A New Standard

Faced with a growing population and an Emergency Department already taxed to its limits, CoxHealth in Springfield, Missouri, knew that it desperately needed to expand its emergency services on its south campus. CoxHealth and the design team from The Beck Group set out to rethink the Emergency Department for maximum flexibility and efficiency.

The new ED grew the operation from 24 rooms to 62, also incorporating a 26-bed CDU with a stat lab, satellite pharmacy, embedded radiology with two CTs, one MRI, ultrasound, and radiology, and in the process created a new “front door” for the entire facility. HEALTHCARE DESIGN Editor-in-Chief Todd Hutlock spoke with The Beck Group’s Director of Healthcare Architecture Sean Wilson and Associate Principal Michael Kaiser, CoxHealth’s Director of the Emergency Department John Archer, RN, CEN, and Interior Designer Celeste Pratt of Cannon Design (formerly with The Beck Group) about the project.

Project origins

John Archer, RN, CEN: In 2003, CoxHealth started exploring the concept of a new Emergency Department for the South campus. Initially, we thought to simply build it in the same section of the facility where the existing ED was, but for a number of reasons, the project faded and there wasn’t much momentum behind it. Then, in October 2006, the CoxHealth Board of Directors resurrected the project and decided we needed to move forward with the new ED; we had simply outgrown the old one. The national average is to turn an ED bed about 3.5 times a day; we were turning ours over seven times per day. The space was equipped to handle around 35,000 patients per year, and we handled around 67,000, with another 4,000 walking out the door without being treated. We had a 24-bed ED and we were simply out of room—there were days when we had patients in the hall. It was unacceptable from patient privacy, satisfaction, and safety standpoints.

We met with The Beck Group in early 2007, and the project was realized from there. We built the ED to accommodate 10-to-15-year growth; we wanted to do it right the first time. We spent a lot of time with the architectural design team, and we all collaborated to assess what our long-term growth needs were. The modular design that Beck came in with proved to be the ideal solution. We are currently operating two pods around the clock and two other pods that we flex open during peak hours, with a fifth pod that we haven’t even touched yet, set aside for future growth.

Development and planning

Sean Wilson: This project was a collaborative effort made possible by Rod Schaffer, CoxHealth VP of Facilities. He had the vision and foresight that allowed us to deliver the project in a fully integrated fashion. Michael Kaiser was responsible for the development of the aesthetic and the creativity behind the design elements, and I was responsible for the departmental planning with John Archer and his clinical team. Celeste Pratt and Brandi Barnes handled the interior design. Additionally, because it was an integrated project, we had our construction team involved in the design meetings from Day One. This allowed us to stay on budget and ensure there were no delays in schedule.

Michael Kaiser: We also utilized BIM software to allow interactive virtual walkthroughs, and this allowed us to really visualize how the project would look very early on and tweak things as needed, quickly and easily. This modeling really helped to serve the collaborative process we were going for on this project. We put as much as we could into those models so all the team members could see all of the elements of the project, and to provide a more realistic view. This was one of our first fully realized BIM projects, and it has now become standard operating procedure for us.