Franciscan Missionaries of Our Lady – Our Lady of the Lake Regional Medical Center Heart and Vascular Institute, Baton Rouge, LA

Stantec (VOA now Stantec)

EBD Goal 

To build a cardiovascular hospital that is both technologically superior and exceptional in its capability to support patients and promote family comfort and caregiver satisfaction. Specific goals defined by the team, administrators, and designers included: 1) create a patient- and family-centered environment; 2) improve the quality and safety of healthcare delivery; 3) support care for the whole person, enhanced by contact with nature and positive distractions; 4) create a positive work environment; 5) design for maximum standardization, future flexibility, and growth.

Overview

Our Lady of the Lake Regional Medical Center’s (OLOLRMC) new Heart and Vascular Institute and emergency services expansion was designed to advance and redefine the field of heart and vascular care for the community by offering innovative treatments, state-of-the-art technology, education, and research.

Challenge 

This project represented the first of its kind: a public-private partnership between the State of Louisiana, FMOL, OLOLRMC and Louisiana State University, along with statistically meaningful and proven outcomes to be met for patients and care team members at the bedside. Based on a series of agreements at the state level to provide medical education and community-based healthcare (including both incentives and penalties for non-compliance with timeframes, costs and services) the FMOL and OLOLRMC Board of Directors set expectations to provide a consistent level of premier care. 

Solution 

As the largest private medical center in Louisiana with multiple centers of excellence, along with a commitment to being “the safest hospital in the nation,” it was imperative that a streamlined and effective process be upheld. To develop a care network for the most complex patients as well as preventive care in outpatient settings and provide emergency care services in the community required flexible thinking and a robust plan.

OLOLRMC’s focus on patient safety, preservation of patient dignity, and reduced infection rates as key drivers resulted in the decision to apply known evidence-based design (EBD) strategies and resources and to research the results of newly implemented approaches. Strategies to improve outcomes in surgical and inpatient environments included:

• Within the surgical services area, provide private prep/recovery rooms with dedicated toilet rooms to decrease infection-related issues and boost patient and family satisfaction
• Within the emergency departments, provide enclosed medication rooms with proper lighting and soundproofing to reduce medical errors
• Provide on-stage and off-stage areas for care providers to separate circulation pathways and reduce nosocomial infection rates
• Development of research tools to validate improved outcomes during post-occupancy reviews

Operational efficiencies were achieved through process improvement workshops in which Stantec’s medical planning team partnered with OLOLRMC’s Chief Nursing Officer and operations team to deconstruct processes and provide Lean solutions.

In the ICU department, a layered care team model was developed to improve patient care and observation as well as team interaction. Care team stations were developed to support 12-bed units, combined with two-care team stations for bedside observation of two beds. This was effective at supporting holistic care, as patients required less sedation and medication.

Results 

The resulting Level 1 trauma center can accommodate the state’s most intensive cases at a scale along with the critical care services that have been recognized as the 2015 ICU Design Citation by the Society of Critical Care Medicine, the American Association of Critical Care Nurses and the AIA Academy on Architecture of health as both humanitarian and highly functional. Results from OLOLRMC’s trademarked Nursing Environment of Work Survey showed significantly reduced stress levels and interruptions, increased physical energy level, and increased organization of charts/ documentation. This is a critical point of differentiation as OLOLRMC competes to attract and retain qualified team members.

The first post-occupancy evaluation (POE) conducted after three months showed initial satisfaction on areas ranging from patient experience, connection with nature, patient room size, and satisfaction with lobbies and lounges. The second survey completed after 12 months of operations showed improvements in efficiencies in operations as caretakers worked in their new environments.