Tomorrow's Hospital?

BCRA envisions a new service delivery model for in-patient healthcare, which focuses on community integration and breaking down the "fortress" perceived of today's hospitals.

Transcript

1. Embrace and thrive Focused on integration. This design strengthens our environment, embraces the self, and encourages communities to thrive. Designed for success. The new Center for Wellness model challenges the design philosophies of today’s modern hospitals. It begins with the perspective of patients, and layers new principles of asset efficiency, patient flow, and centralized care to ensure affordable solutions. Center For Wellness
2. “storyline.. wkj fejiwefj second line fneiof sdfjeij fef dsfhf ewkfj third line jfiodwf waeafj afhewoif;h f fg;he fh f Name/title “This unique, memorable design promotes a compelling Kaiser Permanente brand, yet the intentional use of modularity in building form encourages easy and cost-effective growth and contraction. It’s a place where people want to come to work.” Hospital Administrator A New Form: Heart & Soul The Center for Wellness challenges traditional form, by opening the box to community and embracing the positive benefits of nature by creating a heart and soul. a. Labyrinth b. Amphitheater over Parking Garage c. Future Destination: Sports and Retail d. Future Destination: Outpatient and Urgent Care Facility e. Marketplace f. Future Destination: Skilled Nursing Facility g. Future Destination: Hostel g j a h i b c d k e f Traditional Form • Box-like and institutional • Intimidating and unmoving • Promotes growth of more boxes • Exclusive and shielded Open Form • Introduces more light and air for all • Reaches outward • Promotes connection “spines” • Creates a central heart New Form • Creates natural entrances • Embraces complementary and preventative services • Promotes dynamic uses • Encourages healing h. Expansion: Future i. Delivery/Loading j. Orchard k. Bioinfiltration/Water Treatment Pond Center For Wellness
3. True Sustainability The Center for Wellness addresses specific requirements for future building energy consumption and environmental sustainability: “One unexpected outcome of my stay was learning more about how natural medicines could invigorate my recovery.” Patient Reduce the overall building energy consumption by becoming more efficient • Improved building envelope and insulation systems • High efficiency heating and cooling systems, including solar-powered radiant heating • Redistribution of heat loss through waste and sewage disposal • Solar hot water collections will increase efficiency and wear of chillers and boilers • High efficiency LED lighting systems • Green roofs to moderate heat loss and keep facilities cool Support an environment-supporting water cycle • Campus-wide rainwater capture • On-site water filtration and UV purification system • Wastewater redistribution for non-potable supply • On-site black water treatment for ponds and recharge of ground water Provide replenishable on-site food sources and local distribution • Localized composting recharges community gardens and agriculture • Recycling of treated grey-water for irrigation • Herbs and vegetables grown on-site support kitchen use, natural patient healing, and community education • Farmers markets provide local fruit and vegetables to the kitchen and community • Education for urban agriculture Achieve at least 30% of energy use from on-site renewable sources for a net-zero facility • Methane capture for water heating and electrical consumption • Massive solar power and water heating generation capacity • Wind-derived power systems in wind corridors on-site • Battery banks store net power gains from peak generation times • Wind and solar electric systems grid-tied to supply municipal power 2 4 1 3 Center For Wellness
4. Programming A strategy for efficient care Not taken lightly in the new Kaiser Permanente Center for Wellness is its efficiency when it comes to patient care and healthcare operations. This five-floor design expands on proven in-patient and specialty care adjacencies. At the core, this design maintains the operational conditions required to keep the cost of care low by eliminating redundancies and unused spaces. This program supports robust asset manage- ment, while removing a patient and family’s fear of entering a traditional hospital “fortress.” LEARN HEALING Emergency & Diagnostics • Consolidate services and blur borders between service lines for optimization • Universal flexibility of the whole, not the parts • Greatly reduced need for growth facilities support services • Central Supply Systems • Focus on function • Infrastructure for technological and functional