By Meg Wingerter
The Denver Post
WHEAT RIDGE, Colo. — If all goes according to plan, ambulances will leave Lutheran Medical Center every four to six minutes over the course of nine hours Saturday, ferrying an anticipated 180 patients across Wheat Ridge to the hospital’s new $680 million home.
After more than a century in the same spot at 8300 W. 38th Ave., Lutheran Medical Center is moving four miles down the road, to a newly constructed 620,000-square-foot facility at 12911 W. 40th Ave., on the western side of Interstate 70.
The all-day convoy of ambulances will cap more than two years of planning with consultants who had previously overseen hospital moves. That included dress rehearsals in June and July to ensure emergency crews wouldn’t get lost in the hallways while wheeling patients out and that staff had everything they’d need to care for patients once they arrived at the new facility.
Tuberculosis patients received treatment on the old campus as far back as 1905, but Lutheran’s current building dates to 1961. The hospital, which sits on 100 acres of land, gradually added wings over the decades. However, it now faces some technological problems it can’t renovate its way out of, Lutheran Medical Center President Andrea Burch said.
For example, monitoring devices now use Wi-Fi to send information about patients’ vital signs to their nurses and doctors, but the wireless signal can’t penetrate the 3-foot-thick concrete skeleton of the building, she said.
“We’re really limited in how advanced we can get” in the old hospital, Burch said.
The 38th Avenue facility will receive patients as usual until Saturday morning when the emergency room will close to new arrivals, said Casey Bogenschutz, director of strategic initiatives for Intermountain Healthcare, which owns Lutheran.
“At 6 a.m., we will stop receiving patients at the old facility and start receiving patients at the new facility,” she said.
That will require most hands on deck to fully staff both emergency rooms, Bogenschutz said. Some departments won’t have to double up, as staff can get in their cars and follow their patients to the new hospital when their turn comes to load up in the ambulances, she said.
Lutheran doesn’t own any ambulances, so American Medical Response and Platte Valley Hospital are renting the hospital about 20 to move patients. UCHealth is also contributing one that has the equipment and layout to take critically ill patients.
The ambulances will obey the speed limit unless a patient has an emergency en route.
The team collected data on the number and type of patients Lutheran usually would see on a summer weekend, which is typically a relatively slow time, Bogenschutz said. Unless something unexpected happens, hospital staff plans to move about 180 patients. Each one will have a clearly mapped path from their room in the old hospital to an ambulance, and then to their new room, she said.
Patients who are most seriously ill will move in the middle when staffing is roughly equal on both ends of their journey.
“We’ll have the most resources on each side,” Bogenschutz said.
The location adjacent to I-70 will be more convenient for patients in emergencies, Burch said. Lutheran now has one of the busiest emergency departments in the metro area, and it isn’t ideal to frequently send ambulances speeding through residential neighborhoods to get to the old building, she said.
The new facility will have 226 beds for inpatients, like the old one, and will offer the same services, said Sarah Ellis, spokeswoman for Lutheran Medical Center. It also will employ about 1,700 people, as the current hospital does.
But it will have some advantages, including the ability to convert ordinary rooms to provide intensive care in the event of another pandemic or disaster, she said. It also can fit larger equipment, including an MRI machine that’s currently operated out of a trailer.
“Nearly all of those (patient rooms) are built to ICU standards and can be converted very quickly,” she said.
Patients will notice larger rooms and that each wing has multiple nurses stations, to keep staff closer to patients, Burch said.
Major construction on the new hospital building finished in early May, almost three years after groundbreaking. Some equipment was moved in earlier in the summer, but other items will arrive with patients on Saturday, such as the beds, monitors and intravenous lines from rooms being used that day.
Scoping out the move in advance
The moving day itself is only a small part of the process, though.
Planning for the move started about two years ago, with the help of HTS, a consulting company that has done this with other hospitals, Bogenschutz said. Getting the equipment and people in the door is important, but hospital management also needs to make sure everyone knows how to work within the space, so they aren’t struggling to find the necessary tools in an emergency, she said.
To do that, they held two test days, to try to find everything that could reasonably go wrong when opening a new hospital.
The first, in early June, involved bringing over some employees from the old hospital to run through scenarios they typically encounter. In one of those scenarios, a patient in labor arrived in the emergency room and started to hemorrhage, while the baby — represented by a roll of paper towels — headed straight to the neonatal intensive care unit.
“You don’t want them running through it the first time on opening day,” Intermountain regional spokeswoman Sara Quale said.
At that point, the physical space was largely ready, though employees couldn’t use the water fountains because the filtration system wasn’t yet running. Signs marked which bathrooms they could use, and which still lacked soap and paper towels.
