Time flies when you’re Building on the Promise (Time-lapse Video)

While they didn’t move quite as fast as it seems in this video, the workers who built the Kay Jewelers Pavilion helped ensure the project was completed months ahead of schedule, and well under the projected $180 million budget. There is also an extended version of this video.

Community open house set for April 26 to celebrate opening of Kay Jewelers Pavilion

Kay Jewelers PavilionHere’s your first chance to step inside Akron’s newest gem and celebrate our community’s most precious jewels – kids.

Patient families, friends and the general public are invited to take their first look inside Akron Children’s Hospital’s new $180 million Kay Jewelers Pavilion at a community open house from 1 to 4 p.m. on Sunday, April 26.

The open house will include:

  • guided tours of our new ER, NICU, GOJO Outpatient Surgery Center and special delivery unit for high-risk newborns
  • kids’ games and activities, including life-size versions of popular board games and a photo booth
  • entertainment, including performances by local kids, puppeteers, costumed characters and a bubble artist
  • Doggie Brigade volunteers

Attendees will also have an opportunity to draw pictures that will become part of a permanent, public artwork at the hospital.

A Look Inside

Kay Jewelers Pavilion lobby

Kay Jewelers Pavilion lobby

The interior of Kay Jewelers Pavilion features a “backyard” theme echoing the joys of childhood and the idea that Akron Children’s has been a treasure in greater Akron’s own backyard since 1890.

“Akron Children’s was founded 125 years ago this year as a day nursery and has grown into a regional health system with the depth and breadth of clinical services that truly enable us to serve all of the children who need us,” said Bill Considine, president and chief executive officer of Akron Children’s. “Every detail of Kay Jewelers Pavilion has been carefully planned with our patient families in mind – and we are thrilled to finally open our doors and invite everyone to see this exciting investment into our children’s well being.”

In following the backyard theme, our new NICU is “The Treehouse” – a soothing, healing environment where families can be comfortable while neonatologists and specially trained nurses care for the youngest and most fragile of infants.

In keeping with the backyard theme of the Kay Jewelers Pavilion, our new ER has a puddle theme

In keeping with the backyard theme of the Kay Jewelers Pavilion, our new ER has a puddle theme

Our ER, nicknamed “The Puddle,” was especially designed to facilitate a more natural flow of admissions.

The GOJO Outpatient Surgery Center, “The Sandbox,” will open with 4 operating rooms equipped for a variety of outpatient procedures, including ENT, ophthalmology, urology, dental and some plastic surgery cases.

Our new labor, delivery and recovery center, known as “The Garden,” is designed for cases when a baby is considered at high risk and in need of pediatric specialists the moment they are born.

New medical building is parent approved

Beth Tenda with her children at the groundbreaking

Beth Tenda with her 3 children at the groundbreaking ceremony for the Kay Jewelers Pavilion.

When Beth Tenda brings one of her children to Akron Children’s new ER, she’ll know every nook and cranny of the space down to the most obscure detail.

That’s because Beth helped design the hospital’s $200 million Kay Jewelers Pavilion as part of the lean project delivery process.

Beth and other parents provide design input to the architects during a focus group in 2012.

Beth and other parents provide design input to the architects during a focus group in 2012.

The process began 2 years ago when doctors, nurses, and other members of the care team met and brainstormed about the ideal ER and trauma bay, neonatal intensive care unit and outpatient surgery center.

Beth and several other parents served as the voice of patient families in the process.

They collected and studied data, looked at pictures of other children’s hospitals, worked with architects and engineers, and built and tested simulated space using cardboard walls.

The goals were to build the best space for patient care, improve efficiency, minimize mistakes and keep the construction on time and under budget.

“Wow, this is just as we had planned it,” said Beth, who was on a tour of the building several months before it opened to the public. “The door spaces, the room spaces are perfectly as I envisioned.”

Adopting children with special needs

After raising 2 sons, Beth still felt that pull to parent and adopted 3 children with special needs. Born prematurely, they are now between the ages of 8 and 10 and require the care of pulmonology, GI, sleep, and neuro-developmental specialists.

