As the City of Columbus celebrates its bicentennial, Nationwide Children’s Hospital celebrates the biggest achievement in its 120-year history, changing both the Columbus skyline and the future of pediatric care.
In a dedication ceremony held this morning, Nationwide Children’s, alongside community leaders and partners, celebrated the completion of its seven-year campus expansion, the largest pediatric expansion project in United States history. Once renovations have been made to the existing hospital, Nationwide Children’s will house 460 patient beds on its main campus in addition to the 92 off-site newborn special and intensive care beds the hospital leases from local maternity wards.
The expansion adds 2.1 million square feet to Nationwide Children’s downtown campus. The project will continue to create additional jobs through 2014, bringing the total job creation to 2,400 and a community economic impact of $1.3 billion.
During the last decade, Nationwide Children’s has achieved unprecedented growth and success resulting in the need for expanded and enhanced services for the patients and families it serves. Testaments of growth and success include annual patient volume more than doubling from 400,000 patient visits in 2000 to nearly 1 million today, and the number of employees doubling from 3,700 full and part-time employees in 2000 to nearly 8,000 today. External funding to The Research Institute at Nationwide Children’s more than tripled from $20 million in 2000 to $69 million in 2010, establishing the hospital firmly among the nation’s top 10 pediatric research centers and also one of the fastest growing. In the community, Nationwide Children’s has strengthened relationships with its neighbors and helped revitalize Columbus’ Southside through initiatives including Healthy Neighborhoods, Healthy Families, the Ohio Better Birth Outcomes collaborative and the hospital’s anti-obesity efforts. Maintaining the hospital’s 120-year mission is ensured through tremendous community support including the transformational $50 million gift from Nationwide Insurance received in 2007, and the completion of a very successful $300 million capital campaign (exceeding the initial goal of $250 million). Nationwide Children’s innovation and quality of work have also garnered national recognition including achieving Magnet nursing excellence status in 2005, and listing as one of only 12 Honor Roll hospitals in the 2012-2013 U.S.News & World Report’s list of Best Children’s Hospitals. The hospital was once again honored in every specialty and has appeared on this list every year since 2006.
“We made a promise to the families of central Ohio nearly a decade ago – to become one of the very best children’s hospitals in the country and to provide the finest healthcare available anywhere, right here at home,” said Abigail Wexner, Board Chair of Nationwide Children’s Hospital. “The grand opening dedication recognizes the tireless efforts of thousands of people – committed to the same vision that everything does matter. In every detail, every nuance, every minute decision, we hope it demonstrates how much we value not only the families we serve, but also the neighborhood and city in which we live.”
“During the last decade, Nationwide Children’s has achieved more, and more quickly than any other pediatric institution,” said Steve Allen, MD, chief executive officer of Nationwide Children’s. “These achievements are made possible because of the dedication of our talented staff, unprecedented community support, and leadership by our board and Mrs. Wexner.”
The six key areas of growth of the campus expansion include a 12-story, 750,000 square foot new main hospital; a six-acre front lawn and green space that will complement the existing Livingston Park; a LEED-certified silver central energy plant; expanded parking with the Livingston Avenue garage (more than 1,500 parking spaces) and the two-story underground parking garage (more than 400 spaces) located beneath the front lawn and connected via tunnel to the new tower; a clinical research building that houses the Surgery Center, the Center for Digestive Disorders, GI procedures and clinical psychology as well as two floors dedicated to research; and an expanded West campus that includes a research facility known as Research Building III (RBIII).
The opening of Research Building III, slated for mid-summer 2012, will significantly expand Nationwide Children’s capacity for leading-edge child health research. When all floors are complete, the new research facility will add 225,000 square feet to the current 300,000 square feet in the existing Wexner Institute for Pediatric Research and Research Building II.
“Among the areas of focus in the new facility are scientific programs related to prematurity and pediatric heart disease,” said John Barnard, MD, president of The Research Institute at Nationwide Children’s Hospital. “The steadfast financial support of research from the hospital and community, our recruitment of highly-funded, renowned scientists, and the visionary design of this building will further enhance the impact and national visibility of our outstanding research programs.”
The design of RBIII office and lab space anticipates the evolution of modern biomedical research towards efficiency and team science. It is designed to encourage collaboration with the four labs sharing space with adjacent tissue culture rooms, fume hood alcoves and microscope alcoves, a central, linear equipment corridor with freezers, refrigerators, walk-in coolers, autoclaves and darkrooms. Shared resources are close and centralized. In addition, all offices and staff seating areas are located outside the lab area, separated by expansive glass walls, also encouraging collaboration and enhanced visual interactions.
