The resuscitation area often became a bottleneck because there were not enough inpatient beds or operating rooms, said Karen Doyle, the center's vice president of nursing and operations. The extra operating rooms also mean more surgeries during the day and not overnight, which could be stressful for the staff and uncomfortable for the patients — 96 percent of whom survive their injuries.

A technologically advanced training center for the staff and members of the military who partner with the hospital will simulate conditions at the hospital or on the battlefield, Doyle said.

For patients, the changes include private waiting rooms away from the hustle and bustle where families can learn from staff about the conditions of their loved ones. Patient rooms also include extra space for furniture for family and friends, windows for natural light, and lifts for getting out of bed.

Other small changes include a new private hallway to transport patients out of view of the general public and a roof-top healing garden.

A pneumatic tube system was installed to speed labs, medications and units of blood around the facility.

Dr. Deb Stein, chief of trauma, said some of these additions may seem like "silly little things," but they will mean a lot.

"We wanted an environment that worked for patients and worked for the staff," Stein said.

All the improvements will contribute to treating the "disease of trauma," said Dr. Thomas M. Scalea, Shock Trauma's physician-in-chief, who has been in charge for nearly 17 years. The center is named for his predecessor, the center's first physician-in-chief, Dr. R Adams Cowley, who gave rise to time-oriented treatment in emergency medicine called the "golden hour."

"Everyone wants to do a good job," Scalea said of his staff. "They haven't asked for it to be easy and they haven't asked for it to be slow. They've asked for resources so we could excel."

meredith.cohn@baltsun.com

Shock Trauma's new tower

Space: 140,000 square feet of new construction, including 64 new private ICU patient rooms and 10 new operating rooms

Cost: $160 million, including $1 million donations from the late Tom Clancy and his wife, Alexandra, Willard Hackerman, Edward St. John, George Doetsch Jr., Frank and Janet Kelly, and the University of Maryland Medical System and School of Medicine's leadership team

Construction: 35 months of construction led by Whiting-Turner, including 1,750 workers and 874,000 man hours.

Environment: Gold-level LEED certification pending with the U.S. Green Building Council