Featuring the latest surgical technology, as well as oversized, suite-style patient rooms, the Martin and Toni Sosnoff Pavilion at Northern Dutchess Hospital was built to provide patients in the Hudson Valley with a higher quality of care.
Two years ago, Northern Dutchess Hospital broke ground on an ambitious $47 million, modern three-floor pavilion that employs evidence-based design and focuses on patient satisfaction by offering many amenities. On Feb. 13, 2016, patients were relocated from double-occupancy rooms built 85 years ago into their own quiet, comfortable rooms with an oversized window, private bathroom, wall-mounted flat-screen TV and a pullout sofa bed for guests. Later that month, the hospital opened its state-of-the-art surgical department, with fully integrated technology in six spacious operating suites, 22 surgical prep and recovery bays, and three strategically placed nurses stations.
The Case for Renovation
Single-room hospital design not only creates a quieter hospital stay, but also reduces patient transfers and the risk of infection. Some advantages of single-occupancy rooms include improved patient care, reduced risk of cross infection as well as increased patient privacy, according to a review, “The Use of Single Patient Rooms versus Multiple Occupancy Rooms in Acute Care Environments,” by the Coalition for Health Environments Research.
Dr. Kroll checks on a patient in the new patient pavilion at Northern Dutchess Hospital.
Dr. Wing consults with a patient prior to surgery in one of the new operating suites at Northern Dutchess Hospital.
Dr. Sabia and James Scaduto, MD, hospitalist, together on the medical/surgical unit at Northern Dutchess Hospital
Additional research shows that environmental elements such as natural light, views of the outdoors, quiet and a calming color palette can produce better patient outcomes. More than 1,200 studies have linked the design of healthcare facilities to healthcare quality and patient outcomes, according to California-based advocacy group Center for Health Design. The nonprofit center formed to collect such data after a 1984 study, “View Through A Window May Influence Recovery from Surgery,” by Roger Ulrich, found the group of patients who had better window views of trees versus another building had shorter lengths of stay as well as fewer minor complications, and took less pain medication.
Another major shift in thinking involves hospital visitation. Not so long ago, hospitals had strict visiting hours. But Northern Dutchess Hospital takes a different approach and welcomes guests to stay around the clock to be part of the care team. There is mounting evidence that having a support person in the room improves communication, increases patient satisfaction and can improve patient safety, and the pavilion’s design offers many amenities for the families of patients.
“Patients and their families do better when they are involved, informed and engaged in the process,” says Eric B. Bass, co-author of “A Systematic Review of Communication Quality Improvement Interventions for Patients with Advanced and Serious Illness,” published online in the Journal of General Internal Medicine.
Advanced Surgical Technology
A key component of the Martin and Toni Sosnoff Pavilion is the surgical floor. It contains six high-tech operating suites and the da Vinci Surgical System, which will bring robotic surgery closer to many residents of the mid-Hudson Valley.
One of the six new high-tech operating suites in the Sosnoff patient pavilion
“Because we can now handle more complicated minimally invasive operations, we can keep more patients in our community,” says John Sabia, MD, Vice President of Medical Affairs at Northern Dutchess Hospital. “Our goal is to keep patients local.”
The da Vinci robot at Northern Dutchess Hospital has applications in general surgery, urology and gynecology. When compared with open surgery, the laparoscopic incisions allow for shorter recovery periods, reduced postoperative pain and improved cosmesis. There are also advantages in comparison with traditional laparoscopy. The da Vinci Surgical System offers 7 degrees of freedom and 90 degrees of articulation — dexterity greater than the human wrist — according to Intuitive Surgical, the company that manufactures the robot. The system’s high-definition, 3-D vision system also allows surgeons to visualize tissue more accurately. For surgeons, the robot brings opportunity.
“The availability of the surgical robot will allow us to expand our scope of practice,” says James Wing, MD, a general surgeon with Health Quest Medical Practice (HQMP). “Some of the surgeons who practice at Northern Dutchess Hospital travel to other locations to perform robotic surgery. Having a surgical robot at the Martin and Toni Sosnoff Pavilion is a big step forward in terms of the numbers and types of procedures we will be able to offer in the future.”
To accommodate the robot, one of the operating suites is 820 square feet. The others are also spacious — roughly 650 square feet each — and feature many bells and whistles. Real-time imaging via three wall-mounted monitors and the ability to intraoperatively consult MRIs, CTs and X-rays bolsters patient safety and physician confidence. The rooms use a ceiling-mounted laminar air curtain system to control airborne particulates during surgery to maintain ultra-clean conditions. The suites can accommodate a range of specialties, which enhances surgeons’ ability to schedule procedures and ensures emergency procedures can be quickly added to the surgical schedule without having to wait for the availability of a designated operating room.
Preventing Sepsis, Ensuring Patient Satisfaction
The overall design of the Martin and Toni Sosnoff Pavilion, which features 40 private patient rooms, has been geared toward preventing infections and enhancing patient safety and satisfaction. Traditionally, hospitals have featured double-occupancy rooms. That compromises patient privacy and increases the risk for nosocomial infection, including sepsis — one of the leading causes of death in ICUs, according to the National Institute of General Medical Sciences, and one of the most expensive medical conditions in the United States, according to the Agency for Healthcare Research and Quality.
Rachel Scott, RN, and Patty Sullivan, physical therapist, discuss a patient in the new therapy room on the new medical/surgical unit at Northern Dutchess Hospital.
Northern Dutchess Hospital’s single-occupancy rooms enhance patient safety in several ways. Only one patient utilizes the restroom, which prevents multiple patients from interacting with commonly contaminated surfaces such as sinks, faucets and showers. A staff hand-washing sink is located just inside the patient room door, making it easier for physicians and healthcare providers to wash their hands before and after interacting with patients.
A growing body of research supports the link between the healthcare environment and the transmission of multidrug-resistant organisms such as methicillin/oxacillin-resistant Staphylococcus aureus, Clostridium difficile spores and vancomycin-resistant Enterococcus. According to a literature review published in Therapeutic Advances in Infectious Disease, these organisms can live on surfaces in the healthcare environment for up to five months, which can make containment difficult.
Aside from reducing the risk of nosocomial infection, having all private, spacious rooms promotes a better healing environment, says Douglas Kroll, MD, cardiologist and internal medicine physician at The Heart Center, which will have office space in the new pavilion this April.
“Patients will have more pleasant experiences, and the rooms will be quieter,” he adds. “The rooms are also organized in such a way that care is more efficient and more streamlined with our electronic health system.”
Finally, the Martin and Toni Sosnoff Pavilion incorporates one additional component of healing in its inpatient unit: unrestricted visiting hours. Each private room contains a sofa bed for family members who may choose to stay with their loved one throughout his or her hospital stay. That is especially beneficial for young or elderly patients who may need assistance communicating their needs to the care team.
“Physicians who have had loved ones or friends in the hospital understand firsthand the impact this can have on home life,” Dr. Wing says. “Family members won’t have to plan their schedules around set visiting hours, and the rooms are large enough to accommodate multiple visitors.”
The impact that surrounding patients with loved ones has on morale and recovery, however, shouldn’t be overlooked.
“Family members can provide immediate psychological and spiritual support,” Dr. Kroll says. “It has been demonstrated that people who have unrestricted access to family support are more comfortable, experience less anxiety and may even feel less pain. Family members play a direct role in helping their loved ones recuperate.”
The Martin and Toni Sosnoff Pavilion meets and exceeds the requirements of 21st century health care. Among the facility’s additional advancements are:
- Attractive physician office space in close proximity to diagnostic testing and a laboratory, which increases synergistic physician collaboration
- Nurses stations strategically placed throughout the patient floor, with views into every room
- Carpeted hallways to help absorb noise, a frequent patient complaint, and reduce risk of slipping. Carpet also reduces stress on joints for staff.
- Two private counseling rooms where physicians can speak confidentially with family members as well as two family lounges with comfortable furniture
Eye on Integration
The first floor of the Martin and Toni Sosnoff Pavilion features 25,000 square feet of physician office space that houses primary care physicians, general surgeons and The Heart Center cardiologists. Having these specialties in close proximity to one another not only benefits patients, but physicians are also better able to consult with colleagues on complex cases.
