PHOTOS COURTESY OF YALE-NEW HAVEN HOSPITAL

Mechanical floor under construction. Smilow Cancer Hospital at Yale-New Haven
Mechanical floor under construction. Smilow Cancer Hospital at Yale-New Haven

This is the annual Architectural Showcase issue of

HEALTHCARE DESIGN, a juried review of recent projects submitted by architectural and design teams. As you thumb through these pages, you will note the complexity and magnitude of detail it takes to design and construct a healthcare project. What is not transparent, however, is the amount of coordination it takes to open and operate a facility after the construction dust settles.

Few design competitions allow enough copy and few opening ceremonies allow enough time to pay tribute to the entire cast of characters it takes to operationalize a new facility. It is no easy feat to open a healthcare facility's doors to patients and families. It takes a complex network of dedicated team members that follow through from design and construction to operation. So, for all of the projects showcased in this issue, let's acknowledge the effort it takes many different teams to get from a beautiful structure to an operational healthcare facility.

Commissioning: Making sure a complex building is fully operational takes time. Teams of equipment manufacturers and systems engineers need to turn the engine room, so to speak, over to hospital engineering and maintenance personnel. Newer mechanical and technological systems are generally employed and new routines that mesh with existing systems in adjacent buildings require time to learn and understand. This is a complex process that starts long before a building opens and may last for sometime after the first patients are seen.

What is not transparent, however, is the amount of coordination it takes to open and operate a facility after the construction dust settles.

Staff orientation: Staff members often participate in visioning and user reviews during the design phases. This may include clinicians as well as maintenance, engineering, and environmental services personnel. Prior to opening, a construction manager turns the building over to an owner allowing enough time for all staff members to participate in orientations so that the building is fully understood as an operational machine. Dedicated teams conduct these orientations sharing scenario plans with staff members who need to be ready to make the move and be prepared for new operational cultures. The preliminary preparation for this kind of training usually begins many months and sometimes years before the facility opens.

A nursing unit becomes a command center as the anticipation builds for the first patient to move from an existing facility to a new facility. Smilow Cancer Hospital at Yale-New Haven
A nursing unit becomes a command center as the anticipation builds for the first patient to move from an existing facility to a new facility. Smilow Cancer Hospital at Yale-New Haven

Maintenance & cleaning: The final polish on a building takes many dedicated environmental services individuals who need to learn about new materials and different cleaning techniques. Miles of spaces get cleaned inspected and checked quite thoroughly. For LEED-certified buildings, everything needs to be ready for an off-gassing phase.

Installation of owner items: Many things needed to open a new facility are not within the responsibility of the construction manager. Owner-installed equipment and accessories, such as soap dispensers, require time and the dedication of the facility's maintenance and engineering staff.

Acknowledging the first patient with flowers and a private escort. Smilow Cancer Hospital at Yale-New Haven
Acknowledging the first patient with flowers and a private escort. Smilow Cancer Hospital at Yale-New Haven

Celebration: Finally, a team of public relations personnel rolls out the red carpet and organizes events to celebrate the completion of this intensive effort. Coordinating the schedules of dignitaries and special guests is just one piece of a celebration. Staff members need to be mobilized and trained to conduct tours. Appropriate press materials and printed materials also need to be created. Ideally, promotion of the new facility starts months before the doors officially open.

From “Hope is Coming” to…
From “Hope is Coming” to…

Showtime: Lastly, the first patient arrives at the door and clinical teams coordinate the move of existing patients carefully and skillfully with precision and safety in mind. Before this happens, however, public and emergency personnel should be notified of new routes or addresses for critical services.

…“Hope has Arrived.” Smilow Cancer Hospital at Yale-New Haven
…“Hope has Arrived.” Smilow Cancer Hospital at Yale-New Haven

Hope: All of the subtleties of pride and ownership celebrated in this issue are shared by everyone involved in the project. A building that was conceived, designed, constructed, and operationalized to deliver better care is an important community asset that provides hope for the future. HD

Rosalyn Cama, FASID, EDAC, is Board Chair for The Center for Health Design located in Concord, California. For more information, visit www.healthdesign.org. Healthcare Design 2010 September;10(9):10-12