March 21, 2023

Bryan Well being Merrick Medical Heart

Bryan Well being Merrick Medical Heart was initially designed to offer inpatient look after the small, rural group of Central Metropolis, Neb., about 90 minutes away from the state’s capital metropolis of Lincoln.

However as ambulatory calls for elevated over time, the Vital Entry Hospital’s small, semiprivate rooms; compact working room; and indifferent outpatient Rural Well being Clinic (RHC) restricted the companies and specialists that the growing older construction may accommodate.

Moreover, the hospital—inbuilt 1959, earlier than The People with Disabilities Act—additionally offered challenges for an growing older inhabitants with complicated medical wants. For instance, the power’s slender doorframes restricted wheelchairs or walkers from accessing loos and sure examination rooms.

With the aim of increasing its onsite service choices whereas accommodating sufferers in a extra trendy, comfy area, Merrick additionally got down to construct a model new facility that higher mirrored the group’s mission and companies, as properly.

“Sufferers instructed me that the earlier facility didn’t give them consolation or confidence that they’d obtain high-quality care,” says Patrick Avila, president and CEO of Merrick Medical Center, which is a part of the Bryan Well being community based mostly in Lincoln. “We wanted a contemporary, patient-centered facility that represented the extent of care we may present.”

Understanding its rural market wants

The challenge formally kicked off in 2019 when the Dinsdale household, well-known philanthropists in Nebraska, donated 22.4 acres on the southwest aspect of city—a super location for the brand new hospital with direct entry to the principle freeway.

The medical heart partnered with structure agency Kahler Slater (Milwaukee) on the challenge, starting with an in-depth strategic market evaluation to know the hospital’s service utilization on the time.

Among the many findings was that Merrick skilled a 15 p.c decline in annual inpatient discharges over the prior few years, with noticeable fluctuations in emergency visits, surgical procedures, and commentary stays of lower than a day. Armed with this perception, the designers envisioned the brand new facility with versatile rooms that would swimsuit a mess of makes use of as an alternative of separate areas to serve distinct medical calls for.

“You don’t design rooms to be utilized to full capability sooner or later and sit empty the remainder of the week,” says Melinda Pogwizd, affiliate principal and architect at Kahler Slater. “We tried to easy out these utilization ebbs and flows, whereas understanding that each Vital Entry Hospital expects quantity variability. We regarded on the volumes for every service line and use sort to find out which features could possibly be shared or flexed.”

Designing a brand new Vital Entry Hospital

The answer was six adaptable care rooms that may accommodate six several types of care together with sleep research, infusions, specialty exams, prep and restoration, commentary, or emergency care overflow. These companies, which are inclined to peak at totally different instances all through the week, had been beforehand carried out in inpatient rooms that didn’t essentially meet the mechanical necessities.

The brand new care rooms at Bryan Well being Merrick Medical Heart are designed to essentially the most stringent put up anesthesia care unit (PACU) Section 1 Restoration specs, incorporating all the required air flow methods, medical gases, electrical retailers, and mattress clearances for the very best acuity eventualities.

Moreover, by switching out beds for stretchers, reclining chairs, or examination tables, these rooms can simply be transformed for much less crucial affected person wants.

Dave Sheedy, principal and healthcare workforce chief at Kahler Slater, says the aim was to design the rooms to satisfy the worst want, whereas giving them the power to simply flex all the way down to low-acuity makes use of, equivalent to specialty exams or different sorts of visits.

Shortly after the brand new hospital opened in June 2022, Merrick’s two emergency division (ED) trauma bays stuffed up after a serious freeway accident quickly and the adaptable care rooms had been in a position to deal with the inflow.

Handy adjacencies for healthcare workers

With 4 physicians, 4 doctor assistants, and a small cross-trained nursing workers transferring between inpatient rooms, emergency care, and the beforehand indifferent RHC, the brand new facility required strategic adjacencies to optimize Merrick’s restricted medical workers.

“Our workers must flex in quite a lot of totally different areas,” Avila explains. “A nurse right here may deal with an inpatient on swing mattress standing, assist with pre- and post-surgical care in addition to outpatient procedures, after which must cowl the emergency room, too. In a bigger facility, that’s a number of totally different departments; however right here, that’s one nurse on any given day.”

These department-crossing calls for drove the structure of the 51,307-square-foot facility, which is 70 p.c bigger than the earlier constructing. Previously, suppliers needed to bounce between the principle inpatient hospital and the nonadjacent outpatient constructing throughout the road. Bringing the 18-room RHC inside the identical facility streamlined the supply of care.

The structure of the constructing maximizes these efficiencies with crucial proximities. For instance, the nurses’ station is centrally positioned close to the six adaptable care rooms, six inpatient beds, pharmacy, ED, and surgical suite, which contains a spacious working room and one other procedural room.

