Firm's role on the project: Planning, Programming, Architecture, Design, Interiors
To implement all-private patient room units (with the exception of enlarged rooms for twins/multiples); provide clear visibility and direct line of sight to all patients; increase privacy and offer greater support for mothers to nurse and have “kangaroo care” time with their newborns; improve family and nurse/physician communication; and reduce overall noise levels on the units.
Continual growth and increasing patient volumes at Akron Children’s Hospital drove the development of an extensive campus master plan with aggressive future growth strategies. In 2012, Akron Children’s announced a $200 million expansion to meet the current and future needs of children in northern Ohio and their families: the Kay Jewelers Pavilion, a 368,735-square-foot critical care tower. The seven-story Kay Jewelers Pavilion at Akron Children’s completes the first phase of the master plan.
In addition to the four 25-bed neonatal intensive care units, the new critical care tower is comprised of: a special delivery unit for high-risk babies that includes labor, delivery, recovery, and postpartum (LDRP) rooms with connected cesarean-section and fetal operating rooms; an emergency department consisting of 31 exam rooms, five behavioral health rooms, and three trauma rooms; a new outpatient surgery center with eight pre-operative rooms, four operating rooms, and space for two more in the future; and an enclosed concourse taking patients and staff members from the 1,250-space garage to the new critical care tower and existing hospital.
The challenges specific to the design and operation of the neonatal intensive care unit, included adaptive learning; working efficiently and effectively with a new workflow, garnering support services involvement, standardizing rooms across the units and within the support cores, and providing appropriate and separate space within the patient room for family activities.
The workflow transition from six-bed pod arrangements in the existing NICUs to the new all-private patient room units caused the greatest amount of uncertainty with the staff. They were concerned that the new design would not allow similar access, visibility, and ability to communicate with families they had when working in the multi-bed pods. The perception many of the nurses and physicians had about increases in travel distances added to the challenges to overcome.
Testing scenarios and running various simulations in the full-scale mockup of the NICU relieved many of the uncertain perceptions staff members had about the transition and revealed refinements that enhanced the design of the units and individual rooms. Additional strategies developed by the team included: nurse charting alcoves outside every room (response to visibility); high noise-reduction coefficient (NRC) ceiling tile in patient rooms and corridors (response to noise); a separate family zone within the room (response to family activities in the room); and family nourishment/lounge spaces on the unit (response to family activities in the room).
The unit opened in May, 2015. It is crucial to thoughtfully prioritize and plan key EBD goals and objectives from the start, in order to successfully realize the many needed fundamental design concepts. If the effort to critique the initial brainstormed list of EBD goals and confirm the appropriateness to meet the unique aim of the NICUs had not been done, the design would have suffered, as the concepts would have been too broad.
With the aim clearly determined, the design developed and evolved naturally to resolve and address each goal established at the onset. The “icing on the cake” will be to conduct a post-occupancy evaluation to validate the effectiveness of each design strategy and the overall design solution against the project goals. Two studies are underway — one on the Lean integrated project delivery (IPD) system, which has shown considerable cost savings using a collaborative process, and another on staff engagement during the transition process.