Test First, Build Later: Group Simulations Help Refine Design

At a hospital known for innovation, no idea gets implemented without rigorous testing. The same is true for Packard Children’s expansion. In planning the layouts of the new patient rooms and operating suites, life-size mockups were constructed off-site and assessed by representatives of everyone who would use them: surgeons, radiologists, nurses, even parents.

But the mockups are being used for more than just a walk-through. More than 800 people took part in a number of scripted, realistic scenarios to see what worked—and what needed to be changed. Feedback from the simulations allowed the planners to make changes in the design before any actual construction begins—saving millions of dollars.

“Because of the size and the scale of the expansion, this process is really vital. No one knows how equipment should be laid out better than the people who actually use it,” says Jill Sullivan, vice president of hospital transformation. “There was no shortage of opinions, observations, and recommendations. Not one room stayed as originally designed.”

In the patient rooms, caregivers acted out every kind of contingency. Were the monitors easy to access? Was the bathroom big enough for a parent to sit by the tub? If a wheelchair topped over, was the door wide enough for nurses to help? Based on their feedback, monitors were moved overhead to allow 360-degree access to the child’s bed and bathrooms were reconfigured for a more logical floor plan. Doors were made extra-wide, and reading lights and an additional TV console were placed near the spare bed.

“In some of the scenarios, we know what needed to be changed within minutes,” says Denise Bickert, MSN, RN, director of pediatric perioperative services.

In the operating rooms, surgical teams went over details large and small to provide absolute safety and efficiency while re-enacting a number of surgeries. Based on team feedback, MRI magnets were repositioned, lights and screens were moved for better visibility, electrical cords were lengthened, cables were reorganized, and room controls were centralized. Even the ceiling was changed to better accommodate the weight and mobility of the imaging equipment.

“We had a number of walkthroughs and asked every sort of question,” says Michael Edwards, MD, chief of pediatric neurosurgery. “The scenarios allowed us to make important changes so the ORs will be logical and well organized once we actually start using them.”