Circling toward privacy
This past year, nearly 50,000 patients visited the emergency department at Brookhaven Memorial Hospital Medical Center (BMHMC) in East Patchogue, New York. The new Clare F. Rose Emergency, Trauma, and Chest Pain Pavilion, which opened its doors in September 2002, has enabled BMHMC to better meet the demands of its community, whose numbers are bound to increase as the population within the Medical Center's service area continues to grow and age. New York Governor George E. Pataki, keynoting the ribbon-cutting ceremony in August 2002, heralded the opening as one of the largest and most state-of-the-art emergency departments in New York State.
The $14 million, 27,000-square-foot expansion features 46 emergency beds, specialized treatment facilities, a centralized nursing and admission station, and an expanded visitors' area, including space specifically designed for children. Designed by RBSD Architects, the new Emergency Pavilion constitutes the most significant single project at BMHMC in 20 years. RBSD worked closely with BMHMC administrators and physicians to develop the most appropriate design solutions for all facets of the new facility, which is designated as a level-two trauma center, capable of providing state-of-the-art medical care in any emergency situation.
A striking feature resulting from this collaborative process is the new circular waiting room (figure 1). It seats 75 people, offers nourishment facilities, and locates the entry, registration, waiting, and triage functions in close proximity (figure 2). “Everyone in the waiting area is in full view of someone from the staff, including triage and registration,” notes Steve Barbino, vice-president for facilities at BMHMC. The waiting areas were developed in clusters to provide private spaces for patients and their families, with floor-to-ceiling exterior windows offering pleasant views and admitting lots of natural light. Spaces have been created that allow children to amuse themselves (figure 1).
The waiting area is separated from the corridor and patient registration area by an interior glass wall, which serves the dual purpose of providing a sound barrier while enabling the natural light that illuminates the waiting room to permeate the registration area. To further promote patient confidentiality, the registration area features individual cubicles where each patient can speak privately with a member of the hospital staff (figure 3).
In keeping with an emphasis on patient privacy, the corridor is designed so that patients can be taken directly to one of three treatment areas—the general treatment area (GTA), the psychiatric evaluation area, and the main, fast-track treatment area—without having to pass through each other's space (figure 4). “This way the patients and families who have different needs don't have to interact or create disruption for each other,” says Barbino. “And they remain separated until they either are discharged or admitted to the hospital.”
The main treatment area, with its centralized nurses'/doctors' station and support facilities, is surrounded by the patient spaces, maximizing visibility and access for staff and equipment (figure 5). Privacy and efficiency have been further enhanced through the design of the patient rooms, which feature side partitions rather than curtains. The curtained front of each treatment cubicle allows medical personnel optimal access to patients. Patients' comfort is enhanced by the larger size of the cubicle, as well as by the provision of a private sink, storage space, telephone, handrail system, and individual overhead heating unit.
The new Emergency Pavilion provides better, more efficient spaces for new technologies than the original building could. For example, each trauma room offers digital radiography access via wireless bedside computer, allowing convenient phone consultation by physicians at bedside and at remote locations. If necessary, registration can be conducted by wireless in the treatment cubicle, as well.
According to Barbino, the second phase of this project includes remodeling the former emergency department to provide administrative support facilities. “This will bring the administrative staff next door, as opposed to across the hospital,” he says, noting that the second phase also involves creating a new outpatient center. Also, although the program only called for the emergency department addition, RBSD's design has allowed for expansion of the hospital by including a 25,000-square-foot unfinished basement to house future facilities.
Designed to be both patient friendly and state of the art, the new Clare F. Rose Emergency, Trauma, and Chest Pain Pavilion will allow the BMHMC medical staff to continue to meet the demands of the community by providing the highest quality of care in a less crowded, more relaxed setting. HD