Fulfilling a promise to its patients and taking full advantage of the unique opportunity to design from scratch and build to completion a new hospital-based model of care for the 21st Century, Emory University Hospital today unveils its new Neuro Critical Care Unit.
This innovative intensive care unit realizes Emory's vision for providing cutting-edge health care in a patient-and family-centered environment. The unit brings together 20 new, state-of-the art patient care rooms that allows for centralization of the most critical medical services for patients suffering from severe neurological trauma – including severe brain injury, strokes and aneurysms. It also provides an unparalleled level of comfort and convenience for family members who wish to remain near their loved ones.
"Emory's mission is to not only research and treat disease, but to also deliver a level of care that takes into full account the emotional and spiritual requirements of our patients and their loved ones, who are so critical to the healing process," says Michael M.E. Johns, MD, CEO of Emory's Woodruff Health Sciences Center and chairman of Emory Healthcare. "Today, we deliver on our promise to provide cutting-edge care to our most critically ill patients. But just as importantly, we will do so in a facility that will allow us to also help comfort the comforter by providing many of the same conveniences of home."
John T. Fox, president and CEO of Emory Healthcare, says "At Emory, we continue to see increasing numbers of critical, neurologically-ill patients who require highly-specialized care not available in local or regional community hospitals. To ensure that each patient and his or her family members have the best outcome possible, we've designed an ICU that capitalizes on the remarkable medical technology available and the expertise of our medical team.
"This care philosophy is the same in all of our ICUs," notes Fox. "However, with this new unit, Emory now raises the proverbial 'bar' and sets the standard, locally and nationally, for critical care."
Emory's new unit is one of the largest in the United States, and one of only a few of this type of unit in the Southeast. It will be staffed by neurointensivists (neurologists specially trained in critical care) as well as a dedicated team of critical care nurses, nurse practitioners and pharmacists.
This approach---offering around-the-clock monitoring and care management---has been shown to improve overall survival rates, as well as long-term recovery of function and quality of life.
The entire design of the new unit was created in order to make the patient and family top of mind and central to the entire unit's existence, according to Owen Samuels, MD, director of neuroscience critical care.
"There is a large body of current research that links the quality of a health care facility's physical environment to both patient outcomes and staff efficiency," says Dr. Samuels. "The plans for the Neuro Critical Care Unit incorporate core principles of evidence based, patient-centered design---a holistic approach that focuses on the patient's physical environment as a tool to facilitate healing."
Evidence-based design uses research to determine how attributes of a healthcare environment can affect not only patient outcome, but also clinical staff (especially staff efficiency) and the patients' families. For example, families are now recognized as central to the healing process and their presence can facilitate the healing process and reduce a patient's length of stay. All 20 patient rooms have been designed and built around those evidence-based design principles.
"In a neurology ICU where the average length of stay is 13 days, but is often many, many more, this can be especially beneficial," says Dr. Samuels. "Evidence-based design can focus on a number of areas. These might include the effects of natural light, reduction of noise, increasing staff efficiencies, incorporation of new technologies, ways design can improve patient outcomes and more."
The unit was created with sufficient space to perform intricate procedures at the bedside and not transport fragile patients across the hospital to perform them. The patient rooms will be large enough to include a separate area, partitioned off with a wall and glass block window that will include reclining chairs or pullout sofas to allow family members to stay with the patient inside the room. Additionally, every room includes wireless Internet access, television and a table.
A high-resolution CT machine is housed in the unit, allowing very ill patients to be scanned as they are admitted and throughout their stay - without the need to be transported to another area, as is typical in most other hospitals. Until now, critical neurological patients at Emory University Hospital have been housed in one of three different critical care units.
"These patients often require numerous CT scans each day and must be prepared by a team of caregivers to be transported throughout the hospital – exposing them to higher, undesirable levels of noise and light, as well as exposing them to greater risk of infection present in open areas," says Marilyn Margolis, director of nursing for emergency service neuroscience.
"The time it takes to prepare, transport and scan a patient can take up to two hours each trip," she says. "The new scanner will be located within steps of each room, saving precious time between necessary scans, thus freeing up valuable time for caregivers, and shielding patients from exposure to unnecessary external noise and light stimuli and possible infection."
Although the new unit is more than four times the size of the current ICUs at Emory University Hospital, nursing staff now have much improved observation of patient rooms because of a design that incorporates studies of the clinical and physician staff patterns, and the appropriate type of work stations. Small nurse station alcoves, placed between patient rooms, provide a direct line of sight for all patients in rooms on either side of the work unit - further minimizing the transfer of charting noise, while increasing patient and staff comfort and quick access to information and telecommunications.
While the new unit combines the ultimate in medical technology, with many home-like features for patients' family members, including showers, a kitchen and laundry facilities, what truly differentiates the project is its inclusive, start-from-scratch design, according to Dr. Samuels.
"A task force comprised of neurologists, critical care nurses, pharmacists, social workers, family members of former patients and health care design experts spent months discussing everything from the best use of new technology right down to the color of the walls and how to position the nursing stations," says Dr. Samuels.
"But the group's focus was not just on satisfying different clinical demands," adds Margolis. "We knew that an equal factor in patient outcomes is family support and interaction. Many of our patients in this unit spend a very long time here, and, of course, so do their loved ones. This unit was designed just as much for them."
The creation of an entirely new unit within a hospital also requires additional staffing needs, particularly qualified nurses. Margolis says that the new ICU is a vision-come-true for hospital staff, but it also indicates Emory's commitment to care and the caregiver.
"There are tremendous challenges that are met each day by our nursing staff in providing care for some of the most critically injured and vulnerable patients in this hospital," says Margolis. But what better place for a nurse to practice his or her trade than in a model center of compassionate care?"