BJC HealthCare – SLCH/WUSM
Poltronieri Tang & Associates
SLCH/WUSM
Off-Site Pediatric Ambulatory Center
Imaging
Meeting Attendees
Grace Cuddihee
Paul Duell
Debbie Joseph
Kelley Mullen
Suzanne O’Connell
Laura Poltronieri
Ellyn Rosenblum
Jeannette St. Aubin
Kelley Werts
Elissa Almeter (for Debbie)
PT&A Project No. 11-10
BJC Project No. 11C018
October 27, 2011
Revised 29 November 2011
BJC PD&C
WU/P&C
Radiology Manager
WU FPP
PT&A
PT&A
SLCH PBD
WUSM
WUSM/FPP
Radiology Supervisor
glc0003@bjc.org
duellp@wusm.wustl.edu
dah6023@bjc.org
Kelley.mullen@wustl.edu
suzanne@poltronieritang.com
laura@poltronieritang.com
ejr8635@bjc.org
st.aubin@wusm.wustl.edu
wertsk@wusm.wustl.edu
Functional Program
Description of Services/Model of Care:
▪ Imaging modalities, including MRI, plain film, fluoroscopy, and ultrasound CT scan (still an
open issue)
Existing and Proposed Location:
▪ Proposed case mix is currently being performed at BJWC, OC, and SLCH
▪ Proposed location is in the new offsite pediatric ambulatory surgery center
Patient Population:
▪ Pediatric
Current Volumes vs. Projected Volumes (including assumptions):
(refer to the key room projection matrix)
Hours of Operation/Shifts/Visiting Hours:
Mon.
Tues.
Wed.
Mon – Fri
Sedated
MRI staff
▪
730-430
6-6
730-430
730-430
Thurs.
Fri.
730-430
730-430
7:30am first patient appointment, 4:40pm last patient appointment
Number of Staff per Shift and Job Descriptions:
Based on Busiest Shift:
Number
Title
Computer Use - % of Shift
Departmental Staff
2
MRI Tech
2-3
X-Ray Tech
2
Ultrasound Tech
1
Fluoro Tech
Providers
1
Potential Staff
2
Radiologist
fluoro
Patient access reps
If decentralized model
Sat.
Sun.
1
▪
CT Tech
If modality is approved (can do
x-ray and Fluoro)
Techs take care of nursing requirements for sedated patients
Circulation / Flow:
Patient:
▪ Patients arrive at the main (or imaging) registration area, registers and wait in the waiting room.
A tech will come to the waiting room to get the patient and place them in a procedure room.
The procedure is conducted, and patients are discharged via a separate exit.
▪ If the patient is a Fluoroscopy patient, they will change in a changing room and wait in a
gowned sub-waiting until the procedure room is ready, and the tech will to go the sub-waiting
room to get them.
▪ If the patient is a non-sedated MRI patient, they will wait in a separate waiting area by
registration, and a tech will get them and bring them back to the MRI area. The patient will
change in the changing room and wait in a gowned sub-waiting until the Tech gets them and
brings them to the prep room. After prep, the patient is brought back into the MRI room, and
parents wait in the sub-waiting until the procedure is complete. Patient then are discharged and
leave via a separate exit.
▪ If the patient is a sedated MRI patient (30% of MRI’s), they will flow through the surgery
department. They will arrive at surgery registration, and are brought back to pre-op to be
sedated. After sedation, they will be wheeled into the MRI suite via an internal corridor that
connects the surgery and imaging departments, complete their procedure, and be wheeled
back into post-op to recover. They are discharged from post-op and will leave via the surgery
exit.
Visitor:
▪ Visitors will approach a receptionist/registrar with their needs
Tech/Staff:
▪ Radiology techs/staff will work in the tech work station(s) in the core of the imaging
department. They will travel to the waiting room to bring their patients back to the procedure
rooms before conducting the procedure.
Physician/Resident:
▪ Radiologist will work in the core of the imaging department; either in the reading room; or
collaborating with tech at the tech work area. Radiologist will also consult with patients/parents
in the consult room.
Ancillary Staff:
▪ Pharmacy does not dispense contrast for OP.
Materials Management/House Keeping/Materials/Supplies/Soiled:
▪ Technologist responsible for room cleaning and turn over
Key Adjacencies:
Internal:
▪ There should be a separate flow for sedated and non-sedated MRI patients from rest of
imaging
▪ Highest volume rooms (plain film) should be nearest to waiting room
▪ There should be sub-waiting for Fluoroscopy, and MRI with contiguous changing rooms and
bathroom flow from corridor into fluoro room
▪ There should be sub-waiting for Ortho patients
▪ Main tech workstation should be centrally located in core of imaging department
▪ Bathroom close by for Ultrasound
External:
▪ Imaging must be adjacent to surgery department and connected with an internal corridor
because sedated MRI patient flow through pre-op for sedated and flow through post-op for
recovery
▪ Imaging must be adjacent to Ortho Clinic and connected with an internal corridor because a
high volume of Ortho patients need imaging services on same day as their clinic visit
▪
There should be a separate patient exit
Education or Training Initiatives:
Anticipated Changes/Trends:
New Services or Expansion of Existing Services:
▪ Flash CT would reduce need for sedation (TBD if part of program)
Changes in Healthcare Delivery or Technology:
▪ Central registration (?)
Additional Design Criteria/Considerations:
▪ Dedicated restroom for the Fluoroscopy Room with 2 doors
▪ Ultrasound needs adjacent bathroom
▪ Separate waiting areas for non-sedated MRI vs. rest of imaging patients
▪ Electronic games for distraction in waiting room, eg. iPads, video games
▪ X-ray has sub-wait and connection to ortho for fast turnaround
▪ MRI-safe equipment
▪ Appointments for sedated patients are grouped back-to-back
▪ Wait time for MRI patients can be up to 3 hours; may use pagers for family
▪ CT scan would require similar relationship
▪ If CT scan included a small percentage of patients will be sedated
▪ Each room is stocked daily from central linen and supply area that could be shared
▪ Staff arrives in scrubs
This document represents the agreement on the functional information provided by you:
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Administrator:
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