flexibility • Structural skin eliminates rigid internal configuration Surgical Suite • 8 hybrid/universal operating rooms with daylighting • Designed around peak period flex- ibility Lounge • Peaceful retreat • Away place to linger and recharge within the building Roof • Dual use green roof and outdoor space Conference & Multi-Purpose • Facility and community use gathering • World class spaces for research and education 34 In-Patient rooms • Segmented building with standard- ized parts for rapid and cost effective construction 33 In-Patient rooms • Surgical recovery areas literally and symbolically bridge between the treat- ment and healing branches of the hospital • Day lit universal recovery rooms serve as ED overflow rooms for disaster preparedness 33 In-Patient rooms • Focus on Hospitality embracing family and nature • Expansive views of dynamic campus site and activities • Optimized flow based on prototype facility Community Wellness Center & Reception • Embrace healthful behavior patterns • Connected to site and community • Dynamic public place Facility Support Services • Materials Management • Dietary HEALING HEALING PROACTIVE REST REACTIVE EFFICIENT REACTIVE “By blurring the lines of traditional hospital nodes, this new layout encourages expansive care and eliminates rigid internal configurations.” Doctor 5 4 3 2 1 B Center For Wellness
5. Emergency & Diagnostic Imaging A universal standard for patient rooms between Emergency Exam Rooms and Surgery Pre-Op/Level 2 Recovery Rooms create a synergy between the two departments that can be employed during a catastrophic event when Emergency, Diagnostic Imaging and Surgery services are strategically located adjacent to or near each other. Efficient Flexibility • Safe and rapid transport of patients in the E.D. simplified with many services performed in the room at the patient’s bedside. • Covered decontamination space for multiple stretchers in E.R. in addition to dedicated staging area for mass decontamination outside, adjacent to the E.R. • Private Surgery Pre-Op / Level 2 recovery rooms optimize efficiency of space by blurring the lines of similar levels of care. • Surgery P.A.C.U. open bays have same square footage as Pre-Op / Level 2 recovery rooms for flexibility. • O.R. rooms are larger 1,000sf hybrid design to optimize surgical services and accommodate changing technol- ogy. All eight O.R.s located on outside walls and have high windows for natural light. Window shading can be controlled remotely from the O.R. • A generously spaced and centrally located case cart holding and supply area with vertical access to C.S.S. is directly accessed from each O.R. Pass-through cabinets and doors allow stocking and case cart transfer without the need to go into the O.R. Environment and Technology • “Front of House” and “Back of House” planning keeps the hectic pace of patient care behind the scenes from public eye. Private patient and staff corridors are conveniently separated from public corridors. • Larger standard rooms allow compact, mobile imaging equipment to be brought to the patient. This eliminates the need to transport most patients to the imaging equipment and back. • Patients use computerized smart beds, which include network monitoring systems and medical gas services for I.C.U. level of continuous care and monitoring. a. 156 ft2 (negative pressure) E.R. exam rooms & surgery pre-op/Level 2 recovery private rooms b. Surgical lighting (E.R. only) c. Mobile smart bed with integrated medical systems d. Moveable patient wardrobe e. Headwall free of medical gases f. 156 ft2 surgery P.A.C.U g. Daylighting ribbon windows h. Sliding break away door (private rooms can “flex” into 312 ft2 procedure rooms) i. Common hand wash per 2 rooms j. Sliding breakaway door j i c b g d e a a h f c Center For Wellness
6. Concierge: Reception A place for reassurance and comfort In the new Center for Wellness, smart technology empowers patients and family with the information and power to make decisions. This whole new approach to arriving at the center offers the following benefits to visitors: • Proximity technology is integrated through the cloud with automobiles and smart phones. As visitors near the Center for Wellness, media touch screens in cars or smart phones are enabled with directions to valet parking and a series of pre-screening questions based on the type of visit. This also alerts staff of the incoming patient’s situation to allow for planning and greeting. • Ambulance entry is not visible and interior design and way finding signage are intended to calm visitors. • No Registration Desk – bedside registration through handheld EMR / POC testing “Checking in online at home before I left was so comforting. It allowed me to customize my experience, almost like I was headed to a hotel. The open, no-pressure concierge let me take a few deep breaths in an otherwise stressful situation.” Labor and Delivery Patient Center For Wellness
