When Wellstar Kennestone Hospital’s emergency division (ED), in Marietta, Ga., was constructed within the Seventies, it was predicted that the quaternary care middle would serve about 60,000 visits yearly. “Over time, after all, that quantity has continued to extend to the purpose that we’ve seen 140,000 visits per 12 months,” says Mary Chatman, govt vice chairman, Wellstar Well being System, and president of Wellstar Kennestone and Wellstar Windy Hill hospitals (Marietta).

In response, 84-bed ED was pressured to get inventive to handle rising demand, Chatman says, for instance, including hallway beds to extend capability and bringing in a modular therapy unit for short-term use throughout a previous flu season, which then grew to become a long-term care house. Despite these challenges, the ED, which serves as a Degree 2 trauma middle in addition to a complete stroke and cardiac facility, had excessive affected person satisfaction scores, Chapman says. “It was a real testomony and demonstration of how you can take what you’ve and work with it.”

Nonetheless, 10 years in the past, hospital leaders started in search of a greater resolution, planning a brand new ED with 166 beds (133 common beds and 36 transitional beds) designed to assist as much as 200,000 visits per 12 months (with house for 36 further beds for future development)—making it one of many busiest EDs within the state of Georgia and second largest within the nation when it opened in July 2020.

Mapping out targets and options

Situated in a residential neighborhood, preliminary plans sought to find the brand new ED on the prevailing hospital campus, however the concept received pushback from neighbors due to the proximity of the alternative ED to close by homes. So the hospital bought a triangle-shaped parcel of land throughout the road to deal with a brand new, two-story ED. This resolution offered house for bettering effectivity and care companies via a contemporary ED, however introduced one other problem: connecting the brand new ED to the primary hospital.

The answer was a two-story connector constructed throughout the two-way street that separates the 2 services, with one degree designated for transporting sufferers who’re being admitted to the hospital and the second for guests and members of the family to maneuver between the 2 areas with out having to go exterior. “We wished to ensure that entry was pretty direct for a affected person coming from the emergency room to surgical procedure and the CATH labs and different interventional areas,” says Matthew Manning, principal at ESa who served as design supervisor on the challenge, with ESa (Nashville, Tenn.) and Huddy HealthCare Options (Fort Mill, S.C.) collaborating on the challenge. “A whole lot of the planning was primarily based strictly on the place these present companies had been within the present hospital the place we will make a connection.”

One other challenge objective was finding ancillary companies throughout the new ED house to enhance care in addition to assist operations. “We actually wished to make the emergency division to be virtually a hospital inside itself,” Chatman says. For instance, an imaging suite with CTs, MRI, ultrasound, and X-ray companies gives entry to diagnostic companies while not having to move sufferers to the primary hospital. “The extra we will truly make it a resource-heavy diagnostic middle, the simpler it’s to make choices about what the following step is for sufferers,” says Dr. Vik Reddy, chief medical officer at Wellstar Kennestone and Wellstar Windy Hill Hospitals.

To accommodate the positioning’s pure slope, the challenge crew structured the two-story ED atop a 75,203-square-foot parking storage. The primary flooring of the 263,000-square-foot constructing homes a 12-bed trauma pod and a separate 16-bed pediatric ED. Every of the trauma rooms is deliberate to accommodate in-room imaging whereas three have direct connection to a CT for quick entry. An isolation room situated between two grownup and pediatric triage areas on the primary flooring is used to rapidly relocate somebody who poses an an infection danger. To maximise flexibility, the room makes use of airborne isolation know-how and ligature-resistant options so it could possibly additionally operate as a de-escalation room for behavioral well being sufferers, when wanted.

The second flooring includes a 12-bed behavioral well being unit with separate pods of eight grownup and 4 pediatric rooms. The items embody non-public affected person rooms with ligature-resistant options akin to security {hardware} and equipment, a day room, bathe services, and a safe consumption space to permit sufferers in an agitated state to de-escalate earlier than getting into the unit. An adjoining six-bed ED pod on the second flooring can be designed just like the behavioral well being rooms to permit future flexibility. “We in the end determined that for the variety of visits that that they had been anticipating seeing that it might be higher for the behavioral well being unit to be situated on the second flooring,” Manning says. “It’s extra remoted, so it might be harder for sufferers to elope, and we might give them some daylight entry and different options that you just won’t be capable of do if it was on the primary flooring of the ED.”

Neighborhood connections

To assist streamline visitors, the hospital contains three entrances, together with separate entrances for grownup and pediatric sufferers and a devoted house for trauma and ambulances, with three ambulance bays for various ranges of acuity in addition to parking for as much as 17 ambulances. “It’s near our high-acuity space so these sufferers can get proper to that zone from the emergency medical companies drop off,” says Marianne Hatfield, vice chairman and chief nursing officer of affected person care companies at Wellstar Kennestone Hospital. “That wasn’t straightforward to do with a single entry previously.” There’s additionally direct entry to the trauma care space from the rooftop helipad through an elevator.

For the interiors, Chatman says the challenge crew tried to tie in with the aesthetics of the primary hospital, however in an method that was acceptable for the completely different affected person populations the ED serves. For instance, affected person pods within the grownup ED have a tree theme, with corresponding colours and graphics for every, whereas the pediatric ED has a water/bubble theme. “The entire signage performs off of that theme and the colours are slightly bit brighter within the pediatric pod,” Manning says.

Moreover, the challenge crew labored with the native authorities officers and the county to verify the structure tied in with the neighborhood. For instance, sidewalks had been situated across the new ED to supply entry to inexperienced house on campus. The challenge crew additionally tried to reduce what number of timber had been lower down throughout building to maintain the positioning as lush as attainable. Lastly, the connector bridge was outfitted with town’s “M” brand. “We see it as a bridge to the Marietta neighborhood, and as a bridge to connecting our companies,” Chatman says. “It stands out in the neighborhood.”

Anne DiNardo is govt editor of Healthcare Design. She could be reached at anne.dinardo@emerald.com.

For extra on design developments in emergency departments, take a look at the article, “Essential Stability,” in Healthcare Design’s March problem.

 

Venture Particulars:

Venture title: Wellstar Kennestone Hospital Emergency Division

Venture completion date: July 2020

Proprietor: Wellstar Well being System

Whole constructing space: 184,093 sq. ft. new building; 597 sq. ft. renovation; 75,203 sq. ft. parking storage

Whole building value: N/A

Price/sq. ft.:  N/A

Structure: ESa (Earl Swensson Associates)

Inside design: ESa (Earl Swensson Associates)

Basic contractor: Brasfield & Gorrie

Engineering: Kimley-Horn (civil); KSi (structural); SSR (MEP)

Builder: Brasfield & Gorrie

AV tools/electronics/software program: Mazzetti + GBA (guide)

Carpet/flooring: Shaw Contract, Res-Tek, Johnsonite, Altro, Mannington, Shaw, Stonepeak, Sherwin Williams

Ceiling/wall programs: Armstrong, Nationwide Gypsum

Doorways/locks/{hardware}: Finest, Pemko, McKinney, LCN, Von Duprin, Ives, Stanley, Marshfield, Mesker

Material/textiles: TJNG Companions Specified (guide)

Furnishings—seating/casegoods:  TJNG Companions Specified (guide)

Handrails/wall guards: Inpro, Nudo Trim

Headwalls/booms: Stryker

Lighting: Cooper Lighting, Hubble Lighting, Lutron Lighting

Surfaces—stable/different: Corian, Wilsonart, Zodiaq, Hanstone

Wallcoverings: Nationwide Wallcovering, Wolf Gordon, Altro, Sherwin Williams

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