Heart of Design: Patient experience gives life to John R. Oishei Children’s Hospital

By Uma Ramanathan  |  Photos by Tim Wilkes

For nearly 125 years, Women & Children’s Hospital of Buffalo provided world-class care to the moms, children and babies of Western New York.

The 617,000-square-foot hospital property was comprised of seven interconnected buildings constructed between 1917 and 1995. The campus had become cumbersome for circulation, the floor plates were inefficient, and some buildings were aged past their utility.

With the trend toward ambulatory care and a growing demand for expanded inpatient and outpatient services by Kaleida Health, the time had come to replace the 125-year old campus.

Shepley Bulfinch was engaged to right-size, consolidate and relocate Women & Children’s Hospital of Buffalo to the newly designed John R. Oishei Children’s Hospital on the Buffalo Niagara Medical Campus, and fully integrate the new facility with Buffalo General Medical Center, Gates Vascular Institute, the new Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo, and other medical office buildings.

The opening of the hospital in November 2017 marked the completion of the $270 million, 410,000-square-foot health facility, New York State’s only freestanding children’s hospital—one of 43 nationwide. The 185-bed modern hospital is the regional center for comprehensive pediatric trauma, surgical, and medical care, including neonatal, perinatal and obstetrical services.

Named after Buffalo native, industrialist and philanthropist John R. Oishei, the 12-story Oishei Children’s Hospital leverages existing logistical support services on campus including mechanicals, materials management and centralized clinical labs.

An underground tunnel connects the new building with Buffalo General Medical Center and Gates Vascular Institute to provide back-of-house circulation and utility connections. A pedestrian sky bridge connects both buildings to two floors of clinics and an outpatient surgery center in the adjacent Conventus, providing circulation for patients, visitors and staff.

Improving the patient experience through design

The massing of the building fans from the street edge as it transitions from platform to tower, decompressing the campus at the pedestrian level and creating a hanging garden effect on the entry façade that welcomes patients, families, and the community.

With a colorful, bright and inviting building envelope inspired by the vibrant house colors in nearby Allentown and the profile of City Hall, the façade features cascading gardens and a transparent exterior that speaks to a youthful culture.

Upon arrival, families and visitors enter a large, playful lobby dotted with several activity areas and defined by an information desk, gift shop, and grab-and-go food kiosk. Like the waterways throughout Western New York, a blue meandering pattern within the terrazzo floors winds through the public lobby, directing foot traffic to and from entrances, elevators and family amenities. A digital mosaic composed of 17,000 self-portraits of patients and community members speaks to the commitment of Buffalo families.

In lieu of a traditional cafeteria, a deli on the second floor offers indoor seating and an outside terrace that give families a place to linger between appointments. To augment the grab-and-go dining, a pavilion off the lobby features seating and a stage for child-friendly entertainment and performance space.

The elevator lobbies and public areas on each floor face the main entryway with floor-to-ceiling windows. Each floor’s theming, color scheme and environmental branding assist families and visitors with wayfinding, as well as playrooms and public spaces where patients and their families can gather and relax. Space such as the Fisher-Price/Mattel Family & Child Support Services Floor was prioritized for family respite, education and care. This tranquil space away from clinical and public areas located on the fifth floor includes a Family Resource Room, laundry amenities, kitchenettes, family lounge, winter garden, non-denominational chapel and meditative roof garden.

Continuance of care

Classified as the only Level 1 Regional Pediatric Trauma Center in Western New York, the new Alfiero Family Emergency Department is accessible from the main entrance on the first floor and features 19 ED rooms, five Kids Express rooms, and four trauma rooms. Doubled in size compared to the old facility, the ED offers an improved waiting area for families and a more efficient flow for patients transferred from the helipad, which was specifically designed for children.

A separate, six-room triage area for laboring mothers also provides direct access to patient elevators for quick transport to the 15-bed labor and delivery unit that occupies half of the third floor. The pedestrian bridge to Buffalo General Medical Center and Gates Vascular Institute on the second and third floors reduces the distance helping to deliver care to high-risk moms.

