Built for Improvement, Used for Innovation

February 13th, 2012

How the New Hospital Mockups are Transforming Hospital Design

They’re the crash-test dummies of modern medicine: two sets of full-scale hospital rooms—operating rooms, recovery rooms, patient rooms, and more—constructed to the architectural specifications of the new Stanford Hospital and expansion of Lucile Packard Children’s Hospital blueprints, and include every fixture from sinks, beds, overhead booms and monitors, right down to electrical outlets, oxygen and gas hookups, light switches and hand sanitizer dispensers.

The rooms are the new hospital facility mockups, built to test the new designs and workflow well before construction begins. Though much of the equipment is real, there’s also a lot of truly “mock” equipment: booms made from PVC pipe, a surgical biplane crafted from foam board and duct tape, and string standing in for electrical wires.

“They didn’t send the space shuttle off without building models, testing and modifying,” said Michael Edwards, MD, chief of pediatric neurosurgery at Packard Children’s. “We may not be as complex as the space shuttle, but the process is still important to ensuring safety and effectiveness.”

Physicians, nurses, and multidisciplinary care teams toured the rooms to experience the space and provide feedback. “You can look at pictures, but it’s not until you see something modeled that you understand the space,” said Grace Hsu, senior project manager for design and construction at Stanford Hospital.

At the Packard Children’s mockups, multidisciplinary teams including parents visited together to run realistic, scripted scenarios. “There was not one room in which we didn’t make significant changes,” said Jennifer Romer, RN, lead senior project manager for Packard Children’s says. “By modifying the design now, before building, we saved millions of dollars.”

The patient’s input was also critical. “From the patient focus group that I helped facilitate,” says Nancy Lee, RN, vice president of patient care services and chief nursing officer at Stanford Hospital, “more than 100 of their suggestions were included.”

Building mock-ups also helps the construction teams, who analyze how the headwalls come together, and how to position pipes, electrical wiring and data infrastructure. “The contractors can actually test how they’re going to build the rooms when the time comes,” says Hsu.

One of the most advanced aspects of the new design reflects the increasing use of imaging-guidance and diagnostics during surgery. The new “hybrid” rooms will include MRI scanner rooms directly connected to the surgical rooms, to contain patients in a sterile zone, to reduce risk and infection, and to improve outcomes and efficiency.

But during testing, the “hybrid” mockups proved to be a place not just to refine existing design, but to pioneer groundbreaking medical equipment in collaboration with vendors. The teams needed a bed that would fit both the angiogram and MRI scanner, so that patients would not have to be moved from table to table. But between the two scanners—made by two different manufacturers—no such table existed.

“The breakthrough comes when you’re thinking of something that hasn’t been done yet,” says Edwards. “You tell the vendor what you want to do, and they say, ‘We don’t do that yet.’ But then they realize that the trend is starting here, and that other companies will need the same thing in the future. So they build it.” In other words, the mockups had a positive affect not only the future design of the Stanford Medical Center, but on the future design of hospitals everywhere.

“The process of involving everyone throughout this whole experience has been very valuable,” says Ann Weinacker, MD, Stanford Hospital’s chief of staff. “The staff has appreciated being asked for suggestions. We know that the rooms planned are really going to be conducive to delivering the best care.”