Boston Children’s Hospital excels in providing the highest quality of care for their patients. For more than a century, Shepley Bulfinch has partnered with Boston Children’s on a variety of projects, including several expansion buildings and a number of multi-phased renovations. The new 11-story Hale Family Building, which anchors the most ambitious reimagining of its facilities, will address critical capacity needs and its delivery of high-level tertiary and quaternary care.
The newly named Boston Children’s Benderson Family Heart Center will be located in the Hale Family Building to optimize the patient experience and create a state-of-the-art comprehensive platform for cardiovascular services. It will improve patient flow and operational efficiencies through patient, family and staff centered design.
An integrated Heart Center
Boston Children’s Benderson Family Heart Center provides care to patients who are affected by congenital heart disease and those who have developed cardiac conditions in their childhood. It is one of the largest pediatric heart centers in the United States.
The clinical components of the existing Heart Center are located on four floors of five different buildings on its Longwood campus. Relocating the Benderson Family Heart Center to the Hale Family Building will smartly design a facility that serves the needs of cardiac care, provides adequate capacity for the current operations, and allows for anticipated future growth. The Heart Center offers comprehensive cardiovascular services that involve the departments of Cardiology, Cardiac Surgery, and Cardiac Anesthesia, and it provides both outpatient and inpatient services.
Designing for efficiency and collaboration
The Shepley Bulfinch design team implemented various processes and research to inform the design in partnership with the Boston Children’s team. During the master planning process, Shepley conducted a ‘shadowing exercise’ for the Heart Center whereby the team observed and documented day-to-day activities of the clinicians. The team found that with the current departments located in different buildings, there were limited opportunities for adjacencies, team collaboration and spatial efficiency.
Additionally, the team designed a new interventional platform to anticipate future disease treatment trends. To ensure that the future interventional platform would accommodate the needs of various interdisciplinary operations and procedures, the team consulted a multi-disciplinary team of cardiac surgeons, interventional cardiologists, cardiac nurses, and all other supporting staff. The guiding principles were established by the Heart Center’s Oversight Committee so that the patient-centered care remained at the heart of all decision making for creating the new interventional platform for cardiovascular procedures.
All the cardiac services that require use of anesthesia such as cardiac surgery, interventional cardiology, cardiac MRI, and procedure rooms for echocardiograms will be consolidated on one floor: the 6th floor of the Hale Family Building. Doing so will optimize staffing efficiencies, improve patient safety, and enhance interdisciplinary care capabilities. Under the new unified platform, physicians and staff from all of the Benderson Family Heart Center’s disciplines will work hand-in-hand to provide comprehensive cardiac care for patients at Boston Children’s.
Inpatient care at Boston Children’s Benderson Family Heart Center
The new inpatient units in the Hale Family Building are designed through the eyes of family members for them to remain actively engaged during hospitalization of their children with the focus on safety, quality and efficiency of care. Being a tertiary pediatric facility, the proportion of patients from outside the local area is relatively high, resulting in greater need for space at the bedside for families to stay and/or sleep. New inpatient rooms will feature a designated family zone and provide adequate space to accommodate visitors as well as caregivers. Each inpatient unit includes two family lounges, one located at the entrance to the unit and the other adjacent to the public elevators. The lounges are designed as multi-functional spaces with a variety of seating arrangements and areas for different uses such as relaxation, work, dining and TV viewing. A laundry room is located adjacent to the family lounge and a multipurpose activity playroom is located within each unit for the patients and their siblings.
Borrowing from the hospitality industry, the design creates a separate “front of house” and “back of house” circulation systems to ensure that noisy, congested support operations are isolated from the patient experience as much as possible. A patient unit is divided equally into two subunits with 18 patient rooms that include centrally located patient and family support spaces. A centralized teamwork area is located at each end of the unit to promote caregiver collaboration while decentralized nurse workstations are provided between two patient rooms to foster appropriate nurse to patient ratio depending on the acuity of the patient.
Inpatient cardiovascular patients are often some of the sickest patients, requiring high levels of intervention and care. The inpatient rooms are designed to facilitate urgent in-room procedures quickly, safely and efficiently. The inpatient beds can be rotated to any orientation within the rooms, accommodating any configuration of mobile equipment and providing space for caregivers. Outside each pair of patient rooms is a care provider zone that includes a staff observation station and supply cabinets for point-of-care delivery to the patient. The decentralized staff workstations help to maximize visibility and sightlines to patients. In addition to the vision control windows, other finishes within the inpatient rooms help the nursing staff assess the patient’s health. The room color palette intentionally does not include blue tones for the wall or floor field colors. Clinicians are highly sensitized and trained to check for blue tones in a cardiovascular patient’s skin pallor; omitting blue in the color palette decreases the chance of inaccurate assessments. The selection of light fixture types further assists the clinicians towards quickly and efficiently assessing the patient’s appearance.
Boston Children’s strives to provide the highest quality patient- and family-centered care to all patients. Every detail is critical when designing a pediatric facility. Through the long-lasting partnership with Boston Children’s, Shepley Bulfinch has always worked to maintain a meticulous approach from listening to the staff’s expertise on facility operations to developing a deep understanding of patients, their families and staff’s needs. When planning and designing the relocation of the Heart Center, these were high priorities to ensure that the patients and their families are provided with a comfortable and adaptable experience while the staff is provided with a collaborative and supportive workplace. Relocating the Benderson Family Heart Center to the Hale Family Building supports the hospital’s mission to provide the highest quality of care for patients and families.