Rush Medical Center (Chicago) clues us into a gap in state and regional health care planning: planning for disaster and epidemic response
Chicago's Rush Medical Center has the ability to surge capacity by 130 percent, but without people taking aggressive preventative measures, including staying home, it can still be overwhelmed. So, instead of advertising on the side of their building, they're using it to tell people to "wash your hands" in an effort to limit cases of a new coronavirus. Photo: Rush Medical Center.
A couple years ago, I wrote a three-part series about how DC could leverage the construction of a new United Medical Center in Southeast Washington--located in the East of the River section of the city, which experiences a great rate of poor health outcomes--as a way to create not just a superlative hospital with a transformational public health focus, it could also be used as a way to drive a biotechnology research and medical education initiative as an economic development measure, utilizing the St. Elizabeths campus, which the city has been working to redevelop for almost 20 years.
-- "Ordinary versus Extraordinary Planning around the rebuilding of the United Medical Center in Southeast Washington DC | Part One: Rearticulating the system of health and wellness care East of the River
-- "Part Two: Creating a graduate health and biotechnology research initiative on the St. Elizabeths campus"
-- "Part three: the potential for donations around an expanded program"
-- "Update on DC's plans to build a new United Medical Center"
-- "Community Health Improvement Planning"
-- "A glaring illustration of the need for comprehensive health and wellness planning in DC: Providence Hospital"
A recent Newsweek article on Rush Medical Center, "THIS CHICAGO HOSPITAL WAS BUILT AFTER 9/11 WITH AN EPIDEMIC LIKE CORONAVIRUS IN MIND," which built a new medical campus after 9/11, made me realize that I missed a big potential element, enhanced emergency, disaster response, and pandemic response capabilities.
From the article:
The attacks on September 11, 2001, highlighted the need for emergency preparedness, and Casey said anticipating a range of disasters that could strain health care systems is the "new reality." Constructed with the foundational mindset that a disaster will cause an influx in patients, Rush has the ability to rapidly expand its bed capacity, intake capabilities and negative pressure units.Also see:
"Our tower opened in 2012, so certainly that was top of mind a decade after 9/11–that we need to be prepared for this and we need to build to be prepared for this," Casey explained. ...
To get ahead of a likely influx in cases and prevent infection among staff members, Rush converted two units to negative pressure, a method used to prevent cross-contamination. Each unit has 20 beds, but hospital staff can double that number, bringing it up to 40 beds. Multiple floors within the hospital have this conversion capability and so far, they've flipped two.
"Twenty minutes. It's impressive," Casey said when asked how long the conversion takes. "We tested this over a number of years in different exercises, including the outbreak of an infectious disease."
-- "Rush Medical Center raises tent in ambulance bay to test coronavirus patients" Chicago Sun-Times
-- "This is what Rush was built for," Rush University press release
-- "Nation's First Center for Advanced Emergency Response Opens on January 6," Rush University press release, 2012
In the DC area, a new Washington Adventist Hospital just opened in the White Oak section of Montgomery County and a new hospital is under construction in the Largo district of Prince George's County, replacing the Prince George's Hospital, as a way to shift control of the hospital system to the University of Maryland Medical System. And the problem-wracked UMC is to be rebuilt.
I doubt that any of these "construction projects" have responded to the potential for disaster in the way that Rush Medical Center has.
Recently, Washington Adventist took over Howard University Hospital ("Adventist to manage Howard University Hospital," Washington Post) and going forward there is a good chance that HUH will be rebuilt. And in terms of disaster response, it is much more centrally located that the above-mentioned hospitals.
Labels: change-innovation-transformation, health and wellness planning, hospitals, provision of public services, public health


6 Comments:
Looks like Prince George's County, and presumably other communities with high population of people of color need to develop similar programs marrying health care and public health programming more directly.
https://www.washingtonpost.com/local/prince-georges-maryland-coronavirus-health-disparities/2020/04/26/0f120788-82f9-11ea-ae26-989cfce1c7c7_story.html
Like how UMC probably isn't being built the same way that Rush Medical Center was, to be of special use in times of panedemic, the same is probably true of the new UMMS hospital in Largo.
https://www.bizjournals.com/washington/news/2020/04/22/prince-george-s-health-system-names-permanent.html
https://www.bizjournals.com/washington/news/2019/09/20/new-empire-in-prince-georges-the-road-ahead-for-um.html
WSJ, "Rethinking the Hospital for the Next Pandemic"
https://www.wsj.com/articles/rethinking-the-hospital-for-the-next-pandemic-11591652504
6/8/2020
We must reimagine how to address D.C.’s persistent health inequities
https://www.washingtonpost.com/opinions/2022/06/17/we-must-reimagine-how-address-dcs-persistent-health-inequities/
MetroHealth’s new $759 million Glick Center opens Nov. 5, signaling a new era of healthcare.
https://www.cleveland.com/healthfit/2022/10/metrohealths-new-759-million-glick-center-opens-nov-5-signaling-a-new-era-of-healthcare.htm
10/15/2022
The COVID-19 pandemic taught hospitals the necessity of being able to add more patient beds quickly. The 11-floor Glick was designed with that principle in mind, though the design phase actually got started well ahead of the pandemic.
“In an emergency, this tower can go to over 600 beds,” MetroHealth CEO Dr. Akram Boutros said of the glassy new facility. “During COVID-19, people were talking about taking care of patients in auditoriums and hallways — we don’t to do need that.”
https://fortune.com/well/2023/12/01/flu-covid-rsv-syndemic-tripledemic-winter-2023-respiratory-virus/
‘The Future of Hospitals’: Flexible Space for the Next Pandemic
After struggling to respond to a crushing Covid caseload, many hospitals are remodeling so that when the next crisis comes, they’ll be better able to meet it.
https://www.nytimes.com/2022/09/13/business/hospitals-pandemic-flexible-space.html
Much of the shift in hospital design revolves around surge capacity, which is how health care workers adapt inside their buildings when the number of sick patients jumps substantially. In March and April 2020, the sudden rise in contagious patients meant some hospitals were scrambling to find beds, setting up overflow tents in parking lots and rationing equipment.
“Now hospitals are identifying wards, usually of 24 to 32 beds, and they can stack some of those wards together to become pandemic wards.”
To prepare for that shift, designers are thinking about how traditional rooms can quickly morph into isolation wards by upgrading or overhauling their heating, ventilation and air-conditioning systems. Fabrics and finishes, too, are being reconsidered, with an eye toward durable materials that can withstand industrial-level scrubbing.
Finally, the pathways that lead to these wards need to be rethought, Mr. King said, “so the transportation for patients and staff allows these spaces to be isolated and operated independently from the rest of the hospital.”
A new I.C.U. at Doylestown Hospital in Doylestown, Pa., which opened in 2021, has private rooms meant to flex between intensive care and step-down care. The rooms are clustered in pods of eight to reduce traffic in corridors.
It will be the second new wing with flexible design at Doylestown. After realizing that a new wing for heart and vascular care that opened in January 2020 could be used for critically ill Covid-19 patients during the pandemic, hospital administrators leaned into flexible design.
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“The pandemic proved the need to have flexible space,” said Jim Brexler, chief executive of Doylestown Health. “The impact of having adequate critical care space was essential, and you don’t want to build all that out and not be able to use it for other purposes.
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