Has It Really Been Two Years? A Pebble Project Reflects on Success

Inpatient room satisfaction peer ranking moved from the 19th percentile to the 94th percentile. Falls with injuries were reduced by 86%. Medication errors were reduced by 19%. These are just some of the exciting results Paoli Hospital has witnessed since opening its new Patient Pavilion just two years ago. The 275,000-square-foot addition includes a replaced emergency department (ED), operating rooms, surgery department, as well as an intensive care unit/progressive care unit and new private med-surg rooms. The pavilion nearly doubled the size of the hospital to 487,000 square feet. 

This year, Paoli Hospital was named for the third time to Thomson Reuter’s 100 Top Hospitals. It also is designated as a Magnet Hospital by the American Nurses Credentialing Center.

 

Paoli’s engagement with the Pebble Project

There were several issues that needed to be addressed in the new design: 

• The 23-year-old emergency department was overcrowded and outdated. It was designed to handle 18,000 patients, roughly 50% of the volume in 2008, resulting in diversions or long wait times;
• The intensive care unit was also small, outdated, and not family-friendly; and
• The patient rooms were semi-private (90%) and too small to accommodate the families and equipment of today’s healthcare environment. 

Using research and experience from the other Pebble Partners was an integral part of the design process. As a result, the following features were included in the design: 

• An ED triple the size of the old ED, including fast track, multiple triage rooms, acute treatment rooms with improved privacy, and comfortable family waiting with separate children’s room and vending areas;
• A surgical department four times the size of the old space, with 12 state-of-the-art operating rooms and shell space for two additional operating rooms;
• A new and expanded intensive care unit and progressive care unit with 30 beds;
• Ninety-four new private patient care rooms with bathrooms and showers located off of the headwall; larger windows for increased natural light, “same-sided” rooms to improve orientation; and warm, comfortable surroundings with space for family members’ overnight stays (see Figure 1 for the typical inpatient unit layout);
• Improved visibility of patients through decentralized nurse station design;
• Healing gardens, accessible by both staff and patients;
• Increased natural light for staff throughout patient care areas, with staff lounges on patient care units and separate educational rooms on each floor; and selected artwork.

 Post-occupancy review

Naturally, after the dust settled, Paoli Hospital wanted to determine whether the new pavilion performed as it had hoped.  Anecdotally, administrators know that it has met expectations, as the facility is completely full and target patient projections for what was anticipated to be several years down the road have already been hit. Comments from patients also tell a success story: