IPD, Lean Deliver New 7-Story Akron Children’s Patient Pavilion

Akron Children’s Hospital, Akron, Ohio, opened its new $180-million Kay Jewelers Pavilion May 5—ahead of schedule and under budget.

Kay Jewelers Pavilion

The seven-story, 368,735-square-foot facility enhances and expands Akron Children’s services as the hospital celebrates 125 years of delivering family centered care this year.

The building features a new neonatal intensive care unit with 75 private rooms, a new emergency department, an expanded outpatient surgery center and a labor and delivery center for high-risk births—the first such dedicated space in the hospital’s history.

The project team included:

• CBRE Healthcare, onsite project manager
• Hasenstab Architects, Inc., design architect
• The Boldt Company, Integrated Lean Project Delivery construction manager
• HKS, Inc., associate architect
• Welty Building Co., construction manager

Full-scale, cardboard mockups of special delivery unit.

Integrated Lean Project Delivery process saves time, money and space
The Kay Jewelers Pavilion was completed two months ahead of schedule and with $60 million in cost savings from the original estimate.

“Throughout the project, we were able to implement —and stick to—an accelerated construction schedule by following various Lean practices in the design and construction of the building,” said Ray Walker, managing director, CBRE Healthcare. “On a project of this size, it’s a testament to the processes and teams in place to finish ahead of schedule and significantly under budget.”

Akron Children’s used a nontraditional approach for the building’s design and construction that allowed the people who use the building—patient families and staff—to help design it. This approach, as developed by The Boldt Company, brought everyone involved in the project together to offer input before any designs were finalized.

“The goal of the collaborative ILPD process is to eliminate the waste that typically exists in a conventionally delivered project. The result is a project that can be delivered at a lower cost with increased quality in a shorter period of time,” said Dave Kievet, group president, Boldt. “We looked at everything from rearranging department flows for efficiency to reducing the height of floors to lower construction costs.”

ILPD teams had a goal to reduce baseline space and cost needs by 20 percent. In the end, they trimmed more than 34,000 square feet of building space from the NICU, emergency department and outpatient surgery center combined—a nearly 21 percent space savings and $20 million in cost savings.

“Teamwork and a culture of transparency and accountability were central to reducing duration and costs from the design and construction processes,” said Patrick Oaks, project executive, Welty Building Co. “Throughout the project, teams engaged in collaborative planning, testing and redesigning to eliminate any potential constraints before they had the opportunity to impact actual construction.”

Staff, parents help design new building
Team collaboration is at the heart of the transformational ILPD model. Long before turning the first shovel of dirt, Akron Children’s and its project partners brought together an array of individuals to design the Kay Jewelers Pavilion.

From mid-2012 to early 2013, Akron Children’s executives, physicians, nurses, clinical staff and patient families met regularly with architects, builders and the hospital’s in-house Lean Six Sigma experts to discuss ideal spaces for patient care delivery. The intent was to catch design flaws early and solve problems before it was too late to make changes.

“Project teams addressed such issues as minimizing walking for patient families, doctors and nurses, ensuring efficient movement of supplies in and out of operating rooms and providing a calm environment that promotes privacy,” said Jeff Stouffer, AIA, principal-in-charge, HKS, Inc. “Following multiple design iterations, the final plan for the hospital greatly improved patient flows, offered easy access to supplies and minimized steps throughout the building. Wherever possible, we also built in flexibility for future growth and change.”

Critical input came from a series of kaizen events, which were two- to five-day workshops aimed at designing the most efficient and flexible spaces within each service area in the new building.

Department teams first used small-scale models to design floors of the facility. Later, the teams tested these blueprints in full-scale cardboard mockups constructed in a local warehouse.

The replicas of each floor allowed the ILPD teams to try out the spaces, such as in a mock trauma scenario, and make layout adjustments to improve the building’s space, flow, equipment and furniture—before the real construction started.

“Obtaining the perspective of parents was one of the most valuable aspects of the kaizen events to help the hospital deliver better family centered care,” said Marge Zezulewicz, AIA, project manager, Hasenstab Architects. “For example, parents participating in the emergency department kaizen suggested having more restrooms, providing a larger waiting room, giving security a stronger presence and improving overall flow and wait times.”

GOJO outpatient surgery center check-in.

Designing child- and family oriented spaces in “The Backyard”
The building’s “backyard” theme echoes the joys of childhood. Each floor represents a different aspect of the backyard, with unique décor supporting the following themes:

• The emergency department, or “The Puddle,” features a cool, calming aqua palette
• The two-floor NICU, or “The Treehouse,” includes tranquil, inspiring green and raspberry hues
• The GOJO Outpatient Surgery Center, or “The Sandbox,” has lively orange colors
• The new labor, delivery and recovery center, or “The Garden,” features a soothing yet cheerful color palette

“A soothing and engaging atmosphere is such an important part of caring for children, as it’s been proven to help them with recovery and ease pain,” said William Considine, president and CEO of Akron Children’s. “We used colors, paintings, sculptures, photographs and interactive displays to actively engage a child’s imagination, which is the most powerful tool a child has to envision an encouraging future outside the hospital.”

More than 400 pieces of colorful, child-friendly art, including 285 pieces created by local school children, adorn the building’s walls and match its backyard theme.

In addition, backyard fences in the main lobby and outpatient surgery center waiting area feature peek-a-boo holes placed at various eye levels, providing age-appropriate graphics and interactive elements based on the height of the holes.

Photo source: akronchildrens.org.