Improvements noted at VCU's Critical Care Hospital

SLIDESHOW: Critical care, and comfort

VCU Medical Center's $192 million Critical Care Hospital opened in October with the vision of it being a facility of the future, with features that make patient care better, safer and more cost-efficient.

Six months into operations, officials say, is too soon to tell whether the hospital is achieving goals such as reducing infections, shortening patient stays and improving recruitment of medical residents.

But some things are starting to turn around.

For one, the medical center is not having to divert ambulances to other hospitals as much because of a backed-up emergency department or because there isn't an appropriate available bed.

From October through March, emergency-room diversion decreased 43 percent from the same time last year, said John Duval, chief executive officer of MCV Hospitals. As a Level 1 trauma center, VCU Medical Center always takes gunshot victims and other critically injured patients.

"It would be wrong to attribute all of this to the new hospital," Duval said. "We have had teams working long and hard for the last several years to reduce the numbers of hours on diversion."

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Still, it's hard to find anyone who thinks things are not better compared with before the Critical Care Hospital opened.

"We have seen increases in perception of safety and increases in the likelihood of patients to recommend us to friends and relatives, to their perceptions of the overall hospital experience," said Duval, citing preliminary patient-satisfaction data.

A number of patient-care units moved to the new building at 1213 E. Clay St. from the older structures on campus: the art deco-style West Hospital, the 50-plus-year-old North Hospital, and the 20-plus-year-old Main Hospital.

Occupying the new 367,000-square-foot space are neuroscience, surgical trauma, neonatal and medical respiratory intensive-care units; the VCU Pauley Heart Center; the Evans-Haynes burn unit; acute-care surgery and medicine units; a cancer center; 10 operating rooms; and a secured corrections unit for inmates.

The difference on some units is striking.

Whereas the old neonatal intensive-care unit was two large rooms connected by a work space, the new unit is 32 single patient rooms and four rooms for twins.

The rooms are stretched along a corridor where big monitors at nurses' stations let staff members see immediately how babies are doing.

"The two major objectives of the design were to control sound and light, which are known to be important to and sometimes adversely affect the development of babies, particularly preterm babies," said Dr. Gary Gutcher, a neonatologist who marveled at the new unit on the sixth floor.

"So putting them in single rooms all by itself does that," Gutcher said.

To that end, the floor and ceiling are made of special sound-muffling material. Also, the lights can be dimmed; in the old unit. lights could be turned only on and off.

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The ease of communication also is something staff single out as a big improvement.

In the past, said Jake Swenson, a nurse on the expanded Evans-Haynes burn unit on the eighth floor, when he needed help midprocedure, he would have to leave the patient's bedside and track down someone.

Now, he can push a button on his wireless phone and ask for help. The phone connects him to the other nurses on the unit and to the nurses' station. Patient alarms also go directly to those phones.

Also getting good reviews are the high-tech, $30,000 patient beds.

"It makes it so user-friendly for the nurses," said Ann McRae, a registered nurse at VCU Medical Center for 22 years who works on the coronary intensive-care unit.

"If you have a large patient you need to turn or get out of bed, the bed will help you. That's been a huge time-saver.

"It's like a Cadillac. This bed can do everything," McRae said.

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There were some glitches.

"We have had a couple of minor flaws in the building. As you full-load the building with activity, you stress some systems," Duval said.

There were some "water events" that required the facilities crew to jump in. Also, there was an unexpected view of labor and delivery from across a courtyard that required some hastily installed window shades.

"As with any new building, you will have intermittent episodes of something not working and needing correcting," Duval said.

Some of the hospital's features are tied directly to goals.

For instance, staff want to move patients less frequently. Every move raises the risk for a medical mishap -- for a fall, for infection, for tubing to be dislodged. Because one of the most common reasons patients are moved from their rooms is to have dialysis, all the rooms can support portable dialysis.

The patient rooms also are larger, so there is space for people and equipment to do tests. In an era where care is patient-centered, the larger rooms also accommodate families better, with a foldout bed for a relative to stay overnight.

"This is very nice," said Dorothy Leahey, who was a patient in the coronary intensive-care unit in November. The Williamsburg resident said relatives who visited were impressed. "They were amazed at the amount of room I had."

Duval said patient satisfaction has increased. More people are rating the accommodations and cleanliness as "excellent" in surveys, and hospital admissions are up 1.2 percent over last year, he said.

"It's a little too early to see a change in clinical outcomes, but we are looking for that information," Duval said. "We will continue to gather and monitor over time to consider how successful we are."

One thing that's on hold is the emergency-department expansion on the ground floor.

"The economic downturn has slowed down that project," Duval said. "We are not pushing that start button until, frankly, the larger economic indicators go up. . . . We are watching our expenses very closely."

Contact Tammie Smith at (804) 649-6572 or TLsmith@timesdispatch.com.

Aims of the hospital