital for Women with an additional 16 beds.

Proposed outpatient space on the 7th floor of the North Building will house a multi-disciplinary Digestive Health clinic, incorporating GI, surgery, endocrinology and genetics. The projects round out with a new 3T MRI space designed for the Tower Building’s 3rd floor to accommodate Imaging volume increases.

view a simulation video of the sub-specialty clinic spaces.

Array’s entire team has exhibited an

exemplary knowledge of Healthcare

Design. Array and their consultants have

done a professional job of sticking with

the problem and providing workable

solutions.

- Francis Vecchione, AIA, Jones Lang LaSalle

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Array is also working with CHoNY on a surgical services expansion project. This multi-phase project requires the relocation of family waiting, surgery intake and PACU to create space for the construction of two general ORs to accommodate projected demands.

The project began with a detailed condi tions assessment survey before the team embarked on a feasibility study requiring conceptual design. They also participated in the development of construction cost and total project budget estimating. The entire surgical services department was

Implementation

SuRGICAL SuITE AND PACu IMPROvEMENTS

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evaluated for compliance with the FGI 2010 Guidelines for the Design and Construction of Healthcare Facilities, New York State Public Health Law – Article 28 and overall life-safety standards. Infrastructure deficiencies, as well as the current system’s useful life, were identified.

When complete, the project will feature new family waiting, a consultation suite, an exam/interview/prep space and new PACU positions with privacy and bedside family space. The new PACU will align with the current Stage II Recovery Suite for flexibility and efficiency. In addition to program development, an existing physical conditions and infrastructure life safety analysis was conducted for the entire Surgical Services Department.

The projects are currently in varying stages of documentation due to project complexity, decants, infrastructure improvements, project phasing, regulatory requirements and donor/funding sequencing. These projects have been team efforts requiring significant commitment, communication and collaboration by all parties involved.

Consistent oversight by CHoNY administrative and NYP facilities project management teams, supported by the NYP Regulatory, Clinical Technology and Information Technology divisions, has ensured conformance to NYP requirements and standards. Substantial user group contributions by nurses, physicians and support departments have contributed to idealized clinical environments in support of best-practice pediatric healthcare.

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