“The quality of care physicians and nurses provide to patients is certainly a big component of achieving quality outcomes. However, hospitals can’t overlook the importance of the physical space. Healthcare facilities must be able to provide the infrastructure for advanced technology, as well as offer patient rooms with ample sunlight and an opportunity for family members to stay with their loved ones. These things have a significant impact on overall patient satisfaction.”
— Douglas Kroll, MD, cardiologist and internal medicine physician at The Heart Center at Northern Dutchess Hospital
Denise VanBuren, RN, Director of Surgical Services, consults with Dr. Wing in one of the six new operating suites at Northern Dutchess Hospital.
“The opportunity for physician collaboration is tremendous,” says Dr. Wing, whose office is relocating to the new pavilion. “If I have questions regarding a patient’s presentation, I can walk next door to one of my colleagues and rapidly seek an additional evaluation.”
Moreover, the ability for patients to schedule follow-up appointments with a cardiologist or general surgeon in the same office space as their primary care physician helps ensure compliance following a specialty referral.
“Convenience and immediate provider availability translates directly into better care,” Dr. Kroll says. “Patients can literally walk across the hall to schedule an appointment with a specialist, which reduces the likelihood that they will get lost in the system or have to wait days or weeks for a consultation.”
Newly Redesigned Heart Center
The Heart Center’s new location within the Martin and Toni Sosnoff Pavilion is larger than the center’s previous space and includes an on-site cardiac testing suite. Because of the practice’s location in the pavilion, patients can also access diagnostic imaging, laboratory testing and other services in one building.
“Coordination of care is greatly improved — the pavilion offers a one-stop shop where patients can potentially attend to all of their health needs,” Dr. Kroll says. “Because we’re located within the hospital, we can also directly admit patients as necessary.”
The on-site location benefits not only community members, however. Previously, Dr. Kroll had to travel to the hospital to address any immediate patient needs or to complete patient rounds. That’s no longer necessary because of his new office’s close proximity to the inpatient unit.
“From a workflow standpoint, our location within the pavilion is much better,” Dr. Kroll says. “An average day consists of caring for both inpatients and outpatients. The only thing that now separates me from seeing patients and performing daily rounds is a set of stairs. I am much more available for consultations, and I can respond more quickly to patient needs, which ultimately translates into better care.”
The Heart Center provides a variety of in-office, noninvasive diagnostic tests, including electrocardiography, stress tests and echocardiography. Some of these techniques require a physician to be present or on-site, to be available if there is a complication, or to provide real-time interpretation with more sophisticated protocols. Examples include contrast echocardiography — a technique used to provide better quality imaging and potentially information on the blood supply of the heart — and stress echocardiography— a noninvasive study to look for coronary artery disease, as well as assess heart muscle and valve function during exercise. Because the Heart Center physicians no longer have to leave the building to care for patients in the inpatient unit, community members will have expanded access to these and other sophisticated diagnostic tests.
Similarly, the greater physician availability will enable The Heart Center to more easily perform outpatient procedures and in-office treatments such as the administration of intravenous medications, including dobutamine and milrinone, via an infusion pump, for treatment of heart failure.
Enhancements in General Surgery
The office of HQMP Division of General Surgery includes two minor-procedure rooms, multiple exam rooms and enough space to accommodate several additional physicians. In addition to routine general surgical procedures, the new pavilion features the capabilities necessary to perform bariatric surgery, a procedure that was previously unavailable at Northern Dutchess Hospital. The general surgery office space, as well as one of the patient rooms on the inpatient floor, has been designed to accommodate bariatric surgery patients.
The exterior of the new Sosnoff patient pavilion at Northern Dutchess Hospital
“We have incorporated a broad spectrum of features that make an inpatient hospital stay nicer for patients,” Dr. Wing adds. “I urge my colleagues in the community to send their patients to us — our brand-new building and amenities allow for a much better patient experience.”
For more information about the Martin and Toni Sosnoff Pavilion and the services available at Northern Dutchess Hospital, visit healthquest.org/rhinebeck/northern-dutchess-hospital.aspx.