Tuesday, May 24, 2022

Jefferson Health’s Vision For Inpatient Care

The story of how the new face of inpatient care at Jefferson Health came to be began in 2014. Then, the leadership of what was then Kennedy Health recognized that the three hospital campuses comprising its southern New Jersey system were in need of master planning.

It had been more than a decade since the organization had addressed market demand, facility assessments, and system-wide strategic planning, while the last major facility improvements were completed in 2000.

Conducted by CallisonRTKL (Washington, D.C.) and completed in 2015, the master plan for the three campuses ultimately reflected a commitment to bring advanced clinical services closer to home for southern New Jersey residents, a private patient room model to accommodate growth and consumer demand, and modern facilities with the latest technology to further enhance the patient experience.

In 2017, the system was acquired by the Jefferson Health network, a provider of primary and specialty care across the greater Philadelphia region and southern New Jersey. It was renamed Jefferson Health in New Jersey, with those three campuses becoming Jefferson Stratford Hospital, Jefferson Cherry Hill Hospital, and Jefferson Washington Township Hospital.

And the new owner agreed with the vision laid out for the system’s future. “The legacy Kennedy Health system knew there were aging facilities and equipment and a need to make upgrades to remain competitive in the marketplace and to enable clinical program expansion,” says Brian Sweeney, president and COO at Jefferson Health New Jersey (Stratford, N.J.).

With funding secured, Jefferson Health moved forward with a multiphased project that included simultaneous expansions to the Cherry Hill and Washington Township campuses, which would set the precedent for all future facilities.

“We called it the 2020 Vision for Inpatient Care at Jefferson Health,” says Ray Brower, principal at CallisonRTKL, which went on to provide architecture, interior design, medical planning, medical equipment planning, and technology design services for both projects.

Same and different

Construction for the campuses was scheduled between 2016 and 2021, with Cherry Hill breaking ground in 2016 and Washington Township a year later.

The former, a two-phase, $250 million expansion, included a new five-story atrium lobby connecting a new 100,000-square-foot medical office building (completed in 2017) with a new seven-story, 230,000-square-foot patient tower (completed in 2020).

The second phase, the $222 million Washington Township expansion, began with a new eight-story, 835-spot parking facility (completed in 2019) and was followed by a new seven-story, 240,000-square-foot patient tower (completed in 2021).

“To begin to get them to an all-private model, each campus needed 120 private patient rooms added,” Brower says. The number was based on 10-year admissions and bed demand projections for the campuses and CallisonRTKL’s assessment of facility conditions and existing private room capacity of the existing facilities.

Cherry Hill’s existing bed tower, constructed in 1958, had reached the end of its useful life. “So the new 120-bed expansion facility was a replacement facility with bed capacity growth,” Brower says. Washington Township had a significant number of existing semiprivate beds and also faced bed shortages due to overcrowding in its emergency department, so the plan for 120 additional private rooms was targeted to resolve current shortages and add rooms to achieve private accommodation, he adds.

To create standardized nursing practices across both sites (desired so staff can seamlessly transition from one facility to the next if they work across different campuses), the new bed towers house four identical floors of patient rooms with 30 beds on each floor.

While the towers are the same, the approach to the overall building architecture differed. “The exterior aesthetic of each is unique to reflect the differences in the existing campus language, community preferences, and specific design goals,” Brower says.

To reflect the Cherry Hill campus’ more modern design language, its patient tower is “slightly more progressive” in its lighting and materials palette—including precast concrete paneling with custom imprinted patterns, dark gray brick, and wood accents on windows.

For example, uplighting was installed to highlight the building’s upper cornice while a continuous light runs below the length of a signature corner stair tower. That stair tower also features a curtain wall of glass that when lit up at night reveals the zigzag pattern of the stairs against a backdrop of wood panels. “The [front-facing] location of the bed tower warranted an iconic element to serve as a branding element,” Brower says.

Primarily brick with precast accents, Washington Township’s exterior architecture offers a modern yet timeless response to the campus’ more traditional design language, comprising red brick. “We were looking for a design that was complementary to the existing facility [in terms of materials] but more contemporary,” Brower says.

Inside, the three lower floors of each building share similarities, as well, but reflect different strategic needs.

