Positive growth

Project Overview
Project Name  Franklin Square Hospital Center Expansion
Location   Baltimore
Total floor area (in square feet)  378,875 (341,225 for patient tower; 25,390 for central energy plant; and 12,260 for renovated space)
Number of floors  8
Number of beds  291
Project cost $175 million
Construction cost $137 million
Groundbreaking October 2007
Opening November 2010

Project Team
Owner  MedStar Health
Architect   Wilmot Sanz Inc.
General Contractor Bovis Lend Lease
Project Manager  Lillibridge Healthcare Inc.
Environmental Consultion and Landscaping  Dewberry
Interior Design   Wilmot Sanz Inc.
MEP Engineering  Leach Wallace Associates Inc.
Structural Engineering  Rathgeber/Gross Associates
Medical Equipment Planning   Medequip International

A hospital's image is fundamentally based on the care it provides to patients, says Adrienne Kirby, FACHE, president of Franklin Square Hospital Center in Baltimore. The facility is an extremely important component of that, she adds.

To prove the point, Franklin Square Hospital Center's recent addition is enabling the hospital to improve care in several ways.

The new patient tower provides space for an increased number of critical care and telemetry beds and for private rooms with family accommodations. The new emergency department (ED) is large enough to treat a growing volume of patients and the physical plant provides enough power to adopt the latest technology for patient safety.

First impression

Every aspect of the hospital addition was designed to serve patients and their families better, including the new lobby. "A big part of what we were trying to do was create a new sense of entry," says Curt Mugge, AIA, project manager for architecture firm Wilmot Sanz Inc., Gaithersburg, Md. "Everybody can see that this is the entry. It was hard to find before."

A meditation garden with benches and trellises welcomes patients and visitors to the front entrance. The glass canopy and front door are designed to draw people into the facility. Fans and intake louvers were carefully sited to meet fire codes for smoke evacuation without interfering with the transparency of the lobby.

"It's very spacious, very inviting," says Dennis Kephart, senior director of facilities at the hospital center.

The entire lobby spans three floors, from a lower-level lobby off the ED to a second-floor elevator lobby that overlooks the main space. Bamboo plants, approximately 20 feet tall, reach up from the lower level, providing greenery and life in the space. Sheets of stainless steel curve toward the ceiling along an upper wall, transforming into sculptural birds that soar across the top of the lobby.

Seating areas, water features, a fireplace, café, gift shop and chapel provide a number of ways to make people feel comfortable in the hospital. "It makes a nice impression when you come in," comments Stephanie Glusman, interior designer at Wilmot Sanz.

The lobby also serves as an event space for hospital galas, and it even has been requested as the site for a wedding.

Efficient emergency care

The new ED can handle 150,000 visits a year. According to the hospital, it is the busiest ED in Maryland.

The hospital's previous ED was built to accommodate 60,000 patient visits a year, but was receiving about 105,000 visits a year by the time the expansion project was completed, says Kirby. "You can just imagine what that facility was like, trying to care for all those patients." The new ED is designed to manage a high volume of patients efficiently and well.

The ED ambulance and walk-in entrances both lead to a triage area where patients with minor aches, pains and lacerations can be attended to and sent home. "It's not fair to tie up very high cost and high-end technical treatment rooms in the clinical ED for somebody who could really be treated in a much lesser acute setting," says Rolando Sanz, AIA, principal-in-charge at Wilmot Sanz.

Next to triage is a fast-track area where somewhat more serious cases are treated. The most serious cases are seen in treatment bays arranged in four pods in an open design with total visibility from the nurse stations. Sliding glass doors on the treatment bays provide privacy and noise control.

One of these pods is built to serve pediatric emergency patients and inpatients. This hybrid design makes the most efficient use of pediatric specialists and square footage by not having to maintain and staff a separate pediatric inpatient unit that may experience seasonal lulls in its patient census. It also allows children who need to be admitted to the hospital from the ED to stay with the same care team.

Just off the ambulance entrance is a six-room behavioral health ED. Security and safety are paramount in the design of this area, but it also has floor patterns, accent paints and attractive furniture for a noninstitutional look and feel.

A small imaging department with X-ray and computed tomography equipment is located adjacent to the ED, and the hospital laboratory and pharmacy are on the same floor.

'Great place to practice'

Besides creating a more prominent entry and larger, more efficient ED, the other main goal of the expansion project was to relocate as many beds as possible from the existing hospital into the new patient tower. The project team was able to move all the beds — and even add a few more — and stay within the original budget.

The former rooms were semiprivate and 198 square feet in size. Each new private room covers 300 square feet, allowing space for family members to be involved in patient care. "That's really an important thing," says Kirby.

The isolation and bariatric rooms are fitted with patient lifts. The remaining patient rooms have the infrastructure for lifts to be added at a later date.

The addition opened last November; by February, the hospital already had reached capacity and broke its record for patient volume.

According to Kirby, physicians are happy with the space and privacy the facility allows for patient care, and they have been great proponents of the hospital. She says physicians have said to her, "'Boy, is this a great place to practice medicine.'"

Amy Eagle is a freelance writer based in Homewood, Ill., who specializes in health care-related topics. She is a regular contributor to Health Facilities Management.