Hoag Orthopedic Institute: Evolving the Specialty Care Model

Hoag Orthopedic Institute is a new orthopedic specialty unit within Hoag Hospital Irvine. To create it, TAYLOR, a healthcare architecture firm based in Newport Beach, designed the complete renovation of a 20-year-old community hospital in Irvine, Calif. Recently opened, the institute is already being viewed as a model for successful orthopedic practice within a community hospital.

During planning, hospital administrators, physicians, designers, construction managers and contractors explored the community’s needs and opportunities to have a facility that would contribute to health and wellbeing far into the future.

“We took our cues from an interested community for everything we did to remake this hospital,” says Alyssa Scholz, TAYLOR practice leader and designer on the project. Alan Beyer, M.D., an orthopedic surgeon and project advisor adds an orthopedic center of excellence made sense for Orange County, whose population is very sports and wellness oriented.

“There are a large number of recreational athletes here – many aging but active baby boomers – who particularly benefit from Hoag Orthopedic Institute’s services,” he says. “The project took orthopedic care here to a new level.”

Scholz says the team’s mandate was to innovate. “The design accommodates new medical processes and technologies that improve care, and structural changes that allow a smoother flow through interior spaces for both patients and staff.”

Simple design concepts changed the aesthetic sensibility of the hospital entirely, while leaving the lion’s share of the budget to be invested in state-of-the-art technology, new medical programming and re-imagined patient-flow patterns.

Dr. Beyer worked directly with the design team from the beginning. “We set out to create a facility that supported absolute alignment between the physicians and the hospital,” says Beyer. “In terms of the design, we threw away a lot of old models to create something new – assessing how we could be more efficient, how instruments are used, cleaned, stored and what the layout of the outpatient surgery should be.”

Dr. Beyer adds the collaborative design process resulted in larger pre-op and post-op spaces than in a typical inpatient surgery.”These are typically choke points that slow down the surgical schedule.”

Pre-op and post-op were designed to swing in peak times, so in the morning staff can fill up the pre-op side; the process can be reversed in the afternoon. An induction room was placed just ahead of the operating theater, allowing patients to receive anesthesia and be readied for surgery faster. These, and other innovations, help assure the surgical processes are efficient, and that patients spend less time in the operating suite – a factor in positive outcomes.

A quiet color palette, textures and soft lighting help create a positive patient experience. “We wanted it to not look like a typical hospital, and while I wouldn’t say it is spa-like, the environment should help the patient feel less anxious and help us improve outcomes,” says Beyer.

The institute offers inpatient and outpatient services of private practice orthopedic physicians and other specialists. It includes orthopedic surgery, with nine operating rooms and an 18-bay pre-op plus 18-bay post-anesthesia care unit. The 70 patient beds devoted to orthopedic care are associated with a new physical therapy gym, new sterile processing department, new staff lockers and lounge area and a nurse-navigator program.

Ideas that TAYLOR incorporated from physicians, administrators, community and the land itself, resulted in a new hospital that works extremely well, and resonates with the unique geographic qualities and population characteristics of Southern California.

Editor’s Note: Stay tuned for the March/April edition of MCD, which focuses on specialty facilities.