Beth estimates she has made more than 50 visits to Akron Children’s ER over the past few years.

“Parents carry stuff – diaper bags, purses, infant carriers, toys. I typically had a stroller or wheelchair and not all of us are petite so, in our meetings, I always questioned door space and room space,” said Beth. “You don’t want to be left in an exam room that feels like closet.”

Beth also got to provide input on the interior design of Kay Jewelers Pavilion at a parent town hall meeting in 2013.

Beth also got to provide input on the interior design of Kay Jewelers Pavilion at a parent town hall meeting in 2013.

Beth also recommended family restrooms, glass doors in the ER (where patients are less likely to feel forgotten) and a larger security presence in the ER waiting room.

Beth Tenda with Dr. Emily Scott at a design workshop for the ER

Beth and Dr. Emily Scott at an ER design workshop

“Two years ago, I would guess I made an ER visit at least every other month so I know it well,” she said. “I’ve been there when it was standing room only. So I am very excited to see the new ER in action. It’s all about flow, triaging the patients based on symptoms, and getting them treated sooner. Registration will take place in the exam room, so that means one less stop.”

Beth contributed about 100 hours to the project, attending town hall meetings in the evenings, at least 4 all-day design workshops at a warehouse, and many other sessions.

Beth participates in a simulation workshop for the outpatient surgery center

Beth participates in a simulation workshop for the outpatient surgery center

“You see different ideas and I learned so much about how all of these people interact to provide care to keep kids healthy. It was an eye opener,” she said. “There is so much that goes on behind the scenes to make the typical ER visit or the typical medical appointment happen.”

Beth’s experience as a member of the design team has impacted how she views her day-to-day life.

“I look at things differently now,” she said. “Whether I am shopping or on a doctor’s appointment myself, I get annoyed if processes are not consumer friendly. Getting my kids ready for bed is now clockwork.”

Beth at the NICU town hall meeting in 2012

Beth at the NICU town hall meeting in 2012

Beth continues to volunteer as a parent advisor at the hospital, providing input on various hospital committees and performance improvement projects.

“In many places and in many ways, parents are given the opportunity to have a voice in their children’s medical care or education and we need to use those opportunities,” Beth said. “Whenever I walk into that new building, I think I will want to pat myself on the back and say, ‘I did this!’”

Where the familiar things are

Abstract design features in the future lobby play into the "things familiar" and backyard ideas. The blue wall represents an abstract fence. The design team is also working on large tree sculptures and a ceiling sculpture element to symbolize a tree canopy of leaves.

Abstract design features in the future lobby play into the “things familiar” and backyard ideas. The blue wall represents an abstract fence. The design team is also working on large tree sculptures and a ceiling sculpture element to symbolize a tree canopy of leaves.

Where does a child’s adventure begin?

The answer: In the child’s backyard.

That answer led to the theme for Akron Children’s new medical tower – “things familiar.”

The idea was to inspire imagination while being comfortable and safe at the same time – like in a child’s backyard.

The theme was a result of a visioning process between HKS Architects and hospital leadership.

The theme meets hospital leadership’s desire to create a place that’s distinctive and serves as a beacon to the community. It also conveys a connection to the natural environment, and inspires creativity and hope.

“A child’s imagination is the most powerful tool we have,” said Becky Baumer, an interior designer at HKS Architects.  “It transports them into another time, another place. It takes them out of their current state and into their perfect future state.  It holds their dreams. It is healing. It is comforting. It is calming. It is playful.  It turns things familiar into magical retreats.”

Each department in the new building will feature a backyard-related design that drives the building’s interior look and feel.

These themes will be reflected in abstract design features appropriate to the departments, and each floor will have an assigned a color, signage and accent walls that fit the themes.

