Author: Jenabeth Ferguson

By: Ron Laramie, Regional Sales Manager – Business Development, Nucor Insulated Panel Group

St. Michael Medical Center expansion builds on health care legacy rooted in community service

The recent $500 million, 500,000-square-foot acute care expansion of the St. Michael Medical Center (formerly Harrison Medical Center) in Silverdale, Washington, is a project that builds on a caring legacy started by the Harrison family more than a century ago. With a keen focus on providing the best in health and wellness to the Kitsap and Olympic Peninsula communities, the new state-of-the-art medical facility features the latest in technology and patient-centric design—geared toward serving the community “without a trip across the river,” and centralizing the center’s nationally recognized cardiac and surgical care.

The nine-story, light-filled facility can also boast that it is the most energy-efficient hospital in the state. Ketul Patel, CEO of project owner CHI Franciscan Health (now part of Virginia Mason Franciscan Health), is quoted in the Puget Sound Business Journal, sharing, “The facility was … built to use 50% less energy than the average hospital in the Pacific Northwest, use 36% less water and save the carbon output of the equivalent of 700 homes.”

To help meet the ambitious design and sustainability goals, CENTRIA dealer Flynn Group of Companies—an industry leader in North America when it comes to the total building envelope—worked with CENTRIA to incorporate the array of panels, windows, sunshades and louvers that would make the project a stunning success.

Ron Laramie, the CENTRIA district sales manager on the project, recalls that Balfour Beatty, the general contractor, called him in to discuss the design and how CENTRIA’s diversified abilities could support the architectural vision. He says, “They liked the idea that we could not only provide metal panels, but also windows, sunshades, and louvers as a complete envelope package. This is something unique to CENTRIA compared to our competitors—the ability to provide a single source solution for the exterior skin, with one set of details, and typically one installer.”

Essentially becoming part of the design team, the representatives from CENTRIA and Flynn met regularly with the architect, the engineer, and the GC to develop the project specifics and details. In the end, the CENTRIA/Flynn team was successful in securing the project award, ensuring a smooth construction process from start to finish.

CENTRIA provided project management for the insulated metal panels, single-skin panels, and integrated windows, as well as louvers and the design of a special, customized sunshade. Laramie explains, “We partner with Construction Specialties (CS) for sunshades and louvers, which are integrated into our systems. For the St. Michael Medical Center, the architect wanted a sunshade design that didn’t exist. The team at CS designed a sunshade specifically for this project that provided the aesthetic and performance requirements the architect wanted.”

He explains further that sunshades are normally an outrigger, meaning that at the top of the window, there’s a horizontal support to which the sunshades attach, like an eyebrow. “For this project, the design called for individual blades attached vertically to the window. We were able to modify our window system to accommodate the CS custom design.”

The louvers, too, are all integrated, meaning there’s no flashing, extrusion, or anything between the systems. “The joinery of the louvers and windows fit into the joinery of our panel, so it’s all just one system,” Laramie adds.

As for the wall panels, CENTRIA’s Formawall Dimension Series (FWDS) IMPs were used, which are flat panels, as well as FWDS-60, which is a ribbed profile panel. Additionally, the single-skin IW-40A 22-gauge panel, a 12”-wide concealed fastener panel with an 11”- flat and a 1” recess was used on the project. All CENTRIA IW panels share a common lock-joint design, which makes them interchangeable on a project.

Another benefit that CENTRIA brings, according to Laramie, is the ability of its products to integrate efficiently into the overall design, which includes other building materials and work with other trades. He says, “One of the interesting features on the front of the building is the incorporation of our foam insulated metal panels with vertical ribbons of CMU block, which looks like stone. From a design perspective, it goes back and forth—panel, window and then the vertical section of stone and then panel, window, etc. Those details required a lot of work and coordination to provide what the architect wanted from both a design and performance perspective, as well as from a thermal standpoint.” He adds that another area of the building is a full glass curtain wall, and again, CENTRIA developed details where they connect into that element as well.

CENTRIA’s integrated windows are exceptionally efficient, Laramie notes, explaining that normally when a window is put in, there is thru flashing around the rough opening where you set the window, and there’s a transfer of heat all the way around that window. “With CENTRIA integrated windows, we don’t have that issue,” says Laramie. “Our window is fully, thermally broken, and the panels are fully, thermally broken, making the complete wall system significantly more thermally efficient than traditional window systems.”

The completed St. Michael Medical Center, which opened in December 2020, is part of Virginia Mason Franciscan Health’s system of 10 hospitals and 230 specialty clinics. With its beautiful appearance, inside and out, along with its superior efficiencies, the facility is ready to welcome and care for its local community members, living up to its “mission to heal, a promise to care.”

