Parkland Health & Hospital System: Walter Jones, Jr, AIA, Senior Vice President of Facilities

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“By our actions, we will define the standards of excellence for public academic health systems.”

That is the vision statement of Parkland Health & Hospital System, a healthcare system serving more than 2.3 million residents in Dallas County, Texas. Parkland hospital has 723 beds and about 55,000 annual admissions. It is the teaching hospital for the University of Texas Southwestern Medical Center and boasts 10 centers of excellence.

For nearly 10 years, the hospital has been evaluating strategies to achieve such a lofty vision, and in the fall of 2010, Parkland broke ground on a $1.27-billion, two-million square-foot replacement facility.

To receive funding for the project, the hospital sought taxpayer support for a bond issue that would provide $747 million of the project’s funding.

“We received 82-percent approval for the bond issue from Dallas County voters,” said Walter Jones, Jr., AIA, senior vice president of facilities. “That is overwhelming support from the community for the value of our hospital. We appreciate that support and try to show it in every activity we do. We are now working together to build an excellent facility that can provide the level of service and quality our institution is dedicated to.”

In addition, Parkland employees have pledged more than $1 million toward the fundraising campaign.

Using evidence-based design

Parkland and its contractors have been using evidence-based design to create a patient-centered healing environment. Jones said the new facility will have 862 private adult rooms with private showers in each room. Each room will have a dedicated family area. The 96 beds in the neonatal intensive care unit will also be private.

“Accommodations for family in our existing facility need improvement,” Jones said. “A lot of family shows up to be with patients. We believe that there is no better advocate for the patient than their family members. The design of our new facility will provide more space and comfort for family members to stay with patients and be an active part of their care.”

The existing hospital has about 70 percent semi-private rooms and dormitory showers. Jones said these were the norm in the 1950s, but today’s privacy laws and patient expectations require more. Parkland evaluated retrofitting existing rooms to accommodate private showers, but it would reduce the bed count and square footage in rooms detrimentally.

The hospital will also incorporate features that increase comfort and healing elements, including temperature control in rooms, large windows to allow for more natural light, and gardens and landscaping that are visible from most rooms. Jones said that approximately one-third of the land for the new facility is dedicated to landscaping.

Slip-resistant flooring, no curbs on showers, and visible hand sanitizer throughout the facility are some ways in which the hospital will improve patient safety. Noise control is another evidence-based design element being incorporated.

Staff will have separate elevators, card access to staff areas, decentralized workstations, and wireless capability to provide a higher level of care. Jones said the floors are designed so clinical care, charting, and ordering can take place in patient rooms or workrooms.

The design team meets with a patient and family advisory committee to ensure the design choices meet the needs of patients and best practices as seen from the patients’ eyes.

Sustainability and flexibility

Building a replacement facility is a balancing act in incorporating new technology, purchasing new equipment, choosing what equipment to carry over from the previous facility, and planning for future technological advances.

“A major component of this project is deciding how much to buy,” Jones said. “The new facility is double the size of our existing hospital. We are adding more operating rooms, expanding the emergency room, and growing our imaging department. We are determining how much equipment should be new and how much should be transferring what we have.”

The new Parkland will incorporate sustainability features and flexibility with the intention of lasting 50 to 100 years. Jones said the hospital is on track to achieve LEED Silver status and is a handful of points away from LEED Gold.

“We are trying not to build a facility that is limited by our thinking or determined only by what’s in place today,” Jones said. “We are looking for the best we can find today and remaining flexible to adapt to what might come.”

Managing the transition period

Keeping such a large project on track and within budget is a huge feat for any hospital. To keep all contractors and consultants involved, Parkland has brought the primary contractors and consultants on site for the duration of the project. They are working in the existing facility in a collaborative environment. Jones touts the advantages of this model because he believes it develops an understanding among disciplines and keeps conflicts at a minimum.

During the construction, which is scheduled to be completed in 2014, Parkland is also faced with difficult decisions about how best to provide care in the existing facility and what investments to make.

“The existing facility is undersized and overcrowded,” Jones said. “What needs to be done in this facility to continue to deliver quality care is becoming a more intense question.”

Despite challenges, Parkland is on track to have an advanced facility that will enable it to provide quality care and achieve its mission of superior medical service.

-by Patricia Chaney

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