  • ED is “the puddle.” This theme was chosen because water has a calming effect for this high-stress environment. The first floor ED will be blue.
  • The outpatient surgery center is “the sandbox.” Located on the new building’s 3rd floor, outpatient surgery will have a more energetic orange color scheme, reflected in color, texture and pattern.
  • The high-risk delivery area, located on the 4th and 5th floors, will be “a garden,” which is appropriate and restful for this adult audience.
  • The NICU, also occupying two floors (the 6th and 7th), will create the feeling of “a treehouse.”  One floor will be the treehouse at night, using the color magenta and setting the scene for a camp-out or sleep-over. The 2nd floor will be green, to reflect the feeling of spending the day in the tree tops.

“The hope,” Baumer said, “is that as the campus grows and areas are refurbished, this type of theming can be continued.”

Wrapping our latest gift

construction-fence-2

1,200 feet of fencing wraps around two sides of Akron Children’s construction site

Wondering what our new medical tower will look like? We’ve got a big dirt mound here now, but surrounding the construction site is a fence wrapped with pictures of the building.

See the architect’s image of the front of the building, the front of the new Emergency department entrance, the beautiful new lobby, one of the NICU rooms and the same-day-surgery waiting room.

We’re designing this building with the comfort of patient families in mind – along with the best practices for clinicians to help care for your little ones.

The eye-catching fence wraps around the construction site from Perkins Square Park to Exchange Street

The eye-catching fence wraps around the construction site along Perkins Square Park and Exchange Street

construction-fence

The fence along Exchange Street

The fence along Perkins Square Park

The fence along Perkins Square Park

How will healthcare look in 20 years? That would be nice to know as we build now

Dr. David Chand talks with Dr. Emily Scott, a pediatric ED attending physician, during the August kaizen to design the new ER.

As Akron Children’s Hospital moves forward with its $200 million campus expansion, a crystal ball would come in handy.

With health care reform, changing demographics, and other uncertainties, our goal is to build flexibility into our design in every way possible. We can make educated guesses regarding future patient volumes and acuity, reimbursement levels, the always-changing technology and best practices for care, but they are just that – educated guesses.

The kaizen process is a group effort.

The first phase of the plan includes a critical care tower to be built on Locust Street, west of our main hospital. The tower will include a new emergency department, neonatal intensive care unit and outpatient surgical suites. A new parking deck, which will connect to the tower, is already under construction. Later projects include an expansion of the Ronald McDonald House of Akron and additional space for clinical programs.

Akron Children’s is using a forward-thinking design process called Integrated Lean Project Delivery (ILPD), which has brought all stakeholders – physicians, nurses, parents, and staff – together with the architects and engineers to design the new space efficiently and with the best possible patient experience in mind. The guiding principles echo back to the hospital’s original promises of:

  • Treating each child as if our own,
  • Treating others as we would want to be treated, and
  • Turning no child away regardless of ability to pay.

Using this process is a natural evolution for Akron Children’s, which began to embrace the Lean Six Sigma process improvement principles when it created the Mark A. Watson Center for Operations Excellence in 2008.

I have been most closely involved with the team designing the emergency department, which was built to serve 45,000 patients annually but has been serving closer to 60,000 in recent years.

Moving through the design process, we held several architect-led meetings, including a week-long “kaizen” in a local warehouse. Using sturdy cardboard for walls, we were able to test true-to-size floor designs and the functionality of the space by wheeling a patient down a hallway, measuring the time needed to get an x-ray, and counting the steps a nurse takes when reaching for supplies.

We have tested various ED scenarios, including a common case of asthma, a trauma, and a teen having a mental health crisis. A pediatric ED is a busy place and we have sought the input of other hospital professionals who provide services there, including our social workers, dietitians, chaplains, transport team members, pharmacists, lab and radiology technicians, and security and housekeeping staff.

Testing patient care flow during a kaizen to design the new ER.

We studied data, such as our average daily census and length of stay, and created “current state” and “future state” value-stream maps, which quantify all the employees, functions, time and costs that follow a patient from arrival to discharge.

Some surprisingly low-tech supplies such as Post-It Notes, yarn, masking tape, and paper cut-outs have been employed to capture ideas and study work flow.

The goal is to catch design flaws early, reduce the number of change orders and, of course, solve problems before it is too late to make changes.

