Input from operational roles is crucial for hospital expansion projects. They have great ideas because they see and affect everything.
By Angela Kolosky
AIA, ACHA, NCARB, LEED AP BD+C
Associate Principal, Healthcare Planning Market Leader
I recently spent time with a family member in the hospital. I was impressed with the doctors and nurses who provided excellent clinical care. But the people I remember the most are the environmental services techs who diligently tended to the room each day. Always with a smile, they would quietly enter the space, ensure all areas were orderly and clean, check that everything was going okay, and efficiently move on to the next room.
When you think about the “money makers” in a hospital, departments like surgery come to mind first. Practicalities are paramount in these spaces: do they have enough storage, supplies, and so on. But so much of surgery room performance is driven by people who aren’t the surgeons and nurses. They’re the ones who resolve how quickly a room can be cleaned and turned over. The ones who process used instruments, move supplies to sterile storage rooms, and keep the systems running optimally. The people who pick up trash and launder scrubs.
Heroes of the hospital
I call these people the unsung heroes of the hospital – the departments most patients and visitors don’t immediately think of, such as environmental services, facilities, materials management, nutrition services, sterile processing, laboratory services, and all the other staff in a busy healthcare environment. The ones helping it hum without interruption.
Their input on the operations of a hospital is a critical aspect of successful design. Whenever I get a chance to engage with these experts, I’m reminded of how much they influence workflow. What they perceive as day-to-day efficiency can influence design throughout the facility, like placing linen hampers and cabinets near the entrance of a patient room, so they can empty and resupply with minimal disruption to the patient. Small moments like this can have huge impacts on the satisfaction of patients and staff – and can be missed if we don’t include their voices early on in a project.
Big projects, big impact
Without this input on large projects or new tower additions, support service spaces can easily be underestimated and undersized. These spaces are just as dependent on patient volumes as are operating rooms and inpatient beds. Early discussions about how these areas can be right sized for future growth and appropriate placement (it’s never fun to relocate landlocked operations, like nutrition services) will save the project time and money when coordinated early.
Whenever we start a project, we bring these varied groups together to leverage all they know about supporting patient and staff safety, reducing waste and steps, and creating higher-performing spaces. One example: Our in-place renovation of Allegheny General Hospital’s new Level 1 Trauma center. Engagement from stakeholders across the facility was crucial for project success, both during construction and implementation.
At the beginning of the project, stakeholders were asked to look for success within their own services as well as their counterparts. This led to rethinking the structure of staff stations to support visibility and collaboration amongst all team members as well as strategic locations of support rooms to allow the ED to flex during various volumes without isolating support staff or creating long walks.
There’s a saying I like: “If you want to go fast, go alone; if you want to go far, go with a team.” Designing a hospital requires the input of all its team members, especially from the support services who keep the place running every day.
Angela Kolosky, AIA, ACHA, NCARB, LEED AP BD+C | Associate Principal, Healthcare Planning Market Leader
As a Healthcare Planner, Angela uses her experience, client data, and national benchmarks to create solutions where design can create positive outcomes for patients and staff. She brings this thinking to every project and has a passion for creating impactful, positive spaces for a critical and vulnerable population. Angela is an ACHA board-certified architect and was named one of Healthcare Design’s Rising Stars in 2020. Angela speaks and writes nationally on healthcare planning topics for Healthcare Design and Healthcare Facilities Symposium and is responsible for leading healthcare planning across both of DesignGroup's offices. She’s also a founding member of the Ohio Chapter of Women in Healthcare where she advocates for the advancement of women in healthcare outside of the field of architecture.