How do we build a same-day surgery center that satisfies the needs and desire of everyone – patients, patient families, doctors, anesthesiologists, nurses and surgical support teams?
As Akron Children’s Hospital moves forward with its plans to build a $200 million critical care tower, teams continue to meet, brainstorm and test out architectural designs in a true-to-scale setting during weeklong Kaizens. Kaizen is a Lean term that refers to improving processes continually by making incremental changes.
In September, a team representing outpatient surgery gathered in a warehouse, where cardboard-like walls defined surgical suites, recovery rooms, pre-op areas and other spaces and allowed doctors, nurses and patients to move through their typical day.
As the Kaizen began, several issues were front and center:
- The need to create the ideal number of surgical suites based on current patient volumes as well as future growth.
- The need to keep the ORs running as efficiently as possible, taking into consideration the ebb and flow of higher and lower volume procedures, as well as planned and emergency cases.
- Focus on flow – How much walking will be required for patient families, as well as the doctors and nurses?
- Movement of supplies in and out of the ORs. Surgical instruments come into the room sterile and the proper equipment must be assembled for each case, whether it’s an ENT procedure, an eye surgery or an orthopedic case.
- Providing a calm environment that promotes privacy.
As the week began, it felt like this was an impossible task to come up with a floor plan that addressed all of these concerns and made everyone – from the anesthesiologists to the surgeons and the surgical support team – happy.
We were reminded again that Akron Children’s is a dedicated pediatric hospital and that children are not “just small adults.” The team worked to ensure excellent sight lines of patients in the recovery unit design to enhance patient safety.
“Unlike an adult hospital, children in the recovery unit don’t necessarily stay in bed,” said clinical coordinator Tina Sanzone, RN, BSN. “We need to have patients in view to ensure patient safety.”
The team went through phases of anticipation, discouragement and hope as each day welcomed success, frustration and new architectural drawings of the space. Each layout, when constructed three-dimensionally, generated dissatisfaction that the ideal plan still had not been developed.
Until Day Four.
The last design greatly improved patient flow. It offered easy access to storage. Doctors and nurses were not wasting extra steps within surgical suites or between them and other key spaces. The plan built in flexibility for growth and change down the road.
“The translation of design from paper to three dimensions can be eye opening,” said Beth Carr, MSN, MBA, RN, director of Nursing for Surgical Services. “When you see a design on paper, you envision it to work correctly. It’s not until you are actually in the space, and moving within it, that you realize it may not be ideal. The process takes time and patience. When you think there are no options, options present themselves.”