We learned a few things early on. We want separate ED entrances for ambulances and families bringing children on their own. We want as much standardization as possible to reduce the risk of error. And we want rooms to be universal – able to change in function by simply moving equipment in and out.

The parents on our team told us they hope for improved way-finding and easy check-in. A good sense of safety and security is also a top priority. We were reminded that they often come to the hospital with baby carriers, diaper bags, strollers and siblings in tow and few pediatric ED visits are ever planned. The input they have given us has been invaluable.

Construction will begin this spring, with completion scheduled for 2015. We can only wonder what changes we will see in health care by the time the doors of our new critical care tower officially open.

Dr. David Chand is a pediatric hospitalist and member of Akron Children’s Hospital’s Mark A. Watson Center for Operations Excellence.

Simulations help team design most efficient ER

Dr. Gregg DiGiulio examines a mannequin during a simulation to help design the new ER.

A 15-month-old lies in an ER trauma room after being transported by EMS from an adult hospital. Lab results indicate possible kidney failure.

A 6-month-old suffering seizures is being treated in an ER patient room.

A baby has been found not breathing in a bassinette by a babysitter and has been brought to the ER by EMS.

A normal day in Akron Children’s Hospital’s ER?  Not today.

These are 30-minute simulations being played out at the warehouse in Green Township. They’re helping the ER team in its continuing effort to design the most efficient ER, which will be part of the hospital’s new Critical Care Tower.

In previous sessions, the ER team defined equipment needs, room sizes, basic layouts, and the location of support services.

Dr. Mary Patterson is part of the team helping design the new ER and trauma space in the new critical care tower.

This week, ER team members are enacting simulation scenarios created by Dr. Mary Patterson and her staff in the simulation center, to refine the details of the space and determine how it actually works in practice with a patient.

This means fine tuning what’s in the rooms and where everything is placed. Is equipment easily accessed or in the way of staff providing patient care?

ER staff members are assigned roles to play – residents, attending physicians, medical nurses, procedure nurses, recording nurses, respiratory therapists, x-ray techs, anesthesia assistants, observing students, child life specialists, even distraught parents – to evaluate how well the space and equipment work for each member of the team.

The team surrounds the “patients” – mannequins with pulses, eyes that react to light, and breathing and heart sounds – to test the placement and functionality of equipment.

These simulations are videotaped, and with Dr. Patterson leading the debriefing sessions that immediately follow the simulations, team members watch the videos and talk about their own experiences to identify what’s working and what needs to be changed.

As the week progresses and equipment and cart placements are decided, slow-motion simulations will be used to confirm that medications and critical equipment are within the reach of all members of the team, from the tallest to the shortest.  Simulations will also capture patient care at and from ambulance bays.

All of these workshops taking place at the warehouse are part of what’s called a Kaizen, a rapid process improvement event. This will be the last Kaizen meeting for the ER team. Refinements made in this session will be reflected in the completed architectural drawings due by March 8.

Using our senses to describe the ideal emergency department

Megs knows just where she is going to place her stickers.

I know I’ve said it before, but we are privileged to have a hospital that cares to ask its employees and parents for input on how to create the best hospital around.

The second town hall meeting consisted of a few parents from the previous meeting as well as new faces and employees. Again, we were asked what we liked and disliked about the hospital and what we would like to see in the future. We described what our senses tell us – how we feel and what we see and hear.

Some parents suggested activities for the families to engage in during the waiting process. I love this concept. My feeling is, “How long can you stare at fish or pictures?” Engagement helps pass the time. Emergency departments aren’t necessarily known as in-and-out experiences. There may be testing to be completed, specialists to be contacted or materials to be gathered. One of the attendees suggested having a video game console or iPad in the rooms.

Activities or internet access in the surgery waiting areas would also be helpful. One of the team members approached Randy and I about placing our belongings in a locker. I love this idea. When you have surgery in the winter or have extra bags it’s hard to gather them up when you need to move around the waiting area, speak to the surgical staff, or leave to get something to eat. If there were lockers it would be one less item you need to be concerned with that day.

