One way to reduce the sticker shock that hospital and system boards experience during construction and renovation projects is to build in value right from the start, according to a report from Trustee sister publication Health Facilities Management. Facilities designed for operational efficiencies can help caregivers to respond faster to patient needs, increase throughput and substantially lower design and construction costs. Three innovative projects serve as examples.

• When patient rooms are clustered near nurse stations, rather than aligned down a corridor, nurses can see the head of the bed in each room from the nurse station, meeting the observation requirement for critical care. This arrangement also creates a more efficient work environment. At the Heart Hospital at SwedishAmerican Health System, Rockford, Ill., installing four clusters of eight beds per floor was found to reduce walking distances by 50 percent compared with a traditional racetrack layout, and increased the amount of usable space in the building, improving the ratio of net to gross square footage. Centralized nurse stations are spacious enough to provide room for the experienced nurses to mentor newcomers.

• Instead of building a $30 million sub-subbasement for support services, the project team at Maine Medical Center, Portland, identified a number of ways to streamline operations, including taking items directly to the floors from trucks parked at the loading dock, building an off-site facility for the dietary services department’s cook/chill program and holding linen at the laundry. Implementing designs for these solutions is projected to cost only $8 million.

• Combining interventional radiology, cardiac catheterization and surgical services in one department creates staffing efficiencies. At Ronald Reagan UCLA Medical Center, Los Angeles, the second floor of the facility is dedicated to interventional procedures, with 23 operating rooms, six cardiac cath labs and eight procedural suites for interventional imaging. These dovetail into one location with 60 rooms for pre-op and post-op care.

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