©Francis Zera / zeraphoto.com
Building Better Patient-Centered Care
Why EvergreenHealth used industrialized construction for their newest critical care unit
Ty Heim was looking down the barrel at another big construction project.
He’s retired now, but in 2018, the Executive Director of Design and Construction at EvergreenHealth was looking at adding a critical care unit (CCU) to their hospital in Kirkland, Washington. He had supervised the construction of a progressive care unit (PCU) in 2017, but this project wasn’t quite the same.
“It just needed to be a different animal than what we did with the PCU,” says Heim.
Part of the evolution stemmed from the hospital’s basic needs. A critical care room means more people, more equipment, and therefore 50% more space than a typical medical-surgery room. In addition, leading up to construction, their nurse medical planner had taken time to get doctors and nurses to work at a variety of other facilities. This gave them a chance to learn what worked elsewhere and make it their own.
Looking at everything they wanted to accomplish, the decision was made to build out the CCU with as much DIRTT as possible. It was a decision over a decade in the making.
Evergreen Hospital
Cory Parris Photography, Inc.
Building over time
EvergreenHealth has been using industrialized construction since 2009. Heim remembers when he first worked with DIRTT to create a cardiac testing unit.
“We just needed some walls put in quickly, but it was in the middle of this building. We were working on 5,000 square feet of a 50,000 square foot building, and we needed to go in quick, quiet, easy and get out of there fast. And DIRTT was exactly perfect for that,” he says.
DIRTT precision manufactured wall assemblies and pre-finished wall panels off-site, allowing EvergreenHealth to quickly, cleanly, and quietly install them on-site. “The fact that we could go in and just tilt up these walls without all the impact of doing drywall and painting and all the other stuff was huge for us.”
Over time, the partnership between EvergreenHealth and DIRTT grew. The PCU didn’t just use walls. It took advantage of a robust construction system that includes casework and integrated electrical. All in service of their forward-thinking approach. “It was always about patient-centered care,” says Heim. “So, how do we deliver the latest and greatest patient-care technology and capability at the bedside.”
EvergreenHealth Progressive Care Unit in Kirkland, Washington
IMAGE CREDIT: Nathaniel Wilson Photography
Critical care unit
With the lessons learned from past projects, EvergreenHealth decided that using as much DIRTT as possible was the best way to serve patients and support staff. Base building conditions don’t fall under DIRTT’s scope of work, and healthcare code requirements prevent DIRTT from being used in certain applications. But admin spaces, smoke corridors, patient rooms, and nurse stations DIRTT could be used to build out the interiors. Essentially, if it could be built with DIRTT, it would be. Heim says limiting the number of trades people on-site prevents the job site from being crammed with workers.
The less number of moving parts or really moving trades you can deal with, the better and quicker and easier the project comes out.
Ty Heim, Executive Director of Design and Construction at EvergreenHealth
IMAGE CREDIT: Cory Parris Photography, Inc.
Integrations
So, what would using DIRTT as much as possible look like in the CCU. In some cases, it meant repeating a few of the things that had been done in the PCU. Easy-to-access headwalls with electrical, data, and medical drops as well as wall assemblies with modular electrical in them for example. Other updates were unique to the CCU. Several surface-mounted 60” monitors would be embedded in the wall behind glass to act as patient-status boards. The wall acts an infection prevention layer for easy cleaning but also houses the technology needed to run the status boards.
Patient Status Board
©Francis Zera / zeraphoto.com
On a larger scale, DIRTT’s UL-listed electrical systems were deployed in the patient room headwalls for both critical and normal power. This meant that walls were equipped with healthcare-grade factory-installed cabling, reducing the amount of time and effort spent by electrical contractors on-site.
“The whole ability to get a wall system with systems run in it when it comes to the site for things like a headwall in a patient room is just a huge time saver,” says Heim. “I mean, if people want to get facilities up and operational quickly, that's a huge bonus to a DIRTT-like system.”
Modular quick-connect electrical
IMAGE CREDIT: Cory Parris Photography, Inc
The headwalls also used DIRTT’s Flex Gas as the basis for design. As a flexible medical-gas solution it offers easy install and maintenance. And in this case offered cost and time savings. During construction, in response to COVID-19, the decision was made to make all 20 rooms in the unit negative pressure environments. This required the medical gas to be rerouted. Using flex gas allowed EvergreenHealth to simply change the lengths of the hoses rather than having to discard and redo the brazing which would have taken more time and money.
“These are plug-and-play components that are really saving time and... bring a project online months earlier because you have this capability,” says Heim.
DIRTT headwall assembly with modular electrical and flexible medical gas
IMAGE CREDIT: Cory Parris Photography, Inc.
Further evolution
Throughout the unit there’s evidence of DIRTT solving healthcare construction challenges of in large and small ways. EvergreenHealth knew some nurse station furniture had trouble handling their critical electrical needs. Using a low DIRTT Solid Wall with integrated electrical cabling solved this. Applying original artwork to Corning® Willow® Glass graphic panels improved infection prevention by making walls easier to clean. Locking casework cabinets were used to create custom nurse servers that improved efficiency on the ward while adhering to strict safety protocols required on a CCU.
Nurse Stations with DIRTT low walls
IMAGE CREDIT: ©Francis Zera / zeraphoto.com
Embedded artwork
IMAGE CREDIT: ©Francis Zera / zeraphoto.com
Nurse Server
IMAGE CREDIT: ©Francis Zera / zeraphoto.com
Cut to the chase
In the PCU, DIRTT’s wall assemblies integrated plumbing, allowing for easy maintenance. When a dialysis box sprung a leak, removable wall panels allowed the hospital to get back online in a matter of hours rather than a few days. In the CCU, the size of the rooms created configuration challenges. By creating a custom plumbing chase, DIRTT could accommodate both the structural and aesthetic needs of the space.
“Your team just did a fantastic job of working back and forth with prototypes and saying, well, what about this? What about that?” says Heim.
DIRTT plumbing chase
IMAGE CREDIT: Cory Parris Photography, Inc.
The next step forward
Stepping out into the completed space, Heim saw the result of three years of work. And it was gratifying. “I think it's just going to be an incredible unit,” he says. Seeing the space represented the next generation in constructing a practical, functional patient-care space.
“IV bags blow up. I mean, strange things happen in hospitals for no good reason. And you've got to think about cleaning it from the ceiling to the floor,” he says. “And any place there's a crack, any place there's a gap, any place there's a horizontal surface and something can land on and is that readily cleanable and manageable. And if it gets damaged, can I fix it quickly?
“The CCU was just the next great step forward in making that a much more safe, operable, cleanable unit.”
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