An inpatient surgical suite on the other half of the third floor, as well as an ambulatory surgery unit on the second floor, provide 14 operating rooms that are larger and better configured than before. The second floor also includes a new imaging hub with connectivity to the adjacent medical office building, providing convenience for families and children having day surgery.

The hospital’s 64-bed private room Children’s Guild Foundation Neonatal Intensive Care Unit on the fourth floor, was designed to be quiet, calm and private. Oishei Children’s Hospital is the region’s designated Regional Perinatal Center and a Level III NICU, providing the most comprehensive and specialized care for the region’s at-risk moms and babies. The womb-like floor allows mothers to be with their babies around the clock and features an all-weather solarium that provides respite for patients, family and staff.

The new NICU is divided into four areas: three self-contained patient areas each with a designated team of nurses and physicians, and the fourth area provides a family waiting room, overnight room, bathroom, lockers and laundry facilities. All patient rooms offer ample space for amenities, including in-room seating that turns into sleeping areas for visiting family. There are eight rooms for twins and one room for as many as six babies.

The Sal H. Alfiero Pediatric Intensive Care Unit on the ninth floor features 20 private patient rooms designed to foster a comfortable, family-centered care environment.

The Mother-Baby Unit on the eighth floor welcomes new mothers and their newborns after labor and delivery. With an increased focus on evidence-based medicine, all mother-baby rooms are private to encourage skin-to-skin contact immediately after delivery as well as continued mother-baby bonding. A nursery with large glass windows allows visitors to look in at high-risk babies.

More patient rooms occupy the 10th and 11th floors. The 12th floor is dedicated to specialty services, and pulls together two previously separate outpatient and inpatient units into a single, expanded-service facility, creating a joint pediatric hematology/oncology unit for the care of children with cancer, rare blood diseases and epilepsy. To support its mission of patient-focused, family-centered care, the hospital decided to provide all-private, acute care rooms that are 50 percent larger than the former hospital. Each patient room features a sleeper sofa, a large wardrobe, a safe for valuables, and a special patient education/entertainment system for both patients and visitors.

For family convenience, each patient floor offers two nourishment rooms equipped with a full-size refrigerator, microwave and ice machine. Waiting areas at the entry to every floor/unit are flooded with natural light and provide spectacular views of the city. Pieces by local Buffalo artists adorn the public areas, adding to the bright, family-friendly environment.

Tying research and education to the patient experience

Research and education among staff can occur in formal meeting spaces as well as patient care units. Caregiver work stations are adjoined to a collaborative hub. While the hub encourages multidisciplinary collaboration through meetings and debriefs, the caregiver work stations provide space for administrative work, staff socialization, and shift handoffs. Allowing for close proximity to patients, these workstations provide staff with three work zones: curbside, step-in, and immersive. The curbside zone provides a highly visible place for patients and visitors to easily identify and approach staff yet offers privacy for huddled conversation. Step-in areas are designated for computer entry when interruption should be minimized. Immersive space displays important patient information, facilitates communication amongst caregivers, and allows for functional flexibility between day and night shifts.

Additional satellite work stations throughout the units help to control noise levels, maintain patient privacy, allow for easy documentation close to the bedside, and maximize sight lines between work areas and patient rooms. The work stations reduce distractions and interruptions and provide flexibility and choice in workflow, resulting in error reduction and maximized outcomes.

The new John R. Oishei Children’s Hospital is the result of a thoughtful patient-focused design approach that creates an innovative, high-quality and freestanding facility, providing advanced care and comfort to families and sick children.

The Project team includes:

• Design Architect: Shepley Bulfinch
• General Contractor: Turner Construction Company
• Civil Engineer: DiDonato Associates
• Mechanical/Electrical/Plumbing Engineer: Cannon Design
• Structural Engineer: Simpson Gumpertz & Heger, Inc. (SGH)
• Landscape: Brown Sardine

Uma Ramanathan, AIA, LEED AP, is a principal at Shepley Bulfinch

To read this article in the May/June issue: https://mcdmag.epubxp.com/i/985214-may-jun-2018