The Challenge: From a clinical standpoint, Borgess Medical Center in Kalamazoo, Michigan offers award-winning service. Their existing facilities however faced an enormous number of challenges. Many of their clinical facilities were antiquated and outpatients traveled all over the medical center to obtain treatment. This contributed to staff inefficiency and patient dissatisfaction.

The Opportunity: To address these needs, Borgess decided to develop the Stryker Center, a 110,000 sq. ft. addition to replace antiquated facilities, improve staff efficiency and enhance outpatient access and convenience. Borgess recognized this as an excellent opportunity to challenge existing operations and preconceived ideas. The vision and progressive approach of Borgess executives resulted in some truly innovative approaches to the provision of healthcare, particularly in addressing short hospital stays.

The Plan: Rather than developing typical separate departments, each with their own prep and recovery facilities, Borgess developed a centralized 80-bed Short Stay Center accessed directly off the main lobby, with an array of diagnostic and treatment facilities surrounding it. The Short Stay Center incorporated these unique characteristics ~

1. Universal Rooms: Pre-procedure preparation rooms and post-procedure recovery rooms are identical allowing universal use. This accommodates morning peak times for pre-procedures and afternoon peaks for post-procedures.

2. Room Types: Two types of universal rooms were provided 44 smaller rooms for shorter stays, such as outpatient surgery recovery and 36 larger rooms for longer stays such as interventional cardiology procedure recovery.

3. Room Amenities: Every room has a door and a toilet room.

3. Operational Approach: Operationally, the Short Stay Center was considered one large unit, although it was separated into zones for varying services, such as cath labs, outpatient surgery, G.I. labs, angiography and other short stays.

4. Peak Times: Zones are located adjacent to one another and flow from one to the other to accommodate varying peak times for each.

5. Phased Recovery: Phase 1 recovery and Phase 2 recover for outpatient surgery occurs in the same facility; rather than moving the patient, staffing levels are adjusted for the varying phases of recovery.

6. Alternative Short Stays: During off-peak times, the facilities are used for lengthy outpatient procedures, such as IV antibiotic administration, infusion and autologous blood transfusions.

7. Observation: The facility is also used for Emergency Observation.

8. Overnight Stays: Licenses were obtained for 16 of the 80 beds to allow patients requiring overnight (or late) stays to be consolidated within the unit without being transferred to a nursing floor.

This presentation reports on the use of the facility after three years of operation to describe how significant operational changes were actually integrated into the medical center's culture. The study will also evaluate which efficiencies originally contemplated were actually realized, how the facility is currently being operated differently than what was originally planned and what lessons can be learned for the effective design of future short stay hospital facilities.