Northwestern Memorial Healthcare | Galter 13 Behavioral Health Unit Safety Assessment

In 2016 Northwestern Medicine requested that PFB Architects conduct a Behavioral Health Risk Assessment of the Galter Pavilion 13^th floor, identifying any patient / staff safety risks and develop a report of our findings. PFB conducted our assessment through several meetings with the multi-member executive team, site visits, and a thorough evaluation of the hospital’s operational narrative. The results of the final  assessment report address patient privacy and dignity in addition to safety and risk concerns, in order that the unit improvements address appearing less restricting and more holistic. An excerpt from the report is provided above.

The Risk Assessment resulted in an implementation plan to address the noted deficiencies. PFB worked with Northwestern and the contractor to develop a detailed execution plan for each identified deficiency across the unit.

One primary outcome of the Behavioral Health Risk Assessment was a 2018 / 2019 update that addressed potential ligature risks at patient bathroom doors. PFB was engaged by NMH to develop multiple options to eliminate the top-of-door ligature risk posed by traditional swinging doors. PFB presented both passive and active solutions, and ultimately NMH selected an anti-ligature barn door product by Accurate Lock for a pilot program. PFB worked hand-in-hand with the Hardware Vendor, NMH, and Skender Construction to develop installation details, table-top mock-up for user evaluation, and eventually a full-size mock-up of the barn door system. The mock-up served numerous purposes, from end user “test-drive” to validating header and door stop design as well as flooring transition and base details.

Following the successful construction of the Pilot Barn Door on Galter 13, a trial period was conducted by Clinical Staff to confirm if any lingering safety concerns were present and to test the installed functionality of the opening. Positive staff feedback generated the request for a phased implementation plan for installation of barn doors on all patient room bathrooms. PFB, NMH and Skender construction worked collaboratively to create a 15-phase construction project that would limit disruption on the unit and allow staff flexibility if patient census rose and required additional patient rooms. The Barn Door implementation plan also provided an opportunity to address minor risks on the unit, including corridor door hardware upgrades, repairing or replacing damaged construction and replacing furniture with appropriate anti-ligature, weighted products.

Northwestern Medicine | Central DuPage Hospital

The Danada Outpatient Behavioral Health Clinic at Central DuPage Hospital is designed to provide patient-centered care to two patient populations. The Adolescent Area offers (4) Group Therapy rooms, (1) Family Consult room, a Breakroom, and a Classroom and Expressive Therapy room, separated by an operable partition for maximum flexibility in programming. The Adult Area offers (3) Group Therapy rooms, (1) Family Consult room, and a Breakroom. Centered in the core of the space are (4) Office / Consult rooms, as well as (2) large Group Rooms and (2) large Multipurpose Rooms, each separated by operable partitions and accessible to both patient populations. For safety, staff maintain visibility of the corridors and Patient Toilet Rooms from their glass-fronted “Fishbowl” work areas. Finishes and fixtures throughout the project were selected based on guidelines from the New York State Office of Mental Health to minimize safety risks.

Northwestern Medicine | Central DuPage Hospital | Behavioral Health + Neurology

Central DuPage Hospital spent more than $14 million expanding its Behavioral Health Unit in Chicago’s Western Suburbs, as more hospitals seek to meet the growing demand for Behavioral Health Treatment. The design more than tripled the unit, from 15 beds to 48 beds. New beds include 10 Acute Psychiatric and 4 Geriatric on the Third Floor of the Center Building and 14 General Psychiatric and 4 General Geriatric on the Fifth Floor of the Center Building.

The high demand for Behavioral Health Treatment at CDH resulted in an accelerated documentation schedule of 4 months from initial programming to completion of construction documents. PFB met this challenge by assigning three architectural design teams to the roof, interior build-out, and window replacement respectively. Construction Documents for 59,000 square feet were completed in 3 months and bids came in $1.4M under budget.

On the 3^rd and 5^th Floor Behavioral Health Units, pocketing cross-corridor doors are located at key locations in plan. Staff can easily open or close the doors to allow for flexibility in segregating patient populations. A unit can grow or shrink on a daily basis depending on patient population acuity, age, or specific clinical needs.

Fourth Floor Neurology includes 2 exam pods with 9 exam rooms in each. Each Exam Pod includes a Treatment Room and Family Consult Room. Other support areas include Neuro Psych, Speech, Physical Therapy, two Nurse Stations, and a Community / Conference Room. To accommodate the extensive program requirements, the planning team promoted shared office space to encourage Physicians to be out on the floor with patients. The existing adjacent Neurology Clinic utilizes the established Facility Finish Standards. The design team worked collectively with the facility Interior Designer to ensure the new expansion will blend seamlessly with the existing clinic as well as the rest of the campus.

PFB’s renovation of the 3^rd and 5^th floor Center Building at Central DuPage Hospital was featured in the Summer 2015 issue of Behavioral Healthcare Magazine.

About the project

The goal of this Southwest Addition is to dramatically raise the quality of care for the outpatient population as well as increase patient and staff satisfaction by joining all executive offices and outpatient functions into the new addition. Phase I includes a two story addition and Phase II adds an additional floor. The program supports all current and future outpatient functions with additional group therapy rooms, classrooms, physician interview rooms and outpatient support functions. The addition also accommodates the projected increase in hospital employees and physicians by approximately 21% by adding MD office suites and administration staff offices.

