Project Manager Paul Becks rallies his crews to accomplish great things

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(L-R) Becks discusses a safety concern with project executive Patrick Oaks after their weekly safety meeting.

Paul Becks admits he’s a demanding person. As Welty-Boldt’s field manager on Akron Children’s Hospital’s $200 million “Building on the Promise” expansion campaign, it’s a vital personality trait that helps him lead hundreds of crew members to keep the project on time and on budget.

“When you’re the type of person who has high expectations for your team, I think if the team respects that, they step up and the entire team performs on a higher level,” said Becks, a Lean Six Sigma-certified Team Leader Training instructor. “The entire culture is based on that mutual respect. It’s because of that we’re able to accomplish such great things.”

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Becks talks about progress in regards to the schedule with HVAC foreman Chris Fowler and his teammate.

Becks facilitates the process of planning each task on a rough basis about 6 weeks out. Then, as that specific task approaches, he’s busy getting all the details and components in place and finally, he rallies his crews to implement it.

He and his team set up the workers for success, thinking through all the potential pitfalls prior to implementation. If any issues do creep up, he works hard to resolve them quickly and efficiently so there’s minimal disruption on the job site.

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Paul Becks (on left) discusses the HVAC vertical risers with the installation team.

“I like to think we’re building one of the most complicated machines out there,” he said. “The number of pieces and parts that come together to make a building, I don’t know if anybody has ever counted, but it’s quite a lot. And we’ve scheduled it so tightly that if there’s a hiccup, it pushes back our ability to [complete the next step].”

To keep his team informed, Becks holds daily huddles with all the trade partner project managers. They discuss issues or concerns on the job and make every effort to resolve them right then and there.

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Field manager Paul Becks (on right) discusses logistics for the pedestrian bridge installation with iron worker foreman Louie Cataldo.

In addition, he hosts “Lunch and Lean” meetings on Wednesdays with the construction team, where they watch educational videos or hold discussions on ways to work more collaboratively and efficiently.

Becks also gets together with his construction crews for impromptu lunches and happy hours to keep the morale high.

“A lot of people talk about team building. We look at the root cause of it and say if you need to build your team, there’s probably something deeper,” Becks said. “If you just fix those underlying root causes … you won’t have to build your team. The team builds itself.”

Becks got his start in construction early on. His father also worked in the industry, but he discouraged his son from following in his footsteps due to the job’s demanding nature.

But while attending Ohio State University as an aerospace engineer, Becks realized construction was where he belonged. He wanted to build things. He wanted to be out in the field amidst the action, so he switched his major to civil engineering and has never looked back.

Since then, he has helped transform the region by working on major construction projects, including the Cleveland Clinic’s Intercontinental Hotel, Akron YMCA and Goodyear Tire & Rubber Co. headquarters.

“I always love these projects here in downtown Akron,” said Becks. “There’s just a certain sense of pride that you have building what I consider to be a landmark for our city. We’re not just building a building. We’re building a $200 million-plus life-saving machine. That’s a really good feeling.”

Construction team takes a page from the Buckeyes playbook

Construction workers for Akron Children's new medical tower affix stickers of the hospital's iconic logo symbol to their hard hats as symbols of their successes and teamwork.

Construction workers for Akron Children’s new medical tower affix stickers of the hospital’s iconic logo symbol to their hard hats as symbols of their successes and teamwork.

Great coaches like Woody Hayes know that a little extra motivation can go a long way when a big game is on the line. That’s why, according to Ohio State football lore, he started giving buckeye leaf stickers to players 45 years ago.

Taking a page from the legendary coach’s playbook, the construction crew has started a helmet sticker recognition program of its own.

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Much like the football players sport buckeye leaf stickers on their helmets, the workers are affixing stickers of Akron Children’s iconic logo symbol (aka “the bambino”) to their hard hats as symbols of their successes and teamwork.

“We want to acknowledge everyday improvements to celebrate our successes,” said Nick Loughrin, Welty/Boldt production manager. “We have so many on a daily and weekly basis.”

