Morton Plant Hospital - Patient Tower by Gresham Smith

SHOWCASE7

Transforming for the Future

Morton Plant Hospital - Patient Tower GRESHA M, SMITH AND PA RTNER S

MORTON PLANT HOSPITAL PATIENT TOWER

Transforming for the

FUTURE Established in 1916, Morton Plant Hospital (MPH) was the first hospital built in northern Pinellas County, Florida. As typical for many hospitals, growth over time resulted in disjointed spaces leading to inefficient care and confusing wayfinding. Losing market share because of these challenges, MPH—a part of the BayCare Health System—sought ways to improve several major areas of care. GS&P was originally enlisted by Morton Plant to design a four-story renovation to expand its women’s services program as called for in an earlier master plan. Concurrent with this effort, hospital leadership was also focused on growth in areas such as surgery and orthopedics, and soon began to question whether having women’s services on multiple levels would actually provide the optimum solution for their needs. In response, GS&P, together with MPH, recommended consolidating all of women’s services on one level. The same recommendation was also made for surgery and orthopedics, creating a superior environment that would greatly enhance the overall patient experience.

BEHAVIORAL UNIT

ORTHOPEDICS UNIT

23 Patient Beds

52 Patient Rooms PT/OT

WOMENâ&#x20AC;&#x2122;S CENTER 16 LDRP 5 Assessment 5 Antepartum 2 C-section (1 Future) 26 Postpartum 15 NICU 7 PACU for Existing Cardiac ORs Blood Bank

SURGERY

PUBLIC SPACES

18 Operating Rooms 2 Future ORs with Intraoperative MRI 39 Prep/Phase 2 Recovery 34 PACU

New Main Entrance Retail Pharmacy 300-Seat Auditorium 2 Conference Rooms Resource Center Pre-admit Testing Admitting/Registration

Guest Services Reception Lobby Gift Shop

ENVIRONMENTAL/ MECHANICAL

STERILE PROCESSING AND CENTRAL STERILE

Environmental Services and New HVAC for Existing Lab

“... what started out as a 55,000-square-foot, four-story renovation turned into a

420,000SQUARE-FOOT multi-phased patient tower project... ” — BOB BERRY, Senior Architect

“The hospital’s needs were clearly changing,” says Bob Berry, senior architect and principal-in-charge. “We knew that combining all women’s services on one level would not only increase staff efﬁciencies, but also give the hospital the opportunity to do the same thing with the surgery component. This ultimately led Morton Plant to expand their project scope to combine their women’s services program with surgery and orthopedics as horizontal platforms of care. We provided planning and design services for the new effort, and what started out as a 55,000-square-foot, four-story renovation turned into a 420,000-square-foot multi-phased patient tower project that will consolidate major services currently disjointed on campus.”

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11 SECOND FLOOR: SURGERY 1

Public Elevators

Surgery Waiting

Prep/Phase 2 Recovery (2)

Neuro-Spine ORs

Urol/Plastics/Opthal/ENT ORs

General/GYN/Robotics ORs

Orthopedic ORs

Future Intraoperative ORs

Lobby Below

Clean/Dirty Elevators from SPD

PACU (39)

Anesthesia Offices

Garden Below

Discharge Elevators

Connecting Bridge

Patient arrival and flow through surgery will be greatly improved in the new program, permitting easy wayfinding from vehicle drop-off/valet to public elevators, where patients and visitors will be greeted immediately upon arrival. From the conveniently located surgery waiting area, the patient and family member will be called into a private prep room. Once prepped, the patient will be transported to surgery across a connecting bridge that overlooks a calming garden space.

GARDEN VIEWS

PLATFORM OF CARE: SURGERY To be located at the center of the existing campus, the footprint of the new patient tower was driven by the need to maximize square footage for one of the project’s biggest components— the hospital’s surgery department. “In the existing program, general surgery is located in the basement of an older part of the hospital, while day surgery is located on the second floor in a different wing of the facility,” explains Berry. “The current configuration consists of very old and small operating rooms that simply weren’t outfitted for the types of demands surgery has today. “The new platform of care will combine both general surgery and day surgery on the patient tower’s second floor, as well as all of the support spaces for prep and recovery. So everything will be on the same level, creating a far more efficient

Surgery Waiting

environment for staff, which will allow them to be more responsive to their patients’ needs.” Where Morton Plant’s existing ORs—some as small as 400 square feet—currently limit the hospital’s ability to perform, the new ORs will be larger with similar layouts that support the majority of cases. Following surgery, the patient will be brought to the PACU and then transferred into the Phase 2 recovery area if appropriate. GS&P’s design incorporates natural light into the prep, PACU and Phase 2 recovery spaces using high windows that also provide privacy from the adjacent building. Discharge will occur back on the tower’s ﬁrst ﬂoor by way of separate elevators that connect to the main lobby via a new corridor that features views to the garden.