Visit www.centria.com to learn more about Formawall Dimension Series IMPs.

By: Stephen Parker & Robyn Linstrom

Often the stress experienced by mental health and addiction patients can be mitigated with access to outdoor spaces. Outdoor spaces should be designed to create a safe, therapeutic environment with a close connection to nature.
Elopement prevention should be discreet and effectively detailed, with limited hand and foot holds on vertical surfaces, especially with relation to building devices and systems in need of coordination by the architect.

Natural elements should be safe in case of accidental ingestion while providing a variety of sensory opportunities in terms of color, tactility and olfactory stimulation to mimic biophilia. Trees should be limited in height without easily accessible branches for climbing and prevent elopement while enhancing the feeling of a calming, natural environment. Plants should be selected that prevent their use as weapons or for self-harm while being native species and limit the need for excessive maintenance or irrigation, such as drought tolerance. Materials for walking paths should be selected to avoid loose materials such as small gravel and stones that could be thrown or ingested.
 
Natural elements, especially those as part of gardening therapy, have a proven stress-reducing effect per evidence-based design strategies. These concepts can aid in staff respite as well. Green micro breaks facilitate stress reduction for overburdened staff, aiding in staff retention in the process. The use of green houses for these adjunctive therapies should be considered as a balance between therapeutic value and patient safety.

If these outdoor environments create views of nature for patient bedrooms or social spaces, then patient privacy should be addressed. Translucent film on windows or vegetative screening are possible solutions to consider.
Landscaping rocks and features should not be able to be moved, thrown or otherwise used for damage to property, others or self-harm. Ample lighting that is exterior-rated and tamper-resistant should be provided for after-hours monitoring. At the Nanaimo Psychiatric Emergency Department on Vancouver Island, British Columbia, this is pushed further with inclusion of a water feature, raised beds and culturally relevant vegetation.

Furniture is often fixed and immovable, so the design of seating arrangements to facilitate patient choice is paramount. These more substantive seating arrangements limit damage while providing comfortable seating for individual self-reflection, one on one conversations or various social gatherings as chosen by patients in a safe manner. Furniture should be sited to mitigate elopement in coordination with other site features. The building could serve as an implicit barrier, defining the space while not aiding in the institutional feel of the mental health hospital. Such outdoor furniture selections should limit contraband opportunities as well as mitigate barricading. All of these considerations should strive to maintain a clear line of sight from staff observation areas to ensure patient safety. Ample camera coverage should be provided in outdoor spaces with clear coverage of exits and entrances, and blind spots should be eliminated. Cameras should be impact-rated for exterior use and coordinated with other outdoor devices and features, such as exit signs, lighting and scuppers to avoid creating a climbing opportunity.

Use of outdoor environments should be considered based on client population, but should include a variety of opportunities. Labyrinths and walking paths allow clients to pace to self soothe and self-regulate helping with de-escalation. Basketball courts and other sports focused areas allow for release of energy or anger. Alternate seating types and areas for reflection all contribute to a healing outdoor environment.

By: Caryn Hewitt, MBA, BSN, CENP, CPHQ, Senior Director, Consulting Services at CenTrak

The expression, “It takes a village…” isn’t exclusive to parenting. In my experience, thoughtfully planning, strategizing, and implementing emerging technology and design layouts within a new healthcare facility should take a community mindset. In line with the village advice, healthcare facilities consist of many different groups that must come together, interact positively, and collaborate for the betterment of the goal. To apply the village mindset in a new facility or implementation, various departments in the health system (nursing, IT, security, administrative, etc.) must share their expertise to ensure the facility flourishes and provides a safe environment. The village approach helps understand the direct needs of frontline staff and their patients – which increases the value of the new healthcare facility.

Throughout my career as a registered nurse, IT leader, chief information officer, director of operations, and digital health consultant, I have been given the opportunity to witness first-hand what healthcare professionals and patients want in a healthcare setting. To better understand what our colleagues and patients desire, we must invite them to the table. These individuals, once together, must serve as a sounding board to one another, listening to each other’s concerns and becoming a team when approaching senior leadership.

A recent study with the National Center for Biotechnology Information demonstrates how involving participants with different organizational and clinical backgrounds leads to higher user satisfaction when implementing technology such as electronic health records (EHR). By involving various perspectives when designing shared spaces and tools, there’s a greater chance of employee buy-in, enhanced usability, and improved efficiency and communication. This approach outlines the method personally used when integrating emerging technology and Real-Time Location Systems (RTLS) into a new 400-bed trauma hospital in North Dakota.

