By Bill Trüb
From the May 2013 issue of Today’s Facility Manager
You can’t spell hospitality without hospital. This truth must have been held paramount by the planning and design team of the Louis & Peaches Owen Heart Hospital (LPOHH), a 154,000 square foot facility opened in December 2012 in Tyler, TX. Construction costs neared $40 million.
A striking, modern design combined with state-of-the-art medical technology provides patients, staff, and visitors the level of comfort and care expected at a world-class hospital. Named for Louis and Peaches Owen, the philanthropists who donated $18 million to help construct the facility, the six story, 72 bed hospital specializes in cardiac care. This focus on the heart is evident upon entering the main lobby, where large red sculptures shaped like healthy blood platelets hang above the information desk.
A Catholic hospital located on the Trinity Mother Frances campus, LPOHH offers a chapel at a major hub between the inpatient and outpatient programs, a nod to how the human heart supports the body. This oval shaped place of worship, a counterbalance to the hospital’s rectilinear architecture, is wrapped in panels of stained glass and is meant to be a spiritual center for people to reflect on the healing process. Outside is a meditative garden. Artwork throughout the facility takes its cue from regional imagery and green spaces.
John McGreevy, senior vice president and CEO of LPOHH, says, “Patients and visitors generally express gratitude for the beautiful spaces and comment on the calming, peaceful surroundings that do not seem institutional.”
“Having an open, welcoming glass concourse on the first floor with a clearly defined entrance [a bold metal canopy] helps invite people into the building,” says Tushar Gupta of WHR Architects, the architecture firm used for LPOHH. “The use of warm woods, Texan limestone, access to natural light and nature, a heart healthy cafe, and comfortable lounge seating evokes hospitality.”
A Chat With John McGreevy
In your position at the Louis & Peaches Owen Heart Hospital, what are your responsibilities? I serve as the primary administrator, handling day-to-day-operations, for the facility and all cardiovascular services.
How long have you worked for the Trinity Mother Frances Hospitals and Clinics system (which includes the Louis & Peaches Owen Heart Hospital)? I have worked here for 21 months.
In handling the daily operations of a healthcare facility, what features of this facility do you see as highlights? This facility was developed with the vision of total patient centered care for both inpatient and outpatient services. By centralizing access to medical records at physician offices and the hospital, we provide a complete team approach to care for all patients.
Just off of the hotel style, multi-level lobby is a highly visible cardiac rehabilitation center featuring exercise equipment and energizing red walls. Designed for outpatient and inpatient needs, the rehab center has views of the courtyard and a small juice bar where patients and staff can mingle and build camaraderie. The warm color palette continues through this space and into the rest of the facility.
Keeping Core Mission In Sight
With such precise attention to design detail, it is unsurprising the same meticulous care is given to the patient experience. LPOHH offers 72 ICU capable private rooms on three floors that are dedicated exclusively to cardiac patients. The modified universal bed model is employed, which allows all aspects of care, admission through discharge, to happen in one room. As patients progress through the healing process, the resources of the room flex to meet their needs rather than moving them through different units of the hospital. This minimizes stress on the patients, whom can be visited by family 24 hours a day, seven days a week.
LPOHH also has implemented the use of electronic health records (EHR), a digital collection of a patient’s health history. “The EHR [system] allows for everything from better medication reconciliation to a quicker response from providers due to faster turnaround times of diagnostic test reporting,” says McGreevy. “This allows us to meet best practice standards in patient education, reduction of length of stay and patient safety.” The use of EHR also lessens the need for paper, which helps reduce waste.
McGreevy continues, “Decentralized nursing substations (one shared by every two rooms) allow our nurses to be more involved with patients and their families while the enhancement of the EHR gives the connectivity to the rest of the care team.”
In planning the hospital, members of the project team visited other facilities, including the Cleveland Clinic and the Indiana Heart Hospital, to see which designs and evidence based practices they had in place. “We wanted the best of what was available,” McGreevy says, “and to not duplicate problems or inefficiencies.” [To read TFM’s November 2009 coverage of a Cleveland Clinic expansion, visit this link.]
LPOHH’s medical facilities and equipment include a cardiac observation unit with a 24/7 physician and mid level coverage; three dedicated cardiac, vascular, and thoracic operating suites with the ability to expand to five; three robotic surgical systems; and cardiac catheterization and electrophysiology (EP) labs with digital imaging technology.
