Design to elevate people’s potential | EUA 1 MICRO-HOSPITAL EXPERIENCE Architectural + Interior Design
2 Micro-Hospital Experience EUA has extensive experience with emerging facility models such as micro hospitals. We bring value to our healthcare clients in the following key areas: SPECIFIC FACILITY EXPERTISE In addition to our work in general acute care and critical access hospitals, we have also completed a number of micro hospitals. Project types have included new freestanding buildings, major additions, and interior renovations; development models have included third-party developers as well as health system direct ownership. In the course of these projects we have worked through various regulatory compliance details in multiple jurisdictions. BREADTH OF HEALTHCARE EXPERIENCE Our dedicated healthcare team of over 30 individuals has extensive experience in every type of healthcare project, including diagnostic and interventional imaging equipment replacements, outpatient clinics, and virtually every hospital department. We bring this general healthcare knowledge to bear on the specific nuances of micro hospitals. COST EFFECTIVE DESIGN We know that development and operational costs are of particular concern when considering the micro hospital and other ambulatory care models. We take our clients’ goals and drivers very seriously and our designs are fully informed by them. To that end, we have designed facilities at a range of budgets, optimizing our designs to maximize return on investment. COLLABORATIVE APPROACH We receive high marks from our clients and construction partners for our positive, team-oriented attitude and ability to work as a trusted partner along with others on the design and development team. As a partner in the process, our goal is to make this a positive experience for not only the project team, but the staff and patients who will be utilizing the micro hospitals in the future. We look forward to further discussions about your healthcare facility needs and how EUA can support your goals and vision.
Design to elevate people’s potential | EUA 3 EUA BY THE NUMBERS: 116 Years in Business 270+ Talented Employees 140+ Registered Professionals 40+ LEED® Accredited Professionals 7 Client Markets 5 Office Locations Our core values have been the same for over a century: always do the right thing; treat clients, partners, and communities with respect; and deliver quality planning, design and engineering solutions. We’re committed to the markets we serve, including education, community, healthcare, industry, learning, living, science + technology and workplace. We believe that informed and effective design elevates people’s potential. We’ll make sure this happens by asking you a lot of questions about what your space needs. We encourage you to share your thoughts and ideas — our design philosophy always puts your visions first. eua.com milwaukee : madison : green bay : denver : atlanta
4 Micro-Hospital Experience HEALTH + WELLNESS STUDIO EUA’s dedicated healthcare team consists of architects and interior designers with a variety of health and wellness experience. From campus-wide facility master planning to new construction and renovation projects, to ambulatory care centers and specialized clinics for cancer care and women’s health, our staff has dedicated significant time to the pursuit of advancing health and wellness environments across the country. With diverse backgrounds and a wealth of experience, our team has the knowledge, design expertise and technical skills to develop spaces for the future. 30+ DEDICATED HEALTHCARE EXPERTS 1,200+ HEALTHCARE PROJECTS IN 10 YEARS EUA SERVICES Our clients hire us for our expert advice, problem-solving skills and creative planning and design solutions. We are strategic business partners with our clients, focusing exclusively on architecture and using consultants for engineering and specialty design needs. We offer a comprehensive range of design-focused services: • Historic preservation • Interior design • Lab planning • Master planning • Programming • Project management • Re-zoning • Site planning • Site selection • Space planning • Strategic planning, marketing + graphic design • Sustainable design • Workplace + corporate design standards • Workplace strategy • ADA / accessibility studies • Architectural design • Building code reviews • Building systems coordination • Change management assistance • Community engagement + outreach • Computer animation + visualization • Construction administration • Contractor selection • Environmental Branding • Existing facility surveys + field verification • Facility assessments • Feasibility studies • Furniture selection “OUR PEOPLE ARE OUR GREATEST ASSET.” Greg Uhen, CEO, EUA