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Here’s how the Bambino Program works. Anyone on the project team can nominate team members for ideas that:

  • save time, cost or increase quality
  • improve the working environment
  • remove a constraint
  • improve project safety

Welty/Boldt leaders Chuck Voigt, project safety director, and Tom Conti, superintendent, present the awards weekly at the Tuesday safety meetings.

(L-R) Chuck Voigt and Tom Conti

(L-R) Chuck Voigt and Tom Conti

“The team is very excited,” said Loughrin. “This is good positive reinforcement of what they’re doing.”

The idea for the Bambino Program came from the construction education committee, comprising Loughrin, Bernita Beikmann, of HKS, and Will Lichtig, of Welty/Boldt.

New members of the crew also receive a welcome package when they go through the mandatory safety orientation. The package includes a number of safety items, including a yellow vest with the Akron Children’s logo on the back.

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“We want to reinforce that we are ‘one team’ from the first time someone steps onto our project,” Loughrin said.

Collaboration saves time and money for building project

The Structural Innovation Team is studying the best approaches to constructing the foundation and super-structure.

The Structural Innovation Team is studying the best approaches to constructing the foundation and super-structure.

Collaboration among Akron Children’s design teams for its new medical tower has shaved weeks from the construction schedule and saved millions of dollars, while adding features that will increase patient satisfaction and improve outcomes.

“To deliver the best value for the hospital, seven innovation design teams were created to study as many design solutions as possible,” said Nick Loughrin, production manager for Welty-Boldt. “Working individually and collaboratively, during the entire design phase, the innovation teams have captured ideas that have reduced the overall project budget by more than $30 million, while remaining true to the hospital’s design criteria.”

“…the innovation teams have captured ideas that have reduced the overall project budget by more than $30 million, while remaining true to the hospital’s design criteria.”

Each innovation team includes a cross pollination of ‘thinkers’­ – designers, trade partners and members of the construction management team.

  • The Site Innovation Team is responsible for the design of the underground utilities, landscaping and road work.
  • The Structural Innovation Team is studying the best approaches to constructing the foundation and super-structure.
  • The Enclosure Innovation Team is concerned with the aesthetics of the exterior of the building, like the exterior skin and windows, and air and vapor barriers.
  • The Medical Equipment and Technology Innovation Team includes IT, building security, nurse call systems and OR equipment.
  • The Interiors Innovation Team is working on the interior design and finishes, including wall coverings, flooring and furnishings.
  • The Mechanical, Electrical, Plumbing and Fire Protection Innovation Team is designing the HVAC, plumbing, fire protection and electrical systems.
  • The Production Innovation Team is focused on finding the most productive methods to construct the building.

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Using a decision-making process called “Choosing by Advantage,” the teams look at their options, identify the advantages of each, including cost considerations, and reach a consensus on whether a particular set of advantages are worth the cost.

Nick Loughrin Project Manager The Boldt Co.

Nick Loughrin

Each team’s ideas are then preserved in a log. So far, the process has resulted in a number of improvements in the design and construction process:

  • Initially, the mechanical rooms were going to be located in the middle of the building. The teams knew that the location needed to be convenient for the maintenance staff while providing the most flexibility for possible future renovation, and that the noise needed to be as far from patients as possible. The consensus — the basement provided the best solution to the problem.
  • There will be 69 bathrooms in the NICU. “Instead of building the bathrooms on site, it was faster and easier to prefabricate bathroom pods in a manufacturing facility. The pods will be flown in and set in place, saving nearly three weeks in the construction schedule and approximately $50,000,” said Loughrin.
  • The teams studied lowering the ceiling height from 9 feet to 8 feet 8 inches. This reduced the height of the building, which means less brick, windows and metal.  There will be less wall space to finish, and the duct sizes can be reduced. “Lowering the ceiling, which does not impact the design intent, results in a savings of approximately $190,000,” Loughrin said.

Meet Tom Conti: Man at work

tom-conti-with-plaqueTom Conti was born to build. In fact, his passion for construction can be traced back to his very first rattle  as a baby – a hammer.

“My wife just had a surprise 50th birthday party for me and my mom gave me [that rattle] as a gift on a little plaque,” said Conti, project superintendent for Welty-Boldt. “There’s never anything else I ever wanted to do.”

