Healthcare Design - January 2014 - 11

Lessons from bringing a
Katrina-devastated hospital
back to life

we ask questions on what the impacts are of
the built environment ... the more we'll be able
to ask the questions of value and insert the
value discussion first and not just the discussion of cost," he said.
The tide is turning, he added, and people
are starting to listen and recognize the value
that the built environment brings to the table.
"Over the last decades, evidence-based
design and tracking outcomes are starting to
make a difference and audiences are ripe to
listen. We have to be confident that we can tell
that story, because they will be coming to us
for the data, stories, and quantified outcomes,"
he said.
Closing out the 2013 conference, keynote
speaker Jake Poore, founder and president
of Integrated Loyalty Systems (Orlando, Fla.),
shared how some of the lessons he learned
during his time working at The Walt Disney
Co. could be applied to create an ideal patient

experience. "Our job, first and foremost, is
to remove the anxiety and fear," he said,
highlighting how oftentimes the healthcare
environment is more closely aligned with
prisons than hotels, citing examples like strict
visiting hours and even patients being given
a "uniform" to wear. "We have to break the
paradigm," he said.
To do that, Poore said, the industry should
take a page from Disney's philosophy that the
people, the product, and the physical environment together create an ideal experience. He
highlighted Disney's four "cast member prioritized standards": safety first, courtesy, show,
and efficiency. Complemented by the motto
"We create happiness," these standards create
an environment where employees on every
level are working toward achieving those goals.
"You design, create, and build the most
wonderful place in the world, but it takes
people to make that dream a reality," he said.

ERIC CAMDEN/GLOBAL PHOTO ASSOCIATES

Get comfortable Tips for designing ergonomic work environments
Adoption of electronic medical records has been growing over the past several years, and
today more than 44 percent of hospitals use electronic records over paper, said Jessica
Ellison, principal consultant, NorCal operations manager, Environmental and Occupations Risk
Management (EORM; San Jose, Calif.), during the Healthcare Design Conference.
In the rush to accommodate this new way of information gathering and recording, designers
and owners may also be creating unnecessary risks with quick-fix retrofits to patient rooms
and nurses' stations. Instead, she said, designers should first think about how a space is going
to be used and then the type of equipment that will be in the hands of the staff, whether it's
computers, mobile devices, or laptops. Issues regarding work surface heights, monitor location, and chair heights must also be factored in to ergonomically smart design discussions.
Acknowledging a lack of standards to assist designers in this task, Ellison pointed to the
Australasian Health Facility Guidelines, which suggest a maximum thickness of 2 inches for
work surfaces, while computer work benches should have a depth of 24-30 inches and a
height of 28-38 inches.
Additional design considerations include:
t6TJOHIFJHIUBEKVTUBCMFXPSLTVSGBDFTGPSTJUUJOHBOETUBOEJOH
t 6UJMJ[JOHLFZCPBSEUSBZT
BEKVTUBCMFMFHT GPSSFUSPýUT

BOEDBSUT
t$POTJEFSJOHQMBDFNFOUPGBDPNQVUFSJOSFMBUJPOTIJQUPQBUJFOUTUPFMJNJOBUFBXLXBSE
postures for the staff
t,FFQJOHXPSLTVSGBDFTPSTNBMMDBSUTBWBJMBCMFJOQBUJFOUSPPNT
FWFOXIFSFNPCJMFEFvices are in use, since employees will still need places to put down their devices to make
notes or observe patients
t6UJMJ[JOHEFWJDFTUIBUDBOCFEPDLFETPUIFTUBGGEPFTOUIBWFUPIPMEUIFVOJUTXIJMF
working.-Anne DiNardo

Walking through the former Pendleton Memorial
Methodist Hospital, a facility in New Orleans East
that was devastated by Hurricane Katrina, was an
eerie experience, said Glenn Boardman, associate
director of the healthcare real estate practice at
Navigant Consulting Inc. (Chicago).
"Every patient room calendar was stuck on
Sept. 5," he said. Boardman and Mark Ripple,
partner at Eskew+Dumez+Ripple (New Orleans),
shared this and other details of the 2005 storm's
aftermath as part of their session at the Healthcare
Design Conference.
Following a number of difficult and complex
discussions, including whether to build a new
hospital or not, the project got the green light. A
hospital strategy group was established and a site
was purchased from Universal Health Services.
Daughters of Charity and Franciscan Missionaries
of Our Lady signed on to operate the new facility.
Several plans and approaches were discussed,
but the final project included a three-story pavilion
that houses an ED, imaging, and surgical suites
as well as a renovated tower where patient rooms,
the ICU, and public spaces-like the lobby, cafeteria, and chapel-would be located.
But the real story behind the transition of the old
space to the new came down to resiliency. "There
was real pressure from day one," Ripple said.
While several levels of resiliency were considered, the decision was made against creating a
facility where patients and staff would defend inplace, due to the significant investment it required.
Instead, the hospital group chose a long-term approach in the case of disaster but with a plan that
the building would be evacuated within 72 hours.
To support that plan, critical services like surgery and imaging were designed on higher floors
of the facility so that they could safely remain in
operation even in Katrina-level flooding, while
services located on the first floor were more "sacrificial" in nature. The central plant is located on the
roof of the pavilion, and a helipad and ramps to the
ED provide exit points even in flood conditions.
For those involved in the planning process,
the discussion surrounding resiliency wasn't an
easy one. It's probable that Katrina is a once-ina-lifetime storm, but fear remains nonetheless.
"The arguments regarding resiliency were often
subjective and emotional. The ground rules are
constantly changing," Ripple said.
The team reported it's on schedule and under
budget with a substantial completion date anticipated in spring 2014 and opening expected
shortly after.-Jennifer Kovacs Silvis

HCDmagazine.com 02.14

http://www.HCDmagazine.com

Healthcare Design - January 2014

Table of Contents for the Digital Edition of Healthcare Design - January 2014