At Cherry Hill, for example, after visitors make their way through the new five-story atrium lobby, which offers a direct connection to the new patient tower on all levels, the building’s lower level houses a pharmacy, support services, and double-height cafeteria. The cafeteria offers views up to the waiting room for diagnostics and imaging on the first floor as well as outdoors to a dining area and healing garden. Its second floor is dedicated to surgical services.

The Washington Township tower takes visitors through a new covered main entrance to a two-story lobby, where the second-floor outpatient surgery center is visible. To the left, a dramatic staircase leads down to this tower’s lower level and a double-height cafeteria, which connects to an outdoor space including an amphitheater-like stepped seating area where staff can have meetings and public events can be held.

“The cafeteria, a huge amenity for both staff and visitors who are seeking respite, also becomes a public community benefit, the way it relates to the outside,” Brower says.

Privacy and point of care

In both towers, the upper four floors of standardized nursing units and patient rooms, including critical care on the third floor, acute care on floors four and five, and shell space for an additional 30 patient rooms on the fifth, were arrived at in part through visioning sessions the design team conducted with staff.

“Because we were designing standardized rooms for two institutions, we had over 120 clinical people involved in the visioning sessions for the programming design and operational concepts of those patient care units,” Brower says. “So we didn’t just have, for example, one team of critical care nurses telling us what they want. We had two hospitals of critical care. We had two of everything.”

The core of the patient unit is set up for point-of-care nursing, affording proximity of clinical support spaces (staff documentation stations, clean supply, medication preparation) to patient rooms to maximize efficiency.

“New units with 100 percent private rooms are much bigger, so point of care becomes important to minimize nurses walking extensive distances,” Brower says. With patients able to control everything from temperature to lighting to window shades through remotes, the 330-square-foot rooms (including patient bathroom) also were designed to maximize the window wall and light/visibility by nesting bathrooms between rooms. “That amenity is probably one of the nicest things we did in terms of planning,” he says.

Each floor of the towers includes waiting rooms and private family consult areas along with private staff respite spaces and staff lounges placed along the exterior walls. “From a staff perspective, there are many more amenities to support them,” Jefferson Health’s Sweeney says.

Along with moving staff respite out of the core, the new tower design also improves clinical workspaces through technology that allows for simplified, coordinated care among team members and ties back to patient rooms equipped with large LCD screens that interface with electronic health records.

Interior identities

Showcased through the selection of materials, furnishings, and other key design elements like specialty lighting and applied graphics, the interior design throughout both patient towers was designed to give each campus its own look and feel while still establishing a recognizable brand identity, says Tamra Green, associate principal at CallisonRTKL.

In the patient care and respite spaces, which are nearly identical in terms of materials palette, furnishings, and room layout, wood and warm neutral tones are accented by more subtle colors used in applied wall graphics in the corridors of the patient floors and within the patient care spaces themselves, Green says.

“Each private patient room has a nature-themed graphic placed at the footwall to support the use of biophilic principles throughout,” she says.

Meanwhile, in public spaces, while both campuses incorporate large-format abstracted nature graphics as artwork, the Cherry Hill site uses vibrant accent colors (red in the atrium cafeteria) while the Washington Township campus incorporates more natural materials like stone and wood—each a nod to community feedback heard in the design process.

Continued growth

Jefferson Health continues to move forward in its growth of the New Jersey campuses. With a ribbon cutting anticipated for summer 2023, a new $35 million cancer center is currently under construction at the Cherry Hill campus.

To support the growth at the Washington Township campus, a new ambulatory care building is being constructed in the same township. “These plans are beyond what was contemplated in the original master plan,” says Sweeney, noting that Jefferson Health has since evolved to become the largest provider of services in its region over the past five years.

The vision established at the Cherry Hill and Washington Township campuses has set the bar for all new and updated facilities moving forward, as well. “These two projects are the basis of design for Jefferson Health’s facility standards here on out,” Brower says.

Joann Plockova is a freelance writer based between Jupiter, Fla., and Prague, Czech Republic. She can be reached at joann.plockova@gmail.com.

The post Jefferson Health’s Vision For Inpatient Care first appeared on HCD Magazine.



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