In “Lessons Learned from Two Emergency Departments,” a session at the 2012 HEALTHCARE DESIGN Conference, Kathy Bell from S/L/A/M Collaborative and Wendy Weitzner from Innova Group launched right into a description of their work in expanding the ED for Middlesex Hospital in central Connecticut. That project, for which the master plan was completed in 2004, required the addition of more private rooms and more flexibility and universality throughout.

The new ED, which opened in 2008, was laid out in a ballroom configuration with same-sized rooms and beds oriented feet-out, a distinct fast check, and a few larger rooms. Team stations offered a lot of flexibility, with multiple heights (seating and standing) for staff and room for cart parking underneath.

The second ED the presenters talked about was Northern Westchester Hospital in Mt. Kisco, N.Y. This project, like Middlesex Hospital, included a new ED built adjacent to its old one, and underwent its transformation during the same time period. The previous ED in this 233-bed Planetree hospital had outgrown its space, was outdated, and afforded its patients little privacy.

The new ED, which opened in March 2011, features a “streets and avenues” layout that’s “all about the patient experience,” said Bell. The “streets” offer distinct main paths for patients while the “avenues” offer shortcuts and offstage access for staff. In the universal exam rooms, patients are oriented parallel to the corridor, and there’s enough room for staff and family.

For both projects, the team conducted post-occupancy surveys and walk-throughs. For the most part, the staff in each hospital was very pleased with the visibility afforded in the new spaces, though some complained about the increased walking distances.  (It’s worth noting that in both hospitals, the overall size of the ED increased greatly from its previous incarnation.)

A particularly interesting finding, said Weitzner, was that the staffs discovered that they did less documentation within the exam rooms than they thought they would. As a result, they all wished there were more places at the staff stations for documentation.