Healthcare Design - March 2014 - 29

BENJAMIN BENSCHNEIDER

for demolition. While the hospital had been
constructed over years, with some areas far
more outdated than others, outdated space
didn't necessarily mean unusable space. "It
resolved itself by combining old and new. The
older space can easily hold office, research,
or less-intensive bed usage like psychiatry. It became apparent that there's a lot of value there,
a lot of synergies by connecting intelligently,"
Stellmacher says.
Core services provided from the existing
building include pharmacy, clinical laboratory, central stores, central sterile, outpatient
services, radiology, and surgery. By taking advantage of what Seattle Children's already had,
the expansion avoided duplication and reduced
initial costs by 60 percent.
And thanks to all of the CPI work that had
been done, Seattle Children's knew exactly
what it wanted out of its new space, even if the
scope was far from what was originally anticipated. Guiding principles included a keen focus
on safety in every aspect of design, ensuring
that caregivers were able to spend as much
time as possible at the bedside, and enough
flexibility to account for the unknowns surrounding the future of healthcare delivery.
To achieve those goals in the new space, a

group of stakeholders including staff, the
Lean consultants, and the design team set
out to first assess the hospital's current
state through a 3P event (production, preparation, process). "They went to patient care
units, followed registered nurses, hunted for
supplies, went to medication rooms, looked
for equipment, and recorded all of that. We
had a sense of time spent at the bedside
and in wasteful activity," Johnson says.
One approach used to eliminate waste,
reduce travel distances, and place key
departments together was to use horizontal
stacking for the new building as opposed
to a more traditional vertical model. Core
services are located on the same floor as
inpatient beds to allow caregivers to go
between inpatient and outpatient environments for a single service line (e.g., inpatient
cancer treatment beds are on the same
floor as outpatient cancer services).

Patient rooms were designed to
be universal to allow the hospital
more flexibility in response to the
unknowns surrounding the future
of healthcare delivery. To support
that flexibility, as well as the need
for family space, the rooms are
larger at 292 square feet plus a
42-square-foot toilet room. "They
chose an investment in size to
ensure longevity in the inpatient
room, which required us to Lean
the supply delivery process to
remove waste. It sounds simple,
but it took a big investment of
people and time to get it right,"
says ZGF's Allyn Stellmacher.

Getting it right
While ideas for how the space could best
be used surfaced, the team relied upon
Lean to ensure it was right. And a big piece
of that process was gaining a realistic view
of what was being designed. "In Lean, you'll
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Healthcare Design - March 2014

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