Children’s Hospital Los Angeles: Elizabeth Cochran, MHA, Associate Vice President of Construction Design and Facilities Management

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In July 2011, Children’s Hospital Los Angeles completely occupied its new 460,000-sq.-ft. state-of-the-art facility for the first time since planning began in 1999.

Originally a 286-licensed bed hospital, the project added 317 more beds to the hospital for a total of 603 beds, making Children’s Hospital Los Angeles the largest Children’s Hospital in California.

Conducting the orchestra

Elizabeth Cochran, MHA and associate vice president of construction design and facilities management, was hired years after the project had started. Children’s Hospital Los Angeles brought her onboard to coordinate the construction, activation, and occupation of the building with timeliness and efficiency.

When she arrived, steel was out of the ground, and the construction team was starting to frame the hospital and install all mechanical systems. Cochran’s first task was to determine whether the current timeline for construction and building activation was still feasible.

“It was really a multitude of activities needing to be assessed and then determining what status we were in terms of preparedness,” she said.

Cochran spent her first 60 days on this and describes the process in terms of an orchestra leader conducting a large symphony.

Her next step was to prioritize the order in which various areas of the project would be completed. In this case, she was prioritizing 40 different activities, including final equipment selection, timing of installation, setting up an infrastructure for transition planning, and coordinating the integration of work among all the committees, whether licensing, executive steering, patient-in-move, patient care, or IT.

“All of these committees together worked on critical tasks,” Cochran said. “Each one had a large list of critical tasks on which they had to evaluate, test, and complete assignments, so that at the end of the list, it ensured that everything was ready for operationalizing our new hospital.”

Accommodating the occupants

If one word could be used to describe this new facility, it might be accommodation. Each room is zoned to accommodate patients, families, and caregivers and designed in such a way that all three can be accommodated while in the same room together.

Evidence-based design played a large role in determining these features. The hospital examined some of the results that were coming out from the Pebble Report and other children’s hospitals.

“There was a lot of research that was done prior to the design of the building, and there was a considerable amount of work with patient families and asking children, in fact, what it is they would like to see in a new hospital,” Cochran said. “And what the architects did is they used all that information and worked with the staff on what would be the most optimal use, not just on how the rooms would be designed, but also how they would be used by the family, the caregiver, and what the patient would experience while they were in there.”

For example, children wanted something to look at on the ceilings other than white tiles. Thus, graphic ceilings with clouds, butterflies, hot-air balloons, and other scenes designed around nature were developed so a soothing effect could be had on the patient.

Whereas in the past, parents weren’t always allowed to stay and sleep in a child’s room, they are now encouraged to stay for as long as they want. Studies have found that this can be a stress reliever for both child and parent.

“Every room is designed that a parent may be able to stay and sleep with their child at the bedside,” Cochran said.

Each room has its own restroom and entertainment system that also serves as an educational programming center where the parents can access materials that will help them better understand their child’s illness.

Architects also developed a series of urban gardens on the grounds of the hospital that include patio settings where families can eat together and a beautiful playground with ADA access and electrical outlets for IVs.

“In talking with families, one of the goals was to provide a place where families can be outdoors and relax or meditate, if you will, get out of the hospital and go into a green zone or an area that was not urban and was more relaxing,” Cochran said.

It’s all about the team

As Cochran looks back on the process, she is amazed at how each phase flowed.  Although the project wasn’t completely devoid of any flaws or hiccups, Cochran said it was one of the smoothest construction projects in her experience. There were no major redesigns or changes in spite of a short coordinated slowdown because of a budgetary matter.

She credits the success of this project to the construction management, architect, and contractor all working together in coordination rather than in individual silos. Everybody was required to go into the field every day, updates were communicated immediately, and issues were resolved jointly. Executive leadership made a commitment to avoid major changes in the designs at the last minute, and they strictly adhered to this commitment.

Even the donor base went above and beyond in its support of the project. The hospital foundation raised $250 million of the $636 million needed for the new facility.

Cochran, therefore, offers one piece of advice to other hospitals who are embarking on large-scale projects.

“Hire the right teams,” she said. “It’s all about the teams—the architect team, the contractor and their team. It makes the biggest difference when you have executive-leadership support of the construction and project-management team. I’ve been on other projects, and some even bigger than this one, and that one thing made all the difference in successfully completing our goals together.”

-by Pete Fernbaugh

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