New and Noteworthy

Spring 2011

“Developing Best Practices for Expanding a Children's Hospital "

Laura Poltronieri, AIA and Rick Majzun Vice-President Strategic Operations and Planning at St. Louis Children's Hospital will be presenting at the NACHRI Creating Connections Conference in Baltimore, Maryland, March 2011.

This presentation will discuss how challenges including, rapid volume growth, and a desire for all private rooms, can be addressed within tight capital constraints. Advanced planning tools such as scenario planning, and simulation modeling will be discussed.

Winter 2011

“A Research Study Examining How Unit Design Effects Family and Staff Presence in Pediatric Intensive Care Units"

Laura Poltronieri, AIA to present on January 28th, at The 24th Annual Gravens Conference on The Physical and Developmental Environment of the High Risk Infant, Clearwater Beach, Florida.

Changing physical models, specifically private patient/family rooms in both PICU and NICU, are being designed to address issues of family-focused care, patient privacy and infection control. The move to single family room NICU's at numerous hospitals across the country was in many instances preceded by a similar move to single family room PICU's. Much can be learned from research already completed in these PICU environments.

Key design issues which highlight similarities as well as differences between NICU's and PICU's settings will be contrasted.

Spring 2010

“PICU Design: Influence on Patient Outcomes and Staff/Family Satisfaction "

Laura Poltronieri, AIA and Charles Schleien MD., presented in March at at NACRHI 2010 Creating Connections Conference in San Diego, California.

This presentation summarized the research finding of a recent study which documented the impact different physical models of PICU design have on family and staff presence and behavior in the PICU environment.

Summer 2009

“Addressing Emotional and Spiritual Needs of Patients and Families through the Design of Children’s Hospitals"

Laura Poltronieri, AIA presented in August at the The 4th International Conference on Patient- and Family-Centered Care in Philadelphia, Pennsylvania.

This presentation provides a case study of how the emotional and spiritual needs of patients and families at the Penn State Children’s Hospital are being addressed through the implementation of 50 operational initiatives. These new and responsive initiatives influenced not only the design of the new children’s hospital building but the design team which the hospital selected to implement its intentions.. The presentation will include: patient and family stories, gathered through the design process as well as an overview of current patient and family focused national design trends and an interactive audience sharing session as the basis for the exploration of the issue of emotion and spirituality in children’s hospitals.

“Patient and Family Stories – Responding Through Healthcare Facility Design”

Laura Poltronieri, AIA presented in August at the The 4^th International Conference on Patient- and Family-Centered Care in Philadelphia

Illness and disability are frequently strong catalysts for artistic expression and creativity. Patients often use the written word to document, examine, and share their deepest most intimate feelings, ideas, and experiences. This presentation shares our work exploring and analyzing various texts written by children and young adults facing physical illness and disability. In addition to this written information, our investigations are supplemented by additional patient and family stories gathered from interviews and questionnaires conducted for design projects at different children’s hospital facilities. Our resulting collected information has been translated and incorporated into a series of patient- and family-generated design recommendations that aid us in understanding patient concerns for use on specific design projects.

Spring 2009

“Patient Generated Design Guidelines: What Do the Children Say?”

Laura Poltronieri, AIA spoke in May at the NACHRI 2009 Facilities Design Conference in Austin, Texas.

Illness and disability are frequently strong catalysts for artistic expression and creativity. Patients often use the written word to document, examine and share their deepest, most intimate feelings, ideas and experiences. This presentation shares our work exploring and analyzing various texts written by children and young adults facing physical illness and disability. Our investigations are supplemented by patient and family stories gathered from interviews and questionnaires conducted at children's hospital facilities across the country. The resulting collected information has been translated and incorporated into a series of patient- and family-generated design recommendations that allow us to better understand how patients have experienced their hospital stays, and how we can best mediate the designed environment to ease the negative effects of inpatient episodes on patients.

“PICU Environmental Research Study: Comparing/Contrasting Three Physical Models”

Laura Poltronieri, AIA spoke in May at the NACHRI 2009 Facilities Design Conference in Austin, Texas.