Where it all started: Bedside nurse turned IT leader

After a few years as a bedside nurse in the Intensive Care Unit and witnessing first-hand the growing importance of emerging technologies, I felt that I could leverage my knowledge as a nurse to implement technologies that would make a real difference for patients and staff. My goal was to make the clinicians’ lives less stressful and promote better patient care. While I understood it at the time, it’s only become more apparent to me that it is crucial that IT teams have a strong understanding of what clinical personnel do, why they are doing it, the tools used in their day-to-day workflows, and what circumstances health IT aims to solve with the technology we’re implementing.

I joined and remained in an IT role for 25 years, implementing emerging technology and real-time location systems. I found my passion and purpose, demonstrating the positive impact thoughtful technology and workflow design can make for staff and patients. I began training staff with new use cases and highlighting how to apply them in meaningful ways. I’m always aiming to make sure clinicians understand the technology and its purpose. Subsequently, following an acquisition, I was blessed with an opportunity to serve as director of operations for a new state-of-the-art facility and standardize our technologies.

Connecting with “the village” is the first step to developing the plan to implement digital solutions for a new facility or existing department. Aiming for the new hospital to be a space designed for caregivers and patients by caregivers and patients, I connected with all relevant departments to further consider the best technologies for a patient- and caregiver-centric facility.

The importance of working together on a phased assessment

Deciding on the best path forward when implementing new technology involves assessing any challenges within the current facilities and anticipating the overall needs for the next 2-5 years within a new or updated space. I recommend completing the facility analysis through a comprehensive phased approach, which includes stages such as assessment, readiness, and transformation. When stepping into the assessment stage, healthcare decision-makers need to hear input from departments such as equipment distribution, supply chain, IT, and nursing. In my weekly meetings with 100+/- departments during the new hospital development, teams shared updates to reduce siloes and ensure a standardized, purposeful plan moved forward.

Once perspectives are shared in the department manager meetings, teams must gain consensus on the proposed technology use cases to prioritize and develop a strategic roadmap, deployment plan, operational model, and budget summary. This assessment phase enables facilities to take the first step in making impactful changes with emerging technologies. Aiming for a strong ROI and factoring in the needs of the larger “village,” we pursued RTLS; a trusted technology that had been supporting the health system’s overarching goals. For example, we used RTLS data to rightsize equipment needs based on our historical utilization, a key factor when determining the mobile medical assets required to support a new facility. The location technology and sensors powering RTLS platforms use badges, tags, and wearables to provide accurate location information for equipment, patients, residents, and staff. Through an automated workflow system, teams and facility managers maintain synchronized, real-time insights and communication to continuously measure interactions, minimize bottlenecks, monitor patient milestones, evaluate movement patterns for optimal staffing, reduce workplace violence, and increase workflow efficiency throughout the healthcare facility.

Following the assessment period, the operations team should evaluate the readiness of the staff to leverage the technology. When everyone is in a room together during the weekly department meetings, there’s also the opportunity to discuss upcoming training. Following our weekly meetings, 200 Health System leaders offered to assist in department-specific and general training on the new technologies. Through simulations and role-playing, 10,000+ employees received the necessary training. This benefits staff buy-in, creates comradeship, and ensures the relevant team members understand their new devices, equipment, and platforms.

The growing comradeship and support are crucial heading into the next phase: going live and continually monitoring the actionable intelligence from the technology to transform the facility and ensure the desired ROI. Every facility has its own unique challenges as they’re fine-tuning and preparing to go live. When developing a strategic team that incorporates nurses, hospital administrators, and clinic managers as part of the implementation team, challenges can be quickly identified, escalated, and resolved to provide quick time to value for the facility.

Applying director and CIO experience to health IT consulting efforts

Pursuing technology that offers standardized processes provides layers to facilitate caregiver insights – without physically entering the room – and ensures definitive spaces in rooms for patients, staff, and family is crucial when considering patient- and caregiver-centric technology and design. Even so, initial staff support and stakeholder buy-in can present a challenge. The key components for buy-in success when implementing new technology include early transparency, leadership support, and staff education on the technology’s purpose. Successfully deploying location solutions requires incorporating the proper expertise from the healthcare facility’s individual departments and vendor partners.

To enhance the ROI following implementation, leadership should consider pursuing an ongoing staff buy-in campaign. Video education and video learning can be beneficial tools that provide small bites of information, making the information easier to digest. It also helps to continue in the mindset that RTLS and emerging technology programs start at the top, which means leadership should wear their IoT-enabled badges to show their support and belief in the program. Team leadership should also showcase RTLS staff duress tools at daily floor huddles and discuss the purpose behind the location technology.

