Inside Children's Blog akronchildrens.org

Getting the details right

During the kaizen to design the new high-risk delivery area, mock scenarios were played out to test the various design concepts.

During the kaizen to design the new high-risk delivery area, mock scenarios were played out to test the various design concepts.

How many corners does a gurney need to turn on the trip between triage and the OR?

What is the best placement of the bed in a patient room to ensure maximum privacy?

Is there a need for refrigeration in the medications room for breast milk?

These and other considerations relating to patient and family comfort and privacy, as well as operational efficiency, represent the final refinements to the high-risk delivery space that will occupy the fourth and fifth floors of the new building.

Dana Nelson

Dana Nelson

“We looked at waiting and reception area flows – that is the family’s first impression,” said Dana Nelson, administrative director of Akron Children’s Maternal Fetal Medicine. “We also wanted to make a very smooth flow for the mothers with as few turns as possible. And we looked for opportunities to bring moms and babies closer together.”

The high-risk delivery space is being designed to accommodate a projected 100 patients annually, but will have plenty of room for expansion as the patient census grows.

The unit will serve pregnancies where the baby, not the mother, is high risk and is expected to need immediate care or surgery after delivery.

Dr. Stephen Crane, director of Akron Children's Maternal Fetal Medicine Division, participates in team discussions about the high-risk delivery space.

Dr. Stephen Crane, director of Akron Children’s Maternal Fetal Medicine Division, participates in team discussions about the high-risk delivery space.

For inspiration, the team, comprised of NICU nurses, representatives from Maternal Fetal Medicine, architects and trade partners, anesthesia, IT and other support services, and former NICU parents, looked at similar high-risk delivery departments at Children’s Hospital of Philadelphia, C.S. Mott and Denver Children’s.

Then they began the now-familiar process, previously used to design the NICU, ER and ambulatory surgery spaces, of mocking up the high-risk delivery space with cardboard as well as actual furnishings and equipment at a warehouse in Akron.

kaizen-team-in-cardboard-seThe mock unit included LDRP (labor-delivery-recovery-postpartum) patient rooms with bathrooms, triage bays, a waiting room and family lounge, C-section/ NICU ORs, a resuscitation room, an ultrasound room, a medications room, an anesthesia work room, consult and conference rooms, a nursery and team work areas.

writing-notes-on-wall-postiDesigned for maximum access, the ORs lead directly into a resuscitation room, where the baby can be stabilized before being moved to the NICU in the adjacent elevator.  Dads can easily move between Mom in the OR and the newborn in the resuscitation room.

When Mom has recovered, she has easy access to her newborn in the NICU via a short elevator ride, instead of being transported from another hospital.

“We also had to talk about those outcomes that aren’t what we hope for,” Nelson said. “We created peaceful, private bereavement space for families.”

Dr. Anand Kantak, director of neonatology at Akron Children's, brings up points about the design concepts.

Dr. Anand Kantak, director of neonatology at Akron Children’s, brings up points about the design concepts.

With team members playing the roles of patients, doctors, nurses and family members, the team continued to move beds, chairs, carts and equipment, until they were sure that the space provided the best patient experience.

At the end of the workshop, team members expressed amazement at the number of details they had to consider in designing a space that was workable for both patients and staff . . .  and the big difference that moving a single door can make in assuring both privacy and efficient treatment.

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