Graceful and welcoming, the design of Froedtert Memorial Lutheran Hospital, Milwaukee, is best defined by logic. By taking logical steps grounded in research and economic sense, the hospital administration is providing superior service to its patients and staff. Froedtert Hospital's attention to detail has also garnered the interest of potential applicants and the community at large.Creating a Healing EnvironmentTotaling 2 million square feet of space, this tertiary care facility is an academic medical center that delivers a high level of care as well as being a teaching hospital. Teaching hospitals are unique, because they have the commitment to patient care, but they [also] have a commitment to medical education and research. That distinguishes us from other hospitals in the area,” explains John A. Balzer, vice president, Facility Planning and Development, Froedtert Memorial Lutheran Hospital. In addition to a wide range of medical services “including a cancer center, level one trauma center, neural sciences, women's health, transplants, and the home base for the flight for life” medical helicopter program “the 424-bed hospital works in conjunction with the Medical College of Wisconsin.A smooth-running facility is critical to handling the hospital's teaching and medical services responsibilities. Balzer is responsible for the procurement of finishes in construction and modernization projects as well as the equipment in those spaces. Those standards are oriented around what is cost-effective, maintainable, and logical products,” says Balzer. Froedtert Hospital was constructed in 1980 and now features approximately three dozen medical specialties.Rather than a strict standard, the facilities department focuses on competitive pricing among a small number of products in the same categories. Balzer oversees an operations staff of 35 members, the biomedical engineering staff, and the in-house food serv-ice and housekeeping departments. For maximum efficiency, Balzer outsources architecture and interior design services on a project-to-project basis.Part of the healthcare organization's commitment to patients, staff, and visitors includes creating quality indoor environments. To this end, the building operations team has worked closely with Milwaukee-based Johnson Controls since the hospital's creation. The company has installed integrated building control systems and pioneered new processes; in turn, this technology helps the hospital provide patients with high-quality care.Passion to ImproveTo measure the effectiveness of its interiors, Froedtert Hospital is involved with the Pleasant Hills, CA-based Center for Healthcare Design's Pebble Project. The Pebble Project is a research program that gives examples of healthcare interior design that have made a difference in the quality of care. I am a very passionate person when it comes to the healthcare environment,” says Balzer.The Pebble Project is one of the first initiatives to scientifically measure the impact of the physical environment. Adds Balzer, As time goes on, it will be more standard in the industry; and to me, it is very important that as we go forward with new construction and modernization to know that we are putting our money in the right places.”Froedtert Hospital was one of the early members to join the project. There have been many medical studies that show the better the emotional state of patient[s], the better they recuperate physically,” says Mark McLaughlin, media relations, Froedtert & Medical College. Froedtert Hospital has a strong focus on outcome-based criteria regarding its interiors. Froedtert Hospital's five-year, multi-million dollar project involved the demolition of Doyne Hospital and the building of a new North Tower addition for patient beds; a new 60,000-square-foot cancer center; new on-site warehouse; new clinical laboratory; and renovated food service.While the North Tower design by the Milwaukee office of Hammel Green Abrahamson Inc. (HGA), headquartered in Minneapolis, is not an official Pebble Project facility, the hospital has done extensive surveys of patients in association with healthcare survey consultant Press Ganey Associates, South Bend, IN. Press Ganey intensively surveyed patients and their family three months before and three months after the relocation process to the five-story addition.The hospital's Press Ganey scores increased in a significant way, offering proof that the more comforting the environment, the better the healing process will be. In patient satisfaction, the Press Ganey score rose from 78 to 87. There was a similar, substantial increase in staff satisfaction rates at the addition.The North Tower facility also had a beneficial effect on the hospital's recruitment goals. The hospital human resources department launched a program entitled, 100 Nurses in 100 Days,” and used the North Tower as a recruitment tool. Job fairs for medical professionals featured a tour of the new facility with its beautiful views in patient and staff areas.We were surprised by how many people that we were recruiting commented about it and said how much they would like to work here,” says McLaughlin. The recruitment program resulted in the recruitment of 130 nurses. To support employee retention, the hospital is creating rooms for staff members with views to nature.In light of these benefits, Froedtert Hospital has re-examined its original structure and has decided to modernize its 10 nursing units one at a time. Each unit consists of 28 bedrooms and a nursing station. This renovation is under the auspices of the Pebble Project and is scheduled for completion in 2006.We are incorporating a lot of the things we learned and implemented in the North Tower into the remodeled units, but we are taking it a step further now,” says Balzer. Since Froedtert Hospital is renovating each unit individually, the hospital planners are surveying each individual nursing unit “staff and patients “and getting baseline data. Drawing upon the feedback derived from each unit modernization, the hospital will be able to tweak the modernization process for optimal results.I am surprised about the number of facilities that will plan an addition or a building without the input of the people who will be working there,” says Balzer. Froedtert Hospital places a premium on end-user involvement in the design process.With architects and interior designers, Balzer stresses that the configuration of spaces be efficient and convenient for the staff. For example, before the North Tower construction, the hospital set up a 1:1 full-scale model of a patient room with a real hospital bed and enticed the staff to inspect the model and fill out a comment card. Each comment card was evaluated and people in the project team manned the mock-up room to answer questions. Design meetings with end-users were also held in the mock-up room so suggested changes could be easily understood and made instantly.A Healthy PrognosisIn addition to supporting the needs of the patients and staff members, Froedtert Hospital values the needs of the patients' families and visitors. In the North Tower, each floor has a space with lovely vistas called the living room, expressly designed for the patients' families. It is nestled within the inpatient bedrooms, but it is the ˜living room' where the patients and families can go to get on the Internet or gaze out the window or sit and visit,” says Balzer.As part of its mission to support hospital visitors, the hospital has comfortable family lounges separate from the inpatient environment to accommodate larger visiting groups. The hospital has created a family center near its intensive care unit with rooms for overnight stays; whiteboards so that doctors can better explain treatment; Internet access; and private areas for confidential conferences. Hospital staff serve as a resource to family members offering information on hotels for extended visits.In the past, families would congregate in the hallways. Now, they have an area to call home base,” says Balzer. Patient relations, the finance department, the chapel, and pastoral care are also gathered near the family center to support the patients' families. The family center also provides space for kids with child-sized furniture and a connection to outdoor courtyards. Adds Balzer, It is important to treat the whole person and that includes the family.”Handling 22,000 inpatients and 500,000 outpatients annually, the next large project on the drawing board is an outpatient orientation development. Currently, Froedtert Hospital is seeing double-digit growth in its outpatient business and needs to expand to support that growth. Fortunately, the hospital has been designed to accommodate future expansion.We are always looking into the crystal ball so that we site the facilities accurately and lay the utility infrastructure for future growth,” says Balzer. By making logical and sound facility decisions and placing a premium on the emotional health of its staff, patients, and their families, Froedtert Memorial Lutheran Hospital is able to deliver stellar healthcare serv-ice and ensure continued growth.Regina Raiford Babcock ([email protected]) is senior editor at Buildings magazine.