Staff duress and/or asset management solutions are often the first step for healthcare leaders moving through a journey with RTLS. When health system leadership collaborates with “the village” to assess top pain points, decision-makers typically pursue the need to better monitor the mobile medical equipment (MME) or provide greater support to staff who may experience duress. These scalable implementations can be done step-by-step as they’re beneficial instead of requiring a full system overhaul, ensuring the technology is more accessible to all health systems. Health systems can leverage scalable technology to follow the path that best fits their needs, facility size, location, and 2–5-year plan.

After the initial selection of RTLS, teams can continue to scale the technology with various system add-ons as desired. Since implementing its real-time location system, a hospital in North Carolina has over time successfully implemented over 50 use cases leveraging real-time visibility data and reports more than $10 million in overall benefits. The healthcare facility even continues to collaborate with its RTLS partner for consulting insights to ensure the technology is used to its fullest potential. Through the scalability plan, the hospital experiences savings of more than $900,000 per year simply by deciding to additionally implement an automated temperature monitoring system. Some additional benefits include asset management, which adds a savings of $2 million per year, and an increase in staff productivity, which is valued at over $2 million savings per year for the North Carolina hospital.

Take the time to consider the road ahead

The best way to achieve a substantial increase in value and efficiency across an entire healthcare campus or within a new facility is through a personalized approach that combines a strong patient- and caregiver-focused design with a strategic roadmap that considers the goals for the future. A well-rounded internal “village” team from the health system paired with expert-led consulting and training services can develop the most accurate roadmap to ensure the right technology is implemented to drive greater workflow efficiency, higher safety standards, the ultimate patient and staff experiences, and substantial ROI. By factoring in a range of experienced input, healthcare teams can maximize emerging technologies and RTLS to drive meaningful change throughout their enterprise using practical guidance from within their “village.”

Caryn Hewitt is the Senior Director, Consulting Services at CenTrak, which offers locating, sensing, and security solutions for the healthcare industry. CenTrak has helped more than 2,000 healthcare organizations around the world build a safer, more efficient enterprise. For more information: visit centrak.com.

By: Matt Goche, CEO of Uniguest

When it comes to the patient experience, first impressions are crucial. Healthcare systems seek to develop long-lasting relationships with new and existing healthcare consumers and initial encounters can make or break an experience. New patients, existing patients, and loved ones often take measures to ensure they’re prepared for a visit before stepping into a facility, including confirming directions, parking information, and travel time. I have certainly experienced this mindset when preparing for an appointment or supporting family. Once patients are physically in the healthcare facility, effective visual communications assist in creating a welcoming environment. This is important. The use of digital signage, patient engagement tools, and wayfinding empowers patients and visitors during a time when they may feel a lack of control. Reducing the stress associated with a hospital visit and increasing patient engagement is essential to elevating the overall experience.

As healthcare becomes increasingly competitive, the line between patient and customer blurs. Healthcare facilities must anticipate needs and meet expectations in a timely manner with intuitive solutions and clear communication. Patient expectations are constantly evolving, and leadership, architects, and facilities managers must upgrade designs and technologies to meet these needs while accommodating staff as well. The growing reliance on technology in everyday life is leading to an increase in demand for digital solutions throughout the healthcare journey for all stakeholders. In fact, 84% of healthcare leadership surveyed by HIMSS Research agree that their patients are demanding a “more personalized, holistic digital experience” and the Deloitte 2022 Consumer & Physician Survey revealed that 90% of patients want digital engagement and navigation options. At the same time, Experian Health survey results reveal that 100% of respondents feel staffing shortages have affected patient engagement efforts.

The solution? Thoughtful facility designs and comprehensive engagement systems that help staff reallocate time to patient care. Through this approach, caregivers gain more collaboration with patients to focus on their unique needs and achieve higher-quality outcomes.

Patient Engagement and Family-Centered Care Go Hand-in-Hand

Impactful patient engagement calls for an approach that considers the patient and loved ones at each step of care (planning, delivery, and evaluation) to mutually benefit relationships among patients, providers, and families. It is about better engaging care partners and positioning support around each unique family to drive better outcomes. Increasingly prevalent, the Institute for Patient- and Family-Centered Care says this approach “redefines the relationships in healthcare by placing an emphasis on collaborating” and serves to “promote the health and well-being of individuals and families.”

Leveraging family-centered care allows for a more human experience for everyone and creates greater trust for a smoother care journey. I envision the utilization of the family-centered care model increasing throughout the industry as health system leadership works to implement new technologies within their facility designs. This can be supported in large part at the point of care by implementing a digital engagement strategy that incorporates touchpoints throughout the care journey for improved experiences and outcomes.

