Architecture

Nick Wojciechowski (Image credit: IU Health)

In 2020, Indiana University Health (IU Health) outlined plans for a new world-class hospital that would consolidate two of its Indianapolis hospitals on an expanded downtown campus.

Three years later, with construction in full swing, IU Health’s board of directors decided to expand the project, increasing capacity to 864 private patient beds, up from the initially planned 672 beds, to meet forecasted inpatient demand and higher acuity care needs.

The $2.31 billion project is expected to open in fourth quarter 2027.

Here, Nick Wojciechowski, vice president, project planning and operations at IU Health, discusses the need for flexibility and rethinking acute care campuses.

What drove changes on this project?

Planning and construction of the new hospital started prior to and continued during the COVID-19 pandemic. During this time, our design and construction teams continued to have open and ongoing dialogue with IU Health leadership about the projected impacts of acute patient surges and the evolving healthcare environment.

These conversations, additional forecasting, and further analysis revealed the existing IU Health Methodist and University hospitals (which will be consolidated into the new hospital) play an indispensable role in providing care to Indiana residents.

Therefore, upsizing the bed capacity for the new downtown hospital was essential to be able to accommodate higher inpatient demand, including a growing caseload of sicker patients in the future.

How does it rethink the acute care campus?

The new hospital campus is driven by four guiding principles that are reflected in multiple dimensions of the physical design: Innovation, Adaptation, Resiliency, and Transformation.

The whole campus is designed as an innovative care platform to create greater access for patients through enhanced centralization, therefore adaptable to multiple care models such as acuity scenarios, and demand surges.

For example, clinics can easily shift amongst specialties and surgeries can be scheduled across a broader platform—all with minimal physical changes. The design is fiscally resilient requiring minimal new resources to operate. The new hospital will be a more vertical structure and will have 900,000 square feet less than the total footprint of the two existing hospitals. This layout and the investment in energy efficient measures will result in a projected savings of $50 million annually.

Finally, the adaptable and resilient platform will ignite an operational transformation that will drive the next era of efficiency, safety and experience for patients and team members, removing many of the barriers that challenge the improvement journey it in current state.

Biggest challenges care systems face today?

A larger aging population, combined with the higher prevalence of chronic diseases both nationally and in Indiana, will continue to place a high demand on hospital systems, requiring the need for additional inpatient services.

Another challenge is workforce shortages. According to the National Center for Health Workforce Analysis, the U.S. is projected to have a shortage of more than 300,000 registered nurses, 140,000 physicians and 100,000 psychologists in the next 15 years.

How healthcare systems adapt, remain nimble, and adjust their facilities to accommodate these challenges will determine their success.

How does IU Health’s role in responding to state emergencies impact planning and design on this project?

Our new facility is designed for optimal throughput and flexibility, allowing the new downtown hospital to provide care throughout a variety of large-scale emergency situations including future disease outbreaks, catastrophic natural disasters, or other mass casualty incidents.

We have leveraged our experience as a destination for training and care in emergent situations to inform the design of our campus to support unpredictable circumstances.

Our many clinical settings have been designed with the contemplation of how these spaces might be asked to perform during a public health emergency, optimizing both our physical inpatient capacity and our ability to safely maintain some degree of routine operations during such an event.

For example, in the emergency department, our exam rooms are designed to flex based on the patient’s acuity level, providing additional monitoring capabilities, as needed. The vertical adjacency of our emergency and critical care offerings from the helipad on the roof, to the ICU tower, to the emergency department, will complement the horizontal adjacencies of trauma bays and imaging.

How do acute care campuses need to evolve to meet today’s challenges?

As an industry, we need to find additional ways to care for more patients within the existing physical footprints through operational precision, improved throughput, and more reliable systems. The demand challenges we face are compounded by staffing limitations that make the traditional tactic of physical expansion to meet demand less feasible.

We already see healthcare organizations working to overcome these challenges with the expansion of hospital-at-home programs, allowing select patients with serious illnesses to be cared for at home while still having access to acute-care medical specialists.

Embracing innovation and adopting new technologies such as robots for material transport and artificial intelligence to enhance workforce efficiencies and care coordination will continue to give health systems the opportunity to provide greater patient access and support for team members who are essential to the success of healthcare.

What’s on your radar to address these?

Flexible facilities that actively break down the barriers that limit our potential for seamless transitions across care settings, coordinated multidisciplinary care, and our responsiveness to shifting demand.

When all the cylinders fire correctly, when our operational and information systems are precisely calibrated in a supportive environment, we believe we’ll have the physical capacity and operational resiliency to meet this moment.

Tracey Walker is managing editor of Healthcare Design and can be reached at [email protected].