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On the move with Children's Hospital.

It took only 13 hours to transport the contents and patients of our 150-bed facility, Children's Hospital of Wisconsin, five miles from Milwaukee to the campus of Milwaukee Regional Medical Center in Wauwatosa. Those 13 hours, however, were preceded by seven years of intensive planning.

The age of the original facility and a serious space shortage with little room for expansion had made it necessary to relocate. The new hospital, with 190 beds, amply accommodates the special needs of sick and injured children and their families.

* Preparations. The building's ground-breaking ceremony was held April 15, 1986. Our target date for moving was set for two and a half years later, on the third day after Christmas--a time when the hospital census could be expected to be at its lowest ebb of the year. Having fewer patients meant fewer lab tests, less surgery to be interfered with, and fewer children to transport.

About a year before the moving date, the hospital's board of directors formed several committees consisting of volunteers from every department. Each committee dealt with a different aspect of the move, from relocating patients to space allocations. The groups met with increasing frequency as the moving date approached.

For ideas, the committees studied hospital moves in Denver and elsewhere. In addition, the representative from the moving company who would overse our move had important experience, having supervised a hospital move in St. Louis.

In the middle of October 1988, employees purged the hospital of clutter during Operation Clean Sweep. Dumpsters were placed throughout the facility. Supervisors decided what equipment and furniture would accompany us and what would be discarded or replaced. We gladly junked unusable glassware, ancient paperwork--not patient records, but outdated procedure manuals and the like--and an antique osmometer that no longer worked.

* Packing. Besides cleaning out the old site, all departments had to start packing equipment and supplies as early as possible. Backup equipment, furniture, and supplies in the lab were relocated a week before the move; the rest was transported either just before or just after the patients.

Each department undertook its own enormous task of packing. This job was especially difficult in the laboratory because both sites would have to be up and running the day of the move. We had to decide what equipment and supplies to send ahead of time and what would stay behind until the last minute.

Most of the packing was done by the first-shift staff. Those of us on second and third shifts did our part by completing work that the day staff had been unable to finish. Each day, lab tasks that could not be interrupted, such as differentials, were assigned to different individuals, who did no packing that day.

* HIS-LIS. As if all this weren't enough, we had to learn to use the new laboratory information system (LIS) that would be installed at the new facility. This was true for many hospital employees, since the LIS would be integrated with an entirely new hospital information system (HIS). Two months before the move, we began to learn how to operate the new computer system. Representatives from the computer manufacturer taught the basics to the supervisor and one employee of each laboratory section, who then shared this information with their colleagues.

Everyone in the lab had to be able to work with the LIS. Our phlebotomists logged in specimens they had taken; the microbiology, chemistry, and hematology sections entered test results; the secretaries entered collection times. The reason we couldn't all attend workshops together was that only a limited number of computer terminals was available for the teaching sessions for the 71 FTEs in the lab. (The lab now has 72.3 FTEs.) Because the old computer system would be left behind, we would have no opportunity to do a parallel run. We had to learn certain computer options, such as verifying results and printing labels, only on the screen.

Staffing was higher than usual at that time of year because we had been instructed beforehand to take limited vacations in December. Individual days, but no full weeks, were allowed.

Our physicians backed off on test orders without being told to. The reduced census helped a great deal. We were not about to let the quality or turnaround time of tests diminish.

The movers loaded books, non-fragile supplies, personnel files, instrument manuals, and small equipment onto shelving units mounted on wheels. The rolling shelves, covered with plastic to prevent slippage, facilitated unpacking. They also saved us the time-consuming job of packing and labeling hundreds of cartons. Glassware and other fragile items were wrapped in packing material and boxes.

* Walk this way. From late November to early December, employees were encouraged to become acquainted with the new (empty) building. During each shift, supervisors led two or three employees on a tour of the entire hospital, followed by a departmental orientation session.

Several open houses were held for the public. Employees from each department volunteered to serve as tour guides for the first four floors. Each department displayed posters and graphs depicting its own furniture appearance.

On the Sunday before Thanksgiving, current and retired employees as well as volunteers and their families were invited to the Wauwatosa facility for a reception. The public was invited to tour the building a couple of weeks later. One weekday in mid-December a final open house was held for local government, business, and community leaders.

* Instruments. The lab had to schedule moving times for different instruments. One hematology analyzer, three chemistry analyzers, and half the suppliers for each were transported during the first few weeks of December, when the bulk of the move was taking place. Other sections, such as histology and triage (which included our phlebotomy section), sent half their materials as well. One hematology analyzer, several chemistry analyzer, and remaining instruments and materials such as microscopes and centrifuges remained at the old hospital until moving day.

Several lab employees spent many hours at the new site preparing the moved instruments so they would be up and running on December 28. They also started to unpack materials from the portable racks that had been delivered and to store them in cabinets near the appropriate instruments. The rest of the staff kept the daily routine going at the old hospital.

We were fortunate in that representatives from the manufacturer of our chemistry analyzer would not only supervise its move but actually take care of it. A service rep stayed on after the move to work with the first-shift supervisor and make sure the equipment worked properly. The manufacturer of our blood gas instruments provided similar assistance.

* Moving day. When the target date arrived, the weather was mild--no blizzards or even light snow, we were relieved to find. The hospital census was only about 85 patients, just over half the usual capacity and even lower than the planning committee had hoped. The move gave the children still in residence something to think about during an ordinarily difficult time of year to be in the hospital.

Beginning at 6 a.m., a steady stream of ambulances transported patients individually to the new building. Seven ambulances and attendants, provided at no cost by a local ambulance service, left the hospital approximately every 15 minutes.

