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“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