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New surgical pavilion at Riverside on schedule

The $107 million, 250,000-square-foot addition to Riverside Regional Medical Center in Newport News, part of a building boom by Riverside Health System, is both on schedule and within budget. When completed, in late January 2013, the surgical pavilion will replace 13 operating suites, two G.I. procedure rooms, 72 patient rooms and add a new entrance and expanded parking.

The three-story addition plus a full basement reflects the latest in design for a medical setting with materials designed to minimize infection, high ceilings to accommodate ceiling-mounted medical equipment, larger operating and patient rooms, and a flow to maximize the comfort and convenience of patients and their families.

Indicative of the increased size is that the addition is almost the same height as the five stories of the existing 1960s building, says Diana LoVecchio, Riverside vice president construction and shared services, noting that the expansion is larger than many hospitals. It's cantilevered to tie in with the existing structure and the design allows for significant upwards expansion with minimal disruption in the future.

"In general, everything's much larger," says John Angle, project manager for the construction company W.M. Jordan. The operating rooms are as much as 50 percent bigger and the doors and hallways are wider. On the second floor, four of the 72 patient rooms are specially designed for bariatric patients weighing over 500 pounds. The rooms are ceiling-fitted with special lifts, the doors are wider and there are special beds. On this floor, a central area radiates out into four wings, each with its own specialty — surgical intensive care, general surgery, orthopedics and neurology/neurosurgery.

On the entrance level, home to admitting and the new surgical suites, LoVecchio points out the safety and infection-control features, including doors with a special coating, floor-to-ceiling tile in bathrooms, joint-free solid counter surfaces, and chemically sealed rubber flooring. Evidence-based design for a calming atmosphere includes attention to every detail from an earth-toned color scheme to diffusing the overhead lighting for the comfort of those on stretchers.

Angle credits the use of 3-D computer simulation, known as BIM, or building information modeling, for both keeping costs down and with the smoothness of the final building stage. "We did 80 percent on the computer first," he says. The company then built mock-ups of 10 rooms in the former Value City building a mile from the construction site. Those walking through were encouraged to write their suggested changes and modifications on white foam boards. In all, eight Riverside subcommittees, each with about 20 staff, are involved in the planning, execution and training related to the addition.

Some large changes and hundreds of small changes were made as a result. "The nursing station looked nice, but it didn't work," says neurologist Patrick Parcells, senior vice president Acute Care Division, Riverside Health System, and Administrator, Riverside Regional Medical Center. "It was too big, too wide, too enclosed," adds LoVecchio.

The process allowed them to choose the right size furniture for the rooms; it let nurses determine the best placement of the computers used for record-keeping; and thanks to an observant physician, the Purell dispensers were moved closer to the doors in every room. Sinks and sharps disposers were also relocated during that design phase. "The innovative part of it was doing the mock-ups off-site and much earlier in the process than usual," says Angle.

Other advantages of using virtual modeling are that it charts all the piping and wiring in the ceilings, "all the spaghetti" as Parcells dubs it, and facility managers have access to that for the life of the building. Many lay people have a hard time reading traditional blueprints, not so with the 3-D re-creation. "This way we don't have people coming in at this stage — [75 percent complete] — saying 'ooh, that's ugly' or 'that's not what I expected.' They can really visualize it," says Angle. It consequently minimizes both hand-wringing and the costs involved with making late changes.

The design also emphasizes flexibility for future changes and expansion. Though two of the operating rooms are dedicated for open-heart surgery with dual booms for equipment, Riverside project manager Glenn Gangitano, a former surgical tech, says they can be set up for other surgeries. Likewise, he points out that the ceilings are not solid but made with panels to allow access for adding and removing equipment. So, the operating room custom-built in an L-shape to accommodate the double "gaming console" of a recently upgraded DaVinci robot has "soft space" alongside to allow for a change in room size or function.

And, when the time comes, the third floor devoted to mechanical operations provides a natural barrier to ease expansion upwards, Riverside officials say. In anticipation, the concrete slab and posts are already in place on the roof.

Copyright © 2014, The Baltimore Sun
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