Design to elevate people’s potential | EUA 5 TOP 5 CONSIDERATIONS FOR MICRO HOSPITAL DESIGN It’s been about ten years since micro hospitals were first introduced, shrinking the service of a full-scale hospital into a “micro” sized setting (typically 10,000 - 20,000 sq ft). With a variety of benefits for systems including quick geographic expansion, lean staffing for efficiency and return on investment, a catalyst for introduction of new patients to the system and reportedly higher satisfaction scores, the healthcare industry has seen an increased adoption of these facilities. Here are a few best practices: CONSIDER POSITIONING The geographies that typically work best are ones where a fairly robust network of assets is in place with physicians, ambulatory care and acute settings. But there are a variety of models in how a micro hospital can support a system, from a standalone facility, to an addition to an existing outpatient to an anchor to an ambulatory development. It can also be used entering a new market or bolstering areas with lower market share to reach new patients. PLAN FOR EFFICIENCY At their core, micro hospitals are meant to harness efficiencies and reduce waste for a system. One area this can be done is in supply management. These facilities don’t need to have a lot of supplies stockpiled or the typical storage of a hospital system; and when unnecessary cabinets and cubbies are built in there is a tendency to fill them with unneeded supplies. Also, when launching a new micro hospital, consider not staffing all inpatient rooms until the need exists. AVOID OVER ENGINEERING When designing these facilities, while they are intended to replicate the hospital setting, they do not need to meet the needs of all patients at all times. It’s important to hold true to the model; with an understanding that this facility will treat patients that can be treated, while arranging for immediate stabilization and transfer for other patients. Over engineering these facilities can increase the break even point, slow patient throughput and hurt patient satisfaction and employee engagement. BUILD CONSENSUS A critical component to the success of a micro hospital is the understanding at the leadership level of the model as well as full support at all levels of the organization, including physicians and other clinical staff. As these facilities are scaled down versions of a larger hospital, there are efficiencies that must be maintained in order to be successful, leadership needs to understand these inherent limitations at project onset and avoid the desire to add unnecessary services and components to support “what if” scenarios. CRAFT THE MESSAGE Finally, once the micro hospital is ready to operate, to successfully integrate it into the facility mix and build adoption, systems need to coordinate and communicate with the community and local regions to increase knowledge and awareness of what this facility is available to offer, through a coordinated campaign to educate on the benefits and offerings.
6 Micro-Hospital Experience We are proud to have a long-standing relationship with Froedtert & MCW and have been their trusted partners in designing multiple community hospitals across southeastern Wisconsin. The Pewaukee Hospital project was the first of its kind, establishing a communitycentered model of care throughout the provider’s system. Understanding it can be a difficult or even daunting experience for some patients to come to the main campus, the micro-hospital model brings accessible, acute care closer to home for many people. It also allows the Froedtert & MCW system to distribute care across multiple facilities, reducing high patient volumes at their main campus. This Pewaukee Hospital provides core services, including an emergency room with seven beds, an imaging suite and an inpatient observational unit. It also has a fullservice pharmacy, around-the-clock care, and easy parking for patients’ convenience. The centrally located nurses’ station allows them to respond quickly to patient needs. Clerestory windows in most spaces allow daylight to fill rooms and corridors without sacrificing patient privacy. DETAILS 18,025 sq ft Pewaukee, WI • Emergency department • Inpatient care • Imaging (CT, X-Ray, Ultrasound) • Pharmacy • Lab • Isolation rooms • Trauma rooms • Decontamination room • Food service FROEDTERT + MEDICAL COLLEGE OF WI PEWAUKEE HOSPITAL COMMUNITY HOSPITAL + NEW CONSTRUCTION Design + construct the first standalone micro-hospital in the state
