Transcript Making A Title Slide - Northwestern Memorial Hospital

Inpatient Psychiatry Redesign
Project Update
Galter Project Guiding Principles
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Provide an environment of safety and quality excellence through the physical
design, operational processes and technologies
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Enhance the patient experience by creating an environment that recognizes the
patients individual physical needs as well as their emotional and spiritual needs
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Provide an environment that supports operational excellence
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Advance the art and science of healthcare delivered by:
– Incorporating the successes/lessons learned from previous NMH projects
– Integrating evidenced based innovations from benchmark organizations
– Creating new design/operating/technology innovations (becoming the benchmark – best practice)
Provide flexible/adaptable spaces and infrastructure to accommodate the
dynamic nature of healthcare delivery
Provide an environment that positions NMH as the hospital of choice for staff and
physicians
Contemporary Behavioral Health
Design Elements
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“Mall treatment” and neighborhood concept
On-stage, off-stage design
Access to natural light
Light, airy environment that calms
Maximized patient visibility
Key Design Components
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Due to existing physical properties, the structure does not
allow for patient rooms in either north corner due to safety
concerns
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Chose inboard bathrooms to preserve windows and natural
light for patients
• 29 beds
• 2 rooms are semi-private to accommodate patients that
would clinically benefit from a roommate
Key Design Components
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Rooms are smaller than normal med-surg rooms due to the
specialty treatment requirements for psychiatry
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Maintain code requirements
Majority of treatment for psychiatry patients is in group and milieu rooms;
time in room is limited except for sleeping
• Appropriate ratio of ADA compliant rooms are maintained –
2 singles and 2 doubles (2 double rooms are quite large due
to existing structures and can accommodate ADA facilities
easily)
Key Design Components
• On-stage off-stage concept and improved staff flow
• Address life-safety divisions (fire doors) to remove need for
additional secure doors in treatment mall
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Enhanced operational efficiency and patient safety
Northeast corner is hidden between mechanical shafts and
elevators and is not a viable option for any patient activity
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Moved internal conference room to the corner, freeing up space closest to
nursing stations for support activity such as report room, patient belonging
storage
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Allows off-shift/evening hours use for external/community entities, such as
NAMI and/or AA
Psychiatry Update
Presented at
Stone Institute of Psychiatry
Employee Open Forums
November 8, 2007
By
Maureen Slade and Ronald Krasner, MD
Agenda
• Welcome
• New Chairman – Department of Psychiatry
• Inpatient Psychiatric Services
• Enhanced Outpatient Services
• Questions and Answers
Chairman Selection
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John G. Csernansky, MD
– Washington University School of Medicine, St. Louis Missouri
– Gregory B. Couch Professor of Psychiatry, Professor of Neurobiology,
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Department of Anatomy and Neurobiology
Director, Silvio Conte Center for the Neuroscience of Mental
Disorders
Site Principal Investigator, Treatment Units for research on
Neurocognition and Schizophrenia (TURNS)
Chicago Native
Northwestern Graduate (BA, Chemistry)
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Likely to start February or March of 2008
Inpatient Psychiatric Services
• Galter Pavilion, Floor 13
• 30 Inpatient Beds
• Estimated move Spring 2010
• Beautiful, state-of-the-art, healing environment for
psychiatric patients
Enhanced Outpatient Services
– Offer a short stay unit in the ED to more appropriately
diagnose and link ED patients to the best treatment
options
– Provide Intensive Case Management to our most at risk
patients to support a seamless transition to treatment
– Develop step-down services through a Partial Hospital
Program that serves acute patients
– Improved Access to Outpatient Treatment
– Expanded Emergency Housing Programs and actively
link patients to housing options
Psych ED DMAIC Project
• Goal – Care of the Psychiatric patient in the ED is timely, safe and
effective
• LOS varies between 9 and 15 hours based on disposition type
• Implemented the project in July 2007
• Staff highly involved in defining issues and data collection which
completed in Oct 2007
• Important take away – 69% of Psych patient in the ED are medically
complex therefore 31% of the patients may be amenable to a fast
track for medical clearance
Overview of Initial Process
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Director held meetings with inpatient managers, systems
coordinator, clinical coordinators, and staff educator to
explore existing space, discuss what does not work and
ideas to improve care
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Group held smaller meetings with frontline staff and reported
back findings
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Began meetings with architects in September 2007 and
started discussions with functional and space programming
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2 site visits – Evansville State Hospital, Evansville, IN and
Avera-McKennan Behavioral Health, Sioux Falls, SD
Overview of Design Process
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Knowledge gleaned from site visits used to begin
adjacency/concept designs with architects in early
November 2007
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Schematic design process began and nearly finished in
December, 2007
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Brought in physician leadership and Residency Training
Director for further feedback and refinement
• Process slowed by issues with shafts
• Asked to test-fit a Psych ED within the floor