When the team at Virtua, a non-profit health care system headquartered in Marlton, NJ, began planning its new Voorhees hospital location in 2002, it was agreed that the design of the new facility would be governed by patient care. “The goal we had in mind was to spend our money around the patient,” says Virtua CEO Richard Miller. “When we visited other hospitals, we saw them spending a lot of money on amenities like lobby areas with marble floors. We wanted to take a different approach—making sure the patient felt the care process was personal to them and centered around them. We started with that mindset.” In the years that followed, Miller and his team would engage every stakeholder in the hospital’s design, from nurses to physicians to members of the community, in creating a facility that put patients first. “The priority was always the patient, and frankly, to the clinician the patient is the number-one priority as well,” Miller says. “So we started by building the care process around the patient, making it more effective and efficient; then we said, how do we make things easier and better for the clinician around the patient. And finally, within that framework we looked at the family members and how we could build them in.” The Role of Healing A term Miller frequently uses when discussing patient care is “healing.” “We need to think about how we can promote the healing process,” he says when describing the philosophy that governed Virtua’s Voorhees design. To better understand the needs of patients with respect to healing, the health system’s executive team communicated feedback from the community about its existing hospitals to the management engineers responsible for envisioning the new facility. An example of this feedback cited by Miller involves an aspect of hospital culture so ingrained that it often escapes consideration. “In the older hospitals, patients complained of noise in the corridors,” he says. “So we tested bacteria-resistant carpet in one of our other hospitals for two years to determine if it made sense to use. When we saw that it worked well and held up well, we put it in the new hospital, and you can’t believe how quiet it is.” Although most clinicians and patients alike take it for granted that hospitals will be noisy places, Miller says the change doesn’t just improve the customer experience—it also promotes better care. “People being able to sleep at night and rest during the day without being disturbed improves the healing process,” he says. Each of Voorhees Hospital’s 368 beds is housed in a private, specially designed room with three segments: one for patients, one for clinicians and one for family members. Patients can grant overnight privileges to up to three people, giving these designees 24/7 access to the facility; to make overnight stays more palatable, rooms were designed with pull-out sofas so family members can rest as well. “In the old days, you’d prop yourself up in a recliner and hope you fell asleep,” Miller says. “This is designed for the comfort of the family member. You have to think about how you make them part of the care process—it’s not so much about physically having them there as about how their presence promotes the healing process.” Technology for Smarter Care These softer touches at Voorhees are complemented by extensive deployment of cutting-edge technology aimed at improving clinician efficiency. “We really engaged our physicians, nurses and technical staff in the layout of the hospital,” Miller says. “We asked them to tell us what they thought about design and patient care from each of their perspectives.” Caregivers toured full-scale mock rooms, and, later, were invited to tour each section of the new hospital as it was being built, offering feedback on the real-world execution of the design. “One thing you’ll notice at Voorhees is that staff members are very happy to be there,” Miller says. “They were engaged in the design, they felt invested in the build-out and orientation. There’s a pride of ownership among the employees—this is theirs, and they feel good about that. Clinicians will tell you that the ability to deliver great patient care because of their surroundings is very important to them.” The caregiver segment of every patient room includes a personal computer for entering information into the EMR; outside each room a laptop is available for clinicians to access as well. “All documentation is electronic,” Miller says. Radio-frequency identification (RFID) technology is used to ensure that nurses can access the equipment they need in a timely manner; “Every piece of equipment can quickly be identified and found,” Miller notes. This same technology, employed in admission bracelets, allows the hospital to track patients throughout the facility. Nurses are responsible for a significant percentage of patient care, so their needs were prioritized in the new design. Linens, medication and other items necessary to patient care are stored in areas central to patient rooms, so “nurses’ needs are met without having to walk a hundred yards back and forth,” Miller says. Patient and exam rooms have also been equipped with lifts, reducing the need for nurses to exert themselves physically when positioning patients. “Nurses having to lift patients is a big issue in terms of keeping them healthy,” he notes. “Keeping good employees working and healthy is an important piece of this design.” Economy and Efficiency The design of the new Voorhees Hospital is not only patient-centric; it’s also aimed at contributing to the financial health of the Virtua system. LEED design ensures that from an environmental perspective, the facility is as efficient as possible, resulting in lower total utility costs: “It’s important to do that from a conservation perspective, but also in terms of use of resources,” Miller says. Lean and Six Sigma principles were applied to optimize the available space, resulting in additional efficiencies; current-state process mapping and future-state modeling enabled the Virtua team to better understand both its existing operations and how to achieve more efficient processes in the new facility. “Through GE Healthcare, we were given a great toolkit for designing and building using principles that have been used in manufacturing,” Miller says. “The way the layout of the supply rooms and depots in the hospital has been designed, there will be savings on supply costs. We won’t see as much waste.” For health systems seeking to embark on a similar venture, Miller emphasizes the importance of planning. “Take the time to design appropriately, and use your clinicians, community and patients as sounding boards,” he says. He adds that a judicious eye toward available funds will pay dividends in terms of customer response: “Spend the money toward the patient, not toward common areas or those that don’t impact patients,” he advises. “We have consistently received the feedback from our community that we spent our money well. “Design carefully around the patient and the clinician, and you’ll be successful,” he concludes.

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Cat Vasko is editor of HealthCXO.com.