Patient experience and safety drives building construction decisions for the new academic hospital
The new academic psychiatric hospital building for The University of Texas Health Science Center at Houston (UTHealth Houston）是十年来大部分时间的合作和共识建立的结果。
The state-of-the-art facility, named the John S. Dunn Behavioral Sciences Center, was unveiled on Wednesday, Feb. 2, during aribbon-cutting celebration. The 253,000-square-foot facility includes 264 new inpatient beds. Sitting adjacent to the UTHealth Houston Harris County Psychiatric Center, the two facilities have a combined 538 beds, making it the largest academic psychiatric hospital in the nation.
It is also the first hospital of its kind to be constructed in Texas in more than 25 years, and was built in partnership with the Texas Health and Human Services Commission and the Texas Medical Center.
The new facility is intended to be to be a new standard of care in Texas, and UTHealth Houston leadership took an active role to ensure patients remained at the center of the mission, even during planning and construction of the building.
精神健康障碍患者中most vulnerable in society, and every building detail, down to the type of screws used in construction, were meticulously thought out and vetted in an effort to create a safe and beautiful place for patients to heal.
The Texas Legislature approved funding in 2017. UTHealth Houston and the design firm Perkins + Will spent 2 ½ years on planning, design, and getting approvals for the project. Vaughn Construction worked for another 2 ½ years on construction during the COVID-19 pandemic.
“The patient was the priority throughout this project,” said Cynthia Crespo-Bonaparte, safety manager of the hospital and clinic safety program within Environmental Health and Safety at UTHealth Houston. “There were people with different expertise working together to make decisions. You have to be patient with one another and listen to ideas, but it was never about us. We kept the safety of patients, staff, and visitors at the forefront of discussions, and those discussions got down into the nitty-gritty of the building.”
The nitty-gritty included security screws, so called because they cannot be easily removed with common utensils. The safety of patients is in every detail, including door knobs, clothing hooks, hand rails, and furniture design. All are ligature-resistant, designed to prevent the opportunity for patient self-harm.
The hospital has 11 units with 24 beds in each unit. Nurses, physicians, and psychiatric technicians were consulted to help design the units to ensure patient and employee safety.
Based on staff feedback, each unit has a long, central nurse station that is open to the large central room. From the station, staff can see almost every angle of the unit, including down the two patient room hallways. Therapy rooms have glass walls to provide visibility, and frosted to give patients privacy.
“We put considerable thought into how to build the nurse stations so they remained accessible, but also safe. The desks are built deeply, so someone cannot reach across to harm a nurse while they are working,” said Carina Ayers, director of Clinical and Information Technology at the UTHealth Houston Behavioral Sciences Campus. “We actually brought in a short and a tall nurse to test the position of the computer monitors. We wanted staff to be able to see the screen and patient activities without having to continually adjust the computer angle or seat position.”
Considerable thought was also put into patient experience in the new facility.
“You have to look at everything from a different light,” said Ginger Smith, senior facilities construction project manager at UTHealth Houston. “Every patient room door has a special hinge on it that allows it to swing in or out. A patient cannot lock themselves in a room, and yet you can allow them the privacy to close the door.”
In the bathrooms, soft foam panels are used instead of a traditional shower curtain. Magnets hold the panel in place to allow for privacy while maintaining safety.
它发现手机在单位空间的方法give patients added privacy to connect with their loved ones, and a new program was utilized to allow TVs to have moderated content. This include the ability to control content by parental rating or by channel, giving patients and therapists greater choice.
“The patient experience is so important to healing,” said Derek Drawhorn, associate vice president of IT Infrastructure at UTHealth Houston. “Patients can get agitated if they don’t have anything to do or don’t have anything appropriate to watch. Small details like the quality of television make a real difference.”
With a goal of including longer-stay patients in the facility a Therapy Mall was added to the design to provide spaces for group and expressive therapies such as music and art therapy. There will also be a hair salon and a boutique where patients who are on a behavior management program can redeem the points they earn for snacks and other items.
The facility boasts two enclosed courtyards with a walking trail, and the spacious cafeteria has outdoor seating options. Attention to detail in the courtyards was a priority for the UTHealth Houston safety team. Safety Specialist Cedric Peace researched what trees to plant to avoid potentially poisonous seeds.
