Dublin Methodist Hospital, Dublin, OH

 

The original goal throughout design and construction was to create a hospital that would fit into the community both architecturally and culturally, reduce feelings of fear and intimidation on arrival, provide a clear and simple wayfinding system, and empower patients and their families with a sense of calm and control in a restorative environment. A research program was developed to evaluate the project and publish the results as a contribution to the healthcare design field.

Ohio Health Dublin Methodist Hospital was designed to redefine the way patient care is delivered in central Ohio. As part of The Center for Health Design’s “Pebble Project,” Dublin Methodist’s original design team created a design process capitalizing on the experience of other Pebble Partners, using key research findings, national benchmarks, and best practices where available. The focus of the research included several studies about safety, the patient and family experience, work processes, culture, and return on investment.

When Dublin Methodist opened in 2008, it was considered one of the first hospitals to comprehensively incorporate evidence-based design (as it was understood at that time). The success of the hospital and its subsequent growth have necessitated the fit-out of all-shell space, as well as the use of soft space for clinical functions. A master plan was recently completed to accommodate the hospital’s expansion.

In 2015, AECOM was engaged to fit out the existing shell space with a 20-bed inpatient unit. The design team conducted a post-occupancy evaluation (POE), and a hospital task force also completed an evaluation to determine what changes should be made going forward.

While the intent was to replicate the look and feel of the existing nursing units, there were lessons to be learned from the previous design to inform the new one. The most significant change from the original design was to abandon the acuity-adaptable nursing model. The hospital’s original design featured identical patient rooms that could support everything from general acute care to critical care, allowing the patient to remain in one place while nursing staff appropriate to their required level of care moved from room to room. After four years, the hospital found it difficult to build a stable critical census and decided to return to an aggregated model of care.

Since all of the inpatient rooms were designed to be identical to support a critical care level, no physical redesign was required. However, several other changes were made to respond to patient or operational needs. Eliminating the pull-down doors designed to conceal medical gases and installing cabinets in their place allowed additional storage space for supplies. Storage space was also added for patient and family belongings under the desk at the windows and in the bathrooms for toiletries. Patient amenities were expanded to include clocks, as well as supplementary outlets for charging cell phones and other devices.

The original technology interface was installed on an articulating arm over the bed. A change in EMR providers, along with other software changes, prompted the decision to switch to a bedside computer.

The multidisciplinary collaboration space was replaced with staff teaming and break rooms, and one consultation room became an office for the nursing director. Multiple areas were built into the revised configuration to better accommodate trash cans in order to enhance the patient, family, and staff experience.

In addition to the key findings in the nursing unit, a series of general findings were identified from the post occupancy evaluation. One major finding was the importance of durable materials in a hospital environment. For example, stained concrete floors were used in the lobby and public corridors as a cost-effective measure for high-traffic areas. Unfortunately, multiple cracks have appeared in the flooring as the building has settled. The hospital has begun to cover the concrete floors with resilient flooring to improve their appearance.

There were many positive findings associated with the evidence-based design features. These include the use of daylight in 94% of occupied spaces; the extremely quiet environment; the distributed care work areas fostering collaboration with patients, families, and caregivers; the use of nature, natural colors and materials to create a soothing environment; and a commitment to the core values of the new culture cultivated at the beginning of the project.

During the POE, all of the original EBD design principles were also reviewed to determine if they had been accomplished and maintained. The overwhelming conclusion is that they were, and continue to be, key factors in the hospital’s success, driving positive change throughout the OhioHealth system.