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Construction Trends: Pediatric Healthcare

At a pediatric hospital, the healing process should begin as soon as Mom or Dad drives up the driveway to look for a parking space.

Odds are, in Arizona, that driveway leads to a hospital built by Kitchell: builder of Cardon Children’s Medical Center in Mesa, The University of Arizona Medical Center – Diamond Children’s in Tucson, and Phoenix Children’s Hospital. Kitchell has helped put Arizona on the map as a hub of pediatric excellence.  All three were completed within two years. $702,200,000, 1,449,500 SF, 608 beds.

There many critical issues to consider when constructing or expanding a pediatric hospital. All involved need to minimize negative impacts to the recovering patients. “The patient comes first,” says Mike Wolfe, a Kitchell project director. “If you or a loved one had the misfortune to be in a hospital that was undergoing construction, would you want a construction crew to be jack-hammering concrete in the middle of the night? Working in and around children’s hospitals requires extra sensitivity and flexibility to work around patients’ needs.”

The No. 1 goal of designers and builders is to produce a stress-reducing, healing environment while guarding against infections and medical errors. Bringing all stakeholders–owners, architects, engineers, contractors and even young patients who may be “frequent fliers –into the pre-design phase has proven highly beneficial to construction outcomes.

Space Planning

At pediatric hospitals, space is needed to accommodate more than one family member. Often when one child is in the hospital, the entire family, siblings and extended family included. Ample space is available for fold-out beds and private guest showers in patient rooms. There are more “soft” spaces for siblings and other family members to spend time.

Some Spaces Unique to Pediatric Hospitals

– Expanded kitchens to fulfill children’s menu preferences (pizza, stir-fry, etc.)
– Treatment rooms on each floor so patient bedrooms are “pain-free” safe havens
– Interactive play/family spaces on each floor
– Teen activity rooms
– Lactation rooms
– Auditorium/stages for children to see performances, concerts, graduations, or have parties
– Meditation rooms
– Healing gardens
– Toy stores

Pods vs. Private Rooms

What is better for the youngest patient and family, a private room or a pod arrangement? This is actively being discussed right now. The benefits of private rooms seem obvious, but healthcare experts value the interactive nature of community-oriented pod set-ups, which are conducive to family-to-family interaction. After all, no one can relate to a family’s ordeal better than another family simultaneously going through the same challenges. Current designs have trended toward private rooms, but family areas, clinical programs and hospital-directed family support groups have promoted the “community” healing benefit for the young patients.

Engaging Environments

The most apparent differences between pediatric and traditional hospitals often lie in the visual cues. Bright colors and whimsical designs serve to create a restorative–and entertaining–atmosphere for patients and their families.

Motifs/Theming

Theming to engage and entertain is certainly the most obvious defining characteristic of a pediatric hospital, but how to achieve the right tone, taking age-appropriateness into consideration, is far from obvious.  Cutting-edge technology is being utilized to bring “edutainment” and social media options directly into patient rooms. Multiple textures, varied artwork and soothing finishes reinforce the healing process. Highly durable, vibrantly colored terrazzo flooring is currently very popular. Natural elements, such as whimsical water features, are a dynamic way to bring the outside in (and engage the senses of hearing, smell and touch, as well as sight) to what has traditionally been a cold and sterile place.

Sensory Sensitivity

Lighting makes a huge difference. For example, natural lighting helps babies heal faster. The industry is coming up with creative ways to integrate natural lighting with state-of-the-art LED interior lighting that enables healthcare staff to perform their jobs effectively, but is also pleasing to the patients — a huge leap forward from the harsh cathode lighting of the past. On the sound front, a quiet environment may reduce recovery time. Rubber flooring with high STC acoustical ratings has replaced vinyl sheeting predominantly used in the past.

Facility Maintenance: avoiding “the Jenga effect”

By Sean Bondar, Managing Director, CGL/Kitchell Facility Management

We’ve all played Jenga – right? The game in which wood blocks are removed from a structure, until finally the loser removes the last block that causes the building falls to pieces?

While the Jenga comparison is a simple analogy, unfortunately too often building owners – whether institutional, government or private – take the “Jenga” approach to managing ongoing maintenance of a new project or existing facilities. This approach causes headache, deferred maintenance taxed resources and most unfortunately, can put the public at risk.

The 2013 Report Card for America’s Infrastructure, produced by the American Society of Civil Engineers (ASCE), suggests that $3.6 trillion is required to maintain public projects in the United States by 2020. This amount covers drinking water, wastewater, dams, bridges, roads, as well as public facilities such as schools, government buildings and publicly owned cultural destinations – you name it. It’s the burden we bear living in a civilized society.

President Obama recently proposed in his budget $40 billion for “Fix it First” projects – investments in highway repair, bridges, transit systems and airports. As a professional in the facility maintenance field, I can attest that this investment is vitally important to our country’s future, but also falls woefully short in addressing the total cost of ownership that so many institutional and public owners fail to address at the outset of landmark projects. Most unfortunately, many of the “Fix it First,” as the name implies, cover mission-critical improvements that need to happen as a result of deferred maintenance.

In my role, I am far from influencing public opinion or affecting national budget talks. But I can provide perspective to building owners in my little corner of the world, addressing considerations that affect the decision to build, maintain and operate public and commercial structures.

Normal/Routine Maintenance and repairs are often funded through annual budget cycles to help buildings and fixed equipment reach their originally anticipated life. Similarly, Planned or Programmed Maintenance covers painting, flood coating of roofs, overlays and seal coating of roads and parking lots, etc. Two other, very important facets, which are often not on the radar when it comes to total cost of ownership are predictive and preventive maintenance. Predictive Maintenance, critical in areas that live with the potential for natural disasters, covers routine maintenance, testing and inspection performed to anticipate failure using specific methods and equipment, such as vibration analysis, thermographs, x-ray or acoustic systems. Preventive Maintenance is a planned, controlled program intended to maximize the reliability, performance and lifecycle of building systems, equipment, etc.

In today’s world, we also need to consider external factors such as national security issues, high energy costs, the cost of non-compliance, inflation, political cycles and over or under-burdened staff in the overall cost of ownership. And if we don’t, we’ve created ideal conditions for project failure, inviting risk and a deferred maintenance crisis – or the Jenga effect. Preserving our country’s legacy of proud, solid infrastructure is not an inexpensive feat – but the better way to budget and plan is to be proactive, strategic and plan wisely.