Saint Francis Hospital and Medical Center: Robert J. Falaguerra, VP of Facilities, Support Services, and Construction

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Weathering the recession in the United States has been a challenge for many healthcare organizations. To save money, many have had to put renovations or new facilities projects on hold.

However, Saint Francis Hospital and Medical Center in Hartford, Conn., has come through the recession with a new 318,000 square-foot tower that has greatly expanded the hospital’s capacity and technological capabilities.

Robert Falaguerra, vice president of facilities, support services, and construction, credits the organization’s success with early planning, communication, and coordination.

“Communication with stakeholders started early in the process and continued throughout the life of the project,” he said. “Any new development has to deal with changes that occur in the time between conception and occupancy. Technology changes, people change, service-delivery changes, even philosophy can change. You have to try to predict what would happen if the technology we’re talking about as a possibility today becomes reality when the building is finished.”

The John T. O’Connell Tower, which was named for the son of the primary benefactor of the tower who lost his battle with cancer, houses a new emergency department, new operating rooms, a separate floor for the Connecticut Joint Replacement Institute, three floors of private inpatient rooms and rehabilitation gyms, and a new rooftop heliport to service the emergency department.

Predicting the future

Saint Francis had to adapt the project to several changing elements throughout the course of the tower’s construction. Early planning began in 2005. The original intent was to replace only the emergency department, but talks then led to including more operating rooms. Finally, a feasibility study led the hospital to decide on including inpatient rooms for the Connecticut Joint Replacement Institute as well.

Falaguerra said the hospital began meeting with stakeholders and the architect immediately to determine needs. While developing preliminary design plans, Saint Francis submitted the CON for the replacement tower.

Construction started in 2008 and was completed in April 2011. Throughout those six years from planning to completion, much has changed in technology, healthcare delivery, and sustainability practices. Falaguerra said Saint Francis was able to plan for and accommodate those changes throughout the design process.

For example, flexibility was built into the entire project. The emergency rooms are all identical, allowing them to expand and contract based on volumes. He said this also aids in staff education because they encounter the same equipment and set-up in all rooms.

The 23 operating rooms also followed the same plan, being built identical for interchangeability. The new tower has a hybrid OR of about 1200 square feet. This room can do vascular surgery, cardiac catheterization, angioplasty, and other complicated procedures. Furthermore, the high-tech equipment can be moved out of the way so the room can be used as a traditional OR suite.

To plan for the digital future, Falaguerra said builders ran a parallel set of equipment cables so that new cables wouldn’t be needed as future communication equipment was added. The tower has voiceover IP throughout and includes many high-tech systems that allow for communication and integration within the hospital and with external facilities.

Another major change in design over the past decade has been the increased focus on sustainability and evidence-based design. Saint Francis incorporated these elements by using recycled materials, high-efficiency energy devices, and other sustainable items. The hospital also used documented design efforts that promote “high efficiency and high touch.”

“Our architects took into account current documentation in the design of the emergency department and operating rooms,” Falaguerra said. “We used lighting elements known to promote healing and be functional for medical staff. The colors and finishes we chose were based on historical evidence pointing to their promotion of efficiency and patient comfort.”

Managing the transition

Falaguerra said the transition process began about six to eight months before the tower’s completion. Staff developed a written orientation guide, and leadership met with all stakeholders to go over what they could expect in the new facility.

“For the transition, we had a training guide with three levels–an orientation to the space, training on the new equipment, and fire training and evacuation planning,” Falaguerra said. “Each group of stakeholders also met with architects and administrators to talk about the move. Our communication with stakeholders was a key part of our success in being able to keep the project moving and coming in on time and on budget.”

Looking toward the future

The John T. O’Connell Tower has put Saint Francis in a leading position when compared with its competitors.

“Our planning was ahead of the curve,” Falaguerra said. “We stayed ahead of the recession and completed the project. Many companies had to put projects on hold in the recession. This project puts us about three to four years ahead of our competition.”

Saint Francis Hospital and Medical Center is a 617-bed facility with two campuses, including tertiary care services, a trauma center, joint-replacement institute, a 60-bed rehabilitation center, a heart and vascular institute, an MS treatment and research center, and inpatient behavioral health. The hospital has big plans for the future, including renovating the space left from the old emergency room, operating rooms, and some of the former patient floors.

Falaguerra said the previous operating-room space is adjacent to the new tower and will be renovated to create a new PACU and locker room to service the expanded operating room. Additional outpatient women’s services, a new morgue, and a pathology department will fill the area vacated by the previous emergency room.

-by Patricia Chaney

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