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A new leaf

By Amy Eagle, Health Facilities Management
January 2012

Elmhurst (Ill.) Memorial Healthcare recently took the opportunity not only to replace an outdated, landlocked hospital building, but also to redefine the way they treat patients.

When the system set out to build a replacement facility, it established five main goals for the new building: clinical quality, safety, market growth, financial performance and patient satisfaction. Central to these is the patient experience, says Gail Warner, vice president, strategic planning, Elmhurst Memorial Healthcare. Throughout the planning process, the health system asked, “How do you put the patient at the center, and make that stick?” she says.

To answer this question, the system worked extensively with health care consulting firm Hammes Company, Brookfield, Wis., to research, map and optimize the patient experience. It also joined the Planetree network, an organization based in Derby, Conn, that promotes patient-centered care, including the idea that physical environments can enhance healing, health and well-being. Planetree’s principles for safe, effective, high-quality care that nurture the body, mind, and spirit clearly are evident in the newly opened Elmhurst Memorial Hospital facility, which was designed by Albert Kahn Associates Inc., Detroit, and Pratt Design Studio, Chicago.

Convenient, comforting
The red brick Prairie-style building is adorned with bands of precast concrete molded in the design of a Planetree leaf, a motif used throughout the hospital in tribute to the patient-centered model of care.

Gardens and outdoor seating areas span the front of the building. A water feature is installed just inside the main entrance to provide a serene entry sequence for patients and visitors. Oversized windows fill the first-floor, public concourse with natural light. A number of amenities are located along the concourse, including a flower shop, wellness boutique, Starbucks, Walgreens pharmacy and the hospital’s Wildflower Café.

A health education center is available to the public in keeping with the Planetree belief that access to health information can empower people to participate in their own care. The back of this library opens to the physician lounge, giving doctors easy access to research materials.

A nondenominational chapel with a second-story balcony is adjacent to both the emergency department (ED) on the first floor and the intensive care unit on the second floor. Family members and friends of patients in these critical care areas can access the chapel without having to travel far from the patient bedside.

Planetree symbol of healing ‘built into’ replacement project
At the replacement hospital on Elmhurst (Ill.) Memorial Healthcare System’s main campus, the Planetree philosophy “was built into the project, symbolically and literally,” says Robert Pratt, AIA, Pratt Design Studio, Chicago.

Planetree takes its name from the tree under which Hippocrates is said to have taught some of the first medical students in ancient Greece. A stylized Planetree leaf reminiscent of the designs of Frank Lloyd Wright is the primary decorative feature of the Elmhurst memorial facility.

This symbol is repeated across the exterior of the building and is seen throughout the interior in stained glass and flooring patterns, atop railings, on the backs of chairs and as decorative medallions on the donor recognition wall.

The ornamental leaf honors the hospital’s adherence to the Planetree mission of holistic care. The design also is well-suited to Elmhurst Memorial’s established Prairie-style aesthetic. In the hospital’s nondenominational chapel, the Planetree leaf serves as a symbol of nature, something that resonates with all major religions.
For the facility’s exterior sculptural elements, a three-dimensional digital model of the leaf design was used to create molds for precast concrete. By having these pieces mass produced, the project team was able to add a lot of ornament to the building without adding a great deal of cost. “Right now is the best time in human history to do sculptural pieces like this,” says Pratt.

He says his firm believes “in infusing our buildings with symbols and ornamentation that has meaning and describes the culture of the institution.”
According to Pratt, the Elmhurst Memorial Hospital project is “the most developed version we have done of our philosophy of integrating meaningful symbolism into the building.”

Patient room details
The hospital has 259 private, same-handed patient rooms. The medical-surgical room “is at the core of what we do,” says Warner. “We worked hard on the design, and we think we got it right.”

Each room has a computer work station with an articulating arm that allows caregivers to position the monitor where it can be seen easily by the patient. A stool is provided in every room so caregivers can sit down while speaking with patients. Robert F. Sharrow, AIA, vice president and principal, Albert Kahn Associates Inc., explains that studies have shown patients perceive caregivers to be more attentive when seated.

To save hospital staff the time spent fetching extra seats for visitors, a folding chair is stored in a cabinet in the family zone of each patient room. A small table with leaves that fold down for easy storage can be rolled out from beneath a counter on the footwall to give family and visitors a place to work, share a meal or play games with a patient. The idea that families, friends, and loved ones are vital to the healing process is important to the Planetree approach.

At the far corner of each room, the walls meet in a smooth curve rather than a sharp point, in what Warner calls “our not to feng shui” – a gesture that has surprising impact on making the room more comfortable.

Integrated, ceiling-mounted patient lifts are installed in each room for staff and patient safety. Large bathrooms include roll-in showers sized to enable staff members to assist patients with bathing. The toilet is positioned away from the corner of each bathroom, providing room for two caregivers, one on each side, to help a patient sit or stand. Fold-down grab bars are installed on either side of the toilet to allow patients to help themselves. A recessed cabinet in the wall of each bathroom stores bedpans and other commonly used items.

The project team followed the 90/5 rule in designing the hospital. This rule, which originated in the aerospace industry, states that 90 percent of supplies should be stored within five seconds of where they are needed, says Dave Connolly, vice president, Hammes Company. Nurse servers in each patient room keep supplies close at hand.

Like the patient rooms, the ED exam rooms are private, each with a private bathroom. Two doors lead into each exam room; the staff work area is on one side of the exam rooms and the waiting area is on the other, to reduce noise and chaos.

A six-bed pediatric inpatient unit is located next to the ED on the hospital’s first floor. The rooms here look into a children’s garden filled with fanciful blown-glass globes.

Peaceful environment
Balconies on the end of each unit give patients, visitors and staff a place to enjoy fresh air without leaving the unit.

Staff members who need a private break also can retreat to small “lavender rooms” on the unit – spaces in which people can rest or regain their composure as necessary.
“What can a building do? It can create a calm, healing environment,” says Warner.

Facility organized into zones for better wayfinding and flow
Elmhurst Memorial Hospital is organized into zones for greater efficiency and ease of use. The building features a broad front with a central main entrance flanked by east and west wings, each with a separate entrance.

The east wing, which attaches to an existing outpatient facility, contains services for the lease acute patients, such as the Women’s Diagnostic Center and Family Birthing Center.

The cafeteria, conference center and administrative offices also are located here. Services for higher-acuity patients, like the intensive care unit, emergency department and inpatient suites, are housed in the west wing of the building.

Gail Warner, vice president of strategic planning for Elmhurst Memorial Healthcare, says several names were discussed for the entrances at each end of the facility but, ultimately, they were christened “East” and “West,” for simplicity’s sake.

The building fronts Roosevelt Road, a major local thoroughfare; most area residents can orient themselves easily relative to this well-known, east-west roadway, Warner notes. Exterior signage helps direct patients and visitors to the appropriate entrance. The multiple entrances reduce the distance people have to walk to reach the services they need.

While hospital operations are organized along the facility’s east-west axis, public and staff circulation routes are separated on the north and south sides of the hospital. A public concourse runs along the first floor on the southern face of the building, which receives a great deal of natural sunlight.

Staff circulation routes are located along the back of the building, on the north side. A lower-level service floor with its own elevators keeps service elements out of sight from patients and visitors. Departmental adjacencies reduce patient transport distances, for a safer, quieter care environment.

“The zoning works quite well for us,” says Warner, “The building helps us be more efficient.”

Amy Eagle is a freelance writer based in Homewood, Ill., who specializes in health care-related topics. She is a regular contributor to Health Facilities Management.