Some other concerns were not having cell phone service in the Emergency department and having to repeat your history to each medical professional who enters. It may seem small, but sometimes it feels like a waste of time. Now that the hospital has switched to electronic health records, communication between team members is improving.

We also discussed locating the mental health area in a separate section toward the back of the Emergency department, shorter waiting times, and being placed in a private room sooner. There were attendees who have first-hand experience in the current emergency department, and they had great points. The staff said that not only is there a new building, but there will be a new process for how the department will operate as well.

I also had the pleasure of meeting a child life specialist who works in the current Emergency department. I love the goal of having more child life specialists, and I feel that these professionals are the glue of the team. They are the link to our common language, to show and explain what is happening, create a sense of calm in crisis, and add an extra smile in our time of need.

We are so excited to see where these plans go to create one of the best hospitals in the nation.

Help us build a better hospital

Akron Children’s Hospital hosted its first family focus group in August to help design its new critical care tower.

Akron Children’s Hospital is seeking families to share their vision for a new ER and outpatient surgery center during the second in a series of family focus groups on Tuesday, Sept. 25, 5:30-7:30 p.m.

Our new critical care tower will be designed to enhance the quality, family-centered care we’ve been providing for more than 120 years.

Patient families offer an important perspective in the planning process.

“Your input will help us ensure the space is created as a healing environment for patients and families,” said Judy Doyle, parent advisor coordinator at Akron Children’s Hospital.

Parents are encouraged to bring their children ages 9 and older because we’d like their opinions too.

To attend or for more information, contact Judy at 330-543-3072 or jdoyle@chmca.org. Space is limited.

Check out the August family focus group.

‘Saving lives’ in a mock trauma room

It’s 3 a.m. in the ER when the call comes in. There’s been a car accident. A 16-year-old boy – unrestrained and the driver – is being life-flighted. He is in respiratory distress and has head injuries.

His 10-year-old brother and front-seat passenger is coming by ambulance. His injuries, neck pain and an obvious deformity to the lower body, appear less serious.

The team – a doctor, nurses, a surgical resident, transport team members, staff from lab and radiology, and others – gather in a trauma room. But this trauma room is different. Its walls are made of Falconboard® (heavy duty cardboard) and it’s actually in a 90,000 square foot warehouse where stacks of new automobile tires seem more “in place” than a pediatric medical team.

The mock drill is part of the innovative process Akron Children’s Hospital is using to design its new medical tower, which will include a new emergency department, neonatal intensive care unit, outpatient surgery center and expanded clinical areas.

Leading the mock trauma drill is Laura Pollauf, MD, director of Emergency Services for Akron Children’s Hospital.

“Our goal with this scenario is to really test the size of this room,” said Dr. Pollauf, through a megaphone with the team assembled around her. “When we have a trauma like this, we can have up to 16 people in the room, including the doctor, three nurses, a trauma surgeon, a lab tech, a fellow, child life, a social worker, and the parents.”

During the scenario, the participants pay attention to details. Is the hallway wide enough for a stretcher? Is life-saving equipment in quick reach? Where will the mother enter and how will she be escorted to meet her sons? If the mother is being registered near her children, will this create a bottleneck in the hall?

Jackie Smolinski, a mother of three, including a son with special needs who is well known in Akron Children’s ED, raises the concern that the 10-year-old boy may be traumatized by seeing his older brother undergoing life-saving measures. But Dr. Pollauf suggests that a pull-back curtain could help with that while still allowing the mother to be with both her sons.

Smolinski and five other mothers who serve on the ER design team have also raised issues such as the need for more restrooms in the ER and a larger waiting room, giving Security a stronger presence, and improving overall flow and wait times.

After an informal discussion about the trauma scenario, team members emerge from their cardboard maze ED and return to tables in another location of the warehouse. They will discuss what they liked and didn’t like in the scenario with architects, engineers and construction team.

The goal is to get the design perfect. So when Akron Children’s new emergency department opens in 2015, it will be more than ready to care for two brothers hurt in a 3 a.m. car accident and all other patients who enter its doors round the clock.

Learn more about Akron Children’s building expansion project, called “Building on the Promise.”