The complete master facilities project finishes on-time and under budget with a total estimated price tag of $783 million. The project, including the 12-story hospital expansion and other enhancements, was originally projected at a cost of $810 million. As the effort progressed, additional enhancements were approved by the Nationwide Children’s Board of Trustees bringing the total final estimated project cost to $889 million. These included expansion of both the new main hospital and research building as well as the addition of the underground parking garage and enhanced green space above it. Through focused efforts on cost savings and maximizing favorable economic conditions, Nationwide Children’s was able to deliver the expanded project scope while coming in $28 million below the original projected cost and $107 million below the revised budget figures.
Final cost breakdown of the project:
- New Hospital $430M (completed 6/2012)
- Research Building III $94M (to be completed 9/2012)
- LEED-Certified Central Energy Plant $66M (completed 11/2010)
- Clinical & Research Building $41M (completed 10/2008)
- Livingston Parking Garage $27M (completed 1/2008)
- New – Underground Garage/Site Park $18M (completed 6/2012)
- *All Other Projects $107M
*This includes the underground parking garage, site park and a number of smaller projects within the existing buildings such as expanding the interventional radiology suite and installing an intra-operative MRI.
There were several key factors that enabled these cost-savings. First and foremost was a multi-team approach to making cost-effective decisions without sacrificing quality, safety or the patient experience. This team included internal departments such as Engineering and Patient Care Services working in close partnership with best-of-class advisors such as design and construction firms and other consultants as well as the facilities committee of the Board of Trustees. Additionally, a Financial Advisory Committee was created exclusively for the project. This group provided intensive fiscal counsel throughout the effort and was instrumental in maximizing every opportunity to enhance the project while achieving optimal cost savings. For example, the Financial Advisory Committee recommended pre-purchase of copper wiring for the project during a period of favorable commodities pricing. The copper was purchased 11 months ahead of schedule and as a result of this attentive counsel, the hospital saved over $800,000 on the wiring in the building.
Second, was pre-planning the project. The full-scale ‘mock rooms’ that Nationwide Children’s built in a former Kroger store location facilitated broad-based feedback from more than 500 interested parties (physicians, nurses, families, allied health professionals, etc.) which enabled changes to be made in the mock rooms rather than on site in the new main hospital. ‘Design assist’ enabled the use of key subcontractors for mechanical, electrical and plumbing systems interacting with the architect before the drawings were complete. By hiring the key trades earlier than customary, Nationwide Children’s was able to work with the architect to avoid costly design issues. Building Information Management (BIM) is the computer-aided design that looks at all systems comprehensively. For example, instead of finding out in the field that the plumbing line is intersecting the HVAC line, it can be seen on the computer first and corrected when building out.
Finally, budgeting for an 8 percent cost inflation of materials during the seven-year project, in which material inflation rates actually flat-lined, assisted with cost containment. In addition, vendors projected their costs under initial budget.
Nationwide Children’s funded the expansion through a combination of operations, bonds and philanthropy. Early fundraising success was also instrumental to funding the project with the completion of the $300 million “Change their Tomorrow” campaign (with an original goal of $250 million). Throughout the multi-year effort Nationwide Children’s has maintained a both a Aa2 Moody’s bond rating and AA bond rating from Fitch, the highest ratings currently awarded to any free-standing children’s hospital.
Enhancements added to the project, while still coming in under budget:
- Underground parking garage with rooftop green space
- Larger building footprint for Research Building III
- PET/CT imaging
- Enclosing the Magic Forest
- CTICU/PICU double–boom system in patient rooms
- 2 additional elevators
- Concourse connection to C Building (connector between the ‘new’ and ‘old’ hospital)
- Outdoor dining courtyard off of the cafeteria
When campus expansion planning began in 2005, the entire patient experience, from arrival to post-discharge, was taken into consideration. The result is a campus that is easy to access and navigate inside and out. Examples include, creation of a drop-off loop with a canopy that runs counter-clockwise, so that the patient is exiting closest to the door; addition of an underground parking garage with a six-acre park for its roof; and partnering with the City of Columbus to re-work Parsons and Livingston Avenues as boulevards with trees, wider sidewalks, brick crosswalks and bike lanes.
