New Einstein-Montgomery hospital passes "user" exam

As the skeleton of the new Einstein Medical Center – Montgomery rises in a field in East Norriton, its internal organs are still a work in progress in the basement of a boring, one-story building in a nearby office park.

Go down a bleak staircase and past an unpainted cinder-block wall and you'll find a set of fully stocked, state-of-the-art hospital rooms that were created just so that doctors, nurses, and housekeeping staff could criticize them before they're replicated in the new building.

Mostly, that wasn't what happened as a "user" group made up of doctors and nurses from Montgomery Hospital and Albert Einstein medical centers toured a mock operating room last week. They liked it.

Einstein Healthcare Network is paying for the $355 million, 146-bed hospital, scheduled to open in September 2012. It will replace Montgomery's aging facility in Norristown and, maybe, attract wealthier, better-insured patients. Montgomery Healthcare System joined the Einstein network in April.

Several local hospitals have expanded recently or are doing so - Paoli, Phoenixville, Lankenau, Cooper University, and Virtua among them - but hospital consultant Alan Zuckerman said the hospital-building environment in general is "depressed." Funding is hard to get, and hospitals are concerned about future income.

In the mock-up, eyes grew large as the group took in the room's pristine 570 square feet, its rolling shelves, the lights that looked like giant, compound LED eyes over the operating table, the computer that will integrate information into the electronic medical record.

"Oh, wow," said one nurse. "We could fit about three of our [operating rooms] in here," said another.

Rich Montalbano, a blue jean-clad Einstein vice president who is project executive for the new hospital, let them gawk for a while before drawing their attention back to the questions they were there to answer: Were there enough outlets and shelves? Was the door opener in the right place? Should the desk with the computer be moved?

Montalbano said hospitals have been building mock rooms of various kinds before creating the real thing for decades. It can prevent having to correct hundreds of expensive mistakes later. "We want everyone to see the translation from two-dimensional planning to three-dimensional reality," Montalbano said.

The proliferation of equipment has made planning more difficult and essential.

The basement facility, which includes the mock OR and patient, neonatal-intensive-care, labor and delivery, and an intensive-care unit rooms, cost $150,000.

The hospital leaders are now at the tail end of an evaluation process that started in another warehouse with cardboard molds and tape on the floor. They have already tested several competing OR lights and four types of OR flooring to make sure they wouldn't be stained by Betadine, a gold-colored antiseptic, or squashed by the heavy portable X-ray machines.

Last week's group was the last of about 35 - more than 200 employees had already made about 300 suggestions - to tour the rooms before plans are finalized.

The user groups have not included patients and families. To speak for them, each room - they are all private and spacious - contains a chair for visitors that will never win a comfort competition with your La-Z-Boy. There is also a firm couch that can be modified for sleeping. A chair for patients with an adjustable back and armrests is reasonably comfortable.

In the faux OR last week, Bruce Menkowitz, an orthopedist who is chief of surgery at Montgomery Hospital, wondered about whether equipment would wind up against a wall vent. He thought the desk should be turned around so a nurse could more easily leave the computer to help out with the patient. Nurses agreed they would need more shelves for supplies in complex operations.

Kathy Costello, director of perioperative services for Einstein's medical facilities, asked about backup power. Montalbano said the new hospital has two independent electrical feeds from Peco, plus an emergency power source. "There will not even be a flicker," he said.

Costello thinks the six new ORs and the big patient rooms with lifts for heavy patients will help recruit "the best and the brightest."

Montalbano and other leaders will now decide which suggestions to act upon. There is general agreement, he said, that the OR desk is too big. Grab rails in the patient bathrooms rise up to hit the soap dispenser, so they will have to move. They've already switched granite thresholds between the patient room and bathroom to lower-to-the-ground shaved Corian. The grout joints on the bathroom floors will be narrowed so they hold less water.

It's little stuff, but, Montalbano said, "these are the kinds of details that drive you nuts when you open up a facility."