Each young patient taken to one of the general medical--surgical units was accompanied by a nurse, who remained on the unit for the entire day. For every child, a parent was invited to ride along with the ambulance driver.

The ambulances used for children being taken to the pediatric or neonatal intensive care unit or to the hematology and oncology transplant unit had more sophisticated monitoring and life-support equipment. Space restrictions made it necessary for the parents of these children to travel in hospital vans.

Each child was accompanied by a physician, nurse, and respiratory therapist. Once the patient was settled in his or her new room, the physician and respiratory therapist returned to the old site to accompany other patients to the new one, leaving the nurse with the child.

Patients were moved by units. Once a floor had closed at the old site, the entire staff who worked there shifted to the new one.

On moving day, new patients who had to be admitted after being examined in the emergency room in Milwaukee were transported by ambulance to the new hospital immediately and admitted there. The ER at the old hospital closed on the night of December 28 after all patients had been transferred to the new site.

Any prospective ER patients who were unaware of the move were directed to the new site or to another nearby hospital by a security guard, who was present at the Milwaukee facility for the remainder of the day. After that time, signs on the door directed ER patients to the new facility and gave the address of another hospital that was nearby.

All the operating rooms were equipped and staffed at both sites for one day. Only emergency surgery was performed at the Milwaukee hospital that day.

The radiology, pharmacy, and laboratory departments operated from both sites until the move was complete. The last patient was moved at approximately 3 p.m., as second shift began. Employees of that shift had known since the night before that they were to report directly to the new location.

* Disorientation. The entire lab staff had worked at the hospital for the two final years of planning. We were excited when the long-anticipated day arrived. Our main concerns were to find our way around (especially for blood drawing), located supplies, and get started on the new computers.

At first we felt lost most of the time. On breaks, we would orient ourselves by walking around with floor plans. We were disappointed to find that a limited number of stairwells would make it inconvenient and time-consuming to reach the ER in an emergency. The distance was even more of a problem because with the move, the hospital had become a trauma center. If we didn't get on an elevator within two or three minutes of being beeped as the patient arrived by helicopter or ambulance, the elevator would be held on the first floor in case it was needed, and we'd have to take yet another circuitous route to the ER to draw blood.

The phone system, which we'd never seen before, posed problems of its own. Instead of having "hold" buttons, we had to use special codes to perform such functions as transferring a call or putting a caller on hold. We put stickers from the phone company on the phones as reminders of what buttons to push for which functions. In addition, all the bells sounded the same. In our large open area, we couldn't tell which phone was ringing. This was corrected. The blood bank, chemistry, and hematology sections were given separate extensions so that all the phones wouldn't ring for every call.

* Arrival. Second-shift personnel, including myself, began our day by driving to the Milwaukee County Zoo for complimentary parking. The new parking facility was still incomplete; in fact, it took several more months, due in part to a construction workers' strike and bad weather. The hospital rented a 44-passenger school bus and two 14-passenger vans to transport employees for the five-minute ride from the zoo. The buses ran continuously. An unexpected bonus was that the parking permits entitled us to visit the zoo free. Many people working on second shift would arrive early and those on first shift would stay late to enjoy this unusual company benefit.

Once we arrived at the new site, we reported to our departments. All hospital employees wore blue armbands to help the guards distinguish parents, the media, and the public from the staff. In the lab, the remaining instruments were being checked and calibrated, the last of the supplies put away, and tests performed. Remarkably, the workflow had barely been interrupted.

We had been told that the new computer system would be operational fairly soon. To our suprise, it was up and running on moving day. The computer people, who were amazed to learn there had been (and would be) no parallel runs, remained on site through the week to help us. We started to report test results on the LIS that first day. Printouts were supplied to the floors shortly thereafter, starting with the emergency room and ICU.

* Aftermath. In the following weeks and months we all made substantial adjustments. We had expected the lab to be much bigger than it was; in fact, it contained about the same number of square feet as the laboratory in the old facility.

Since that time the lab has taken over a small adjoining boardroom to be used for developmental research of new tests and instrumentation. Another former office was remodeled to accommodate the amino acid analyzer.

A few days after the move, the hospital census began to climb; accordingly, we had to accommodate an almost immediate increase in test requests. An additional top floor, which was completed in December 1990, houses the chemotherapy section. Bone marrow transplants have increased, partly because more isolation rooms for the recipients are available than before.

Highly sophisticated facilities have created more work for the lab in CBCs, platelet counts, and similar tests. The hospital hopes to begin heart transplants soon as well. While the extra services and resulting revenue are fine, it's not always easy to hire additional second- and third-shift staff in the laboratory.

Although many of us felt pangs of nostalgia as we left our familiar surroundings, we anticipated great things from our state-of-the-art accommodations. Excellent long-term planning eased hundreds of employees into a new institution with minimal stress. That says a lot for the forward-thinking staff members at all levels who worked hard to assure a smooth transition.

The hospital where I work now is about to build a new parking ramp. Employees will be shuttled on minivans from a nearby vacant lot for six to eight months. We'll receive a ticket every day we ride the shuttle; weekly prizes will include a one-week parking space in front of the hospital. I guess the raffle will be fun--but I'll mis the zoo.
COPYRIGHT 1991 Nelson Publishing
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1991 Gale, Cengage Learning. All rights reserved.

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Title Annotation:Children's Hospital of Wisconsin relocates
Author:Skorcz, Margaret R.
Publication:Medical Laboratory Observer
Date:Nov 1, 1991
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