St. Clair Hospital
Emergency Department

The design of this project utilized Lean design theory to dramatically reduce wait times, accelerate delivery of care, increase patient throughput, and achieve exceptional patient satisfaction. It became a key component to both the design of the addition/renovation and the operational planning for each department that interfaced with the Emergency Department.

Lean design was incorporated throughout the design phase. Stakeholders and designers were engaged from the outset to think ‘out of the box’ about their processes and solutions. They were challenged with the goal of creating a superior patient experience. Planning team members and ED staff who did not embrace these concepts were transferred to other departments. These conversations evolved into ideas that translated into design solutions.

The design focused on the exploration of pathways with regard to how to minimize travel and remove barriers to achieving the project goals. It also utilized architecture to support and encourage process change. The triage process was streamlined to a quick basic point-by-point assessment that leads to efficient deployment to a treatment space and caregiver interaction. Strategic placement of this function became critical to patient flow. An analysis of projected peak demand set parameters on the number of treatment spaces to minimize the patient waiting room experience.

As a result of the renovation/addition, average waiting times were reduced from 47 minutes to 17. The distance that a nurse must travel during a shift was measured at 50% the national standard by an independent survey. Patient satisfaction scores compiled by Press Ganey soared from the 14th percentile to the 99th percentile. During many fiscal quarters St. Clair was ranked number 1 in the United States for emergency departments.

The architecture supports this innovative approach and sets the Emergency Department visually apart from the balance of the campus.  The existing hospital campus is largely buff brick and ribbon windows. By abstracting the ribbon window and setting it in motion against the curving entry drive, the design animates the existing motifs and gives the addition a spark of counterpoint. These new metal ribbons unfurl their energy, dissipating as they travel around the building, and find calm resolution in the rear façade.

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