"Risky" New ED Layout At Gundersen Pays Off
Among the many recent changes executed in workflow and campus redirection for Gundersen Health System in La Crosse, Wis., the restructuring of its emergency department stands out as one of the most dramatic shifts, a shift that made Kari Houser, director of construction and project management for Gundersen, quite nervous. “Our prior ED was a perimeter of exam rooms and in the center, it was basically air traffic control,” she says. “From an outsider’s perspective, it was absolute chaos. It was noisy, and you didn’t know who was doing what or who had what patients.” That layout and design, which dated back to 1970, included 16 exam rooms, each no bigger than 100 square feet.
The new department features 44 exam rooms designed on a pass-through (or open core) model. Each room has two doors, one for public access and the other for staff and caregivers. “The public circulates around the perimeter of the treatment rooms, and the staff is located in the center [of the unit],” says Matt Sanders, associate principal and senior design lead for AECOM. “There’s no big waiting area; waiting areas are distributed equally throughout this continuous pathway that meanders around the emergency core.” Most of the rooms are in the 120- to 140-square-foot range now, partly to accommodate the two doors. The bigger footprint of the unit as a whole, Sanders says, means that patients are more spread out, “but it’s a non-issue. Technology helps that, with integrated new systems, nurse call, and security cameras everywhere.”
“It was a pretty big culture shift,” says Houser. But after spending time in the new unit and talking to staff, she found her nerves eased. “What used to be a loud mixing and mashing of staff and family and patients is now this very quiet, very calm, disbursed group of staff doing their jobs. I think that’s a huge win for what I felt was a pretty big design risk.”