Changing patient needs. Advancements in technology. Limited capacity. Strains on equipment. We’re all familiar with many of the reasons that new hospital construction and hospital renovations are on the rise, but that doesn’t mean all client needs are the same. JE Dunn recently completed an addition to The University of Kansas Health System’s campus in Kansas City, Kan. to not only enhance technology and safety, but also to create a healing environment to make it one of the leading-edge hospitals in the country.
As the demand for the highest level of care and patient volumes increased, The University of Kansas Health System needed to expand its facilities. A nationally recognized hospital, it was also vital that the facility stay on top of technology and equipment, so doctors could further foster the best teaching environment using state-of-the-art techniques and innovative practices to equip future practitioners.
After four years of planning and construction, Cambridge Tower A is now open and caring for patients. It would not be possible without teamwork in all phases and collaboration from all partners to not only get total buy-in, but also to overcome challenges together for the betterment of the project. With 11 levels (plus lower service level and 12th floor penthouse mechanical space), 124 beds, 11 operating rooms, an intraoperative MRI (iMRI) suite, and a two-story bridge across a busy street, among other features, the 558,570-square-foot building required a commitment from all team members from the top down.
While it is rare to build a hospital ground-up on a greenfield site, the location was not without its challenges. Framed by busy streets, an active hospital, and residences, the first obstacle to tackle was how to construct the facility with as little disruption to the public as possible. We did this by developing a highly coordinated delivery with minimal on-site staging as well as delivering the material in just-in-time fashion. This reduced the amount of space needed on site, as well as sped up installations to cut back on time and equipment needed by trade partners. JE Dunn also leased off-site parking and shuttled employees to the site to reduce the number of vehicles and construction traffic near the residential neighborhoods.
Adapting to Changes
Though aesthetics and physical environment were top of mind when designing the facility, the selection, installation, and placement of technology was carefully considered as well. Technology—and healthcare standards—are evolving so quickly that they had already changed from preconstruction to when construction commenced. Designing systems to accommodate these changes and ensuring the technology and equipment we installed could accommodate future advancements affected how we scheduled and selected equipment.
Radiology equipment is a good example. It is constantly changing, so the team planned the infrastructure for the most robust technology at the time, knowing changes would likely be required to accommodate even newer technology. To put the best system in place, all parties agreed on a future date for equipment selection and moved forward with the plan. Delaying selection does affect the timing of other installations and trades, so getting everyone on board with the plan before making the decision was huge in keeping the project on schedule.
Changes in the latest healthcare codes kept the team on their feet, too. The hospital embraced the fact that the industry—and its codes—shift regularly, so when requirements were updated after the design was complete, the answer was simple: change the layout of the pharmacy to meet the newest code.
Unconventional timing, creative scheduling, and flexibility in design were the norm for the team on the Cambridge Tower A Project. A seven-floor vertical expansion and one-story pedestrian bridge were added after construction began—features that enhanced the facility and exemplified the true collaborative nature of the project from owner to trade partners. The challenge was keeping the “go live” date for the initial building and first seven stories the same while building a vertical expansion and bridge around it. Because the public still needed access to the main, base building, construction crews added temporary protection measures while the vertical expansion and bridge were under construction.
While members of the construction team collaborated with each other to develop innovative solutions to scheduling and design changes, they also worked jointly with doctors and nurses to better address patient needs and how they administer care. A reflection of the owner’s commitment to creating a facility with patients in mind and how they would receive treatment, the hospital selected a nearby warehouse to have mockups built for staff review months in advance of construction. The team constructed life-size mockups of Operating rooms (ORs), patient rooms, and Pre/Post-Operative spaces. Multiple user group planning sessions were held in the mockups, allowing doctors and nurses to review everything from space and equipment in the ORs, to outlets and grab bars in the patient rooms. That input was then incorporated into the design. “Smart” rooms were also in the beginning stages across the country during the project planning stages, so the designers incorporated the rough-in necessary to prep the hospital for the upcoming smart room needs.
“Our designers did a fantastic job, but the difference maker was our physicians and nurses giving input of what they needed to enhance the quality of patient care,” said Bob Page, president and chief executive officer of The University of Kansas Health System. “The caregivers selected the technology that would serve patients in the operating room and at the bedside. They worked with designers to build in patient safety improvements. They advocated for more natural light and a healing atmosphere for patients, visitors, and staff.”
Because of their input, the design included many enhancements that would ultimately benefit patients. Perhaps one of the most notable improvements is the addition of the first iMRI unit in the region. Tied directly to a neurosurgical operating room, the configuration enables surgeons to image patients during surgery while remaining close to monitor the progress and results of delicate operations.
Feedback from doctors and nurses also resulted in room formations that would help streamline their work. To use technology more efficiently while keeping equipment accessible, the design cut down on the number of steps to reach the patient and supplies. In addition, the technology is positioned closer to patients and staff to provide care more effectively in procedure and operating rooms. “This building was designed with the patient in mind,” said Tammy Peterman, executive vice president, chief operating officer and chief nursing officer. “Even floor designs illustrate information regarding patient care, including how far into the room caregivers can go without protective equipment.”
The flexibility and willingness to find solutions together—whether they were due to changing codes or finding a better design to give patients better care—speaks to everyone’s commitment to getting this right for the community. From the design to accommodate today’s technology needs to planning for the advancements of tomorrow, every decision was made knowing this world-class facility is ready to serve its patients for generations to come.
As seen in: Medical Construction and Design, July/August 2018