An employee group led by manager Diane Roggenkamp started their afternoon session by walking the route from the parking garage to the catheterization lab, to make sure everyone knew how to enter and clock in after hours. They then proceeded to the lab, which performs procedures to diagnose cardiac and neurological problems, where they sent out a call that the imaginary patient had stopped breathing.
Most of the team arrived to resuscitate the patient within minutes, but two members were late because they couldn’t find the right hallway. It mattered which way they came in because some hallways are sterile environments that would require them to cover their clothes.
When everything is ready, the new hospital’s layout changes should make care more efficient, Roggenkamp said.
For example, the helicopter landing pad is directly over the catheterization lab, and both sit above the emergency department. That means patients who’ve arrived by helicopter after an accident are only an elevator ride away from the emergency room, and those who arrive by ambulance with a possible stroke will get to the lab as quickly as possible, she said.
Currently, helicopters have to land in a baseball field near the old Lutheran hospital and crews must transfer patients to a ground ambulance that finishes the trip.
Lutheran’s transition team also had the task of finding any problems with the new building itself or the equipment, with one employee in each group pushing a mobile workstation to log whatever they came across. They found some staff members couldn’t access their work areas with their badges, and that showers in some patient rooms lacked adequate water pressure. In one case, a key got stuck in a closet’s lock, and three people had to finagle it to get it out.
“We’re pulling every cable, pushing every button, so we can find out what doesn’t work,” said Michelle Lancaster, a nurse who came out of retirement to help with the transition.
The list of problems went down to the command center, in a conference room not far from the lobby. By mid-afternoon, they’d found 308 things to check on before the next round of testing in July, Bogenschutz said.
“The idea is that the (problem) list is much smaller after the second one,” she said.
The number of flagged items was similar in July, since a different group came through and discovered other issues, said Ellis, the spokeswoman for Lutheran.
“Turning the lights out”
By mid-July, both the old and new Lutheran hospitals showed signs of the upcoming move.
While the old building was still running mostly as usual, the gift shop had closed, and all its wares sat in stacked cardboard boxes. In the new facility, office chairs lined the halls, waiting for someone to take them to their new workstations, while construction crews finished hanging colored glass from the ceiling at the main entrance.
Perhaps the clearest sign, for those who knew what they were seeing, was a gaggle of high-level managers and contractors assembled outside the main entrance of the old building on a Friday morning, just before an expected heat wave.
Emily Downs, clinical director of transition planning at the health care consulting firm HTS, led the group through the plan for moving day: each patient would get a number and an assigned track, laying out when they were to go and via which ambulances.
On that day, the group was practicing the route for the orange track, which included patients in intensive care, and making sure the equipment supporting them would fit in the ambulances. (Patients in labor or recovering from delivery and their infants would go on the pink track, and everyone else would be on green.)
The routes weren’t always the most direct, Downs told the group, with a warning they’d hit their step goals that day. But they would minimize potential chokepoints where gurneys could back up or collide, she said.
The first group, of less severely ill patients, will leave at 8 a.m. on moving day, with more complex cases following later. The round trip should take about 80 minutes, including driving time, Downs said. Units would start practicing assigning their patients numbers the following Monday, so it would come easily in the days leading up to the move, she said.
Patients who are staying at the old hospital will still have access to all of the tests and procedures they might need if their conditions get worse while waiting for their turn to move, emergency medical services coordinator Micah Larson said during the roving meeting.
“All the services of this hospital will be available until it’s empty,” he said.
The last people out will be facilities manager Jerry McFarland and his team. They will go room by room, to ensure no one somehow got left behind, before locking up.
“We’ll be going through each room and turning the lights out,” he said.
Future of the old propertyThe city of Wheat Ridge’s plan for the site would keep some medical buildings and green space while allowing single-family homes and duplexes on parts of the campus that abut neighborhoods.
Voters will have to decide whether to allow taller buildings in the center of the campus, which the city said was necessary to make other parts of the plan economically feasible.
If everything goes smoothly, the move should wrap up around 5 p.m. Saturday, Burch said. Then the months-long decommissioning starts, which is a complex process of disposing of everything from old medications to the radioactive material used in X-rays, she said.
A hospice facility and some medical offices will remain on the old campus, Burch said. Eventually, a developer likely will buy the rest of the 100 acres Lutheran owns there and demolish the existing facilities, because not many are in the market for a 63-year-old hospital, she said.
Seventy of the hospital’s 100 acres went up for sale in April.
The new hospital should have a similar lifespan, though rapid advances in health care could mean that it becomes outdated somewhat sooner, Burch said.
“I do think we’ll make it 50 or 60 (years),” she said. “I don’t know that we’ll make it to 100.”
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