So after attending Akron’s former Central-Hower Vocational School, Conti began his career in 1985 at Seese-Sveda Construction as a carpenter.

He quickly moved up the ladder and, two years later, found himself working as a superintendent for the Akron-based firm until he later joined Welty in 2002.

Conti has helped transform downtown Akron by working on major construction projects for Goodyear Tire & Rubber Co., Summa Health System, and the University of Akron, among others.

He prides himself on never missing a deadline, keeping projects on or under budget, and making safety a No. 1 priority in the field.

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These days, Conti is busy digging deep into Akron Children’s Hospital’s $200 million “Building on the Promise” expansion campaign as the lead superintendent — a role he says is unlike any other.

“It’s a lot different than just being a superintendent on a project,” said Conti, referring to the development’s Integrated Lean Project Delivery method, the first of its kind in Ohio. “We’re all in this together. It creates that team atmosphere.”

Instead of the superintendent serving as the “lead overseer,” as he puts it, Conti partners and collaborates with each contractor on the job so they can create a lean, efficient process in the field.

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It’s a position that fits Conti’s personality well. He exudes a team-player attitude and works well with others.

“We want to make this a happy job site for all the workers,” he said.

But what’s most fun for Conti is leading one of the largest projects in town.

“It’s quite an accomplishment for me,” he said. “I tell the guys out here that it’s an honor for all of us because it is a very unique and interesting project in Ohio.”

And the award goes to… (Photo gallery)

Trent Jezwinski, director of healthcare construction for Welty/Boldt, took home the Bright Idea Award for recalling information from a training that took place over six years ago, which resulted in a potential six-figure savings for the project.

Trent Jezwinski, director of healthcare construction for Welty/Boldt, took home the Bright Idea Award for recalling information from a training that took place over 6 years ago, which resulted in a potential 6-figure savings for the project.

The seven teams working on Akron Children’s Hospital’s new building can get pretty tired at the end of a work week, especially when there are multiple companies working together for the first time and they’re challenged to change the status quo.

So Bernita Beikmann, of HKS, and Nick Loughrin and Will Lichtig, of Welty/Boldt, put their heads together and came up with a way to energize the teams.

“Our first thought was a monetary reward, but that meant assigning dollar values to specific tasks,” said Beikmann. “And, at some point, the money runs out and future tasks don’t look as important unless dollars are assigned to them.”

Taking a page from the children we serve, they ended up with this fun and lighthearted award system:

  • Super Star with the Sticky Notes – The team or person who made the most strides in improving communication and collaboration.
  • Bright Idea – Any person or team with a new, innovative idea to share.
  • Purple Heart – A team or team member who overcame personal or professional struggles during the week or did something on behalf of another team.
  • Super Spice – The team that brought the highest energy to the project.
  • Raising the Bar – The team whose projected innovation savings surpassed their savings goal.
  • Katniss Everdeen Award – The team that reached their target cost.
  • Down the Rabbit Hole – The team member who helped prevent a task or conversation from going down the wrong path.
  • Energizer Bunny – The team that reached its target cost, but still kept adding innovative ideas.
 Rob Ford, estimator at Baker Concrete Construction, and Pam Best, director of pre-construction services at MMC Contractors, accepted the Purple Heart and Raising the Bar Awards on behalf of the team members working at the site to solve problems and ensure a safe environment.

Rob Ford, estimator at Baker Concrete Construction, and Pam Best, director of pre-construction services at MMC Contractors, accepted the Purple Heart and Raising the Bar Awards on behalf of the team members working at the site to solve problems and ensure a safe environment.

“Despite the silliness of their names, the intention of the awards is to motivate everyone to excel,” Beikmann said.

The “trophies” can be as silly as their titles – a stuffed toy rabbit in a tumbler, a light bulb, a doll or a photo of the Spice Girls.

Anyone can nominate a team or individual, and the winners are chosen by the group at the end of the week.

“It was a little scary in the beginning, not knowing how receptive the teams would be to the idea, but the response has been overwhelmingly positive, with teams even competing for awards,” Beikmann said.

