Barnes-Jewish Hospital touts
floor of the future

Cynthia Billhartz Gregorian
December 15, 2010 3:00 pm

Just a few days ago, nurses working with transplant patients at Barnes-Jewish Hospital were forced to do a lot of scurrying.

Sometimes it was between two storage rooms; first to get medicine, then to get the needle to inject it.

Other times it was to reach a physical therapist, case coordinator and pharmacist before giving up and heading to the paging system.

Then there were times when the nurses would look for a pair of latex gloves or some gauze in a patient’s room, but supplies were stored in a different spot.

Streamlining, it seems, was a design afterthought back in the day. Not anymore.

On Tuesday, Barnes opened its new Abdominal Transplant Unit, billing it as the nursing floor of the future. Designers and engineers took principles developed in automotive manufacturing and used them to make the unit more efficient, thereby lowering costs.

In 10 years, the entire hospital will be refitted like this unit, said Alyson Hughes, nurse manager of the unit.

For instance, the sleek new transplant unit contains storage rooms that have medicines and supplies. Social workers, dietitians, case coordinators, pharmacists and physical and occupational therapists will have cubicles in the nurses’ station. All the rooms are laid out the same so staff members know where to find things immediately, eliminating excess scurrying.

There’s also a holding room which will free up patient rooms.

Sometimes in the initial stages of the transplant process, Hughes said, the hospital will receive a lung or a liver, call the patient to come in and go through the admitting procedure, only to find out the organ is not a good match.

The patient is then sent home, but not before tying up a patient room for several hours.
Now, they’ll wait on “glorified stretchers” in the holding room, where they can get blood drawn and other preparatory work done, while surgeons determine if the transplant is suitable.

Same goes for patients who need kidney biopsies and those who are checking out of the hospital and need central lines or drainage systems removed. They can be rolled down the hall to the unit’s new procedure/exam room.

A conference room next to the nurses’ station contains a long table and chairs where teams of caregivers can meet privately each day to discuss the status of patients. Before, they stood in the hallway or near the nurses’ station where others could hear.

The conference room is also equipped with a large flat-screen computer monitor that displays patient records and allows for video conferences with physicians in other cities when a patient is involved in a paired kidney exchange.

Soliciting ideas

Laurie Wolf, a human factors engineer in the hospital’s operational excellence department, lead the design team. She’s worked at General Motors designing concept cars and at Emerson Electric, designing military cockpits for many years. Her team solicited ideas from doctors and nurses including Renee Figura, and looked at every facet of patient care and procedural step.

“For instance,” she said, “is the patient tripping because the ledge into the shower is too high because they have a shuffly gait?”

The answer to that question was “yes, sometimes.” So they eliminated the ledge between the shower floor and the rest of the bathroom.

Touchscreen computer/TVs in patient rooms are connected to the central computer at the nurses’ station. Patients can log in and see who their nurse will be for the day, and nurses can instruct patients to watch educational videos.

For instance if they’re going to be on immunosuppressive drugs, said Hughes, they’re required to watch an instructional video on the topic. When they’ve finished viewing it, it’s automatically recorded in their patient records.

There’s also a concierge program which gives family members information on local hotels, restaurants and transportation options.

Computers at the nurse’s station in each room have barcode scanners so nurses can scan medications and the patient’s identification on their wristband to make sure they match.
A huge flat screen computer screen called a Smart Board looms over the nurses’ center. It replaces the dry-erase board and informs staff which patient is in which room. A series of colored dots indicate if they’re getting close to reaching specified goals.

Figura said the hallways are wider which allows for easier movement of patients being rolled to dialysis in their beds.

The floor has its own physical and occupational therapy room which eliminates time spent transporting patients to other parts of the hospital.

“All transplant patients are required to get some type of therapy and before this room, they sometimes did it in the stairwell,” Figura said.

The floor is brighter, fresher and more modern than the dreary colors, institutional floor tiles and carpeting found in the old unit on the sixth floor.

The old unit had 24 beds, this one has 38, and 20 of them are private for patients who have suppressed immune systems.

Laminated flooring has been used in lieu of carpeting.

“When people are dripping body fluids all over the place, how sanitary can you get it?” Figura said. “It’s some of the little things that we get excited about.”

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Posted in Fitness on Wednesday, December 15, 2010 3:00 pm