09/24/10 — A new look, yes, but will it help with patient care, working conditions?

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A new look, yes, but will it help with patient care, working conditions?

By Matthew Whittle
Published in News on September 24, 2010 1:46 PM

BUTNER -- A new start. For the staff and patients at Central Regional Hospital, that's what it was when they moved from the John B. Umstead and Dorothea Dix campuses in 2008. And the hope is that the same will hold true for the staff and patients of Cherry Hospital when their new facility opens in about two and a half years.


For Central and Umstead, the differences between the facilities are stark.

Umstead, a former Army hospital, was largely constructed in the 1940s and it shows. Like Cherry, the campus is spread out among multiple building, all of which are built in the same heavy, brick, institutional style, with tight, dimly-lit florescent hallways and group bed and bathrooms.

By contrast, Central is all under one roof. Its hallways, two of which run the length of the building, are wide and bright with lots of windows allowing for outdoor views and natural lighting. Each floor is themed -- ocean for the bottom floor, earth for the second and sky for the third. On the wards, each patient has his or her own private room and private bath, and staff has the ability to expand the number of rooms in each ward if necessary, while common areas are large and spacious and easy to monitor from the adjacent nursing station.

Even the details are taken into account, with the beds made out of one-piece molded plastic bolted to the walls and floors, and easy-to-move blinds built into every bedroom window so patients can control their own lighting.

And for those who work there, those things have all added up to make a palpable difference.

"Umstead was a little darker. (Central) is a little more friendly to me. It's clear, comfortable. It's more relaxed," said Bill Thornton, a 42-year veteran health care tech II on the adult male acute admissions unit. "Patients are more relaxed. Staff feel more encouraged. It's easier to give therapeutic care."

And that's an attitude and an optimism that is reflected in other areas of the hospital as well.

From the pharmacy to the lab, employees praised the improvement in efficiency that has come with the new hospital, whether due to the automated drug system or just a better layout of equipment.

In other areas, the advantages of the more welcoming and efficient layout also are apparent, particularly on the second-floor treatment mall, which features not only therapy, small group and class spaces, but also a library, beauty and barber shop, cashier's office, music room and more. There also are fully accredited elementary and junior/senior high schools on the children's ward.

Yet another area where staff say the new facility has made a difference in patient care is in the admissions department, which is now accessible directly from the parking lot and has been redesigned to be more comfortable and welcoming.

"I think what it has done is allow us to become more focused on customer service," said Jodie Webster, screening and admissions nursing supervisor. "Most of the people who come here are not happy about being here to begin with because they are involuntary commitments, so we try to provide customer service and accommodate them at least as much as we can as long as they are not a danger to themselves or others."

But not everything has been perfect -- there were many minor changes that had to be made for safety reasons immediately after the hospital opened, and staff are having to deal with smaller offices, less storage space and the lack of large gathering spaces for patients. Still, said volunteer services director Linda Dameron, overall, employees are pleased with their new home and the patients seem to be, too.

"People didn't want to move over here. We all fought it. We didn't want to give up what was familiar to them, but you go back over there (to Umstead) now, it's like, 'Why did we fight it?'" she said. "This space was actually designed to be a psychiatric facility. It's focused on patient care -- the way it should be."

She expects the experience to be very similar for Cherry.

"I hope it is," she said.


And while Cherry won't be exactly the same as Central, Terry Hatcher, director of the state Department of Health and Human Services Division of Property and Construction, said it will have all of the same features, just in a slightly different layout.

"There really is no functional difference to speak of in the three hospitals (Central, Cherry and the eventual new Broughton)," he said.

In fact, Hatcher continued, because state officials have had the opportunity to learn from the construction of Central, Cherry should actually have a more efficient layout and design.

"When you go into a new facility, when you actually get people in there, they can tell you if you have things right or not," he said.

The current Cherry Hospital has 569,086 square feet spread out over multiple buildings. The new one will have 410,000 square feet over three stories all under one roof. But, Hatcher explained, that doesn't mean it will be a smaller hospital. Once repetitive space in each building, such as entries, lobbies, dining areas, bathrooms and corridors is taken out, the actual square footage difference is much smaller, he said.

"There's a lot of inefficiencies in that. There's a lot of wasted space when you spread buildings out. The result, in terms of usable square feet, is probably more, definitely no less than what they have now," Hatcher said.

And, he said, it'll actually be able to serve more patients with a 318-bed capacity, as compared to the current 251. The new hospital also is expected to employ about 1,000 people, as compared to 900 now.

But the expectations of those nurses actually at Cherry vary.

Some feel the current problems are more institutional and won't be solved with a new facility.

"I don't see how four new walls will make a violent patient behave," one nurse said, explaining that better policies and more support from the administration would do more to keep people safe. "The staff is not getting hurt because of problems with the facility or the way it's set up."

But, another nurse said, while violent patients might still be violent and injuries might still occur, if a new facility can create a better environment and decrease those numbers by even 10 percent, then it will have helped.

"I'm hoping it improves safety and efficiency. If that's been their experience, then I'll be optimistic and hope it'll be ours, too. Certainly everybody feels better in a new building," he said.

And that's what state officials are counting on -- that the new facility will contribute to improvements in both the quality of both patient care and the workplace environment, rejuvenating the hospital and its workforce.

"I think the new hospital will have a tremendous impact. The atmosphere for safety and the atmosphere for quality will be there," said Luckey Welsh, director of state operated health care facilities. "You take the new building and (a) new management team coming in from outside, I think there are a lot of things coming together right now for Cherry."