The Mechanical, Electrical, Plumbing and Fire Protection Innovation Team even rapped out one of their presentations to win the Super Spice Award.

The Purple Heart Award has been given out to a few team members who have gone above and beyond.

“One recipient gave birth the day after a meeting, another worked until the day before her wedding day, and another member ended up in the ER during the week,” Beikmann said.

And, of course, Akron Children’s received the Katniss Everdeen Award, named after the heroine of The Hunger Games, for its decision to include high-risk OB in the new building.

“In keeping with the book’s story line, the winner of the award reached the target without being set on fire, starving to death, or being killed by another team member,” Beikmann laughed.

For the construction workers at the site, a separate recognition program has been developed with hard hat stickers.

“Construction crew members work as a team and help each other to the benefit of the hospital and the community-at-large,” Beikmann said. “This includes actions like improving the walking paths around the site, cleaning up trash regardless of how it got there, and reducing noise pollution.”

Teamwork guides construction of new space

Tom Conti, left, talks with Paul Becks on the construction site.

Tom Conti, left, talks with Paul Becks on the construction site.

What could the Apollo 13 space mission have to do with the new Akron Children’s Hospital medical building?

Tom Conti, Welty/Boldt project superintendent, believes that what the Apollo 13 team went through is not dissimilar to what a construction team faces: A large group of people, sometimes geographically separated, come together to solve complex problems.

Apollo 13 was launched on April 11, 1970, from the Kennedy Space Center in Florida. Two days later, as it headed toward a moon landing, an oxygen tank exploded. The crew suffered from limited power, loss of cabin heat, shortage of water, and the critical need to jury-rig the carbon dioxide removal system.

With the crew and ground control working together to solve the problems, the crew returned safely to Earth on April 17, 1970.

Tom Conti addresses an issue during a daily huddle.

Tom Conti addresses an issue during a daily huddle.

Conti wants the same level of cooperation from the construction team in working efficiently through difficulties that might arise at the new building site.

“The Apollo 13 team knew what they wanted to accomplish, they had a plan in place to accomplish it, and they did their best, but things happened outside of their control,” said Paul Becks, Welty/Boldt project manager. “The same thing happens on a construction project.”

A good example is the recent storm that blew through Akron and buried some of the previous excavating work that was to be completed the following day. Other companies jumped in and helped the excavation crew “dig out” so the project could stay on schedule.

“It’s about the project, not about the individual companies,” Becks said.

The construction team, which comprises as many as 50 people from HKS, Hasenstab, Welty/Boldt, KLMK and trade partners, are now located together in new office space on the first floor of the new parking deck.

Each team member has a desk and will be on site through the duration of the project.

The Apollo 13 connection is a state of mind, expressed by James A. Lovell, Apollo 13 commander:

There are people who make things happen, there are people who watch things happen, and there are people who wonder what happened. To be successful, you need to be a person who makes things happen.

The members of this construction team want to be people who make things happen.

As a reminder, Lovell’s quote hangs on what has become the inspirational quote wall in the office, which is open to everyone who has a saying or quote to add.

At the beginning of a recent construction team meeting in their large conference room, nicknamed Mission Control, participants were told, “If you’re not confident this team can solve any problem, leave the room now,” said Becks. “No one left.”

Creating new building model is a snap (Photo gallery)

(L-R) Volunteer architects Dan Gilbert and Jonathan Morschl and associate development officer Brian Hollingsworth were instrumental in building the LEGO model.

(L-R) Volunteer architects Dan Gilbert and Jonathan Morschl and associate development officer Brian Hollingsworth were instrumental in building the LEGO model.

With a little more than a month for planning and construction, a team of 30 volunteers set out to achieve the unthinkable – construction of the new building at the Akron campus.

Under the architectural direction of Jonathan Morschl of Four Points Architectural Services, Inc. and Dan Gilbert of DLZ, the team produced the necessary designs, procured the right materials, deployed a loyal and skilled group of building experts, and completed the project on time.

Did we mention they built the building using LEGO®?

