Many healthcare organizations are in the position of upgrading, expanding, or replacing their emergency departments. There are several trends in ED design (such as segregating lower-acuity-level patients into fast track areas), but few have been quantified. With the University of Kentucky (UK) HealthCare’s emergency department open for just over a year, the team is embarking on a research project to document the results of the design of the chair-centric component of the department’s Express Care operational model, as well as to share some of the lessons learned about the design of both operations and the space.
Responding to increased demand, UK HealthCare’s master plan calls for a phased replacement of the original Chandler Hospital building and expansion of current medical center services. When fully fit-out, the 1.2-million-square-foot facility is projected to cost almost $850 million and will include: a trauma center/emergency department; an eight-story, 512-bed patient care tower; 27 advanced operating rooms; a diagnostic and interventional center; public spaces for patients, families, and staff; a health education center; advanced technologies serving clinical, information, and communication needs; and support spaces.
Pavilion A represents the first phase of the master plan. The initial step of the project was completed at 5 a.m. on July 14, 2010, when the first patient came through the doors of the new emergency department at the University of Kentucky Chandler Hospital—Central and Eastern Kentucky’s only Level 1 trauma center. This step culminated thousands of hours of planning by staff, architects, and facilities experts that doubled the size of the previously existing ED to 39,000 square feet.
Featuring carefully planned spaces that enable staff to treat and discharge patients quickly or admit the patient promptly for inpatient services, the ED is designed to provide services for 75,000 annual visits. Simulations were used to determine the overall sizing, but also were used as a mechanism to develop operational throughput processes.
Planning for the new ED was based on UK HealthCare’s guiding principles that shaped the facility and were used by the team to define and develop specific spaces that will better serve the needs of its users by:
- Providing a comforting and welcoming environment that is easy to navigate;
- Incorporating amenities for patients and their families;
- Supporting an integrated care delivery system;
- Increasing quality and safety for patients and staff;
- Responding to future technology with a flexible design;
- Supporting the academic mission; and
- Establishing a new image for the healthcare enterprise.
Careful attention to every detail, from the color palette and artwork to lighting was considered to create a comfortable and soothing environment. Additionally, specific focus was placed on how to best reduce stress for patients and staff. The ED features three separate self-sufficient centers, with dedicated team work areas and services so care is timely and efficient.
The latest technological advances have been incorporated into the new ED, including electronic documentation of high-risk cases, computerized order entry, Wi-Fi coverage in waiting areas, and wireless and mobile X-ray and endoscopy carts to speed delivery of care to patients. In addition, the department incorporates the “quiet ED” concept that reduces overhead announcements by using specialized communication devices.
The Makenna David Pediatric Emergency Center
Adjacent to the Adult Emergency Center, the Makenna David Pediatric Emergency Center has a separate entrance and waiting area that is child-friendly in color scheme and furnishings, and includes a play table, interactive wall, and computer play station area. Additional features of the pediatric services area include:
- Ten standard exam rooms, two high-acuity “crisis” rooms, and two triage rooms;
- Distinct patient, staff, and family areas in each room;
- Televisions for patient education and entertainment;
- Direct access to adjacent radiology and inpatient services; and
- Private consultation rooms for families with special circumstances.