This workshop will present the research findings of a recent study of three separate PICU’s all within the same academic children’s hospital. Each unit has significantly different spatial and environmental characteristics. The workshop will present data which compares and contrasts the differing unit configurations, their physical layouts, space allocations, and functional relationships. The data collected quantifies the correlations between these environmental factors and measurements of: family and patient satisfaction; patient safety and outcomes; and staff efficiency and satisfaction. The results of this research are intended to guide and inform the detailed physical planning and design of the PICU environment. It will provide a detailed and quantified understanding of the environmental design factors that have an impact on the pediatric intensive care setting.

“Finding Inspiration: Physician as Design Muse” Laura Poltronieri, AIA

Children’s Hospital Today Magazine,

Spring 2009

“Fiscally Responsible Development of Pediatric Healthcare Institutions”

by Pamela Ward O’Malley and Laura Poltronieri, AIA

Children’s Hospital Today Magazine, Spring 2009

Winter 2009

"Minimizing the Emotional Stress of MovingTowards New Operational and Physical Models of Care in the NICU"

Laura Poltronieri, AIA, presented a poster session in January at The 22nd Annual Gravens Conference for the Physical and Developmental Environment of the High Risk Infant in Clearwater Beach, FL

The emotional issues involved in moving towards new models of care and new facilities can be traumatic for NICUstaff members. It is often very difficult for clinical staff members to imagine new practice methods and models once they have become entrenched in a specific facility and pattern of care delivery for a number of years.

The purpose of this poster session was to educate NICU administrators and clinical staff members to the diverse range of tools that can be implemented to gently expose their staff members to new physical and operational models of NICU care, thereby easing the transition to newprocesses and environments. These planning tools and methodologies were developed in part to minimize the stress that accompanies significant change, including transitions to new facilities and new models of care.

2008

Article, “Evidence Based Design, Does One Size Fit All?”, by Laura Poltronieri published in Volume 16 of Children’s Hospitals Today Magazine.

"The Third Millennium of Children’s Hospital Design in the United States"

Laura Poltronieri Tang AIA, was a speaker at the Third Millennium Hospital Conference in Alba Italy on May 16.

“Designing for Children’s Health: Why One Size Does Not Fit All”

Laura Poltronieri, AIA to speak at the Healthcare Design 08 conference in Washington, DC, November 2008.

Over $6-billion is being spent annually on construction of new healthcare facilities for children. With this amount of money at stake, what is the best way to design healthcare facilities specifically with children in mind? This presentation discusses the unique aspects of designing environments for children’s healthcare.

A presentation to an international audience of current trends in the design of children’s healthcare environments within the United States.

“Made for Each Other – How to Select the Right Design Team for Your Project”

Laura Poltronieri Tang, AIA to speak at the NACHRI Facilities Conference in Denver Colorado

Co Presented with Jennifer Eno of New York Presbyterian

According to a recent survey by Health Facilities Management magazine, construction of new Children’s Hospital projects has grown at an unprecedented rate over the last five years. With well over five billion dollars in construction each year the size, cost and complexity of these buildings is considerable. Yet, administrators and clinical staff members often do not speak the same language as architects and other design professionals. Institutional project and program managers can sometimes aid in translation, but a major factor in the success of any facilities project remains making a good match between users and designers.

"What Cannot be Measured – Addressing Emotional and Spiritual Needs Through Design"

Laura Poltronieri Tang, AIA was a speaker at the NACHRI Facilities Conference in Denver Colorado

Co Presented with Matt Wain and Patti Light of the Penn State Children’s Hospital at the Milton S.Hershey Medical Center.

Our greatest healers understand the importance of the human spirit in the curative process. Current discussions of pediatric healthcare design focus on evidence based design, “green” buildings, and the creation of healthy, safe, and error?free environments. Institutions long grounded in scientific research remain more comfortable in the realm of the measurable than the immeasurable.