Design to elevate people’s potential | EUA 7 Partnering with the University of Florida Health (UFH) and Covider Health, we’re crafting a strategically located three-story healthcare facility in Ocala, Florida. This new community hospital and outpatient clinic will extend UFH’s reach and offer the local community essential and specialized medical services. The ground floor will house a free-standing community hospital with a surgery center and imaging lab. Above, two floors of clinical space will offer a range of outpatient services. To instill confidence and continuity, the building’s exterior incorporates design elements from other UFH locations, making the brand instantly recognizable to patients. Operational and energy efficiency are pillars of our design strategy. The layout promotes seamless staff movement between emergency and inpatient departments and allows flexible use of inpatient beds during high-demand periods. Energy-saving measures include thermally efficient exterior materials and a specialized HVAC system, laying the groundwork for future solar panel installations on the roof. DETAILS 165,000 sq ft total 60,000 sq ft community hospital 105,000 sq ft outpatient clinics Ocala, FL • 10 emergency exam rooms • 10 inpatient rooms + 4 operating rooms • Perioperative area • Imaging • Pharmacy • Lab • Food service UNIVERSITY OF FLORIDA HEALTH OCALA NEIGHBORHOOD HOSPITAL COMMUNITY HOSPITAL + MOB + NEW CONSTRUCTION Expand access to quality healthcare with a focus on efficiency + patient comfort Site Plan by ETM, Civil Engineer
8 Micro-Hospital Experience FROEDTERT COMMUNITY HOSPITAL OAK CREEK, WI Single story | 13,000 sq ft addition to existing I-2 construction Imaging + attached MOB / ASC Eight (8) ED Exam Rooms Nine (9) Inpatient Beds • Isolation Exam Room + Secure Exam Room • Trauma Room • Isolation Inpatient Room • Behavioral Health Inpatient Room Diagnostic Imaging: CT + X-Ray Support: Lab, Pharmacy, Decontam + Warming Kitchen Owner: HSA PrimeCare | Tenant: Froedtert Health FROEDTERT COMMUNITY HOSPITAL MEQUON, WI Single story | 17,300 sq ft Eight (8) ED Exam Rooms Nine (9) Inpatient Beds • Isolation Exam Room + Secure Exam Room • Trauma Room • Isolation Inpatient Room • Behavioral Health Inpatient Room Diagnvostic Imaging: CT + X-Ray Support: Lab, Pharmacy, Decontam + Warming Kitchen Owner: Ryan Companies | Tenant: Froedtert Health FROEDTERT COMMUNITY HOSPITAL NEW BERLIN, WI Single story | 13,800 sq ft Nine (9) ED Exam Rooms Seven (7) Inpatient Beds • Isolation Exam Room + Secure Exam Room • Trauma Room • Isolation Inpatient Room • Behavioral Health Inpatient Room Diagnostic Imaging: CT + X-Ray Support: Lab, Pharmacy, Decontam + Warming Kitchen Owner + Tenant: Froedtert and Medical College ADDITIONAL MICRO HOSPITAL EXPERIENCE
Design to elevate people’s potential | EUA 9 Advocate Aurora Health Kenosha Kenosha, WI Ascension All Saints Hospital Racine, WI Ascension Columbia St. Mary’s Milwaukee Milwaukee, WI Ascension Columbia St. Mary’s Ozaukee Mequon, WI Ascension Elmbrook Memorial Hospital Brookfield, WI Ascension Franklin Hospital Franklin, WI Ascension Heart Hospital Wauwatosa, WI Ascension St. Francis Hospital Milwaukee, WI Ascension St. Joesph’s Hospital Marshfield, WI Ascension St. Joesph’s Regional Medical Center Milwaukee, WI Aspirus Langlade Hospital Antigo, WI Aspirus Medford Hospital Medford, WI Aspirus Riverview Hospital Wisconsin Rapids, WI Bay Area Medical Center Marinette, WI Beaver Dam Community Hospital Beaver Dam, WI Beloit Health System Beloit Memorial Hospital Beloit, WI Columbus Community Hospital Columbus, WI Edgerton Hospital and Health Services Edgerton, WI Fort Healthcare Fort Memorial Hospital Fort Atkinson, WI Froedtert Hospital Milwaukee, WI Froedtert Kenosha Hospital Kenosha, WI Froedtert Pleasant Prairie Hospital Pleasant Prairie, WI Holy Family Memorial Medical Center Manitowoc, WI Mayo Clinic Health System Arcadia, WI Mayo Clinic Health System La Crosse, WI Mayo Clinic Health System Marshfield, WI Memorial Hospital of Latayette County Darlington, WI ProHealth Care Oconomowoc Memorial Hospital Oconomowoc, WI ProHealth Care Rehabilitation Hospital of WI Waukesha, WI ProHealth Care Waukesha Memorial Hospital Waukesha, WI Reedsburg Area Medical Center Reedsburg, WI SSM Health St. Mary’s Hospital Madison, WI SSM Health Stoughton Hospital Stoughton, WI Stoughton Hospital Stoughton, WI University of Iowa Hospitals & Clinics Iowa City, IA Upland Hills Health Dodgeville, WI UW Health - University Hospital Madison, WI Watertown Regional Medical Center Watertown, WI ADDITIONAL ACUTE CARE EXPERIENCE
10 Micro-Hospital Experience As the world continues to change, we must continue to adapt. Consumers are looking for conveniences and that means healthcare organizations are expanding services to communities where they live. In recent years, the healthcare industry has seen the steady rise of neighborhood hospitals, also known as microhospitals, across the country. EUA is currently supporting clients through exploring ideal design and layouts of the neighborhood hospital concept which recently arrived in the Midwest. From our involvement on planning and design for several neighborhood hospitals, Healthcare Studio Director Paul Stefanski and I would like to expound on what these facilities entail and how they impact an overall healthcare organization’s system-level planning strategy. WHAT IS A NEIGHBORHOOD HOSPITAL? Neighborhood hospitals, or micro-hospitals, are just as they sound—literally small, 