Building for the 21st century

The first building of MUSC's expansion and revamp, a facility that will house the university's Heart and Vascular Center and Digestive Disease Center, is set to open this fall.

As population growth nudges Lowcountry hospitals to capacity, additions and improvement projects are a constant sight at local hospitals, but this glinting glass and metal structure downtown on Courtenay Drive is the first large-scale hospital facility to be designed and built from scratch since West Ashley's Bon-Secours St. Francis went up in 1996.

The Medical University of South Carolina will continue its expansion project for the next 20 years, and Roper St. Francis Healthcare and East Cooper Regional Medical Center both are planning new hospitals in the coming years. For now, an early peek inside the new MUSC building offers a taste of what a 21st-century hospital will look like and how patients will be cared for as medicine marches into the future. We've got a roundup of some of its most innovative traits.

Patient-centered

One of the hallmarks of the current MUSC campus is the maze of corridors connecting the main hospital, Children's Hospital, Rutledge Tower (where most clinics and some diagnostic services are housed) and the clinical and academic offices where doctors and researchers work. Over the years, floors and rooms have been reconfigured and repurposed to house new equipment, and the whole campus is a discombobulating mix of aesthetics. While some floors appear to be straight out of circa-1983 "St. Elsewhere," other spaces are modern and fresh.

It's easy for patients to get lost, and too often, they're discouraged even before they've made contact with a doctor or nurse.

"When you take a sick patient and you have them go to three different places in a day, that's a problem," said Dr. Eric Powers, medical director of the Heart and Vascular Center.

The new hospital is designed to slash those transport woes by consolidating services within the same space. First, a central check-in area on the first floor, plus reception desks on each floor outside the elevators, will help patients and their families get where they're going. Stops inside the hospital will make more sense, too: Someone undergoing an outpatient endoscopy, for instance, will be prepped in a semi-private space (closed on three sides, compared with merely curtained off in the old hospital), rolled down the hall to their procedure and returned to recover in the same space where they were prepared.

Inpatients will notice an upgrade in their accommodations, too. Most of the 156 private patient rooms in the bed tower are about 340 square feet, about a third larger than the average room in the main hospital. A primo slice of property doesn't hurt, either. A look out the window on several sides of the building affords expansive waterfront views and glimpses of boats bobbing at the City Marina. Other patient rooms overlook the light-filled glass "conservatory" that serves as the hospital's main entrance, which will feature full-size trees and other green touches.

Under the traditional model of inpatient care, patients who are recovering from, say, abdominal surgery, might be housed in the same area as those who've had orthopedic surgery. Doctors are hopeful that the streamlined approach to care in the new facility will lead to healthier patients since nurses and other support staff will specialize in just one area of care.

"You have everyone in the same place, and they talk and get ideas," says Dr. Mark DeLegge, medical director of the Digestive Disease Center.

Flexibility

Medical technology and standards of care already have changed since construction of the new hospital began in 2005.

"It's a moving target," said Dr. Fred Crawford, who serves as cardiothoracic surgery director and chairman of the department of surgery.

CT scanners, for instance, now offer such detailed and lifelike images that they're increasingly used for procedures that once required an invasive trip to the cardiac catheterization lab.

But the new hospital's design leaves room for what physicians can't yet know about the way in which they'll treat patients 10 or 20 years from now. In the operating room, most equipment — oxygen, for instance, or devices used to measure patients' vital signs — will pop down from booms in the ceiling rather than taking up space on the floor. That means aging technology can be swapped out easily for the latest equipment.

The same type of ceiling booms are hidden in regular patient rooms and doctor's offices, too, which would allow extra space to be quick-changed into an intensive-care room in the event of a space crunch or large emergency or disaster.

And rather than reinventing the wheel, lots of features take advantage of the hospital's existing infrastructure to provide care. A maze of pneumatic tubes, for instance, will shuttle medications and lab specimens between the new hospital and other campus facilities.

Durability

While the 75-foot matrix of glass panes that fronts the facility's "conservatory" may spider in the face of hurricane-force gusts, it won't actually break. We're told it was road-tested for 220-mph winds and didn't balk. The patient-care portion of the buildings rests on high-test stilts, leaving the first floor open for handicap and emergency parking. The open space also serves to accommodate potential floodwaters before they're sucked into pumps.

The facility is the first in the nation — for at least its first few weeks or months on the job, anyway — to be built under the latest codes for hurricane and earthquake proofing. A central space serves as an "umbilical cord" between the bed tower and the diagnostics and procedure building. Small gaps will be left on either side of the conservatory (patients won't see them) and utility wires wait neatly coiled in the ceiling like spaghetti in the event they'd be stretched to accommodate wind or earthquake damage.

The idea: Even if the rest of the Charleston peninsula were ripped apart by natural disaster, the lights would still burn and the water would still flow inside the buildings.

Cleanliness

Infection control is a top priority at the new facility. The U.S. Centers for Disease Control and Prevention estimates that 36 percent of hospital-acquired infections — at least 5 percent of patients catch one — could be prevented with greater vigilance. New floor plans aim to do just that.

Separate halls within the operating room and procedure portions of the hospital will allow patients to be ferried about without coming in contact with the masses in public hallways, and a central sterile corridor will allow doctors and nurses to quickly cross between ORs during an emergency.

The operating-room ceiling booms also provide extra protection against infection, since less equipment will be wheeled around or built into the rooms. That means less surfaces to clean, and less places for bacteria to hide out.

"If you're not moving things around, you're not stirring things up," Crawford said.

Corian, the coveted kitchen countertop material, coats operating room walls and countertops throughout the hospital. It's not porous, so that means it's unlikely to grab on to infectious bugs or grow mold or mildew. Special flooring that calls for only a minimum of upkeep — no more constant buffing and waxing — paves hallways and rooms throughout the facility.

Family-friendly

There will be no more stuffy waiting rooms with only months-old tattered magazines for distraction while relatives are in surgery. Large windows at the end of every bed tower floor wrap around an airy "family day space," which will have a kitchenette, TVs and spots to surf the Web. Patients also can hang out there — perhaps the bright glow at the end of the hallway even will help coax them out of bed for their first post-operative shuffle.

A dedicated space for families with a sleeper sofa and recliner is set into a window alcove of each patient room, and retail shops will line a ground-floor portion of the hospital's exterior. No details yet, but staffers say the storefronts could be occupied by everything from coffee shops to a dry cleaner.

There's elevated outdoor dining on the back of the building, facing the water, and parking is expected to be easier. MUSC purchased the eight-story city garage adjacent to the new hospital and will add several elevators to shuttle patients to the hospital connector. Valet parking in the wide, Carolina bluestone-paved "horseshoe" out front also will be available.

Reach Holly Auer at 937-5560 or hauer@postandcourier.com.