“We wanted to do something special for the groundbreaking,” said Brian Hollingsworth, associate development officer for the Akron Children’s Hospital Foundation. “We wanted a piece that would show people a visual representation of what the building is going to look like.”

Airbear, Akron Children's dedicated pediatric transport helicopter, will have a new helipad when the critical care tower opens

Airbear, Akron Children’s dedicated pediatric transport helicopter, will have a new helipad when the critical care tower opens

After some brainstorming within the Foundation, Gretchen Jones, the Director of Principal Giving, suggested a LEGO creation that would serve as a
centerpiece for the recent groundbreaking festivities.

Hollingsworth turned to social media to get ideas about how to replicate the building using LEGO and to recruit volunteers to build it.

After a simple Facebook post, the project took off, he said.

“We received just an amazing response,” Hollingsworth said. “People were liking it, commenting on it, and sharing it on their own pages. I received so many messages from people saying ‘I’m a Lego maniac’ or ‘I have a husband or a child who wants to do this.’”

Morschl and Gilbert helped plan the LEGO model so it would stand as a true representation of the new building when the real structure is complete.

They helped determine what types and quantities of Lego pieces would be necessary to build the model to scale with as much authentic detail as possible.

Assembly was challenging, but finding the materials was more difficult, said Hollingsworth. “It was hair-raising at times waiting for the mail to arrive to bring more essential LEGO bricks,” he said.

Ultimately, the model required several dozen different types of LEGO bricks, more than 12,000 pieces in all, and about 120 volunteer hours to construct. It stands 13 inches tall and 2 feet, 10 inches across, resting on a 4-foot-square platform.

The model may eventually find a home on display in the new building when it’s completed in 2015.

“It was a much bigger project than we thought at first,” said Hollingsworth. “It took a lot of volunteers to make it happen.”

Final design workshop for NICU likened to “speed dating” [Photo Gallery]

Mary Beth Frye, Megan Pollock and nurse Sofiya Lizhnyak participate in NICU simulation

NICU family care coordinator Mary Beth Frye, Megan Pollock and nurse Sofiya Lizhnyak participate in a NICU simulation to test the new design space.

Akron Children’s Hospital’s NICU team began its final design kaizen with an approach that could be compared to speed dating.

The team broke into three small groups that rotated around full-sized cardboard mock-ups that represented patient rooms, medication rooms, team rooms, family and staff quiet rooms, supply and equipment rooms, pod work stations, and remote networking or “touchdown” rooms.

Each group had 45 minutes to review and discuss where every stationary and portable item should be placed in each room.

During a simulation scenario, Dr. Jen Grow and mock patient family test out the design of the new patient rooms

During a simulation scenario, Dr. Jen Grow and Megan Pollock test out the design of the new patient rooms.

The teams took the needs of NICU families into consideration – everything from how to provide coffee and tea service most economically and efficiently to the need for recliners in the quiet room for parents to hold their end-of-life babies.

“It’s been great to be able to give input on everything from the chair position in the patient room to the counter space and cabinets in the bathroom,” said Megan Pollock, a former NICU parent.

In all the rooms, the team discussed the smallest details:

  • How many and what types of seating are required?
  • How many phones and chargers for communication devices are needed?
  • What types of storage work most efficiently in different rooms?
  • Would white and cork boards be useful or compromise patient privacy?
  • What size windows provide the best compromise between visibility, privacy and cost?
  • What’s the best location for the breast milk and formula refrigerator and the meds refrigerator in the medication room?
  • Could crash carts be stored in the medication room?
  • Where is the best place to locate sinks to avoid splashing and possible contamination?
  • Are clutter free counters with storage shelves above the best approach?
  • Who will be responsible for cleaning and stocking items?

After the NICU team agreed on changes, they used simulation scenarios to confirm that they knew where to find what they needed and make sure the newly designed spaces work as planned.

“Participating in the simulations was awesome,” Megan said. “The newborn mannequin made the whole experience feel so real. When I practiced kangaroo care with it, I could feel the heart beat.”

The NICU team will now embark on two years of process refinement during the Critical Care Tower construction, culminating in the move to their new space in 2015.

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.