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Smart Growth in a Booming County

blank A member of Johns Hopkins Medicine, Howard County General Hospital is taking expansion to a whole new level with up-to-the-minute additions and amenities slated to debut next year.

Although Howard County General Hospital is only about 35 years old, administrators there decided it was already in need of a facelift.

Today, the community hospital is in the midst of a $105 million campus redevelopment plan to keep in step with advances in health care technology and patient safety requirements. The plan, including a 233,656-square-foot expansion, is the most ambitious capital project in the hospital’s history, says Jay Blackman, chief operating officer.

“We’re the only hospital in Howard County,” Blackman says. “We’ve witnessed a significant population growth over the years, but this population is aging and their health care needs are increasing.”

During the last 10 years, for example, annual admissions have increased 13 percent while emergency department visits have grown by 130 percent.

Central to the plan is a new five-level patient pavilion featuring three inpatient floors, scheduled for completion in fall 2009. All 90 new rooms will be private, and existing semiprivate medical/surgical rooms will be converted to private, yielding an increase of 42 beds, says Beth Plavner, special projects administrator.

Private rooms not only are quieter but promote a “healthy, healing environment,” says Plavner, by reducing the incidence of falls, hospital-acquired infections and medical errors. They are also designed to enhance patients’ comfort and safety. A handrail system helps guide patients from their beds to the bathrooms, the shower is level and allows for better patient accessibility, and rooms are segmented to a family area with daybeds and a nursing side with equipment.

Furthermore, the design enables health care staff to work more efficiently. Charting areas, featuring drawers for medications, are located outside every two rooms so nurses can see patients while documenting their care. And because the design is standardized throughout the hospital, those who work on more than one patient floor will always know where to find medical gases or supplies.

To put their proposed blueprint to the test, Plavner built a mockup of the room in a waiting area on an existing floor and had it outfitted with supplies. Besides running a mock code in the room to check work flow, administrators asked for feedback from nurses, physicians and staff from environmental services, infection control and risk management. The hospital’s board of trustees and a Howard County leadership group also came through for a look, and even some hospitalized patients wandered down the hall to offer comments.

Plavner says the reviews, though overwhelmingly positive, called attention to areas for tweaking and improvement. Nurses said some of the shelves were too shallow to hold necessary supplies. Some workers were concerned that the flooring material would not be as slip resistant or absorb sound as much as others, and questioned the height of the paper towel and soap dispensers in the bathrooms. The contractors are now constructing a new mockup to make sure no further changes are needed “before we copy it 89 more times,” Plavner says.

The pavilion’s lower level will feature two state-of-the-art operating rooms and a larger laboratory and pharmacy, while one area of the main floor will be home to outpatient  services, such as cardiopulmonary rehabilitation; occupational, physical and speech therapies; and diabetes management. A new 550-space parking garage, also part of the plan, opened this summer.

And that’s not all. Adjacent to the hospital will be a new outpatient and physicians’ office building. Through an unusual agreement, the hospital contributed the value of the 10-acre site in return for 25 percent of the building’s equity, while about 80 physicians invested their own funds, accounting for the remaining 75 percent equity.

The new building, to open in early fall 2009, will almost double the current 200,000 square feet of outpatient space and increase patient visits by as much as 30 percent. Thirteen specialty groups, including medical and radiation oncology, urology, orthopedics, cardiology, obstetrics and gynecology, and general surgery, will maintain offices at the site, which will also house a Johns Hopkins retail pharmacy and phlebotomy lab, and the hospital’s cancer resource and wellness centers.

— Karen Blum



Johns Hopkins Medicine

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