The steel beams are in place at the site on Highway 45 and Pleasant Valley Road in the Town of Polk, where St. Joseph’s Community Hospital of West Bend will open in the spring of 2005.
Once the building is cased, the construction crew can begin the interior of what St. Joseph’s officials say will be the safest hospital in Wisconsin.
John Reiling, president and chief executive officer of St. Joseph’s, has been working with C.G. Schmidt Inc., Milwaukee, and principal architect Tom Wallen of Gresham, Smith & Partners, Nashville, since 2002 to implement patient safety into the design and structure of the hospital.
Reiling said he recognized the importance the physical structure of a hospital can have on patient safety and was inspired after reading a 1999 Institute of Medicine report titled, "To Err is Human: Building a Safer Health System."
"It pointed out nationally the level of safety in hospitals is not the level most people thought it could achieve," said Reiling. "The data collected showed between 44,000 and 98,000 people per year die from preventable deaths in hospitals."
Reiling said adverse events, in which an error is committed, but the patient lives, also are statistically high.
"It is becoming more of a public awareness to the point where they are starting to try to measure the design processes of a hospital and how they relate to patient safety," said Steven Chamberlin, president of C.G. Schmidt. "If the whole team commits to the cause, you can build safety into the process naturally without having to do anything extreme. If you want to be closer to providing the ultimate care, there will be justifiable premiums."
To further prevent errors and offer high-quality patient care in a hospital, Reiling organized a learning lab in April 2002 and met with 25 medical professionals from associations and hospitals nationwide to brainstorm.
"When we asked people about the issue, most were physicians in management organizations and could call up errors in which the design of the hospital was to blame," said Reiling. "Most people mentioned the amount of noise, the lack of stability within the hospital and fatigue as reasons for errors."
The final design of the budgeted $55 million St. Joseph’s took into account most factors involved with personnel performance and probability of error.
"We are very confident that when we open, our level of quality and safety will rise because of the design of the hospital and the processes we will create inside it," said Reiling. "We think for our community we have created a wonderful place to come if a person is ill.
"When we talk about people making errors, lapses or slips, whatever happens is caused by something that interrupted them," Reiling said. "A lot of factors that can cause a short-term interruption are stress, multi-tasking, fatigue and noise."
According to Reiling, the noise level in a hospital caused by thin walls and loud equipment can impact the sleep patterns of patients, causing a slower recovery.
The new St. Joseph’s will be a quiet hospital, he said. Instead of overhead paging, the hospital personnel will communicate with vibrating pagers, he said.
The strength of the steel structure is higher than most hospitals, minimizing vibration. Special ceiling tiles will absorb sound along with quiet motors within electrical equipment and carpet wherever possible.
Reiling said the more the staff at a hospital sees and interacts with a patient, it is more likely they will intervene when a patient’s condition slightly changes.
Once open, one goal for the hospital will be to keep the patient in the same room for as much of the stay as possible.
"We tried to think of everything that could go wrong in a hospital and implemented ways to prevent it," said Reiling. "A main concern was having the intensive care unit (ICU) on the floor above the emergency room. Anything can go wrong in the time it takes to ride the elevator, so we eliminated the possibility of failures through the design by placing them next to each other."
Other design factors that will enhance safety include: standardized rooms, with sinks visible to patients to assure personnel wash their hands; air and water filters; and patient rooms with a railing running from the bed to the bathroom.
The 173,443 square-foot hospital will have 80 beds, a rapid admissions area, an ambulatory surgery area and an emergency care area.
Reiling said the cancer care and ambulatory services will remain at the current St. Joseph’s site, 551 S. Silverbrook Dr., West Bend, once the new hospital is open.
The design of the new hospital also will accommodate future expansions, Reiling said.
"We have designed the hospital so that we could literally start an expansion the first day it opens," said Reiling. "On the first floor. We have the emergency room, ICU, radiology and surgery in corners of the building, so we can expand horizontally for all of the departments, depending on need."
The construction of new hospitals has been cited by critics as a key contributor to the skyrocketing costs of health care in southeastern Wisconsin.
However, Chamberlin said the design of the new St. Joseph’s will improve the hospital’s efficiency and help make health care less expensive in the long run, while reducing staff errors.
"As a builder, I know John has a passion for the hospital and has his whole team committed. You need a fully integrated approach to really optimize the patient safety features," said Chamberlin. "We’re excited about it. Our team is excited to work on a project will become a model throughout the Midwest."
Feb. 6, 2004 Small Business Times, Milwaukee
