EMC Annenberg Pavilion Opens as a Monument to Best Care

The Eisenhower Medical Center opened the doors at the new Walter and Leonore Annenberg Pavilion to patients on November 2, 2010. The opening was published in an article by K. Kaufmann on the front page of The Desert Sun on December 13, 2010 entitled, “New hospital a monument to best care.” The 229-bed replacement facility was designed by Moon Mayoras to provide the growing Coachella Valley with relationship-based care in a seismically-sound facility featuring building-wide WiFi, electronic medical records, spacious family waiting rooms, communal workspace with computer hookups, and open space nurses stations. The large patient rooms include flat-screen televisions; handicap-accessible showers; multi-lingual, interactive hospital beds; and equipment management booms. Excerpts from the publication text reads as follows:

The timing of the new $250 million Walter and Leonore Annenberg Pavilion at Eisenhower Medical Center is impeccable, coming online just as baby boomers hit retirement age in a resort area that caters to retirees. The new four-story hospital center that opened Nov. 2 on Eisenhower’s Rancho Mirage campus will provide those potential patients and staff with a high-end facility on par with any in the nation.

“It’s really progressive,” said Cecilia Alvarez, a nurse who’s been at Eisenhower for 23 years. “We have enough equipment to work with everything; we have computers in the rooms. It’s much more effective. You don’t have to go to a chart; it’s all right there at your fingertips.”

Named for the renowned Coachella Valley philanthropists who donated $100 million of the center’s $250 million price tag, the project has been driven both by the Coachella Valley’s phenomenal growth and the previous building’s seismic deficiencies.

On the day when Eisenhower staffers started moving from their 40-year-old building to the new pavilion, the number of patients at the hospital suddenly spiked from 200 to 270, clearly underlining the need for the state-of-the-art facility. Large, unpredictable swings in patient numbers are a fact of life in health care, said Louise White, chief nursing officer at the hospital. But the new pavilion means “we have built capacity within our hospital to care for the valley’s growth for the next 20 years,” she said. “Patients were probably being turned away.” The new beds bring the hospital’s total to 542, up from its previous 313.

The facility also is a telemetry unit, meaning it is specifically for patients needing intensive care or cardiac monitoring. The center’s other big plus for Alvarez is more space—for patients and staff. “There’s so much more room in the rooms,” she said. “If you go to open a window, just the view is very nice.” The sweeping views of the surrounding mountains visible from most patient rooms are one of the more striking aspects of the Annenberg.

Keeping its clinical underpinnings well camouflaged, the place almost doesn’t feel like a hospital. Patient rooms have large, flat-screen televisions and spacious bathrooms with showers equipped with built-in seats. Large storage rooms keep medical equipment out of the hallways, and family waiting rooms are also large, with comfortable couches and chairs, and workspace with computer hookups.

The ground floor cafeteria has a café feel, bright and modern with loads of natural light. The whole building is wired for WiFi and art hangs on every available wall.

Hospital’s design was collaborative
Designing the facility around the needs of patients, families and staff — what White called “relationship-based care” — has been a core principle at the Annenberg throughout the center’s development. That began about 10 years ago, when the hospital was faced with the need for a critical seismic upgrade and decided it would be more cost-effective in the long term to build a new facility, said Ali A. Tourkaman, the vice president of support who has overseen the project from the start. Eisenhower officials had originally envisioned a five-story building but, following community opposition, downsized to four. That meant the building would have to have a larger footprint within its 5-acre site on the Eisenhower campus while also meeting California’s strict guidelines for earthquake safety.

The building is a model of seismic construction, combining a 5-foot thick foundation of reinforced concrete and steel with a braced frame deemed one of the best for earthquake resistance. “The reason for the foundation is our sandy soil,” Tourkaman said. “Here, if you want to drive columns in the ground to support this building, you would have so many columns in the ground that basically it would not lend itself to proper layout.”

David N. Moon, the San Diego architect who designed the building, said working around old pipes buried on the site was a key challenge, along with finding the right balance between the pavilion’s home-like atmosphere and medical function. “If you make it look too much like a house, then people feel like they’re not getting the best care,” he said. “You want to be non-institutional, but you want to maintain the confidence that this is a world-class institution.”

“Part of the answer was involving all branches of the medical staff, along with patient and family representatives, said Tourkaman said, pointing to the layout of rooms in the intensive care unit as one example. We have, at almost the center of the room, the equipment management boom; all of the pieces of equipment the nursing staff usually needs or accesses to perform patient care sit on the boom and there are no pipes, hoses or anything on the floor,” he said. “That was one of the requests from our ICU staff. They wanted to efficiently get in and out of the room and provide the patient care without tripping over stuff, especially in a code situation.”

Center provides better relationships
The other part of the equation was preparing the medical staff for the new pavilion and the relationship-based care model to be used there. That was a three-year process, White said. “Relationship-based care is looking at how you’re providing care, taking in all elements,” she said. “It’s almost like a three-legged stool. You’re looking at patient care delivery, nursing practice, physician practice; you’re looking at how that practice is affecting the patient, the family, the colleagues that are delivering (the care).”

To come up with the new policies and procedures for the pavilion, she said, “We’ve had teams upon teams upon teams meeting for months, looking at every element of patient care delivery and how we’re going to deliver that care in this building.” Part of the result can be seen in the pavilion’s open-plan nursing stations, spacious areas on each floor designed to improve communication among all medical staff, White said.

“Every discipline is in one location so the dietician can see the doctor, can communicate with the case manager and social workers. We have a pharmacist on each floor so they’re right there for people to talk to.” Better communication means better relationships with patients and staff, and eventually better outcomes, she said. “We have an environment where they heal quicker, have better outcomes,” she said.

To read more about the project, click here.

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