Kathrine “Kat” Carongoy, B.S.N., R.N., had heard the complaints for years: When nurses walked into patients’ rooms at Suburban Hospital, they spent their first minutes searching for disposable gloves. Opening drawers and cabinets took precious time, they said, and eroded the professional image they needed to convey.
So when Carongoy, clinical manager for the adult surgical unit, took on the challenge of creating a workflow for the hospital’s new North Building, she had a suggestion: Store the gloves in the same place in every patient room.
That’s exactly what happened.
Carongoy and Regina Morales B.S.N., R.N., nursing manager of Suburban’s acute medical care unit, were members of a workgroup that contributed dozens of design insights and ideas during a two-year review process before the opening of the 300,000-square-foot building in March.
The group, which included nursing teams from across the organization, studied blueprints, debated the pros and cons of different over-the-bed tables, and strolled the halls of the new, larger building. They weighed in on everything from paint colors to equipment placement, always thinking about how to improve their workflow and the patient experience.
“We would talk about what equipment should go on the head wall over the patient’s bed and where the main workstation should be,” says Carongoy.
“We requested blood pressure monitors, thermometers and lab labeling machines be included in each room, which we got,” says Morales.
The workgroup was part of a larger initiative by hospital leaders to include as many voices as possible in workflow decisions for the new building. Physicians, nurses and other employees, as well as members of the Patient and Family Advisory Council, were encouraged to walk through the patient room replica and test products such as the reclining chairs provided for family members.
“We had a mock-up of a patient room that was a few miles away,” says LeighAnn Sidone, D.N.P., R.N., C.E.N.P., chief nursing officer and interim hospital president. “We took our nursing councils there by bus and they looked at the space. They’d say, ‘The needle disposal box needs to go here, the gloves need to go there.’
“Before we picked out furniture and equipment, we brought back samples so the staff and members of our Patient and Family Advisory Council could test them out. When the building was up, we took groups of staff over to the units to talk about important processes like rounding.”
The new building nearly doubles the size of the hospital and includes 108 private patient rooms, each with its own bathroom. The rooms were created with three zones, providing separate spaces for clinicians, for patients, and for family members or other visitors.
The new space is large enough to give nurses separate rooms for meetings and breaks, as well as a dedicated staff elevator so patients and clinicians don’t ride together. The building has a common family waiting area and a separate space for clinicians to meet individually with families.
Nooks between patient rooms give nurses desks and computers to update patient records without having to walk to a main workstation. The nooks are positioned so that nurses can look through windows to see the patients in their rooms.
To prevent hallway congestion and create quieter rooms for patients and families, the doors to patient rooms are recessed.
The rooms are arranged so that family members and clinicians can occupy them at the same time without getting in each other’s way. Message boards outside and inside patient rooms, both connected to the electronic medical record system, provide information such as which doctors and nurses are caring for the patient and whether the patient is at risk for falling.
Patient bathrooms, large enough for wheelchairs, have showers and nonslip floors.
The North Building opened just as the coronavirus pandemic was bringing its first COVID-19 patients to Suburban Hospital.
The opening gave the hospital an opportunity to convert newly available spaces in the South Building into units dedicated to the care of patients with COVID-19. Additionally, one of the new units was built with a separate ventilation system that isolates airborne viruses in the event of a pandemic.
During the first months of the coronavirus pandemic, most surgeries and procedures were put on hold at hospitals across the Johns Hopkins Health System. Now that the hospital has resumed its normal surgery schedule, Sidone says it’s time for some final design improvements, which become apparent from actually working in a space.
For example, she says, a new nurse call system allows patients to make specific requests instead of simply pushing a button for assistance. “We’re tweaking the system,” Sidone says. “If a patient wants water, who gets that call? It’s an ongoing process.”