Comprehensive Planning and Service Design for the World’s Largest Emergency Department
CHALLENGE
The emergency department and trauma center at Doha's Hamad General Hospital was functioning in modular environments far under the requirements needed to operate a contemporary department. During periods of volume surge, patients were literally lined up out the door to check in for care. With the local population expected to climb another 25% over the next decade and the emergency department bursting at the seams, Hamad General Hospital needed to not only expand the emergency department and trauma center, but they also needed to reimagine how care would be delivered in the future. All of this against the backdrop of local cultures and customs that have very specific expectations surrounding healthcare delivery.
40+ stakeholder interviews
Operational analysis
Manual time-motion studies
Patient consumer experiential analysis
Provider consumer experiential analysis
Ethnographic research
Process mapping
Patient journey mapping
Co-creation sessions to explore the emergency department patient, visitor and provider journey across multiple patient types and personas
Customized demand projections + forecasting tool
Key room forecast
Space programming
Campus site of service planning
Computerized simulation modeling
Clinical design peer review
APPROACH
Working with an interdisciplinary team of clinicians consisting of physicians, nurses, technicians, security personnel and others involved in emergency and trauma care along with facility design experts, an new model of emergency department flow was developed to support over 500,000 patients annually. The model was based on performance goals including length of stay targets, travel distance and time goals and the experiential goals for healthcare in a conservative Muslim community with ex-patriots from over 120 different countries.
The overall size of the emergency department and trauma center mean that a single-story solution would be impractical. Various multi-story scenarios were studied to determine the best balance of horizontal and vertical adjacencies. The goals was to limit overall travel distances while expediting care and limiting the number of patient who would have to travel higher or deeper into the building.
RESULTS
Process and design solutions support a four-level emergency department, trauma center and observation unit with over 220 treatment stations segregated by gender and acuity. Patient travel distances that are up to 50% less than in the existing department which is 1/3 of the size of the new emergency department. The solutions developed also support patient arrival patterns that could include as many as 60 patients arriving simultaneously, as is frequently the case at this clinical site.
50%
reduction in travel distances
0
front of house intersection of low and high acuity patients