Universal rooms and health warehouses: Building flexible hospitals
Conceived during the contentious period between 1993 and 1995 when health-care reform was making national headlines, Baptist Health Medical Center, North Little Rock, had to be designed for an uncertain future. But flexibility was on the hospital's agenda anyway, says Harrison M. Dean, lead administrator.
"We needed a facility that would let us go in and totally gut areas," says Dean, giving an example. "We went with outboard toilets, so we can take down all the interior walls."
According to Dan H. Noble, director of health-care design with Dallas-based A/E HKS, all support areas and mechanical rooms were arranged within a spine that divides patient areas from diagnostic and treatment areas, which are built on a 35-ft., warehouse-style grid. "As your beds grow, the service chassis can grow," he explains.
Within caregiving areas, says Dean, "We decentralized resources closer to the bedside, with charting alcoves between every two patient rooms, and medication dispensing machines in nursing and recovery areas." For changing patient flows, says Noble, the team developed "universal rooms" that can serve as medical/surgical areas, intensive-care units or labor-delivery-recovery rooms. Last, the medical office building is connected to the hospital on every level so doctors can easily access patient areas-and so the hospital can grow into the office building if needed.
Flexibility was an issue even during construction, says Scott Copas, principal with Baldwin & Shell Construction, Little Rock. "Several changes had to do with health-care technology, but the owner and architect kept us informed and took our suggestions." For example, says Copas, the builder recommended an EIFS cap for a retaining wall that couldn't carry the load of a specified stone cap.
In sum, these details and design innovations help Baptist Health cope with the ever-changing winds of health care.