The hospital has had an average occupancy rate of more than 80% since its opening. “Unfortunately, cardiac disease is quite prevalent in this region [eastern Texas] so we have brought the needed facilities to the medical providers that fight that disease process,” McGreevy says. “Access is an ongoing focus for our entire health system. We continuously review how referring physicians can build relationships with the providers who practice in our facility and how to better streamline referrals and admissions. Many previous barriers such as access to medical records have been removed with the implementation of EHR.”
While avoiding overcapacity is an ongoing goal for any hospital, one challenge LPOHH successfully navigated was its ambitious construction timeline. From groundbreaking in April 2011 to the December 2012 opening for patient services, the builders were challenged daily to work quickly. WHR had to fast-track the design process in order to respond to the aggressive schedule.
Says Gupta, “We modified our design process using a robust schematic design followed by a blended design development/construction document phase. A construction manager was brought on early, and WHR issued multiple bid packages to facilitate moving the project forward.”
Utilities provided another construction challenge, as plans for an overhead utility bridge connecting to the main hospital campus had to be rerouted. But within 18 months, LPOHH was operational.
Preparing For The Joint Commission
By Kurt Canova
Healthcare facility managers (fms) are continually preparing for their next visit from The Joint Commission, a leader in setting standards for healthcare organizations. Receiving high scores on these surveys has become a must for fms and their facilities. By working with systems integrators, facility professionals can be prepared to provide the necessary tools to ready a facility for a successful survey.
Today, approximately 82% of the nation’s hospitals are accredited by The Joint Commission, which is recognized as one of the most reliable sources of advancing healthcare safety. To improve fire and life safety systems and maintain accreditation, hospitals must undergo rigorous, unannounced on-site surveys conducted by an Environment of Care surveyor. The evaluation is based on the following: inspection of the facility’s fire safety equipment and features as well as compliance with relevant Life Safety Code requirements set by the National Fire Protection Association (NFPA).
Being properly prepared and trained for a survey could make a difference between a poor report and a good report. The regulatory standards focus on how well an organization documents maintenance, testing, and inspection activities to ensure that the facility is providing a safe environment for patients, visitors, and caregivers. When considering accreditation, how can fms ensure a successful survey?
Details In The Documentation
It is all about the documentation. In order to provide thorough documentation for hospitals to use during The Joint Commission visit, fms can consider working with their life safety systems providers who can help ensure paperwork will meet The Joint Commission requirements for ongoing readiness in life safety and environment of care.
Having the necessary documentation is not the only important part of the process; the preparedness of the fms is also a key factor, since fms must know their life safety systems thoroughly. Working with a systems integrator to gain understanding of each system can lead to high scores on the survey as fms must be able to articulate this information to the surveyor.
An Environment of Care survey consists of two parts: discussion and tracer. The discussion part of the survey is perhaps the most important for fms; this tests how well an organization addresses the various Environment of Care risk categories—general safety and security; hazardous materials and waste; fire safety; medical/laboratory equipment; and utilities—in each of the following six management processes: plan, teach, implement, respond, monitor, and improve.
The surveyor will evaluate an organization’s compliance with the applicable standards in the manual, including:
- tracing the care delivered to patients;
- verbal and written information provided to The Joint Commission;
- on-site observations and interviews by The Joint Commission surveyors; and
- documents provided by the organization.
Bringing In A Third Party
Accreditation is a continuous process, and healthcare fms can partner with their systems integrator to help them prepare necessary paperwork for The Joint Commission surveyor. The systems integrator can be involved in mock on-site surveys in preparation for the actual, unannounced survey.
Additionally, The Joint Commission expects a detailed inventory of all fire and life safety equipment. Because of this, many fms realize the importance of collaborating with the systems integrator responsible for designing the fire alarm system in their hospitals.
Developing a process to meet ongoing readiness in the life safety and environment of care realm is key to ensuring successful scores from The Joint Commission. With the regulatory standards focused on how well an organization documents its maintenance, testing, and inspection activities, fms can streamline the process by working with their system integrators. These service providers can help identify and gather the correct documentation need for an upcoming visit from The Joint Commission. Using a trusted fire alarm partner to develop the correct documentation format can present the information in a positive tone for a successful survey.
Combined efforts have been proven to lead to high scores from The Joint Commission. These partnerships can assist hospitals to become leaders in regulatory compliance within the healthcare industry. After all, preparedness is gaining momentum as the “new normal” for hospitals.
