ICU Addition

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Hutchinson Regional Medical Center plans $23 million ICU, electrical upgrade

Hutchinson Regional Medical Center officials have announced plans for a $23 million project to replace the hospital’s Intensive Care Unit and to upgrade the facility’s emergency power system.

The hospital will use primarily revenue bonds to fund the work, which will start next year.

The project, expected to take two years to complete, will create a new 25,000-plus-square-foot, 18-bed state-of-the-art ICU, constructed in the round.

The why

Built where the existing unit stands, as well as extending into new space to the north, the new ICU will replace an intensive care unit originally built in 1975.

“When the ICU was originally built it was intended to handle only the basic intensive-care-type patients,” said Joann Rivera, an ICU nurse at the hospital for 26 years who was involved in planning for the new unit. “As we’ve grown and developed our programs, such as cardiovascular and open heart, it’s important to grow along with that.”

The types of patients the hospital is seeing are changing, and the facility needs to respond to that change, said Ken Johnson, Hutchinson Regional Healthcare System president and CEO.

“What we know is our inpatient census is declining and it will continue to decline,” Johnson said. “What we have instead are the sickest patients, and we don’t currently have the best means to address the sickest patients.”

The future of hospital care, agreed Kim Moore, vice chair of the hospital’s board of directors, is going to be patients needing more intensive care, rather than chronic disease care, “and we want to position the hospital to be at the forefront.”

“Especially as we look to the next 10 to 20 years down the road,” Johnson said. “Developing this unit will give us the opportunity to take care of our community, to take care of patients in Hutchinson as opposed to sending them to other facilities to receive the same level of care.”

Development of a new ICU was part of the hospital’s long-term master plan, but when the ICU temporarily relocated to the pediatric, women and children area on the fourth floor during expansion of the emergency room, the need became even clearer, Rivera said.

It is also an opportune time because bonding rates are so low, Johnson said.

“Our bond counsel told us rates on financing are as low as they’ve been, and it’s an excellent time to consider this type of transition,” he said.

The plan

When they made the decision almost a year ago to pursue a new ICU, part of the planning team included the ICU staff, Rivera said.

“As ICU director, I asked my staff to pull a team together and we’ve been able to be part of the process from the beginning,” she said.

That, in part, led to the round design of the unit.

“It’s a design we felt is most patient-safe and patient-friendly,” Rivera said. “To be able to visually see the patients, for the nurses to have a direct line of vision, is so important.”

“Making the care of patients more efficient and better was a key issue in the (design) decision,” said Moore, who noted he was impressed by the number of ICU staff involved in planning. “It’s not cheaper to do in a round design, but it creates clear lines of sight for the nurses, who can see patients from any part of the facility.”

The design includes several tiers or workstations, with electronic monitors in the center, a centralized area for physicians to collaborate and for ancillary staff, such as dietitians, social workers and pharmacists.

“There are two tiers between each room,” Rivera said. “There’s a station outside of each room and the nurses are there instead of in the center, and then a place for physicians and staff to come through and work closely with us. The nurses are more bedside, and have the ability to document at bedside.”

The rooms

The new rooms will be nearly double the space of the existing units, going from 200 square feet to between 300 and 400 feet.

They will also feature over-the-bed booms to run cables and tubing – rather than lines coming out of the headwall – allowing easier access to patients. The plan calls for plumbing all rooms to allow for dialysis.

“When you talk to a lot of nurses they’re concerned about so many wires and cables and cords,” Rivera said. “To be able to get to the patient is difficult if they’re tethered to the wall. That’s the purpose of the booms, which are very futuristic-looking.”

Having more space for family was also important, she said, because it helps keeps patients calmer, reducing anxiety and promoting healing.

Another unique aspect of the design is placement of the room’s bathroom, directly to the right of the patient’s bed.

“There is data that shows if a patient can see where the bathroom is, they are less likely to try to get up,” Rivera said. “Just knowing it’s there, where they can see it, helps.”

“There was a lot of research went into (the design),” Rivera said. “A lot of people spent lots and lots of hours reading literature about best practices.”

The round design also allows each room to have its own window, which will look out on a new lawn. Plans also call for a “respite garden” on the south side of the unit.

Other aspects

Part of the plan also includes moving the hospital’s CT and MRI scanners closer to the emergency room and ICU, allowing quicker access for stroke patients. The upgrade will also include adding full telemedicine capabilities, said Sue Wray, the hospital’s director of communications.

The new design will likely lead to a need to increase ICU nursing staff, but it will also act as a recruiting tool, for both nurses and physicians, Rivera and Johnson said.

“This project brings state-of-the-art technology to our community,” Johnson said. “It is also a tremendous avenue for the training and recruitment of staff. It’s just a wonderful environment for medical providers to work in and be able to treat patients and interact with families.”

“It’s very exciting,” Johnson said. “We’ve been talking about it more than a year, first getting an internal group to explore the options and making site visits. The first thing we did was really connect with an architectural firm and construction manager. That was the team that helped us move forward.”

The general contractor and construction manager is Arkansas-based Nabholz Corporation, which the hospital partnered with for the emergency room remodel, Johnson said. The architect is Health Facilities Group (HFG), headquartered in Wichita, while the engineer for the electrical upgrades is Professional Engineering Consultants, P.A.

“We’re not going to just go into the existing space and remodel it,” Johnson said. “We’re really starting over and adding square footage, adding a new footprint to the building. It is really an advantage because we don’t have to phase the project, which really increases the cost and creates a cumbersome workflow. We’re already out of that space, so we can go in and do what we need to start.”

The current 13-bed ICU will remain on the fourth floor during the build.

The $6 million electrical project is also “a very significant improvement,” Johnson said.

“We’re upgrading to current standards our ability to have emergency power, and normal power on safe circuits,” he said. “It also improves our ability to manage our power and distribution of electricity to our facility more effectively.”

“It isn’t a glamour feature, but it’s important,” Moore said. “It makes sense to do it at the same time, to coordinate the construction simultaneously.”

Funding

They will need to work out financing before ground is broken, Johnson said. They expected to complete that by the end of the year, with construction starting early next year. A formal groundbreaking has not been set.

The bonds, which will be either 15- or 30-year, will be a type of hospital municipal bond, sold by the city, though the city will have no liability for the debt, Johnson said. Revenues from hospital operations will retire them. The City Council must approve their issuance.

“It doesn’t cause any additional taxes for our citizens,” Johnson said. “It’s just a vehicle to be able to issue tax-exempt bonds.”

The Hutchinson Hospital Foundation will also contribute $4 million to the project.

“We’ve done that numerous times through the history of the foundation, which was formed shortly after the hospitals merged,” said Foundation President Jim Gilliland. “That’s our mission, to receive gifts and memorials from people who have a good association or history with the hospital and want to give charitably. We accumulate that, invest it, and, when the need arises, offer help.”

The $4 million gift is not the foundation’s largest, Gilliland noted. That was a $4.775 million gift to Chalmers for radiation equipment. The foundation currently has about $22 million in assets.

“It’s an exciting project,” Moore said. “From my experience, watching the kind of health care found in the county, this is the kind of investment Hutchinson Regional needs to make. It is where hospital care is being driven. To get in a position to be a regional leader is important.”

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