Upon entering the new main hospital, Nationwide Children’s patients will encounter a design that is uplifting and optimistic. A nature theme is carried throughout the design with natural wood textures and imagery of animals, birds and butterflies. The hospital’s interior design team found that in times of stress and anxiety, images of birds, butterflies and notions of flight created feelings of calm, hope and optimism.
Research has shown that exposure to sunlight improves sleep, reduces depression, enhances patient mood, speeds recovery, improves staff productivity and can even reduce lighting expenses. Therefore, the new main hospital was designed so that natural light enters from all four sides of the building, and every patient room has large windows allowing natural daylight into the room that will help patients recover by reducing anxiety and associated complications.
Patient rooms and corridors are equipped with sound-absorbing materials to reduce ambient noise. Studies have shown that this supports better sleep and less stress for patients, families and caregivers, while creating a safer environment for the delivery of care. Every patient room in the hospital will be private, reducing the chance of infection and potential errors, enhancing sleep and supporting family inclusion. Also, patients and their families will have control of lighting and thermal comfort systems in their rooms.
The standardization in rooms and unit layout will reduce variability in configurations, increase safety through standardization of clinical support amenities as well as patient movement in the room, ease orientation to units, reduce frustration and stress and enhance facility flexibility for future utilization.
Features of the patient rooms:
- Private rooms with a full bathroom featuring a tub and shower combo that is large enough and equipped to accommodate the patient’s caregiver
- Nearly double in size from existing patient rooms to 300 square feet
- Sleeping accommodations for three overnight visitors with a sleeper sofa and trundle bed and a glider recliner that was specifically designed for Nationwide Children’s
- LED color-changing head wall in which the color can be controlled by the patient from their bed – “mood lighting” for kids
- 42-inch flat screen TV for television viewing, Internet access and patient education (i.e.: how to take asthma medication)
- Increased storage with shelves for patient’s personal display items, and a dedicated locked drawer for patient/family valuables
- Walls with magnetic paint allowing for artwork, get-well cards, etc. to be hung and displayed
- Equipped with technology that will support patient identification safety initiatives for medication delivery (bar-coding) and various procedures
- Ceiling-mounted lifts for movement of patients that provide increased safety for both patients and staff (will be located in all rehabilitation rooms and in other select patient rooms throughout the facility)
- Secured cabinets located right outside of the patient room for isolation supplies, frequently accessed supplies and patient medication
- Staff workstation right outside the room so observation and documentation by the nurse can occur without disturbing the patient/family unless necessary
Features of the critical/intensive care patient rooms:
- Latest technology to optimize clinical practice and patient safety (i.e.: a hand held “light stick” that allows staff to remotely direct surgical lights for critical procedures and vital patient care)
- Overhead service booms that house medical gases, power and data in order to maximize the flexibility and positioning of the bed
- Secured medication pass-through that allows pharmacists to deliver patients’ medications to a locked cabinet from the hallway while the caregiver can then access these medications from inside the patient room (supports efficiency and patient safety)
- Private bathrooms (no shower)
- Internal windows allow staff to view both patients in adjacent rooms at one time in order to maximize clinical care and safety (these windows house mini-blinds to support patient and family privacy when the window is not in use by staff)
- Increased storage for families with armoires and cabinets
The Emergency Department:
- Nationwide Children’s Emergency Department, Ohio’s first Level 1 Pediatric Trauma Center, nearly doubles in size from 24,000 square feet to 40,000 square feet with an increase of patient exam rooms from the current 39 to 62 general exam and specialty care rooms.
- The current emergency department treats more than 70,000 visits a year in spaces originally designed to see far less. The new facility supports rapid throughput, enhanced patient experiences and allows for continued growth.
- Current and future trauma rooms allow for family inclusion and appropriate support staff for the family.
- The Emergency Department will continue to operate in its current location until the new ED opens on Wednesday, June 20.
Features of the nurse stations:
- Strategically located around the patient care unit. These more centralized work stations support the collaboration of multiple disciplines that are vital to patient care and unit function. Centralized staff design promotes the family’s ease of accessing their patient caregivers.
- Built with acoustic ceiling tiles that decrease the noise associated with natural gathering locations which could potentially minimize the risk of error.
- Designed to be neat and orderly with monitors mounted on the wall to maximize work space and desk area.
- In addition, centralized medication rooms are located right next to nurse stations. Every unit has a standardized configuration making inventory and stocking practices efficient and safe. This also benefits unit orientation and efficiency for those caregivers who support multiple patient units.
Features of the hospital corridors:
- Reception spaces and elevator lobbies welcome patients and visitors with expansive views of the nature design elements.
