Patient perspectives and staff workflow key to designing new space at Mount Sinai Hospital

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Maureen Riley knows what it’s like to be the mother of a newborn child who needs hospitalization. Riley’s son Sullivan was born 13 weeks early, weighing just over a pound, and spent four months in the Neonatal Intensive Care Unit (NICU) at Mount Sinai Hospital in Toronto.

“Despite the challenges of cramped space in an aging unit, the care that Sullivan received was exemplary and the clinical team was amazing working under those conditions,” said Riley, a health-care professional herself.

Wanting to give something back, Riley has volunteered to be one of many patients, former patients and family members of patients bringing their experiences and voices to the planning table as Mount Sinai embarks on a major capital redevelopment program.

The redevelopment plan – the first undertaken by Mount Sinai in three decades – will span several years with construction of six new floors, expected to begin in the spring. The addition will enhance aging facilities, starting with the Centre of Excellence in Women’s and Infants’ Health, and provide greater access to care with state-of-the-art equipment designed to provide patients the best medicine.

The redesign of new patient care areas is already underway, and Mount Sinai is using two innovative approaches to ensure the space is as efficient as possible. The first method is to include patients and their families, like Riley, giving them the opportunity to provide suggestions and feedback. The second involves analyzing workflow upfront and identifying process changes that need to be integrated early, in order to ensure the space is functional and to minimize the amount of rework in later stages.

“Involving patients and their families in the planning and design phase is an innovative approach that reflects the hospital’s commitment to patient and family-centred care,” says Altaf Stationwala, Senior Vice President of Operations and Re-development. “By weaving the patients’ point-of-view into the architectural plans we will be able to design a space that ultimately provides the best possible patient care environment and experience.”

To do this, Mount Sinai has set up user groups to help plan how to develop and use the new space for the NICU, the gynaecology and obstetrics program, labour and delivery and the high risk mother’s pregnancy program. Each user group is co-led by a nurse and physician and includes a multi-disciplinary team of hospital staff, researchers and patient and family representatives.

The hospital is also analyzing workflow to ensure the space is properly designed from the beginning. By examining current and ideal workflow processes, Mount Sinai’s initial design plans will make the best possible use of the new space and hospital resources.

“Rather than waiting until construction is complete to determine floor plans, we’re mapping out how patients, staff, materials and equipment will flow most efficiently through the system and we’re devising a seamless plan up front,” explains Laura Macdougall, Director, Capital Projects.

For example, one of the major changes to enhance patient and family-centred care following redevelopment will be the shift from a large NICU where numerous infants reside together, to private rooms where families will be invited to stay with their baby and become more involved in their care. Determining the needs of families in this new environment is critical, and understanding the workflow for nurses, physicians and other health-care workers is being addressed now so the new space is designed to maximize efficiency and increase the amount of time care providers can spend with patients.

Expanding the world-class Women’s and Infants’ Health Program is just the start. Plans are also in the works to upgrade and renovate Mount Sinai’s surgical suites, emergency department and Intensive Care Unit.

An initial grant of $8 million for planning and design was announced by Ontario’s Health and Long-Term Care Minister George Smitherman last summer.

Riley, who spoke at Minister Smitherman’s announcement, is pleased that, as a former patient and parent of a patient, she can now help the hospital by advising leaders as to how best design the space architecturally – through the patients’ eyes.

“Having a child in the NICU, I know first-hand how much the new space will help future mothers and their babies in their time of need,” she said. “The Women’s and Infants’ Health Centre of Excellence has a world-class team which deserves the best facilities to deliver family-centred care and I’m glad to be a part of that.”