Emergency Preparedness Put to the Test at Temple University Hospital

Temple University Hospital in Philadelphia, Pennsylvania is one of the Northeast region’s most respected academic medical centers. The hospital is located in an urbanized environment and the emergency department is highly utilized by the community.

Aug_MCDeNews_Projects_Emergency PreparednessIn December 2012, it was determined the hospital needed to replace its parking structure. The old garage did not meet codes and was failing due to the spalling concrete. In addition, hospital officials wanted the existing ambulance emergency entrance, which was open to the outside, to be part of the garage and to provide shelter and space for the ambulances and patients entering the ED. The construction required the temporary relocation of the ambulance drop-off area to approximately 200 feet away from the triage bays while the demolition and construction of the new project was underway.

The $21-millon dollar project consisted of replacing an existing, failing, concrete poured-in-place garage,  with a new 165,000-square-foot, code-compliant precast garage with 454 spaces.

“The challenge was maintaining operations in the hospital without interruption, which included the relocation of the emergency department entrance,” said project team member, David Stepelevich, vice president at Healthcare Building Solutions, Inc.

Stepelevich said the other main challenge was that the hospital was established in 1884 and the existing site included undocumented major utility systems, such as electric and steam, which supports the facility. “Those utilities ran through the site and could not be disturbed, however, had to be relocated to accept the new garage footprint,” he said.

Aug_MCDeNews_Projects_Emergency Preparedness2The team relied on older as-built drawings and the facility management department to help identify the locations of those utilities, as well as a lot of hand digging to identify what wasn’t on drawings. In addition, before the site was a garage, it had various other usages that dated back to the 1840s. There were over 200 undocumented caissons underground that were found as the team developed and dug foundations.

In March of 2015, the ambulance drop-off area opened early. The team understood from past experience that the closer triage rooms were to the ambulance drop-off area, the better the outcomes of the patient would be.

“We considered this the difference between life and death in some cases,” Stepelevich added. “We reviewed the plans for early occupancy of just the ambulance drop-off area within the garage to the state and city inspection teams and presented our solution to Temple University Hospital.

Once there was full support from all parties and, after all approvals were granted, the new drop-off area was turned over to Temple University Hospital three months early on April 16.

Three weeks later, a train disaster occurred.

At about 9:10 p.m. on May 12, Amtrak Northeast Regional Train 188—en route from Washington, D.C. to New York City and carrying 238 passengers and five crew members—derailed and partially rolled over in the Port Richmond section of Philadelphia, Pennsylvania. The train was moving at 105 mph toward a curve with a speed limit of 50 mph. More than 200 were injured and 58 of the most critical were transported to nearby Temple University Hospital.

“You sometimes think there’s a higher being that puts things in place the way they need to, because that space made all the difference for us,” said Michele Jones, Temple’s ER nurse manager.

The project team included Healthcare Building Solutions, Inc.; Array Architects; TimHaahs and Shoemaker Construction Co.

Photos courtesy of Healthcare Building Solutions.

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Posted August 19, 2015

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