Surgery Reception

PLATFORM OF CARE: WOMEN’S SERVICES Over the years, MPH’s competitors have been taking away market share thanks to their new and improved facilities. By offering a new center of excellence for birthing mothers and their families, Morton Plant expects to earn this business back from the competition. “The existing women’s services program is extremely disjointed,” says senior healthcare architect Tamara Rice, “and that has obviously had a significant impact on patient satisfaction. For instance, mothers who have just delivered are taken on a long gurney ride through winding public corridors, and have to descend steep ramps to reach the elevator that takes them to their postpartum room. Family members are also challenged to navigate to a different wing and floor after their loved one gives birth. “The patient tower resolves this wayfinding challenge by locating public elevators near the new main entrance that open directly into a common waiting room which is centrally located between LDRP and postpartum. So the consolidation of

women’s birthing functions and the NICU is essential to providing the very best care for patients, and the more intuitive layout will ultimately mean reduced stress for end users.” Also reducing anxiety levels, the hospital’s new neonatal intensive care unit will offer a distinctly different environment to that of the old NICU. “The new NICU will feature private patient rooms, which will provide ample space for family and staff, and also allow the newborn to get his or her much-needed REM sleep because it’s much quieter,” says Rice. “The old NICU was a noisy and crowded open-ward design that offered no room for family. When the patient tower opens, postpartum, LDRP and the NICU will all move to the third floor, and everyone will finally be able to breathe a huge sigh of relief.” Consolidating women’s birthing functions and the neonatal intensive care unit, the new Women’s Center will include a 15-bed NICU; 16 LDRP rooms; 26 postpartum rooms; five antepartum rooms; a C-section suite; and a well-baby nursery.

NURSE STATION

Family wall outside NICU entry Further enhancing the patient experience, the design brings natural light into the new NICU through the use of clerestory windows above the nurse and physician work areas.

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THIRD FLOOR: WOMEN’S SERVICES

Women’s Reception

Public Elevators

Women’s/ NICU Waiting

Labor Delivery Recovery (16)

Assessment (5)

Antepartum (5)

C-section (2 + 1 Future)

NICU (15)

Postpartum (26)

Well-Baby Nursery

Rooftop Terrace

New PACU for Cardiac Surgery

Blood Bank

Existing Cardiac Open-Heart ORs

Garden Below

PLATFORM OF CARE: ORTHOPEDICS Signaling a new era in orthopedic care for the Tampa Bay area, the patient tower’s fourth ﬂoor will expand the hospital’s orthopedics department and allow all existing orthopedic beds to be transitioned to private patient rooms. The physical and occupational therapy gym will also relocate and be expanded within the orthopedics units in the new tower. “The existing orthopedic bed units are in older spaces in different parts of the hospital,” explains Rice. “The patient rooms are semiprivate with no in-room showers and provide limited space for family. The new orthopedics wing will be divided into a 31-bed unit and a 21-bed unit, and will provide private rooms with plenty of space for both staff and family.” GS&P also designed the private rooms to accommodate patients’

equipment such as wheelchairs and walkers. Five of the patient rooms will be equipped with ceiling-mounted patient lifts, and portable lifts will be utilized in the remaining rooms. Each orthopedics unit will feature a large, open nurse station as well as an enclosed staff work area. A combination of nursing alcoves between each patient room, and the use of workstations on wheels, will allow for charting to be completed either in the patient room while providing bedside care, or outside of the patient room, granting the patient privacy. Staff will be able to get patients up and walking as quickly as possible in the corridor that overlooks the garden below. This passageway will provide architectural features that offer visual clues for interim goals that aid in a patient’s rehabilitation.

Landscape plan of garden

PLATFORM OF CARE: ADULT BEHAVIORAL

Rounding out the horizontal platforms of care, the ﬁfth ﬂoor will house the hospital’s adult behavioral program. The renovation and refurbishment of this existing unit will include a larger group activity space that promotes better patient interaction, a dayroom that can be easily supervised from the nurse station and a sally port design for secure intake into the unit.

“One signiﬁcant improvement from the existing program were the anti-ligature measures we included in the design, which will help prevent patients from injuring themselves or others,” says Berry. “The hospital wanted to create a safer environment for both staff and patients, and bringing their program up to date with these design components, as well as codes and proper security, will help achieve that objective.”

Schematic garden sketch

EXISTING WEST ENTRANCE

EAST ENTRANCE

MAIN LOBBY

A NEW MAIN ENTRANCE Creating a renewed image for the hospital, the patient tower will feature a new main entrance on the first floor that will face east toward the community’s approach to the campus. A new, open lobby will greet patients and visitors with easy access to public spaces that include reception, a gift shop, a retail pharmacy, pre-admit testing, admitting/registration and a 300-seat auditorium. The first floor lobby will also provide views into a new courtyard garden space and serve as the public connection to the hospital’s emergency and imaging departments as well as various patient-bed floors.