Digital Engagement Platforms Guide and Support Patients

Technology is reshaping how consumers access healthcare services and communicate with their providers. From accessing “Doctor Google” to gain insights on what may be ailing us to connecting through a myriad of available digital front doors and making online bill payments, we live in a digital-first, self-service world. Therefore, when patients and families visit facilities for care, the design has to fit this ethos in order to drive engagement, collaboration, and comfort. Patients of all ages are more likely to interact with a system that’s intuitive and familiar. We need to make it easy to ensure the best level of engagement and create a sense of control for patients every step of the way.

Hospitals can be both intimidating and confusing. Some medical centers cover multiple city blocks, causing navigation challenges for first-time and repeat patients alike. Medical campuses often change over time and each new unit or building can disrupt a patient’s previously known path. Navigating the floors and hallways can be equally daunting and add to an already elevated stress level. Consumer-accessible digital wayfinding solutions develop a clear route to guide the user through the navigation process step by step, creating a sense of comfort and control for patients and loved ones at first encounter. Building floorplans are overlaid onto a private, intuitive Google Maps-type interface, allowing users to have a sense of familiarity while gaining contextual information regarding their location and destination. Through interactive maps or directional displays, digital wayfinding solutions foster the independence that is required to manage your health. It’s subtle but it matters.

Once acclimated, a digital engagement platform can guide the family throughout their journey. Large-format video walls welcome arriving patients in a lobby, atrium, and common areas with healing and relaxing imagery that can be placed in rotation with other messaging throughout the day. Common content for signage in common areas includes population health-focused messaging such as reminders to schedule wellness visits, information on getting vaccinations and screenings; seasonally-focused messages such as details on flu shots or managing the heat; and program promotions for at-risk populations that reinforce the system’s commitment to supporting health at all times.

For outpatient visitors, location-specific digital signage solutions in waiting rooms can provide wait times, staff bios, related services, and relevant patient education and discharge content. By proactively providing the answers to the frequently asked questions, stress is reduced while self-efficacy is built. For hospital staff, it is worth noting that each of these endpoints can be easily managed from a central content management system.

Design Health Systems According to Patient Comfort

In the patient room, an Interactive Patient Care System (IPS) transforms the latest smart TV technology into a communication hub for education, empowerment, and, of course, entertainment. Back-end integrations from a range of health information technology (HIT) including the EHR, dietary, engineering, and facilities, allow access to directed patient education, meal ordering, room controls, and service requests conveniently through the device of a patient’s choosing, including a traditional pillow speaker, a hospital provided tablet, or a personal device paired to the system. Again, by providing access through the easy and familiar, system usage increases as families become more comfortable in an unfamiliar environment during an unsettling time.

More advanced IPS systems include additional communication endpoints beyond the TV. The set of HIT integrations can be leveraged to communicate information directly to the patient, family, and staff through a digital whiteboard and to the clinician through a digital door sign. These implementations are designed to build trust and allow each party to remain on the same page throughout the care process. For example, such tools can be set to include the patient’s schedule for the day. This information shows the patient and family what to expect, how to prepare for their daily activities, and where and when key elements are taking place. Through these insights, patients know when they’d like loved ones to be present without the nurse providing a manual rundown.

The IPS also provides advantages for overworked and resource-constrained staff. By automating repetitive tasks such as documenting patient education in the EHR or updating dry-erase boards and offloading non-clinical tasks like adjusting room lighting and heat or ordering a meal, nurses have the opportunity to be more efficient, gain additional time with patients, and practice at the top of their license. More importantly, with less “drudgery,” job satisfaction is increased and employee turnover is decreased.

Digital Engagement Encourages Human-Centered Care

Rising consumerism and increasing competition in healthcare have created a demand for quick access to the information and experiences desired by the patient. Additionally, technological advances have also changed the way providers want to access information and deliver care. Every step of the care journey is essential as healthcare teams strive to deliver high-quality outcomes, reduce avoidable readmissions, and build long-lasting relationships with patients. A comprehensive digital engagement platform incorporated into facility designs helps a healthcare organization stand out as a provider of superior, high-quality, family-centered care.

Matt Goche is the Chief Executive Officer of Uniguest. He brings extensive technology and cybersecurity background to Uniguest with a track record of growing revenue and achieving business results. Since Matt joined Uniguest in 2016 as Chief Operating Officer, later as President, and now as Chief Executive Officer, Uniguest has dramatically grown revenue, expanded the employee base, acquired marquee companies, and moved into new markets with new product offerings. Uniguest now has 15 offices across the globe and supports a customer base of over 20,000 customers.