Hemmed in hard by the East River, Hospital for Special Surgery opened surgical facilities within an innovative new setting, built nine stories above one of Manhattan’s busiest highways.
The newly completed ninth floor includes features designed to enhance the hospital experience for the growing number of ambulatory surgery patients seeking excellent care, a return to pain free mobility and the resumption of activities ranging from walking to acrobatics.
The new floor, equipped to serve also as a global digital teaching facility with advanced videoconferencing components, holds eight new outpatient operating rooms to address the steady increase in demand for specialized musculoskeletal care. More than 22,000 surgical procedures are now performed annually at Hospital for Special Surgery and half of them are ambulatory, that is, the patient goes home at the end of the day.
“In the ten years since our last expansion, outpatient and surgical volumes have increased by almost 60 percent and we’ve recruited 65 new physicians,” said Thomas P. Sculco, MD, surgeon-in-chief at Hospital for Special Surgery. “This unprecedented growth is being fueled by a growing group of people in their 60s and 70s and an increasingly active general population at risk for sports injury. There has also been a rising demand for specialty procedures that is expected to continue into the next decade, making this expansion essential.”
Completion of this phase of the project, which adds 85,000 square feet of new space and 100,000 square feet of re-engineered and re-designed space, required a total expenditure of $64 million. The expansion allows for increased patient bed capacity and ambulatory surgery operating rooms, which frees space in inpatient surgery operating rooms, as well as for new equipment, administrative offices and general support space.
“Our location made this project a construction and design challenge,” said Dr. Sculco. Hospital for Special Surgery is built over the Franklin Delano Roosevelt Drive (FDR) to the east and is surrounded by other buildings to the north, south and west, which left us with nowhere to grow. As is often the case in Manhattan, we looked to expand vertically. But even this was not easy. We added a floor above the eight-story building, which was incredibly difficult because the construction occurred on top of a busy hospital over one of the city’s most well-traveled highways.”
“Not only did we meet this incredible logistical challenge but we were able to do it all while operating at full capacity. Fortunately, physicians, nurses, other health professionals and administrators collaborated to meet this challenge to continue efficient and effective care environments without interruption, “said Dr. Sculco.
The new ninth floor is composed of eight new surgical suites dedicated to outpatient surgery, including sports medicine procedures as well as surgical procedures of the hand and foot. The new surgical suites have hi-tech features like three flat panel television monitors per operating room so that the intricacies of surgical procedures can be viewed by everyone in the room, at any given time. Another hi-tech feature is the boom, the focal point of each operating room. The boom is a fully-adjustable and fast swiveling pendant that is anchored at the foot of the operating bed and holds all of the tools, electronic equipment (drills, saws, etc.) and much of the room’s digital technology. The boom replaces the rolling carts that were previously used to hold tools and equipment and frees up valuable floor space. The boom swings 10 feet to the left and right of the patient, so it is accessible to everyone working in the room. Keeping everything in a central location on the boom and off the floor has been shown to improve efficiency.
These surgical suites were designed with features to ensure patient privacy. Each patient will await surgery in a private room, where family members or friends can accompany them. In this room, patients will meet with their surgeon for a pre-surgical consultation where confidentiality is assured. In addition, the surgical waiting rooms have been redesigned for the comfort and ease of patient families. The new family/guest waiting room looks out over the East River. After surgery, there are postoperative recovery rooms, which were also designed with patient privacy in mind. As the day goes on and more people are recovering from surgery, some of the pre-operative rooms can be transformed into post-operative recovery rooms as dictated by patient volume.
Patient safety is a top priority. In an effort to enhance the hospital’s widely respected infection control efforts, a larger and more contemporary central sterile supply department was constructed. This new unit is located on the seventh floor with separate elevators dedicated to transporting sterile and non sterile supplies to and from surgical suites on the fourth and ninth floors.
The eighth floor will also add 30 new inpatient beds. These new patient rooms – both semi-private and private – were designed to create a soothing environment. Each patient room features eight-foot windows that provide both patient beds magnificent and unobstructed views of the East River.
“Our patients always tell us they love the river views,” said Stephanie Goldberg, R.N., vice president for nursing at Hospital for Special Surgery.” When you are high above the city looking out at the tug boats and the bridges, it takes your mind away from whatever problem brought you here.”
The hospital added other touches to create a calming environment such as linens and fabrics in warm colors, art that hides clinical equipment and wall sconces that provide soft lighting. These decorative touches were selected to give patients a sense of serenity and peace of mind. Ms. Goldberg went on to say that the rooms are designed to feel more like home than a hospital.
Dr. Sculco added that patients at Hospital for Special Surgery are treated by some of the most talented physicians and surgeons in musculoskeletal medicine. “Our goal is to continue to improve the care environment to focus on each patient’s recovery and rehabilitation.”
The hospital’s eighth floor has been reconfigured to accommodate additional clinical and nonclinical space including:
The hospital’s award winning pre-operative patient education programs will be held in new conference rooms on the eighth floor. These programs provide detailed information to prepare a patient for surgery and cover such topics as: what to bring with you to the hospital, what to expect the morning of surgery and during recovery, and resources and expectations regarding pain and pain management. These programs are credited with reducing length of hospital stays and improving patient safety. Hospital for Special Surgery received New York State’s first Hospital Patient Safety Award for its best quality initiatives aimed at improving patient safety and reducing medical errors.
“Our pre-operative classes are a hallmark of this institution, and of great benefit to patients,” said Ms. Goldberg. “The additional space ensures that these programs will continue to thrive and serve as models for other hospitals around the world.”
A new imaging suite will be constructed in the space that was formerly occupied by central sterile supply before it was moved to its new location on the seventh floor. This suite will increase the total number of magnetic resonance imaging (MRI) machines from five to seven, making Hospital for Special Surgery the nation’s largest academic imaging center dedicated to musculoskeletal health.
In the past decade, Hospital for Special Surgery has seen a substantial increase in demand for its specialized services. Requests for the Hospital’s orthopedic, rheumatologic, and imaging procedures are on the rise and surpassing the national average for orthopedic hospitals. With such significant growth expected to extend into the next decade, HSS is expanding its facilities to accommodate this increase in patient capacity.
In May 2005, HSS began adding space to the 5th, 6th, 7th, 8th, and 9th floors of the West Wing and an 8th floor to the East Wing. This first phase of the Major Renovation and Expansion Project is nearly complete, and you will begin to notice some changes in the coming months.
The scope of this major building project calls for additions in bed capacity, inpatient and ambulatory surgery operating rooms, imaging modalities, physician offices, and general operating and support space. With our current facilities, on most days more than 90 percent of the available beds are occupied. On peak occupancy days, bed usage has typically been greater than 99 percent.
Overall, HSS will renovate more than 73,000 square feet of the main building. Two additional inpatient units will be added, for a total of 42 beds. Six inpatient operating rooms on the 4th floor and three on the 9th will bring the count up to a total of 29.
In addition to increasing patient capacity, the expansion will allow for a more efficient and effective care environment. New floor plans that include additional elevator banks and relocated locker and storage rooms are configured for staff convenience.
This summer, the following departments will be relocated to the 8th floor: