Hospitals Look to Innovation to Inspire Design

Photography by Robert House.

To ensure appropriate bandwidth, the IT staff also deployed Cisco networking gear that provides 40-gigabit-per-second speeds at the core and 1Gbps to the desktop. Cisco access points blanket the premises, enabling ubiquitous Wi-Fi access, says Alan Laver, the hospital’s IT application services manager.

Pageler says the hospital features three types of technologies: cutting-edge clinical technology, such as hybrid operating rooms that include MRI machines and other diagnostic imaging equipment; technology designed to enhance the hospital experience for patients, families and staff; and patient room technology designed to entertain and educate patients.

The hospital uses radio-frequency identification and real-time location services to improve and speed up care, Pageler says. The IT staff placed RFID tags on employee badges and most hospital equipment, and installed 1,200 wired sensors on the ceiling throughout the building to help identify staff and track equipment.

As a result, when physicians and nurses walk into a patient room, their names and pictures pop up on the patient’s television screen. The technology also allows the care teams to quickly locate equipment by checking wall-mounted monitors.

“It’s not infrequent where we would need to use the ultrasound machine and say, ‘Has anyone seen it lately? Where is it?’ And we’d spend a ridiculous amount of time tracking it down,” Pageler says. “Now, we go to the map on the wall and go, ‘Oh, it’s in Room 32,’ which makes it so much more efficient.”

The hospital equips each floor with computers on wheels, and every morning, a team of clinicians brings the computer into patient rooms to discuss the day’s plans and answer questions from patients and their family members. The team uses the computers to access electronic health records, place orders for necessary medication and tests, and type in patient notes.

Physicians and nurses also carry iPhones with them for communication and to streamline patient care. Using a phone app, staff can make IP-based calls or securely text each other over Wi-Fi. The app also integrates with the nurse call system, as well as monitors that track patients’ vital signs, notifying care teams if an intervention is necessary, Laver says.

Three-thousand miles east, NYU Langone Health’s Helen L. and Martin S. Kimmel Pavilion, a newly opened 830,000-square-foot, 374-bed facility that also houses Hassenfeld Children’s Hospital on 34th Street, features a bevy of technologies as well.

The pavilion is powered by NYU Langone Health’s existing data centers, and the IT staff splits applications into different virtual LANs for critical and noncritical devices, says Ruth Harris, senior director of NYU Langone Health’s Medical Center IT Enterprise Project Management Office. Harris worked with the construction team and was tasked with ensuring the correct implementation of all technology.

When new patients enter the hospital, they can register electronically through a tablet, and once admitted into their private rooms, they can access a 75-inch HD display — dubbed MyWall — at the foot of their bed through which they can order meals, Skype with family and friends, watch TV, read customized educational materials on their health condition or review the next steps in their care. Tablets allow patients to control MyWall, room temperature and overhead lights, as well as open or close the blinds, Harris says.

Ruth Harris was tasked with ­ensuring the implementation of all technology at NYU Langone Health’s Helen L. and Martin S. Kimmel Pavilion, including MyWall HD displays and patient ­bedside tablets; state-­of-the-art OR ­solutions; and digitally enabled lights and blinds. Photo by Matt Furman.

Each patient also gets a digital medication drawer located outside their room that integrates with the hospital’s EHR system. Robots — part of a fleet of 31 machines programmed to perform separate jobs, such as delivering meals, linen and supplies, or removing hazardous waste — deliver the medication, and a biometric scanner allows nurses to open the drawer with their thumbs, on demand.

“Back in the day, our nurses had to chase down food trays or wear protective gear to get rid of hazardous waste,” Harris says. “This frees up our staff to focus on caring for patients and other key elements of their jobs.”

Additionally, clinicians are equipped with smartphones, which the hospital calls Clinical Mobile Companions. Through an app, doctors and nurses can securely text each other, access the EHR and order medication.

“Everything they can do on a ­computer, they can do on the phone,” Harris says.

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The Operating Room of the Future

Researchers from Clemson University and the Medical University of South Carolina, meanwhile, have spent the past three years designing the operating room of the future, aiming to optimize safety and effectiveness.

Based on their findings, they designed a prototype operating room with 570 square feet of space. An ideal OR will deploy surgical booms from the ceiling to maximize floor space and support cord management, says Anjali Joseph, an endowed chair and professor in Clemson’s School of Architecture.

Other important features include large integrated video displays so surgical teams can access critical information, such as patient vital signs, medical records, videos of the surgical site and previous radiology images, she says.

“Situational awareness has been shown to improve patient safety,” says researcher Scott T. Reeves, professor and chair of anesthesia and perioperative medicine at MUSC. “By incorporating high-resolution monitors with timely critical information, situational awareness can be substantially enhanced.”

MUSC plans to use the design discoveries in four ORs next spring as part of its Children’s Ambulatory Campus and Musculoskeletal Institute.

Both NYU Langone Health’s Kimmel Pavilion and Lucile Packard Children’s Hospital Stanford have already incorporated some of those design elements, such as the large monitors, into their new operating rooms. The latter has gone one step further and created hybrid ORs that also house diagnostic equipment. One OR, for example, includes an MRI machine and angiography equipment, Pageler says.

If an MRI is needed before or after an operation, the surgical team can perform the scan in the same room, which can improve outcomes.

“If you need to do repeat imaging throughout the surgery, you can do that, and it enables the surgeon to have the best information to optimize the surgery. It also minimizes the time children have to be anesthetized,” she says.