News Story

AHRA, July 30–August 3, Las Vegas
Recommended Sessions from the Axis Imaging News Editorial Staff
Child’s Play: Trends in Pediatric Hospital Department Design

AHRA, July 30–August 3, Las Vegas

The American Healthcare Radiology Administrators (AHRA), Sudbury, Mass, will hold its annual conference July 30–August 3 in Las Vegas. Each year, the conference attracts at least one third of the AHRA’s 4,000 members, and this year is poised to be no exception. The conference’s 5 days at the MGM Grand will include sessions on managing assets, information, PACS and other imaging technology, fiscal affairs, and human resources.

Also, for the first time, the AHRA will offer a program on basic management skills, in response to a large-scale survey in which a majority of members expressed an interest in learning more about business and finance.

The Basic Management Skills program is the first offering of the AHRA Imaging Leadership Institute, which will be unveiled at the meeting. For new supervisors and managers, this 4-day comprehensive program will focus on basic management skills, including human resources, communications, operations management, asset management, finance, and budgeting. “The program is targeted specifically for imaging professionals taking on new positions, opportunities, and challenges,” said AHRA Executive Director Edward Cronin.

Added AHRA President Lynn McVey, “As imaging personnel move from clinical to supervisory to leadership positions, different skills are required and critical to success. The Leadership Institute has been created to offer a portfolio of development programs designed exclusively for imaging professionals at all stages of their careers.” Additional programs are in the works on more advanced topics for director-level professionals, and an executive-level series is being developed in conjunction with the Kellogg Graduate School of Management at Northwestern University, Chicago.

“Health care is a rapidly changing environment with new technologies, reimbursement challenges, and the migration to digital,” said AHRA President-Elect Jay Mazurowski. “And a changing environment requires new strategies. Imaging administrators are uniquely positioned to make the system work. We believe our Leadership Institute will provide the knowledge needed to be successful.”

Initial funding for the Leadership Institute will be provided by a major grant from the AHRA Board of Directors. However, Cronin stressed that the success of the program ultimately would be reliant on the input and participation of the imaging industry. “We need to develop sustainable relationships with our corporate partners,” he said. “Ultimately, we all have the same goal, which is to improve health care and provide patients with the highest level of service.”

For more information on the AHRA Imaging Leadership Institute, call (800) 334-2472 or visit ahraonline.org.

—C. Vasko

Child’s Play: Trends in Pediatric Hospital Department Design

By Jim Hohenstein, AIA

In cars, children have separate seats with restraints. In schools, children are separated by age into classrooms. In hospitals, separate pediatric wings treat children’s diseases. So why do emergency and radiology departments deliver the same care to children as they do to adults? Some medical experts believe an entire range of separate children’s medical treatment spaces improve patient outcomes.

Various studies have shown that with separate pediatric departments, patients’ time in the emergency department¹ and operating room² was decreased. Thus, medical experts conclude that spaces with a unique, child-friendly look and feel contribute to children’s healing. An environment that minimizes anxiety—and, in turn, disruptive behavior—indirectly enables physicians to obtain better results.

Economic Balancing Act

A parent can rock his or her child to sleep in a comfortable chair, while slow changes with the soft overhead lighting provide a tranquil atmosphere.

Positive patient outcomes are always a top goal, but tension exists between the economic ideal (efficient space- and equipment-sharing methods) and the treatment ideal (completely separating children from adults). Therefore, a certain “separation anxiety” exists among administrators, who prefer not to separate pediatric and adult spaces because of the high cost of duplication.

Separate space need not always be a capital liability. Designers can work with hospital administrators to compensate for resource duplication and find new efficiencies and economic benefits. For example, a pediatric department may share many of its non–patient care operational aspects with the main hospital.

If a facility cannot support entirely separate pediatric treatment spaces, then at a minimum, emergency, surgery, and radiology departments should create separate pediatric examination and treatment areas. When space must be shared, rooms should be designed for children’s care. It is also important to eliminate cross traffic; planners should create separate pathways for children and extremely sick adults. Further, shared departments should balance separation. The design goal should be to maintain both pediatrics flow and the functional flexibility of resources.

Highlighting The Children’s Hospital in Omaha, Neb, with warm colors and implementing soft edges with plenty of shiny reflections give the facility that “space age” look that children love.

Three major models exist for children’s facilities, and pros and cons for each are outlined below.

1) Freestanding Children’s Hospital

Because a child’s experience begins at the front door, the best design immediately surrounds him or her with a whimsical atmosphere. The Children’s Hospital, Omaha, Neb, has achieved this goal. An eight-story, 292,030-square-foot freestanding facility, it includes three medical-surgical floors, each containing 24 single-occupancy patient rooms. Each room has a parent sleep-bed, desk with Internet access, private refrigerator, television and VCR, and private full bath. Playful “creatures” adorn ceilings, walls, and floors; patients and area schoolchildren created the artwork. Liberal use of water, light, and color produces a tranquil, healing atmosphere.

2) Hospitals within Hospitals

When created in a separate wing of the main hospital, a pediatrics unit is often a self-contained space. It could hold its own intensive care unit and patient rooms, but many times, for efficiency’s sake, it will share surgical suites and/or radiology. The downside of this model—which has been the most prevalent over the past few decades—is that patients must walk through the main hospital to access pediatric space.

3) Attached Hospitals within Hospitals

Like a freestanding hospital, the attached hospital has its own diagnostic, treatment, and surgical spaces, as well as a separate façade and entryway. This model is emerging as a modern trend and offers several advantages. First, a separate entry creates the desired image and atmosphere. Second, the hospital is better equipped to handle outpatient visits. Compared to a hospital within a hospital, this model allows for better pediatric-specific care. At the same time, it achieves similar economies of scale because off-stage functions, such as materials management, dietary requirements, mechanical systems, and parking structures, can be shared with the main hospital.

For example, the new American Family Children’s Hospital will connect to the west side of the existing University of Wisconsin Hospital and Clinics (UWHC), Madison. The current children’s hospital, founded in 1920, is a 62-bed medical and surgical center located within UWHC. Administrators have saved an entire floor (36,000 square feet) for surgery and part of a floor for a new radiology department when funds become available. Overall, the six-story, 235,000-square-foot facility broke ground in late 2004 and should be complete by early 2007.

Both the American Family hospital and Banner Children’s Hospital, Mesa, Ariz, offer comfortable sedation rooms for radiology procedures. They follow the floor’s theme, are playful yet soothing, and enable lighting level changes. Banner also has an alternative to anesthesia: a consultation/quiet room where parents can try to persuade the child to fall asleep naturally prior to testing. This room features a device to dim lighting and offers other ways to soothe children, such as rocking chairs and soft music.

• • •

The ideal in pediatric diagnostics and treatment is not to share. Excepting off-stage operations, the best hospital plan for the future includes completely separate spaces, where services are tailored to children’s unique needs. This will make patients free to enter a space that holistically supports their health and well-being.

Jim Hohenstein, AIA, is a senior vice president and senior design principal with HDR Architecture, Omaha, Neb, with a specialty in children’s hospitals.

References

1. Doolin EJ, Browne AM, DiScala C. Pediatric trauma center criteria: an outcomes analysis. J Pediatr Surg. 1999;34:885-889; discussion 889–890. Available at: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10359200&dopt=Abstract. Accessed July 5, 2006.
2. Kain ZN, Fasulo A, Rimar S. Establishment of a pediatric surgery center: increasing anesthetic efficiency. J Clin Anesth. 1999;11:540–544. Available at: www.jcafulltextonline.com/article/PIIS095281809900080X/abstract. Accessed July 5, 2006.