This presentation will discuss issues of emotional and spiritual needs that are by their nature, not easily measurable yet remain at the core of the work of children’s hospitals. This presentation provides a case study of how the emotional and spiritual needs of patients and families at one children’s hospital are being addressed through the building design process. The presentation will include: patient and family stories, an overview of current national design trends, and an interactive audience sharing session as the basis for the exploration of the issue of emotion and spirituality in children’s hospitals.

"21st Century NICU's: How Operational Models Effect Mission and Margin"

Laura Poltronieri Tang, AIA was a speaker at the NACHRI Spring Meeting in Miami Florida

Co Presented with Judy Smith, Smith Hager Bajo.

The NICU is an important financial cornerstone for may children's hospitals. New operational models of care, most significantly single family rooms, are quickly becoming the standard of care in the marketplace. Children's hospital financial leaders need to understand how these changes influence the mission as well as the margin of their hospitals.

This presentation will present a typology of NICU models, and examine the implications these new models have on staffing patterns and ratios, reimbursement, volumes, market share, length of stay, infection control, CMI, collaborations with other providers, systems, community hospitals, and physician groups, staff satisfaction, retention and recruitment, patient satisfaction, and community relationships.

"Fiscally Responsible Development of Pediatric Healthcare Projects"

Laura Poltronieri Tang, AIA was a speaker at the NACHRI Spring Meeting in Miami Florida

Co Presented with Pamela Ward, Gilbane Building Company.

Children's hospitals are expanding their facilities at an unprecedented rate. But how can healthcare finance executives and board members make sure that these financial investments in buildings are being done in the most fiscally responsible manner possible? This presentation will examine issues of: project costs, construction costs, operational costs, on-going building maintenance, staffing costs, and long term flexibility.

It will identify the issues which uniquely influence andimpact the cost of pediatric healthcare facilities and projects. This presentation will present cost analysis information from numerous ongoing pediatric building projects across the country and develop a typology for analyzing project, construction, and operational costs. The cost model developed as a result of this presentation will become a helpful tool for children's hospitals when evaluating the appropriateness of building project.

2006

"Creating Connections - How A Successful Performance Space Can Help You Connect with Your Key Constituencies"

Laura Poltronieri Tang, AIA presented a poster presentation at the NACHRI Conference in Washington D.C. in March.

Co-presented with Terre Considine

Many children's hospitals would like to develop multi-purpose performance spaces within their hospitals, but their practicality and cost benefits are often questioned. This poster presentation examines how the multi-purpose performance space at the Morgan Stanley Children's Hospital of New York Presbyterian has become the active "heart" of the institution, fostering key relationships with patients, families, staff members, schools, community groups, cultural institutions, artists, donors, as well as members of the wider medical center, and the media.

2005

“Riding the Wave: Planning for the Peaks and Valleys of Utilization in the Emergency Department”

Laura Poltronieri Tang, AIA was a speaker at the NACHRI Conference in New Orleans, Louisiana on March 14th.

Co-presented with Bernadette O’Brien, RN, Vice President, Operations and Meredith Sonnett, MD, Acting Medical Director

“Right-sizing” the pediatric emergency department is one of the most complicated capacity issues facing children’s hospitals today. Standard statistical data including numbers of annual visits and average length of stay don't address the important peak capacity issues that change dramatically with the time of day and year. Supporting family focused care in the Emergency Department adds an important additional capacity issue to the mix.

2004

“New Buildings: Do They Really Matter? Using Statistical Analysis to Evaluate Performance in a Newly Designed Hospital”

Laura Poltronieri, AIA was a speaker at the NACHRI Annual Convention in Fort Lauderdale, Florida on October 4th.

Co-presented with Cynthia Sparer, Executive Director, CHONY and Andrea Colon, RN Vice President of Nursing and Patient Care Services

Every year Children’s Hospitals all across the country spend millions of dollars on renovation and new construction projects. But how effectively do these projects address issues of real concern to patients, their families and staff members? “Evidence Based Design” (EBD) strives to develop statistical tools for evaluating the impact of newly designed facilities on patient outcomes and other measures related to quality of care. By understanding the relationship between the built environment, key design characteristics and health care quality, institutions can make informed and focused decisions regarding their capital expenditures and the resulting facilities constructed.