Healthcare Design - August 2013 - 37

care program at Cincinnati Children's
Hospital Medical Center. His experience in
Cincinnati (and prior to that, at Children's
Hospital of Philadelphia [CHOP] and the
New England Medical Center in Boston)
played a huge role in guiding the design of
CFCC's procedural spaces.
The layout of all the equipment and
supplies in the fetal suite was ultimately
determined by Crombleholme's prior
setup at Cincinnati Children's. But the
size of the room-about 800 square
feet-is much larger. "He was really able
to take the best practices from Cincinnati
and CHOP, and bring them here," Martin
says.
"We went through several simulations
and mock-ups on how to lay out the room
so you could have the most flexibility,"
Nichols says. "Other programs we saw
relied on pediatric ORs or adult ORs and
some combination of pulling adjacent
spaces together. But Colorado was really
committed to providing a dedicated fetal
OR with adequate space, because there
are huge teams of people and adjacent
support spaces, as well."

Top: The nurses' station
includes a central room
"where the mom, the
physician team, and the
nursing team can get together
for private consultation," says
Martin. "It's rather large and
has all the abilities to see the
MRI, OB ultrasound, and fetal
echo. And at the same time,
we can teleconference in our
referring physician." Above:
The crown jewel of the CFCC
is the fetal intervention suite.
The infant stabilization area
(foreground) links the fetal
procedure room (background)
and the c-section room (not
shown). The generously
sized suite was designed to
accommodate large teams of
doctors, nurses, and medical
students; it was laid out
according to best practices
determined by the surgical
staff, field research from other
renowned fetal care programs,
and on-site testing.

Before the new Colorado Fetal Care Center (CFCC) was built
out in the new East Tower of Children's Hospital Colorado,
the project team did a small Phase 1 renovation (two
LDRP rooms, a c-section delivery room, and some support
spaces) within the existing hospital to get the program off
the ground and begin some of the training. It provided a
perfect opportunity to test everything with real patients and
work out a few issues before the launch of the full unit.
"We also built full-scale mock-ups in an offsite warehouse for all key driver rooms, like the LDRPs, NICU
resuscitation areas, and operating room," says Barbara
Anderson, a nurse, medical planner, and associate partner
with ZGF Architects. "The staff simulated all the key functions they'd have to go through."
Based on these simulations and feedback from patients,
several modifications were made, including:
Patient shower. Phase 1 patients begged for bigger bathrooms (which they got in the new space), and more accessibility in the shower. "Our initial design had a shower with a
glass door, and it really looked fancy and nice, but that just
didn't meet the needs of the patients and nursing teams,"
says Mary Beth Martin, executive director of the CFCC's
parent group, the Colorado Institute of Maternal and Fetal
Health. "Some of our patients are having twins and triplets,
and they need assistance in the shower. So we went back
to a different design that allowed mothers to walk into the
shower and have two nurses attend them."
Wood finishes. Claudia Styrsky, associate partner with
ZGF, who led the interior design process, says the team had
tried white oak for the casework, but found it difficult to get
a consistent look and opted for maple instead. And to fit the
desired spa-like aesthetic, she says, "We originally tried a
darker floor color, a wood-look resilient flooring, but it was
too dark and showed marks."
Headwall design. Patient safety required a compromise in
the design of the headwalls, sacrificing a seamless hospitality feel in order to keep supplies and emergency equipment
more easily accessible (and visible).
Pre-op procedures. Once the CFCC unit in the East Tower
was nearing completion, the team went through practice
scenarios with real mothers and staff. For patients arriving
to have a procedure, the plan had been for moms to enter
the unit and then go straight to the pre-procedural suite to
get changed and receive IVs and anesthesia. But the mothers' feedback was strong: "Way too scary," says Martin.
"They're coming to have surgery on their baby, maybe at 20
weeks, or they're having a c-section without knowing what
the outcome will be. They really needed time to check in, go
to their own room, change, and have time to get oriented to
the environment."
Now, those parents have the opportunity to arrive as
early as they like to go to their rooms and even have IVs and
anesthesia consultations there, if that's what they prefer. "It
seems to calm them a lot," Martin says. "We had put lockers in [the pre-procedure suite], and they're just obsolete."

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Healthcare Design - August 2013

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