Canova is president of Tech Electronics, a systems integrator and technology services firm headquartered in St. Louis, MO. He has more than 20 years of experience in the low-voltage industry, from field technician to executive leadership. Since 1963, Tech Electronics has been designing, installing, and maintaining a variety of systems and services for facilities in the government, healthcare, education, and business markets.
Speed to market greatly influenced the design process, as did the value and allocation of available resources. “It was a team goal to develop creative solutions maximizing the value of dollars assigned to the project,” Gupta says. “The exterior design was conceived on a balanced approach. The use of higher cost curtain wall predominantly on the south façade, marking the entrance, was offset by the use of masonry and punched windows on the rest of the building. The surgery floor was designed to tie directly into the existing surgery suite of the [Trinity Mother Frances] hospital, thus allowing us to utilize support spaces within the existing surgery suite and avoiding duplication.”
Gupta notes healthcare systems in general are being more conservative and judicious with their budgets, particularly those related to building and infrastructure. With uncertainties surrounding the upcoming national implementation of the Affordable Care Act, the challenge facing design professionals is to maximize funds. “How do we get clients the best value for their dollar without compromising care?” asks Gupta. “One way we’re doing that is by working with healthcare systems to consider redefining their workflow processes to increase the efficiency of their operations. This directly impacts how spaces are designed. We’re helping clients do more with less space.”
And Gupta’s recent client, LPOHH, is off to a blazing, healthy start within its first six months of operation.
Says McGreevy, “A freestanding, independent heart hospital has long been the vision of our organization, which brought cardiac care to east Texas back in 1983.”
He continues, “The Louis & Peaches Owen Heart Hospital has an amazing, highly skilled clinical staff surrounded by the spiritual guidance and encouragement of the Sisters of the Holy Family of Nazareth. The combination of the two and the desire to meet each and every patient’s need in the best, most clinically relevant manner allow us to meet national best practice methodology and parameters while keeping our practice patient centered.”
Trüb is a freelance contributor to TFM. In 2007, he joined Group C Media, Inc., where he worked as senior editor of TFM’s sister publication, Business Facilities. Internationally focused, Trüb has represented the company on press trips to Europe and Asia.
Name of Facility: The Louis & Peaches Owen Heart Hospital. Function of Facility: Healthcare. Location: Tyler, TX. Square Footage: 154,000. Construction Budget: $39.6 million. Construction Timetable: March 2011 to December 2012. Cost Per Square Foot: $257. Facility Owner: Trinity Mother Frances Hospital System. In-House Facility Manager: Kyle Rutherford. Architect: WHR Architects, Inc. Contractor: Austin Commercial. Electrical/Mechanical Engineer: Smith Seckman Reid (SSR). Structural Engineer: Walter P Moore. Civil Engineer: Ballard & Braughton Engineering. Code Consultant: Rolf Jensen. Food Services Consultant: Renald M Corsi & Associates, LLC.
Furnishings: David Edward Furniture; Nemschoff Healthcare Furniture; Steelcase Inc. Flooring: American Terrazzo; Amtico International; Armstrong World Industries; Dal-Tile; Everlast Sports Flooring; Stonhard, Inc.; Teknoflor; Toli International. Carpet: Karastan Contract; Lees Carpets; Mannington Commercial; Mats, Inc. Paint: Sherwin-Williams. Acoustics/Sound Masking: USG. Movable Walls/Wall Surfacing: DIRTT Environmental Solutions; Evans & Brown; Goldray Industries; Koroseal Interior Products; WilsonArt International. Murals and Wallcoverings: Dal-Tile; Swanstone Products; VilliglasUSA; Walker Zanger. Building Management System: Trane. Fire System Components: Edwards. Lighting Products: 3Form; Alico; Bartco; Bega; Bruck; Finelite; Gotham; Hydrel; Intense; Lithonia Lighting; Lucifer Lighting; Lukas; Mark Architectural Lighting; OkSolar; Pathway; Prisma; Pinnacle; Prisma Architectural Lighting; Sylvania; Tango Lighting; Tech Lighting; Universal; Vista; Winona Lighting. HVAC Equipment: Trane. Power Supply Equipment: Kohler Power Systems. Roofing: EverGuard TPO. Signage: Vista System. Exit Signs: Lithonia Lighting. Windows/Curtainwalls: Acme Brick; Arriscraft; Brazos Masonry (stone); Oldcastle Building Envelope (curtainwall); PPG (glazing); United Commercial Cast Stone. Doors/Door Hardware: Cookson Rolling Doors; DIRTT Environmental Solutions; Eggers Industries. Elevators: ThyssenKrupp Elevator Americas.