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Patients and nurses were at the heart of a renovation of the Carl J. and Ruth Shapiro Cardiovascular Center at Brigham and Women’s Hospital. From bathrooms with colored toilet seats to decrease patient falls to look-alike units that easily accommodate staff because they are acuity adaptable, the layout of the facility encourages interconnected patient care.

At 136 beds total, each floor features private patient rooms, two conference rooms, two large nursing stations, individual nursing stations outside each patient room, floor-to-ceiling windows, wireless Internet, and more. The renovation aligned patient rooms along the perimeter of the building to allow natural light and to make each room easier to flex if necessary. The noise of overhead paging also was reduced since each staff member carries beepers and charge nurses carry phones. Since the renovations were completed in 2008, staff agree patients and visitors appear less stressed.

“We’ve made it easier for patients and family,” says Lisa Downey, RN, BSN, a cardiovascular access manager. “[The renovated space] helps them get what they need in a nice way.”

The environment is conducive to patient care, say nurses, because a room was mocked up before the renovation so staff could test it and make suggestions. The patient room evolved over time through staff suggestions. Concave floors in patient bathrooms quickly drain water after patient baths and are large enough to fit two staff members and a patient comfortably, says Justin Precourt, RN, MSN, nurse manager of cardiac surgery. The shower chair, toilet seat, and toilet seat arms are a dark blue color to make them easier for patients to find and has reduced patient falls. “It gives patients a target when they are sitting down,” says Mary Lou Moore, RN, MSN, CCRN, director of cardiovascular nursing and clinical services.

Nurses also have stations with lights inside and outside each room to document if the patient is resting. Access to all devices a patient on any floor would need, such as gases, also are available in every private room, Downey adds. Committed to family-centered care, the rooms also feature a couch that converts into a bed and is out of the way of staff so families can comfortably stay with their loved ones.

Each floor was designed the same way to easily accommodate extra patient beds on each unit. In fact, the floors are so identical some staff members use the 20 original works of art throughout the building to orient themselves to each floor, Downey says.

To assess bed availability, nurses participate in a daily floor meeting with doctors to decide if patients are ready to move to another floor, say Precourt and Matthew Quin, RN, BSN, nurse manager for cardiac surgery and the ICU. This multidisciplinary approach ignites a team spirit throughout the building and keeps everyone on the same page.

In addition, the nurse managers look out for one another and work well as a team, Moore says. They know one another’s roles and can cover for each other. “The managers are young to their roles,” Moore says, “but they really support each other.”

Like all change, staff were nervous about the outcomes when the cardiovascular center was undergoing renovations. But the center is a success and may become a model for future redesigns. “There was lots of anxiety about change during the move [into the renovated cardiovascular center],” Quin says. “But if you ask nurses if they want to go back, they say, ‘Never, ever.’”

For a photo gallery of Brigham and Women's Hospital's Carl J. and Ruth Shapiro Cardiovascular Center, visit www.nurse.com/galleries/public/index.html?galleryID=1020001.

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Heather Cygan is a regional editor. To comment, e-mail editorNE@nursingspectrum.com.

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