- Way finding is assisted by graphic applications throughout the facility. Visitors will be instructed to follow color paths to their destination. These destination points along the path will also be color-coded.
- Terrazzo flooring was placed throughout the main floor of the building.
- The first floor has acoustic ceilings to decrease ambient noise.
The “wows” of the new main hospital and entire campus – the “Magic Forest”, “Animal Friends” and six-acre park:
The hospital’s design teams heard consistently from providers and families that to achieve optimal health, the patient experience needs to “wow” them. The new hospital features several such “wows” in its public spaces. The following are just a few examples that will play a key role in the healing environment and support positive distraction for patients and families.
- The space connecting the new construction and the existing hospital lobby will become the “Magic Forest” with a café, seating areas and a “seek-and-find” built into the walls. The Magic Forest will have large, fabricated trees and an ever changing light and soundscape set to the current season to prompt the feeling of being inside a whimsical forest.
- Artisans from Mansfield, Ohio (Carousel Works) created 6-to 8-feet-tall, hand-carved “Animal Friends”, which are crafted from solid wood and will “live” in the hospital. Each Animal Friend has a personality trait that is incorporated into their design, bringing them to life for patients.
- The six-acre park just outside the hospital’s new front doors will offer a place of respite for patient families, staff and the community. This green space will feature a maze, fragrance garden and quiet sitting and reading areas.
More upgrades to security, patient “edutainment” and way finding:
With the new hospital come many improvements to existing resources. Security will be upgraded through a hotel-style visitor management system. Key cards that families receive during a hospital stay will only allow them access to the patient’s assigned floor and common areas. The key card will also automatically deactivate once the patient is discharged from the hospital.
Patients and their families will also have improved access to health care education and entertainment options. Patient “edutainment” transforms the hospital room into an interactive care environment with education, entertainment, inpatient services and Internet resources, all available with the touch of a bedside button.
A new way finding system will make the hospital easier to navigate. With each pathway denoted by color, Animal Friends art, each destination designated by splashes of foliage and bright color, and interactive way finding kiosks, families will find their way quickly, effortlessly and efficiently.
Departments and services of Nationwide Children’s and current in-patients moving into the new main hospital will make their move on Wednesday, June 20, 2012. This includes the Emergency Department which will continue to operate in its current location until June 20.
For the most up-to-date information related to the new main hospital, visit www.NationwideChildrens.org. Virtual tours, time lapse videos and information on the new features found in the inpatient rooms can all be found on the website.
Major contractors & subcontractors on the project:
- Turner/Smoot Construction: construction manager – overall construction of the new hospital and RBIII
- FKP: new hospital architect – overall building design
- Andrews Architects: new hospital associate architect – on-site presence for FKP, linking FKP with Turner
- HAWA: mechanical, electrical and plumbing engineer for new hospital and RBIII
- Jezerinac Geers & Associates: new hospital structural engineer
- Equipment Collaborative: new hospital medical equipment consultant – specification and procurement
- Wiss, Janney, Elstner Associates, Inc.: new hospital building envelope consultant – assures exterior building is watertight and well insulated
- Frank Clements Associates, Inc.: new hospital kitchen consultant
- Ralph Appelbaum Associates: new hospital interior and exhibit designer
- NBBJ: RBIII architect – overall building design
- Shelley Metz Baumann Hawk: structural engineer for RBIII
- Jacobs Consultancy: laboratory planner for RBIII
- Formation: campus signage designer – campus-wide way finding signage and environmental graphics
- Big Red Rooster: existing hospital interior designer – adapting new hospital signage/interiors to match the existing facilities
- Gilbane: construction manager – central energy plant and utility tunnels (construction connecting the new buildings)
- MSI-KKG: campus-wide landscape architect
- Olin Partners: campus landscape designer – front lawn/green space design in partnership with MSI
- EMH&T, Inc.: civil engineer for new hospital and RBIII
- The Georgetown Company: project consultants/advisors
- Project Control Systems: owners representative
- Walker Parking Consultants: underground garage designer
- Security Risk Mgmt. Consultants: new hospital security consultant
- FDI: new hospital move consultant
- HCR: new hospital movers
- Jerome Scott Architects: architect/permit drawings and installation coordination of exhibits (structural support, power feeds, etc.)
- Carousel Works: wooden “Animal Friends” construction and carving
- Lifeformations: public space specialty construction (e.g. “Magic Forest”)
- Corna-Kokosing: furniture construction
- Aquarium Adventure: aquarium construction