All Children’s Hospital: Tim Strouse, Vice President of Facility Operations

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Patient- and family-centered care is becoming standard across all of healthcare, but nowhere is it more important than in children’s healthcare. Family has always been a large part of care for children, and the trends toward private rooms, decentralized nursing, and advanced technology are continuing in this area.

One leader in children’s healthcare is All Children’s Hospital in St. Petersburg, Fla. The hospital is located on Florida’s west coast along the Gulf of Mexico. In the summer of 2009, All Children’s moved into a brand-new 259-bed hospital. The entire project consisted of a 795 square-foot hospital, a 253,000 square-foot outpatient center and a 66,000 square-foot central-energy plant, plus a parking deck.

The hospital is beautiful, providing a soothing, welcoming atmosphere for patients and their families. Every detail was considered to provide comfort and high-quality care no matter what happens.

Realizing the need

All Children’s Hospital has been providing care for more than 80 years, and its current facility had been in use since 1967.

“We had added on to the existing facility, but we reached a point where we couldn’t maintain the service we needed,” said Tim Strouse, vice president of facility operations . “We had a number of issues that could have been solved individually, but when you looked at them together, it was clear we needed a new facility.”

Some issues with the old building included inadequate floor-to-floor heights to accommodate new equipment, 85 percent semi-private rooms, and insufficient HVAC and electrical panels to meet the demands of advanced technology. All Children’s decided to build a replacement hospital about two blocks from the old site. The previous outpatient building was converted into a rehabilitation facility.

All Children’s brought the contractors and designers in early to help keep costs under control and stay within the $287-million budget for the hospital and the $49-million budget for the central-energy plant.

When construction began, the cost of raw materials was skyrocketing, and Strouse’s team continued seeking ways to control costs. Contractors were given about 40 percent of the cost savings, and overall, the project came in on time and $10 million under budget.

Planning for the future

Early in the process, Strouse said the project team agreed upon a set of guiding principles that everyone could stick to throughout the project to help direct decision making. One principle was that the building would last at least 40 years. As with most new construction, this requires making assumptions about the future of technology and planning space for adaptation.

“We allowed space within all electrical panels, wiring molds, cable trays, and other areas for expansion,” he said. “We increased the floor-to-floor height, increased power, and allowed for vertical and horizontal growth. We tried to think of everything we could for the future, and within the first year of being open, we already faced pressure to add technology.”

In addition to anticipating advances in technology, the new hospital is prepared for natural disasters and man-made occurrences. All Children’s is in an area vulnerable to hurricanes, and Strouse said the planning team applied many lessons learned from past hurricanes, including Katrina, to implement features that would keep the hospital running no matter what crisis could strike.

The building has six 200-horsepower generators that allow the hospital to run at 100 percent power for up to two weeks in the event of a natural disaster. All mechanical equipment is located on the fourth floor rather than the basement in order to avoid the possibility of flooding.

“One of our guiding principles was that we would take care of our children no matter what,” Strouse said. “We have learned that you can’t always depend on outside help, so we have made the hospital as self-sufficient as we can for a long period of time in the event of a disaster.”

Planning for the hospital began before Katrina hit the Gulf Coast, but All Children’s made one significant change in planning upon seeing the effects of Katrina in New Orleans. After watching patients being transported from hospitals to open areas because the helipads could not accommodate a military helicopter, the hospital chose to build a helipad that could handle a full-sized military helicopter.

All Children’s is also prepared for biochemical and biohazard events. The hospital has a decontamination unit as well as an isolation wing.

Taking care of patients and their families

Not only is the hospital prepared to care for patients in the event of any emergency, but the facility also provides upgraded features to help patients and their families feel more comfortable. Strouse said the planners incorporated evidence-based design involving family-focused care with individual rooms that have space for family members, a dedicated floor for the neonatal intensive care unit, playrooms, a family resource center and a rooftop playground.

The designs also incorporate natural light, decentralized nursing stations, and local artwork meant to inspire the children and their families.

Most recently, All Children’s Hospital became integrated with Johns Hopkins Health Systems. The hospital already has an excellent teaching and research program, but through the integration with Johns Hopkins, All Children’s looks to expand its opportunities.

All Children’s maintains its mission to provide the best care to children and has left nothing to chance in all its planning to achieve that mission.

-by Patricia Chaney

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