Cleveland Clinic Mentor Hospital, Mentor, Ohio

Cleveland Clinic operates more than 22 hospitals and 275 outpatient facilities around the world, including multiple locations throughout Northeast Ohio. The academic medical center expanded this network in July 2023 when it opened Cleveland Clinic Mentor Hospital, in Mentor, Ohio, marking its first hospital in Lake County, Ohio.

The newly constructed facility fills a critical gap in the community by providing inpatient and outpatient care and the city’s first emergency department (ED). “It’s about bringing care closer to home because we don’t want people traveling outside their neighborhood to get care they can receive locally,” says Nicholas Anstine, administrative director, regional hospitals at Cleveland Clinic.

The new hospital also marks an opportunity for the organization to introduce a “new market-entry model,” as Anstine calls it.

Planning a new hospital prototype

At the onset of the project, the healthcare organization looked at its full scope of services across the region and decided that it didn’t make sense for Mentor Hospital to replicate all the clinical capabilities of the nearby 500-bed Cleveland Clinic Hillcrest Hospital in Mayfield Heights, Ohio. Instead, it sought to make efficient use of a smaller facility as a satellite location.

“All hospitals are facing rising operational and construction costs, and we’re charged with being good stewards of the Clinic’s resources,” says David Berlekamp, an architect in Cleveland Clinic Design Studio, the organization’s in-house design team.

“Knowing that redundancies and extra space above and beyond the building codes can add costs, we were tasked with building only what’s essential to provide excellent care.”

At 96,000 square feet, the new hospital includes 34 inpatient/observation rooms, 23 outpatient exam rooms, 19 ED beds, and four operating rooms with 12 pre-/post-anesthesia care beds. Instead of addressing primary care at this site, Cleveland Clinic opened two additional primary care sites nearby, allowing Mentor Hospital to focus on services like cardiology, urology, orthopedics, and sports medicine.

Deciding what was essential to Mentor Hospital’s relatively small footprint required an efficient approach that leveraged Lean design. Cleveland Clinic and its in-house design team engaged Bostwick Design Partnership (Cleveland) for medical planning, architecture, interior design, and team development. Together, they developed a prototype for Cleveland Clinic’s efficient “hospital of the future.”

Starting with FGI industry standards

As design planning began in 2019, the project team used the standards laid out by the Facility Guidelines Institute (FGI) to keep the hospital in line with building requirements. While most healthcare projects begin with these industry guidelines, Cleveland Clinic often exceeds the standard approach to its facility design, explains Bryan Wahl, partner and project delivery leader at Bostwick Design.

In previous facilities, that often meant larger patient rooms, wider stairways, or additional electrical outlets than what FGI and the building code required, which can lead to extra costs. With this project, Cleveland Clinic “wanted to understand if they could provide the same quality of care less expensively by using the FGI requirements,” Wahl says.

For example, FGI requires a certain amount of access around three sides of each patient bed. However, Wahl explains, “we typically exceed the minimum-required room sizes to compensate for construction tolerances.”

For its new hospital, however, he says the design team worked side-by-side with the contractors at Whiting-Turner Contracting Co. (Cleveland), using Lean project management methodologies to unlock real-time feedback from the builders during the design phase to eliminate unnecessary overages. This close collaboration allowed staircases to be built to code requirements and room sizes to be designed and built to the FGI standards.

In some cases, the design team decided to go beyond the FGI requirements—especially when decisions impacted patient care. For example, the original design had ambulances backing into the emergency department (ED) bay to save dock space, while still meeting the FGI requirement to cover patients during transport from the vehicle into the hospital. “We saw that setup as something that would limit the number of patients we could bring in through our ED,” Anstine says.

Instead, the design team opted for an emergency entrance canopy with a pull-through design that can house four ambulances. “While it’s not FGI minimum, it was a great choice because we’re able to get patients in quicker and save more lives,” Anstine says.

Sharing operational resources with Hillcrest Hospital

Early on, the project team decided that Mentor Hospital would share leadership and other operational resources with Hillcrest Hospital, which is 15 minutes away—unlocking efficiencies by distributing manpower and materials between the facilities.

This reduced the demand for dedicated workspace at Mentor because most physicians are based at Hillcrest and spend only a few days at Mentor each week. “We went into the design with some additional focus on hoteling space as opposed to individual offices,” Anstine says. “There’s less office space because there’s less local leadership.”

Additionally, most medical supplies are stored at Hillcrest and then transported to Mentor when necessary, using just-in-time delivery. This approach reduces the need for dedicated storage space and decreases the size of the loading dock at the new hospital.

A shared central sterile processing department was also part of the original plan, with surgical instruments to be delivered from Hillcrest to Mentor as needed. However, after considering what would happen if an instrument was dropped during a procedure, the design team decided to add a small sterile processing area on the lower level of the new facility to maintain a smooth clinical workflow.

“It’s not the full-blown sterile processing that you’d see at Hillcrest,” Anstine says, “but the majority of our instruments are processed on-site now, which is more than we thought we would process here.”

Overall, Cleveland Clinic kept the scope of Mentor Hospital focused on lower-acuity patients with less critical needs—therefore, requiring less clinical space, Berlekamp says. Patients with more acute or specialized needs will be transferred to Hillcrest, Cleveland Clinic’s main campus, or another nearby location.

Model for future care

Cleveland Clinic sees Mentor Hospital as a “learning lab” that will determine how the organization can efficiently meet patients’ needs in the future by designing what’s essential to excellent care. In addition to a forthcoming post-occupancy evaluation, Cleveland Clinic continues to conduct interviews, walkthroughs, and shadowing of clinical and patient experiences at Mentor to inform future projects.

“This model will help us determine what’s necessary and what’s not,” Anstine says. “In many cases, we need a lot less space than we think we do to provide exceptional care.”

However, that doesn’t mean this scaled-down model will work in any market. “That Hillcrest connection is elemental to Mentor’s success,” Anstine says. “If we were to put this in the middle of nowhere, we’d need to rethink our prototype.”

For now, leveraging redundancies and shared resources has helped Cleveland Clinic achieve an efficient facility. “Mentor demonstrated that even a project with a lean budget can provide enough space to deliver exceptional care,” Berlekamp says.

Brooke Bilyj is a freelance writer and owner of Bantamedia in Cleveland. She can be reached at brooke@bantamedia.com.

Cleveland Clinic Mentor Hospital project details

Location: Mentor, Ohio

Completion date: July 2023

Owner: Cleveland Clinic

Total building area: 96,000 gross sq. ft.

Total construction cost: $86 million

Cost/sq. ft.: $895

Architect: Cleveland Clinic Design Studio in collaboration with Bostwick Design Partnership

Interior designer: Cleveland Clinic Design Studio in collaboration with Bostwick Design Partnership

General contractor: Whiting-Turner Contracting Company

Engineers: LeMessurier (structural), Karpinski Engineering (MEP)

Builder: Whiting-Turner Contracting Company

Art consultant: Cleveland Clinic Art

Art/pictures: Eva LeWitt (lobby artwork); various others from Cleveland Clinic Art Collection

Carpet/flooring: Nora Rubber, Anatolia Tile, Royal Mosa

Ceiling/wall systems: Certainteed

Fabric/textiles: Spinneybeck, Kvadrat, Maharam

Furniture—seating/casegoods: Reserve Millwork, Andreu World, Steelcase, Howe, Knoll, Cumberland, Herman Miller

Lighting: Lithonia, Focal Point, Acuity Brands

Surfaces—solid/other: Dupont, Corian

Project details are provided by the design team and not vetted by Healthcare Design.