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March 8, 2017

How one VA hospital took veteran feedback and turned it into something special

Daily Briefing

After Hurricane Katrina destroyed a Veterans Affairs (VA) hospital in New Orleans, the VA partnered with architects and experts to build a replacement facility that some observers say could be a model for the entire VA system, Barbara Sadick reports for the Wall Street Journal.

To create the hospital, VA officials, the architecture firm NBBJ, and other experts spent three years talking to VA staff and veterans about what they wanted from their facilities, and how veterans use health care facilities. Don Orndoff, SVP of national facilities services at Kaiser Permanente and a former VA official, said the new hospital may be "the most veteran-centered VA facility ever designed."

The new facility, which is called the Southeast Louisiana Veterans Health Care Systems (SLVHCS), has 200 beds, nine buildings, and 1.6 million square feet of space. And while it's currently only offering outpatient services, the hospital should be fully operational by the end of the summer.

Sadick rounds up nine features that set the hospital apart:

1. Social space: Veterans said they wanted a space that would build a sense of community and give them a chance to meet like-minded individuals. To that end, SLVHCS has strategically placed clusters of furniture to "encourage conversation," Sadick writes.

2. Furniture: Veterans have high rates of obesity and disability, Sadick reports. Therefore, SLVHCS has furniture with large armrests—to help patients lift themselves up—and extra width, to ensure they can sit comfortably.

3. Patient-centric rooms: The hospital has identical single-patient rooms throughout, but they can be converted to doubles in an emergency or to accommodate family members. Every room features floor-to-ceiling windows (some of which look out over gardens), remote-controlled shades, and a nearby nursing station to increase interaction between staff and patients. Staff can also convert a room into an intensive care unit as required.

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4. Green space: SLVHCS has six courtyards. They "are strategically located to foster emotional and spiritual well-being and to serve as areas for rest and contemplation," Sadick writes. According to Ryan Hullinger, a principal at NBBJ, "each courtyard was designed for a particular use, with some being more ceremonial, some being quieter and more conducive to contemplation, but all having open green spaces and gardens to foster connections to nature."

5. The concourse: This architectural feature is a clear, straight path through the hospital. The design—along with straight staircases—minimizes anxiety-provoking corners. The concourse also has "support hubs that include security information and wheelchair storage … at every major point of patient entry," Sadick writes.

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6. Colors: SLVHCS avoids military camouflage colors and instead opts for softer colors designed to foster relaxation and calm. "The colors found in military dress ribbons and on other patriotic symbols are used in the facility's art, including a multistory American flag stamped into a concrete wall," Sadick notes.

7. Chapels: Veterans said chapels should receive special attention. SLVHCS has two and they both look out onto courtyards and have abundant natural light.

8. Preparing for the worst: With the lessons of Katrina in mind, NBBJ designed the hospital to stand up to hurricane winds and stay independently operational for five days. Critical features such as the water system and power connections are on the fourth floor to avoid flood damage—and all clinical functions are located high above flood levels. In a worst-case scenario, SLVHCS has helicopter landings and boat ramps to facilitate patient evacuations.

9. Bathrooms: Veterans have higher rates of incontinence than civilians, Sadick writes, so SLVHCS has easy access to bathrooms at each of its three main entrances and in the parking garage. Larry Jones, one of the veterans who shared recommendations with hospital's architects, said, "Wherever you are in the hospital, you are no more than 100 yards away from a bathroom" (Sadick, Wall Street Journal, 2/28). 

From bombings to hurricanes: How can hospitals prepare for disasters?

Hospitals must be prepared for myriad disasters that can stress health care systems to the breaking point and disrupt delivery of vital health care services.

Advisory Board has compiled step-by-step procedures for various threats your facility may encounter—though we hope you'll never need to use them.


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