A Healthier Community
The South Patient Tower at Crittenton Hospital Medical Center (CHMC) is an $65M, 87-bed, six-story bed tower with an eight-story steel and glass connector leading to the hospital’s existing patient tower to the north and a steel and glass bridge to the existing parking deck to the south. The tower’s structural system is cast-in-place concrete while the north and south bridges consist of a structural steel and glass curtain wall structure. The tower skin is composed of brick-faced precast concrete panels, punched windows and glass curtain wall.
Crittenton Hospital Medical Center (CHMC) is dedicated to enhancing the health status of the individuals and communities it serves in partnership with its physicians, employees and community members. They dedicate themselves to the communities they serve through creating relationships. These strong relationships have established CHMC as an industry leader not only in providing high-quality healthcare, but also as an organization that strives to improve the health needs of their community. CHMC is a standalone healthcare facility with no parent-operating group. The 290-bed all inclusive community hospital serves residents in Oakland, Macomb and Lapeer counties; providing service to both urban and rural areas.
Barton Malow has had a consistent presence on the Crittenton Hospital Medical Center campus since 2002, working on major construction programs such as the North Addition and Renovations and parking structure, as well as smaller renovation projects throughout the hospital, assisting CHMC in developing greater facilities to serve the community. Detailed knowledge of existing conditions on campus, paired with a decade-long working relationship between CHMC and Barton Malow helped foster the trust necessary for the initial leap of faith into an alternative delivery method, called Integrated Project Delivery, for building the new South Tower.
Lean Operational Design for Patient Care Units
The project was developed from the ground up to provide the most contact time between caregivers and patients. The patient care unit (PCU) planning focused on reducing steps to the most frequented services areas, primarily nurses, and the patients they care for. The methodology used to achieve this was a study of best practice on unit size, then modeling the frequented service spaces and patient beds. The rectangular unit design of 29 beds was broken down into first two operating sections and then 4-6 bed subsections. Within the two operating sections key support spaces; medications, nourishment, clean supplies and soiled utility spaces were provided so that walking steps between any patient room were minimized to 35’ at most. A hybrid nursing model using a central station as well as subunits for 4-6 patients was designed for the best patient contact time possible while remaining flexible.
Evidence Based Interventions for Patient Care Unit Design
Two key aspects of the design of the patient care units (PCU) were; improving sleep quality, and improving hand washing compliance. Improving sleep on patient care units in the hospital is a well-documented way to reduce length of stay. In the PCU’s there were two methods implemented; first, corridor lighting was designed to be at a consistent reduced level for nighttime levels (typically corridor lighting has hot spots), second, service room doors were congregated and faced away from patient rooms in order to reduce noise generated from opening and closing. These interventions produce a quiet, low lit PCU at nighttime thereby enhancing patient sleep patterns.
Improving hand washing compliance is complicated and requires multi-faceted methods to change practice patterns. The environment of care should support operational improvement for hand washing compliance. In these PCU’s significant efforts were made to standardize the process in a one-way pattern from door to patient. The one-way pattern along with the ability for the patient to view the process provides the best opportunity for staff focused on improving outcomes to work with clinicians and others that touch the patient to change hand washing compliance.