Once a financial model was generally agreed upon, inpatient and outpatient projections were developed and a good understanding of the service area market was gained, the Planning Team began campus master planning the new facility. The volume projections, resultant occupancy targets and expected length of stay were the early indicators of the necessary patient bed complement and resulting diagnostic/treatment and support services needed. Particular emphasis was placed on shifting the care site from inpatient and hospital to outpatient and ambulatory services in response to contemporary healthcare approaches and economical use of scarce capital dollars. Room utilization was estimated for 2003 usage and then projected forward for the 2013 planning horizon based on target utilization assumptions. The Planning Team also solicited feedback from a wide spectrum of community leaders and internal stakeholders. The Team worked closely with the future users of the proposed building, MCLNO staff, to develop a department-level space program that shed additional light on the detail of the new facility. Clinic and procedure room utilization were examined by area.
The Team initiated a functional facility assessment from an architectural perspective to analyze the relative capabilities for inpatient and/or ambulatory care with regard to several of the existing campus buildings. A group of MCLNO officials and representatives of the Planning Team also visited John H. Stroger, Jr. Hospital of Cook County in Chicago, Illinois to capitalize on lessons learned during their recent completion of a facility of similar size and scope.
The balances developed indicated the need for a 560-bed tertiary-care Level I Trauma Center with 15 additional beds for clinical research activities. Further, an outpatient clinic area (whether a separate building in the North Option or the reuse of University Hospital in the South Option) would require approximately 275 exam rooms for use in 2014.
Key planning assumptions included consolidation of services and staffing efficiencies, integration of improved technology and separation of public versus staff/patient circulation. Key functional relationships that the team sought included all private patient rooms for infection control, safety and a quality experience. Maternal Child Services will be located in distinct inpatient/outpatient zones. The Emergency Department will have five zones trauma, major acute, fast-track, pediatric and a walk-in clinic. Ambulatory services will include clinics and ambulatory surgery in one location with standardized processes. An Interventional Procedure area will co-locate interventional radiology, cardiology and surgery, and there will be a new prisoner care center for ambulatory care and inpatient access. Finally, the plan was constructed so that the new facility would meet or exceed all anticipated JCAHO and ACGME standards.
In addition, a 17,000sf clinical research unit was planned that allowed 15 inpatient and extended-stay beds, 10 outpatient treatment bays, lab processing, drug storage, metabolic kitchen and associated office space.
The team also identified a number of selected opportunities for innovation in the new University Hospital, including off-site registration, person-to-person medical communication, electronic medical records and bed status, point-of-care testing, ED immediate triage and room assignment, flexible OR and procedure rooms and a pediatrics unit located adjacent from the ED for staff coverage.
External to the building proper, the team developed a transportation analysis, including a review of traffic volumes, street data, sidewalk inventories and curb use utilization. The team further reviewed parking facilities and capacities, proximity of historic districts, applicable flood elevations, existing LSU property ownership and analyzed utility availability and capacity.
As part of an Urban Development Study, the Planning Team developed six separate urban campus development strategies that were discussed fully with the Executive Planning Committee. The goals of the recent Canal Street Corridor Study were acknowledged and taken into account in the different strategies, as well as the LSU Biotech Study. The Planning Team sees this area having the potential for a vital, urban health science and patient care district fully integrated into a revitalized commercial and residential fabric.
Of the six urban redevelopment scenarios presented, LSU HCSD further commissioned NBBJ with fully evaluating two different sites: an area north of Tulane Avenue (North Option) and a site directly west of the existing University Hospital (South Option). The sites were evaluated through five- and ten-year development plans, building stacking diagrams and floor-by-floor block plans, the construction of a new ambulatory clinics building versus the re-use of the existing University Hospital and subsequent cost estimates.
The North Option produced a 16-floor inpatient structure with three floors of parking and an adjacent eight-floor ambulatory clinics building. In the North Option, the new ambulatory clinics building would be developed on campus in conjunction with the new inpatient facility.
The South Option was forced to occur on a more compact footprint, necessitating a 17-level structure on four floors of parking and a connection to the existing University Hospital. In this option, University Hospital would be renovated to house the ambulatory clinics function. In the South Option, the renovation of University Hospital would occur only after substantial completion of the new inpatient facility.
The Planning Team further analyzed several sites on which the new hospital could be located within the North and South Options. The sites were: south of Tulane Avenue, north of Tulane - facing Tulane and north of Tulane - facing Canal. The analysis pointed most favorably toward the location north of Tulane and facing Canal Street with regard to the following: match of cost with LSU budget, adequate area for full renewal, direct transportation access, available utilities, site acquisition cost and complexity, zoning considerations, site issues and the attractive safe location.
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