The same attention to detail was applied to make sure patients, staff, and visitors remained safe during an emergency.
“There’s a lot of glass and light in the building, but we wanted to make sure it was also safe in the event of a hurricane,” Peace said. “The windows can withstand Category 3 winds. They are actually called ‘missile-proof windows.’”
The safety team was also intricately involved in the design of the fire alarm and sprinkler systems and thinking through how to evacuate in case of a fire. Former Safety Manager Jennifer Laine was instrumental in the decision to have an additional stairwell added to the design to allow visitors to evacuate without entering a patient-care area.
The team also connected with the Houston Fire Department to ensure firefighters are aware of protocols unique to the building, and hosted tours during different phases of the construction to help the fire department be familiar with the building’s floor plan.
Construction during a pandemic
Building a state-of-the-art facility during a global pandemic presented its own challenges, but it also created opportunities.
邓恩中心建筑项目是其规模的第一个由Uthealth Houston设施团队进行自我管理的一个。过去，德克萨斯大学系统管理了一个项目的内部运作，包括变更订单和管理总承包商。
令人惊讶的是，在大流行期间，建造医院的优势是建造的，随着承包商Vaughn Construction管理的严格Covid-19规程继续进行。
“We were one of the few projects that didn’t stop in the Greater Houston area because of the pandemic,” Smith said. “Because of that we were able to staff up as other projects were stopping. In some cases, depending on the scope of work being done, we could have two or three staggered crews working instead of one.”
沃恩能够更快地引入分包商，并以竞争性的价格引入分包商，最终导致该项目在预算下以680万美元的价格完成。这些资金已重新分配以增强建筑物。
史密斯说：“从积蓄中，我们能够在设施的南塔中增加四楼，这在建筑物中增加了24张床的单位。”“我们还能够增加治疗和临床办公空间。”
The university was able to spend additional savings on enhancing the atmosphere of the building, including adding warm faux wood finishes to halls and elevators, as well as large photographic murals.
“We hired a photographer to go out and take photos of the Greater Houston area, and we turned those into beautiful murals inside the units,” Smith said. “The wood finishes and murals add a warm feeling that really benefits patient experience. It de-institutionalizes everything. The thing I love about this facility is when you walk in, you would never know it is a behavioral health center.”
The pandemic prompted additional installation of video conferencing equipment, some of which were impacted by supply chain issues.
“COVID-19 kicked in hard and heavy in the middle of our timeline for installing new tech, so we had to shift and change,” Ayers said. “We weren’t sure when equipment would be delivered, so we ordered various options and borrowed equipment from other UT System schools. Then, we tested and evaluated the technology to make sure it would meet our needs.”
这些努力导致了可以改善教学机会的技术。
艾尔斯说：“邓恩中心大楼的房间设置为能够在患者同意的情况下记录心理学课程。”“讲师可以为学生播放课程，或者可以实时审查学生的患者面试技能。这些是令人难以置信的指导工具，能够培训下一代心理保健提供者。”
Special thanks:
Special thanks to all of the UTHealth Houston teams and outside firms that assisted in making this project a success:
- 安全，健康，环境和风险管理
- UTHealth Houston Facilities Project Management Team including Julie Lucas, Ginger Smith, Brady Smyth, and Robin Murtishaw, who collectively managed and delivered this highly successful project on time and well under budget.
- 黛博拉·帕克（Deborah Parker），感染控制从业者
- UTHealth Houston Harris County Psychiatric Center Facilities Team including Gerard Marchand, Alan Dumas, and Richard Carmona
- 蒂姆·伯尔（Tim Burr），绩效改进，商业智能和报告主任
- Norman Dorsett, Department of Health and Human Services inspector
- 设计团队：珀金斯 + Will，Smith＆Company，Shah Smith＆Associates，Smith Seckman Reid，Genesis Planning，Martinez Moore和Kevin Turner具有人为的经验，以了解其知识和对行为健康设施设计的奉献精神。
- T. Vaughn Construction团队在完成该项目的完成方面的合作伙伴关系，知识和专业知识。