The new addition enables enhanced privacy: private interview alcoves for patient - physician interactions, independent entrance, reception and waiting, and a new dedicated parking lot for the outpatient population.

Natural light and views to garden landscaping enhance the quality of the group rooms and outpatient intake areas. Acoustical folding partitions provide the flexibility to divide large group rooms into smaller groups and still maintain privacy. Quality interior and exterior finishes provide a comfortable atmosphere for the patients as well as blend with the existing Alexian Brothers Hospital.

About the project

We were approached by the leadership team at a large healthcare network to create a schematic design concept for a new child and adolescent behavioral health building with both in- and outpatient offerings on their campus, to better meet the needs of their community. After exploring several options, we arrived at a sweeping “neighborhood” design adjacent to their existing adult behavioral health facility.

The inpatient area features Addictions, Adolescent, Adolescent ICU, and Child units, with an Autism sub-unit and the opportunity for all units to flex along the southern corridors to best adapt to changing patient populations. All units have central living room spaces, therapy areas, calming rooms, calming and charting alcoves, and a central nurses’ station overlooking a computer area and dining room.

The units also have access to expansive interior courtyards, classrooms, and an Experiential Wing with activity, art, technology, meditative, and gym spaces. The in-patient areas are designed with a residential aesthetic, with bountiful natural light and views; patient and staff safety are of the utmost importance, but do not hinder the healing quality of the units.

Private and semi-private patient rooms all have expansive views to the outdoors, and feature natural woods and blues for their calming effects. Seating is curved and weighted for safety, and patient belongings are stored in open shelving, which is elevated off the floor and is capped with a sloped top. The clean-lined, modern aesthetic creates an encouraging environment for introspection and healing.

The intake area includes two entries – one for walk-in patients and their families, and another for ambulance-delivered crisis cases. A family accommodations area adjacent to the main lobby provides hospitality-level amenities for overnight stays and a dining area for family interactions.

The outpatient lobby is a soaring two-story space, with separate calm and interactive play waiting areas. Patients have access to their doctors and counselors in a one-on-one office setting as well as several large group therapy rooms. Most rooms feature frosted slit windows at eye-level for natural light without the distraction of the view, as well as clerestory windows for additional light and access to nature.

The staff area provides easy access to all inpatient units while maintaining the separation necessary for decompression and focused work, and includes a break room, relaxation room, staff-only courtyard, resident and staff locker rooms, and a student nurse workroom.

About the project

PFB was requested to evaluate the needs and growth potential of the Alexian Brothers Behavioral Health facility. Although ABBHH was offering state-of-the-art mental health care, the facility was undersized to accommodate the needs of a rising psychiatric population and was also under-recognized for its commitment to psychiatric care. After careful analysis, we recommended they move forward with an east inpatient addition to better serve their community's needs.

The East Addition, a 34,400 square foot, three-story facility, expanded the inpatient capacity from 95 beds to 137 beds. This new bed capacity provides:

Corridors, Patient Rooms, and Group Rooms all have access to natural light and views. Colors and patterns in the spaces are inviting but not disorienting. Each unit uses a three tier approach to calming agitated patients. Enhanced patient security and safety were achieved through keen attention to vandal- and abuse-resistant construction.

The new façade and entrance helped to deinstitutionalize the image of the existing facility. The dramatic impact of this addition resulted in increased community awareness and regional recognition as well as enhanced charitable donations to the facility.

About the project

PFB was tasked by one of our clients to prepare the preliminary design of a proposed Residential Behavioral Health Therapy Center for Board presentation and approval. The Residential Center, on seven acres of wooded landscape, will be comprised of the Main Lodge, Gallery, and 60 private patient rooms, with future third-floor expansion. The proposed three-story masonry structure will incorporate natural building materials and features such as stone, wood, glass, and water to blend the building with the site and the natural elements. The structure will be immersed into the landscape to provide privacy and views to each space.

The Main Lodge will accommodate the receiving and social areas and will include a music room, dining room, entertaining and theater rooms, and a great room with fireplace, stone walls, access to the wooded deck, and views to the new pond. The Gallery will include a kitchen, health / fitness center, indoor pool, and support and administration space. Each Residential Wing serves a different patient population: eating disorders, toxic substances disorders, and alcohol abuse.

About the project

This 2^nd Floor Geriatric Psychiatry Unit Renovation required creating a ligature-resistant environment to provide safety for the patients. All patient room toilets received new vandal-resistant shrouds around plumbing, and ligature-resistant accessories. Hold down clips were added to all patient rooms with existing ACT ceilings. Outlets received new tamper-proof cover plates, thermostats received tamper-proof locking covers, and all existing millwork fasteners were replaced with tamper-proof hardware.

The existing med-gas plastic laminate headwalls were removed as well as the med-gas nozzles. The med-gas outlets received tamperproof hardware. All sprinkler heads in the patient rooms were replaced with tamper- and ligature-resistant fixtures. All mechanical supply, return, and exhaust grilles were replaced with new tamperproof grilles. All light fixtures in the patient rooms were replaced with tamper- and ligature-resistant models. The existing inoperable windows in all patient areas were given added protection with impact-resistant materials.

Four existing patient rooms were converted to Lunch/Group rooms, and received new flooring and paint. The entire unit was repainted and the existing nurse station was modified to provide safety for staff. Outlets in the corridors received tamperproof hardware. Access and egress doors to the unit were equipped with fail-safe locking devices.