This command heart additionally serves as the power administration hub, internet hosting the hearth alarm panel, medical fuel panel, and safety desk.

The imaging lab is conveniently positioned throughout from the RHC and subsequent to the ED to cut back steps between departments. These key features reside alongside a main public concourse that connects the principle entrance and the ED entrance, giving sufferers easy accessibility to medical rooms whereas workers, tools, and provides transfer by means of a separate back-of-house hallway to cut back congestion.

“From a affected person perspective, there’s a pleasant calmness to it,” Avila says. “They don’t see the hustle and bustle or really feel like they’re in the way in which.”

Planning group area on healthcare campus

Situated close to the western entrance to city, the medical heart serves because the cornerstone of Central Metropolis’s newly shaped Wellness Hall that connects the hospital to different native assets together with a highschool, senior dwelling facility, aquatic heart, and scenic strolling path.

Named for the household that donated the land, the brand new Dinsdale Well being Campus sits on a triangular web site between the freeway that leads downtown and a road that kinds the southern border of Central Metropolis.

Somewhat than inserting the hospital on the north aspect of the property close to the road, the design workforce pushed the power towards the south finish of the positioning, sustaining visibility from the freeway whereas leaving room for future additions like public restrooms or pavilions.

This place leaves a group occasion area alongside the road in entrance of the hospital, whereas permitting room for the constructing to develop horizontally by including onto the RHC, surgical suite, inpatient beds, or rehab health club as affected person quantity fluctuates sooner or later.

The hospital foyer features as an extension of this group area and isn’t designed only for affected person registration and ready. As an alternative, the foyer additionally serves to welcome the general public into the newly added eating room, which can be utilized to host group cooking demonstrations and different wellness courses.

“We couldn’t justify an enormous, opulent foyer that sits empty more often than not,” Pogwizd says. “Each single inch of this constructing wanted to serve a mess of makes use of.”

Selling affected person quantity progress

Since opening, the brand new medical heart has seen extra sufferers and suppliers coming by means of its doorways. ED volumes have elevated by 60 p.c, and different ancillary companies are up roughly 20-30 p.c, Avila says.

Whereas the previous facility was capped at about 5 days of surgical procedure per 30 days due to the restricted OR area, the expansive new surgical suite has enabled Merrick to recruit a full-time working workforce that performs surgical procedures about 20 days per 30 days.

Because the second largest employer in Merrick County, in keeping with Avila, the medical heart is attracting nurses and specialists by means of word-of-mouth and drive-by enchantment, making recruitment simpler.

The outpatient expertise scores have exceeded the hospital’s targets, whereas inpatient expertise scores have reached 100% satisfaction. “The constructing design and inner movement have helped alleviate affected person anxiousness and enhance the affected person expertise,” Avila says. “Now the constructing matches the care we will present, and there’s a way of group pleasure that comes with it.”

Brooke Bilyj is a contract author and proprietor of Bantamedia in Cleveland. She may be reached at [email protected]


Mission particulars for Bryan Well being Merrick Medical Heart

Location: Central Metropolis, Neb.

Completion date: June 2022

Proprietor: Bryan Well being Merrick Medical Heart Dinsdale Well being Campus

Whole constructing space: 51,307 sq. ft.

Whole building value: $19.9 million

Value/sq. ft.: $388.90

Structure: Kahler Slater

Inside design: Kahler Slater

Normal contractor: Sampson Building Inc.

Engineering: SES, LLC

Builder: Sampson Building Inc.

AV tools/electronics/software program: Ascom, Bogen, Lowell, Denon

Carpet/flooring: Mohawk Group, Tarkett Industrial, Teknoflor Industrial Flooring, Altro Flooring, Ergon Engineered Stone, Florida Tile

Ceiling/wall methods: USG Company, Rockfon Ceilings

Doorways/locks/{hardware}: VT Industries, ASSA ABLOY, KABA, ABH

Cloth/textiles: Designtex, Arc Com, Knoll, Momentum, Wolf-Gordon, Maharam, Stinson

Furnishings—seating/casegoods: Supply Furnishings, Nemschoff, Herman Miller, Nationwide, OFS-Carolina, Weiland, Hi5

Handrails/wall guards: Inpro Company

Headwalls/booms: Modular, Skytron

Lighting: Lumetta, Lithonia, Lumenwerx, EOS, Acolyte, Gotham, Spectrum, Halo, Evenlite, Brownlee, Erco, Fail-safe

Signage/wayfinding:  Nebraska Neon Signal

Surfaces—stable/different: Formica, Formica-Hardstop, Corian, PPG, 3form, Koroseal

Wallcoverings: Symphony

Different: VuEase (glass markerboards), Buechel (stacked stone)

Mission particulars are offered by the design workforce and never vetted by Healthcare Design.