Monday, February 7, 2011
As we're coming into the final stretches of schematic design (SD) on the Gestalt Healthcare's Uber MOB project, we have dissent in the ranks. At least two of the user groups (that is, the groups of people representing a department and helping us design it) have flatly stated that they don't like where they are in the building. At the last round of user group meetings, they were adamant (and sometimes quite emotional) about how they needed to be on a lower floor/different floor/up a floor/on the west side/closer to the front door/on the other side of the building or they needed to have more windows/direct access to the outside/direct access to the front door/direct access to the back door. They want to be located somewhere else in this building. Now.
Um, to quote Austin Powers, that train has sailed.
When we design multistory buildings with a variety of tenants in them, we do what's called blocking and stacking. We use a program for each tenant (or in this case, department) to tell us how many square feet each tenant should be. We take those tenants and figure out where they should be in the multi-story building. And when we do that with a healthcare facility, we do that with the owners (Gestalt HMO) as well as the users (people who run or have run these departments). So we did blocking and stacking last summer with the Gestalt management as well as a representative from each of the departments, and now six or seven months later, the locations of their departments is un-acc-eptable! Really? You just figured this out now?
I suppose this wouldn't be as hard to deal with if the design and construction schedule for Uber MOB wasn't so aggressive. Any major changes in the plans at this point are a big deal and will cost us at least a month if not more. The Gestalt higher-ups are talking amongst themselves to decide if we're going to do all these big flip-flops, but I strongly sense that the answer is no. Why? Because beyond the schedule, beyond the meetings, beyond all of it, is a simple truth that project manager Gretchen articulated: "Everybody wants to be on the first floor, no matter what their department does or how big or small it is. Everyone wants the first floor, facing the Rockies to the west."
And that's the truth. And it's not the truth because nurses and doctors are rude or selfish--it's because they care about their patients and want to make sure that they aren't walking long distances when they're sick, and they want to make sure that if a patient suddenly codes (has heart failure and needs CPR or other resuscitation) in a department that they can be taken easily to an ambulance. And they want to make sure that when you tell a patient "you have cancer," that the patient isn't in a dark room in the basement but is perhaps able to look out a window at the mountains and think well, I have some options on how to deal with this instead of dear God I have cancer and I'm in a cave. And yes, being on the first floor would also benefit the caregivers and staff--less travel time from the parking lot, a nice and refreshing work environment to see the same inspiring vistas that the patients see--but it is ultimately about the patients.
Alas, land is finite. We have to build vertically so that we can get all the needed departments in one building on one site and still have land left over for parking and loading docks and the possibility of future buildings for when Uber MOB expands in 10 or 20 years. So not everyone can be on the first floor facing the mountains. Someone has to look at the Eastern Plains. Someone has to go on the top floor. Someone has to go in the basement. And we've all done the best we could to get people where they might best serve their patients while also bearing in mind that we can't build a Super-Walmart building for this MOB. So, it's probably not going to change. But if there's anything we can do to mitigate the pain of having a less-then-excellent location in the building, then we'll do it.