24/7 inpatient settings, strategically placed within a community. To be classified as a micro-hospital, the facility must include the following: inpatient rooms, discharge planning, diagnostic imaging, lab, pharmacy, food services and the ability to follow decontamination and organ procurement protocol. Drawing from recent experience, we have identified several unique propositions neighborhood hospitals give to existing healthcare systems. THE IMPACT ON HEALTHCARE SYSTEMS Given their small scale, neighborhood hospitals can be a strategic addition to a healthcare system’s portfolio for several reasons. First, neighborhood hospitals can help systems enter a new geographic market and introduce services without having to commit to building a large, traditional hospital, serving as a means of limiting expenditures while testing the waters in a new community. They can also help fill in geographic gaps in care, allowing systems to expand their reach, supporting communities as well as their own system better. WON’T YOU BE MY NEIGHBOR? THE RISE OF NEIGHBORHOOD HOSPITALS Renee Kubesh, AIA, CDT, EDAC
Design to elevate people’s potential | EUA 11 Another benefit to neighborhood hospitals is that they help relieve some of the pressure from main hospital emergency departments (EDs) and observation beds. For some people, it may even be a crucial matter of lifesaving time having a facility that can treat emergency situations closer to home or work. Neighborhood hospitals can provide a comparable level of care to a traditional hospital while also serving as a triage center to immediately treat patients and assess if they need to be transferred to a higher, more specialized level of care. In many markets, people only have the option to go to the main campus EDs, unsure of what they need. Given the smaller geographic service area, patients will travel less and likely wait less, receiving care more quickly, as well as a guided plan for future care needs. Neighborhood hospitals also have the advantage of being customizable beyond the federal requirements to meet the specific needs of a healthcare system, their target market and key demographics. While all neighborhood hospitals have the core components that define them, many also provide additional services to accommodate the specific population they serve. Since these compact facilities require smaller, more efficient care teams, healthcare workers likely wear multiple hats. This may not be the ideal fit for all healthcare workers, but employees who enjoy this type of work will thrive in this environment. In addition to having a diverse role, working at a neighborhood hospital may appeal to those looking for a shorter drive, intimate team dynamic and opportunities to cross train. For example, nurses may be able to care for both inpatient and emergency patients in the same day, unlike in a traditional hospital where care is more specialized. While neighborhood hospitals can be fiscally advantageous to healthcare systems operationally, patients can also benefit from the rising popularity of these compact, efficient facilities. One of the largest advantages of neighborhood hospitals is that they help alleviate the stigma many people associate with getting care at large facilities on campus environments. By making a facility smaller, easier to navigate and more accessible, it becomes more approachable. For many people, going to the doctor’s office, no matter the reason, is anxiety inducing enough, let alone having to find parking in one of multiple garages at a large campus with multiple facilities where they navigate multiple entrances, wings and floors. Given the size of neighborhood hospitals and the single main entry, barriers are reduced for patients, family and friends. INTRODUCING NEIGHBORHOOD HOSPITALS TO YOUR FACILITY MIX As we continue to learn about this care model, we anticipate a growing popularity of these compact and efficient feeder hospitals to support system strategic goals and geographic reach. For systems considering adopting this approach, we recommend partnering with experienced professionals to understand the nuances and learning from past developments. Since this is still rather uncharted territory for many systems, having experts on board early will help to strike the balance between identifying and mitigating potentials hurdles and speed to market. The need for healthcare will remain constant, but with proper design and operational efficiencies, these facilities have the potential to positively shift the experiences for healthcare professionals and administrators as well as patients.
12 Micro-Hospital Experience KRISTIN DUFEK, AIA, LEED AP President [email protected] | 414.291.8142 333 E Chicago Street | Milwaukee, WI 53202 TONY BREITLOW Healthcare Studio Director [email protected] | 414.291.8171 333 E Chicago Street | Milwaukee, WI 53202 madison : milwaukee : green bay : denver : atlanta eua.com