7. Guest Rooms Ease patient stresses Technology • Patient tablet devices offer online food ordering, climate control, nurse paging, and online access to stay con- nected to the outside world. • Smart clothing monitors vital statistics and reports that in real time to nurse tablets. Patient TV is also a patient monitor with medical staff voice recognition. This eliminates many of the patient monitoring devices at the patient headwall. • RFID chips are embedded in patient bracelets, which eliminates the needs for barcode scanning and gives family members updates as they happen via text mes- sage or email. This also ensures medical records are always available and up to date. • Preset preferences allow patients to stream photos, music, and movies from their web-based collection onto in-room media centers. Environment • Balconies provide access to outdoor environment and fresh air. • Visitor lounge areas offer hotel-like amenities for comfort and to encourage longer visits. • Open floor plans offer comfort by reducing clutter and space for customization. • Nearby plant life encourages healing and wellness. Care Support • Inpatient rooms are private, universal rooms with the same-handedness to reduce errors. • Service lines are “blurred” between departments to allow optimum flexibility during peak periods or a catastrophic event. • Personal communication devices with ultrasound track- ing detect real time location of caregivers, allowing caregivers to stay in contact. • Infrared sensors above doorways activates a spotlight that shines on the hand sanitizing or sink area to remind staff to take the extra step to reduce spread of patient infections. • Patients use computerized smart beds, which include network monitoring systems and medical gas services for I.C.U. level of continuous care and monitoring. • Mobile smart cart units bridge technology allowing stan- dard beds to become I.C.U. beds. a. Dedicated storage room can “flex” as anante- room as needed. Lockable doors allow patient room to “flex” from overnight hotel room for family back to a patient room. b. Decentralized nurse stations, with counter surface computer, improves patient care and supports acuity adaptable design. A central nurse station at the front of each patient care wing controls access. c. Double doors 3’-0” and 2’-0” leafs: manual mode 3’-0” leaf opens, 2’-0” leaf locked. Push plate actives both doors to open d. Door sensor up on exit triggers spot illumi- nated hand sanitizing & hand wash sink e. All room controls wireless at patient bed f. Smart bed, ICU capable with built-in gases, eliminates headwall gases g. TV is interactive patient monitor featuring care provider voice recognition h. Patient and family wardrobe, work surface/ plant shelf i. Patient bathroom designed with bariatric courtesy and sized for staff and family assist j. High windows for day lighting k. Family area with guest bed l. Large bay windows with dynamic views incorporating solar screening/ light shelf m. Private balcony with glass railing and open- ness for breezes n. Living green walls for cooling, color and beauty a g h c e f i j n l n m k b d Center For Wellness
8. Community Connection The main building is oriented in a diagonal alignment so the edges of the site intentionally extend and reach out to the community. A central green spine connects built elements to outdoor spaces that are filled with activity. • A well- groomed central green spine with large covered gazebos sup- ports Farmer’s markets on weekends and other community events, as well as family picnics. • Plantings used as part of the landscape provide freshly harvested produce for the Wellness Center. • A very large garden walk in the form of a labyrinth, provides a walking meditation path that is a metaphor of life’s journey; a spiritual tool which leads to healing, transformation and inner peace. • Expansive lobby areas feature high windows and light wells to accommodate indoor public activities and com- munity events. • Visitors are greeted by valet and directed to a check-in/ concierge desk at the main entrance. • Public areas are at the “Front of House” while patient care and staff areas are strategically separated away from public eye at the “Back of House”. “I’m energized by this place. It’s so much more than just a place to heal. It’s part of the fabric that makes up our community.” Family Member Center For Wellness
9. Center For Wellness Thrive here.