2.10.2009

New Orleans Hospital Planning Lacks Coordination

Building design is important, especially in hospitals. The right design facilitates flow, improves communication and eliminates considerable wasted motion. And it is at least, if not more, important when several buildings are being constructed rather than just one.


Unfortunately, it seems that the people designing a new medical complex in New Orleans do not understand this concept.


The U.S. Department of Veterans Affairs and Louisiana State University are jointly planning a new teaching facility, after Hurricane Katrina led to the closing of LSU's Charity Hospital and the VA Medical Center downtown. The two organizations selected adjoining parcels of land with the intention of constructing two immediately adjacent hospitals.


But according to The Times-Picayune newspaper, the various design options recently unveiled by the organizations would result in “distinctly independent hospitals that appear to lack much of the ‘synergy’ the participating institutions once touted.”


The article, by Bill Barrow, also says the organizations “drifted apart in their planning processes.”


"I haven't heard any mention of synergy," said Elizabeth Merritt, an attorney for the National Trust for Historic Preservation, after seeing the plans for the 70 acres bound by Tulane Avenue, Claiborne Avenue, Canal Street and South Rocheblave Street. "It seems like there's not the level of coordination considering that was such as strong consideration in selecting this site."


Together, the two hospitals would total about 600 beds. The design options from LSU, which would provide two-thirds of the capacity, call for up to five inpatient towers, each with six stories.


There appear to be several issues here. The most obvious is that what should be a joint planning effort disintegrated into two independent efforts. This made impossible to do any value stream mapping, for example, to see whether the two projects have overlaps or disconnects that could be addressed.


I also wonder about having so many separate inpatient towers. I know nothing about hospital design, but I can’t help questioning whether the various departments of a hospital operate so independently that they should be physically separated from each other. I worry that this kind of design has the potential to create silos (almost literally) that will cause problems in communication and interaction.


A period for comments on the plans goes through the first week in February, with more public discussions at some point in the future.


Does anyone care to make a comment?

2 comments:

Dean Bliss said...

Unfortunate story, particularly with the economy in the state it's in. Sounds like they're building in inefficiency that will be difficult to correct in the future, if indeed the organization is interested in efficiency. As far as the inpatient towers, the key is the proximity of the services, such as lab, radiology, and pharmacy. As long as their delivery methods are efficient, the location is less of an issue. In my experience, the staff in various inpatient units have little interaction with each other.

hans said...

Sadly, neither of these facilities were planned by looking outwardly at what was needed in the community but by looking inward at what each facility felt would make it better. The LSU project has clearly amounted to empire building: what is planned is not what is necessary but what LSUHSC wants to make it bigger and better. The history of LSU's ability to administer the Medical Center of LA at New Orleans (MCLNO) demonstrate very clearly that they have been terrible at making the Chariloty hospital selfsufficient. But their biz plan for the new LSUHSC empire hospital relies directly on paying patients (private insurance) who they fantasize will sit in waiting rooms with the poor and indigent patient await the same services. Their biz plan is $500-700M short of funding and hospitals around NOLA are not suffering from 100% occupancy. So, why build a new hospital?? Because LSU wants one.