By RENEE STOVSKY
When Randy DeRousse of Edmond, Okla., suffered an ischemic stroke in 2004, he spent two months as a patient at Mercy Hospital Oklahoma City. After that came a grueling five-month stint as an outpatient there, accessing physical, occupational and speech therapy three days a week to help rehabilitate the use of his right arm and leg and to learn to swallow and talk again.
Now 62, DeRousse says he remembers two things most clearly about that period of his life: the wonderful care he received from nurses, doctors and therapists, and the constant longing he felt to be outside, feeling the sunshine on his face instead of being "closed off from the world" while he struggled to recover.
"I worked outside for 30 years as a loading supervisor for a brick company, and I missed the fresh air and natural light so much," he remembers. "I think if I could have had access to the outdoors, it would really have helped my healing process."
Now patients at the new Mercy Rehabilitation Hospital Oklahoma City, which opened last October, have a beautifully landscaped patio they can use during their recuperation, with benches and chairs for relaxing and paths with various surfaces to practice walking on.
Mercy's newest facilities have been designed with suggestions from former patients like DeRousse and many others in mind. With more than $600 million of construction projects in the works across Arkansas, Kansas, Oklahoma and Missouri, the Chesterfield, Mo.-based health care system has been turning to patient advisory groups to help rethink medical care from a consumer's point of view.
"This has been an amazing opportunity for us to design our facilities from a healing perspective," says Cindy Beckham, Mercy's executive director of building design. "The advisory groups have helped us make decisions and implement ideas based not only on the feedback we gather from doctors, nurses and technicians, but from the people who are directly impacted by the health care they experience."
Comforts of home
When Liz Kemper of Nixa, Mo., agreed to serve on a patient advisory group for Mercy Children's Hospital in Missouri she drew from her experiences in 2004, when she had an emergency cesarean section at the hospital to save her two boys, who suffered from twin-to-twin transfusion syndrome. Kemper found herself spending the next 10 weeks in the NICU as tiny Harrison and Hudson — both barely 2 pounds at birth — struggled to survive.
"It was literally my family's second home," she says.
Now 8, the twins are thriving, despite 21 surgeries and numerous emergency room visits — all at Mercy — between them. Though Kemper, 36, says she "could not have asked for more phenomenal care from the hospital staff," she does remember wishing for a few amenities in the NICU during the long, emotionally fraught stay she experienced there.
"I would have given anything to have both boys in the same room together, since research shows that multiples heal better when they are not separated," she says. "A family area to accommodate siblings — our daughter was 10 at the time — would have been great, too."
Today the NICU in the brand-new Mercy Children's Hospital Springfield reflects the input of Kemper and other advisory group members. The NICU has two rooms that can accommodate multiples, along with rocking chairs and sleeper couches for parents' convenience. There's a kitchen for families to use, a secluded area for moms to express milk and an outdoor children's play area under construction as well.
The experiences and opinions of family advisory board members helped shape this twin room and other facilities at the NICU that opened in December at Mercy Children's Hospital in Springfield, Mo.
Learning from experience
Mercy's Beckham explains that Mercy has had two goals in mind with the opening of more than a dozen new facilities over the next year: to develop a new brand with consistent appearances and amenities from place to place and to focus on design to enhance patients' encounters with all aspects of health care.
To that end, three years ago Mercy began organizing patient advisory groups of 12 to 15 volunteers from communities with new facilities in the planning stages. Each group met formally once a month with Mercy executives and facilitators to discuss agendas that ranged from registration processes to employee apparel programs to architectural concepts and interior design.
"The idea for the patient advisory groups came from our community roundtable process," says Beth Kistner, director of the Mercy Experience Team, a group within Mercy's marketing department that gathers patient input — including through advisory groups, surveys, interviews and other methods — and uses it to inform business decisions and to develop Mercy's brand.
Kistner explains that as part of the roundtable process, "We had been going through a very detailed process of getting together with local municipal, civic and education leaders in every community we serve to dialogue about the area's health care needs. From there, we wanted to put together a smaller group that could give us input on an ongoing basis — and who better to listen to than our own patients and their experiences with Mercy?"
In addition, Kistner adds, Mercy received feedback through focus groups, online surveys and ad hoc interviews conducted through its marketing department. But the patient advisory groups, with their ability to provide deeper, more structured conversations, wielded "an enormous amount of weight with all levels of decision-makers," she says.
Welcoming design
Facilities throughout Mercy have implemented advisory group recommendations, including:
- Various ways to coordinate entry to and through facilities. Loop roads were instituted to provide easier access and to limit pedestrian traffic conflicts. Parking that arcs out from the hospital was designed to provide wider spaces to maneuver in and out of cars for people with walkers or wheelchairs. Main entries were covered to provide protection from inclement weather, and snow melt systems were put into place. Canopy trees were planted to protect walkways and provide relief from hot summer weather. Signage was improved both outside and within buildings. Stairs were centrally located to give patients and staff members an option to get some exercise instead of using elevators.
- Outdoor courtyards that help connect patients with nature. Large windows overlooking planting beds, herb and edible gardens and water features were provided in waiting areas with groups of seats arranged to take advantage of natural light. Some waiting areas also feature televisions — mainly tuned to current events or health news — and plenty of charging plugs so patients can operate their own electronic devices.
- Pediatric clinics and hospital wings to please younger consumers and their families. There are outdoor play areas and indoor discovery areas with interactive floor tiles and platforms for crawling. Cafes are conveniently located, and exam rooms are placed off of wide corridors instead of long, skinny hallways. Inpatient rooms are larger and equipped with down sofas and showers to encourage families to stay and help with caregiving.
- Common spaces in pediatric infusion centers. Instead of private pods for each child, there are common areas where kids, with their IV poles, can play with each other. Conversely, more privacy has been designed in adult oncology offices so that patients can receive exams while accompanying family members wait in separate consultation areas.
- Cafeterias that offer more visible and easily accessible healthy choices. Chefs on staff are preparing stir-fried meals and salads on-site so that patients can learn how to cook them at home. To promote exercise, walking trails with measured distances also are being installed.
"It's amazing to watch members of the advisory groups tour the facilities when they finally reach completion," says Kistner. "They are always so surprised at how many of their ideas are actually translated into our designs."
"It's unbelievable, awesome, wonderful," confirms Kemper, who is still lobbying for photos on the walls of the Mercy Children's Hospital Springfield NICU that show former patients as tiny preemies and then as big, healthy kids to give anxious parents hope. "It just goes to show you what kind of organization Mercy is, to care so much about making people more comfortable."
DeRousse says, "We really had a voice, and because of that, the new Mercy Rehabilitation Hospital Oklahoma City feels like part of our community."