“The hospital is located close to the water, and the current main entrance faces the Gulf,” says Berry. “Unfortunately, people don’t arrive by boat, so they’re presently entering via the back of the hospital. The new main entry portal will actually face the community that the hospital is serving versus having its back to them, and there’s a genuine serendipity to that. So you’ll be able to see the entrance as you’re pulling onto campus, and after you arrive, you’ll simply come in the front door, be greeted, and then easily ﬁnd your way.”

ED ENTRANCE

Above and Left: Curved entry portals clad with limestone reference existing architectural context and become focal points for the approaching visitor. This architectural element is repeated inside the lobby, signaling destinations and portals into other areas of the hospital. Far Left: The new lobby becomes the physical link to both clinical and gathering spaces. Distinctive with its high ceiling space and strong sense of transparency, it offers views into the new courtyard garden.

SOLVING COMPLEX ISSUES Morton Plant’s goal to have new consolidated platforms of care conveniently located next to its existing services required the new addition be placed in the center of an ever-growing campus. Because of this, the overall project involved early construction packages and phasing that relocated mothers and babies to a temporary location away from construction noise; created new space for various groups that occupied buildings slated for demolition; rerouted major existing utilities away from the new tower; and generated new emergency backup power for the entire hospital. The design team carefully planned these early packages concurrently with the design of the patient tower. “One of the biggest challenges with this project was the phasing,” recalls Berry. “Some people liken it to working on a car while it’s moving down the road. But a hospital is a living entity, so I like to compare it to the human body—it has a nervous system, a digestive system and a respiratory system, and all of those systems have to stay working. Our challenge was how do we build something smack-dab in the middle of an existing hospital, connect it to five existing buildings, and then keep all of its systems working at the same time? The answer, of course, was phasing. And it all comes down to how well we understand the impacts to the existing services while creating what we’re doing, and doing it in a way that allows them to stay functional. “Ultimately, it involves taking ourselves out of the architect role and becoming the master of logistics. We have to remove ourselves from just drawing the project and figure out what is really happening. And that involves working closely with engineers, contractors, hospital leadership, doctors, nurses and end users, and being the one who orchestrates the whole process. So in a way, it’s akin to a massive jigsaw puzzle. And our job is to make those puzzle pieces fit.”

The new patient tower will be located in the middle of the existing hospital campus, requiring demolition of existing structures and relocation of offices within those buildings.

Mechanical utilities are being re-routed through buildings and a new utility tunnel under the future tower.

The new tower will connect to five existing buildings. Final renovations of vacated space will occur after the new tower is completed.

“... it involves taking ourselves out of the architect role and becoming

THE MASTER OF LOGISTICS."

— BOB BERRY, Senior Architect

Maximizing patient ﬂow while providing the ultimate patient experience, the 392,000-square-foot, six-story addition and renovation of Morton Plant Hospital’s 687-bed facility will not only better serve the future healthcare needs of the Tampa Bay community, but also allow the hospital to grow centers of excellence based on best practices. “It all boils down to patient satisfaction, and that ties directly into MPH recapturing its lost market share,” says Berry. “A hospital is more than just a building, and people love Morton Plant because of its outstanding level of patient care. The inherent value of this new addition and renovation is it will ﬁnally provide the community with a facility that matches that level of care.”▪

PROJECT DETAILS CLIENT

TEAM

Morton Plant Hospital BayCare Health System

PIC Robert A. Berry, AIA, NCARB, EDAC

Larry D. Leman

PM Tamara Rice, AIA, NCARB, LEED AP

Ellen Lina

PP Angela C. Holcomb, AIA, NCARB

Jonathan Massaro

PC Christopher L. Davis, LEED AP BD+C, CDT,

Blaine Matthews, P.E., LEED AP

Associate AIA

Deron McIntosh, P.E.

LOCATION

Clearwater, Florida

PC Katrina Pasteur, AIA ID Emily R. Farrell, IIDA

MARKET

Healthcare

ID Carrie May Kovacs, IIDA, LEED AP

Edward C. Alonso, AIA Tracey Curray Glenn T. Davis

SERVICES

Danielle Everette

Architecture

Rob Fuller, AIA

Environmental Graphics

Stephan K. Gartman, RA, LEED AP

Interior Design

James R. Harding, SEGD

Planning

Matthew G. Harrell, AIA, ACHA, LEED AP Woudly Homicil

SIZE

Tower Project: 392,000 Square Feet Multi-phased Total: 420,000 Square Feet

Amanda Hunter Deanna L Kamal Shawn M. Kelley, AIA, NCARB, LEED AP

David V. McMullin, P.E., LEED AP Louis Medcalf, FCSI, CCS Ramon A. Cruz Moreno Orlando Lopez-Isa, AIA, LEED AP Ana U. Praskach Amanda Slack, LEED AP Frank Swaans, AIA, ACHA, FHFI, LEED AP, EDAC Bogue M. Waller, P.E. Christopher W. Wahl Nicole L. Williams Ray A. Wong, AIA, EDAC, LEED GA, NCARB

ARCHITECTURE

ENGINEERING

INTERIORS

PLANNING