1. “The Big Top” – An Innovative Approach to Design Driven by Families and Providers Presented by Helen DeVos Children’s Hospital Jonathan Bailey Associates Smith Hager Bajo, Inc.

2. Grand Rapids, Michigan

3. Presentation Outline n Introductions n Process Overview n Design Integration n Design Analysis n Implementation Plan n Key Measures for Success n From a Parent’s Perspective

4. Introductions n Michele Pietras n Curtis Qualls n Judy Hager n Rhonda Hoyle

5. Overview n Project Scope n Planning Process n “Making the Case” for a Children’s Hospital n Market Analysis & Volume Projections n Bed Need Analysis n Board Support n Operational Process Analysis/Redesign n Space Planning/Programming n Site Analysis/Conceptual Nursing Unit n Schematic Design

6. User Group & Space Planning Group Structure CORE TEAM USER GROUPS CARE BEARS PROCEED WITH CARE CARE NECESSITIES IT COMM/FINANCE PATIENT ROOM FAMILY AMENITIES FAMILY/PUBLIC SPACES SPACE PLANNING GROUPS OR/ENDOSCOPY SEDATION TREATMENT SERVICES LAB/IMAGING PHARMACY/RT NUTRITION SERVICES ENVIRONMENTAL SERVICES SECURITY MAT MGM’T STERILE PROC. INFRASTRUCTURE ED SERVICES AMBULATORY CLINICS SUPER USER GROUP

7. Process Overview n Vision developed for future experiences n Idealized a floor to would include the Emergency Department, Diagnostic Imaging Services, Outpatient Lab Draw Services and a Day Hospital n Centralized Support Space n Family Space n Staff Support Space n Scheduling n Check-In Process n “The Big Top”

8. Design Integration

17. Design Analysis Key Measures for Success n Space Efficiencies n Wait Space/Check-In n Holding Rooms/Observation n Staff Lounge/Lockers n Conference Room n Staffing Efficiencies n ED/Observation Consolidation n Global Sedation – one location n Transport (time and distance) n ED -> Imaging n Units -> Sedation/Imaging n Patient and Family Satisfaction n ED n Imaging n Sedation

18. Design Analysis Space Efficiencies When evaluating the space efficiencies, a comparison was made between the shared space plan of “The Big Top” and individual spaces for each area. The spaces included: n Shared wait space n Shared check-in space n Shared public toilets n Staff lockers and lounge n The nine-bay holding area shared by sedation and imaging n Observation rooms (moving observation patients to the ED versus an inpatient unit reduced the size of the observation rooms)

19. Design Analysis Separate Big Top Program DescriptionQty.NSFTotalQty.NSFTotalDifference Waiting Area/Play Area3500187518801100775 Public Toilet6260195022606501300 Check In212030012403000 Staff Lounge330011251600750375 Staff Lockers3400150019601200300 Nine-Bay Holding Room21089245011089 Observation/Patient Room Diff.1037055501014021003450 TOTAL DGSF 14,750 7,1897,561 Space Efficiencies

20. Design Analysis Staff Efficiency n Locating the observation patients in the Emergency Department rather than on nursing units. n Placing sedation services in a single location. n Check-in/registration planned process that will be shared by Day Hospital, Outpatient Lab Draw and Diagnostic Imaging.

21. Design Analysis Patient and Family Satisfaction The final analysis involves comparing patient and family satisfaction in the current facilities with that found in “The Big Top”, once opened. It is planned that satisfaction will be measured (before and after the move) for the Emergency Department, Diagnostic Imaging, Day Hospital Services and the Outpatient Lab Draw Services.

22. Implementation Plan

23. From a Parent’s Perspective n Faith-based, family-centered community n Supportive environment for diagnostic procedures n Services will come to the patient and family n The Emergency Department n Parent will be able to stay and focus on child n Quick access to the most commonly used resources n Overall, decreased stress and anxiety is expected