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P.O. Box 302 Zeeland, Michigan 49464-0302 800 628 0058 http://www.hermanmiller.com/healthcareHerman Miller Solutions
A series of issues-based solutions for healthcare environments.Orlando Regional
Healthcare
Orlando,
Florida
Pharmacy:
Designed with the
future in mind
Goal:
Meet the needs of the communities served in an environment with shifting demographics, mergers and acquisitions, and the ever-changing role of the pharmacy.
Solution:
Replace, renovate, and renew facilities using Herman Miller movable modular casework for pharmacies.
Result:
Facilities that function efficiently even in transition, make effective and efficient use of space, and respond to continual changes.
Orlando Regional Healthcare is one of Florida’s most com-prehensive medical systems, offering a complete range of services for nearly two million residents of central Florida. Orlando Regional Healthcare has enjoyed a history of growth and change since opening in 1918 as Orange General Hospital.
In continuing to grow and meet the challenges of the future, Orlando Regional Healthcare now encompasses many sepa-rate facilities in four counties. Each provides specialized, high-quality healthcare: Arnold Palmer Hospital for Children & Women – 281 beds Leesburg Memorial Hospital – 414 beds
M.D. Anderson Cancer Center Orlando Regional Lucerne Hospital – 267 beds Orlando Regional Medical Center – 517 beds
Orlando Regional Sand Lake Hospital – 292 beds Orlando Regional South Lake Hospital – 68 beds
Orlando Regional South Seminole Hospital – 206 beds Orlando Regional St. Cloud Hospital – 84 beds
U.S. News & World Report
ranked Orlando Regional Healthcare as one of the nation’s best hospitals, and
Fortunemagazine recognized Orlando Regional Healthcare as one of the Top 100 Companies to Work for in America.
Orlando Regional
Healthcare: The
Strength of a System
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Like most healthcare systems in the U.S., Orlando Regional Healthcare operates in an atmosphere of uncertainty: How will changing reimbursement policies affect operations? How can staffing shortages be dealt with? How will shifting population demographics impact the services offered? What will the future bring?
Do these questions sound like current worries in the pharmacy?
You may think so. But these are the same questions asked by Gordon Naruda more than a decade ago when he was the administrative director of pharmacy services at Orlando Regional Healthcare and while he was involved in a pharmacy renovation. Those unanswerable questions were, in part, what prompted Naruda to invest in Herman Miller’s movable modular furnishings for pharmacies.
Naruda and his pharmacy moved from a 3,000-square-foot space to a new pharmacy occupying more than 10,000 square feet. Knowing that change was to be his constant companion, Naruda found Herman Miller products extremely versatile, durable, and affordable.
Affordable?
Yes, affordable, especially considering the long-term use he predicted for the products.
And he was right. The product is still there, still in use, and still versatile. Over the decade, it has been changed many times. It has been moved, transferred to different facilities, added to, and rearranged. And yet it’s hard to tell the old product from the new. And it’s still responding to changes in the pharmacy environment.
Have those questions been answered? Some, yes. Others have been replaced by new questions.
But there is one thing that is different. Naruda has since retired. Those questions are now being asked by a new group of people, such as Orlando Regional Healthcare’s Pharmacy Manager, Jeanette Bonstrom. And by Louis Lorenz, Pharmacy Supervisor, Operations, at Orlando Regional Medical Center (ORMC) in downtown Orlando. And there’s more change in the wind.
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Responding to changing formularies has prompted a number of changes in the layout and organization of the unit dose picking stations.
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Orlando Regional
Medical Center – a
pharmacy in transition
ORMC is a 517-bed acute care medical facility in downtown Orlando, providing a variety of specialties such as critical care, cardiac care, oncology, diabetes, neurological care, and orthopedics.As the Orlando area continues to grow, so does the need for this healthcare system to provide additional services to its growing and changing population.
For Bonstrom, that just raises additional questions. As she explains, “at the Orlando Regional Medical Center, there has been phenomenal growth in the Emergency Department.
“This level one trauma center serves all of central Florida with its own helicopter ambulance service and sees over 85,000 patients per year. As a result, they’ve also outgrown their space. To the ED, the adjacent pharmacy space looks mighty attractive.
“For ORMC, that could mean a pharmacy renovation or a relocation. In either case, it means more change. And it means an opportunity to rethink the layout of the pharmacy and the workflow.”
According to Lorenz, “With managed care and declining reimbursements, we need to be more cost effective in providing pharmacy services. And with shortages of pharmacists, we need to use our resources more effectively as well. We are striving to automate as much as possible to decrease our turnaround time and improve our resource utilization.”
For solutions to these common problems, Bonstrom and Lorenz need look no further than to the pharmacies at two other Orlando Regional Healthcare facilities – Orlando Regional Sand Lake and Orlando Regional South Lake. The pharmacies at these two facilities have recently gone through major renovations to meet the challenges that accompany the changing environment.
Movable modular furnishings have allowed the pharmacy to respond to the changes in IV prep regulations in cleanrooms.
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Orlando Regional Medical Center has been impacted by the many changes occurring in the healthcare industry and in the shifting demographics of the population it serves in central Florida.
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Orlando Regional Sand
Lake Hospital doubled
its capacity without
gaining an inch of space
Located in southwest Orange County, Orlando Regional Sand Lake Hospital is a 292-bed acute care community hospital that provides a wide range of inpatient and outpatient services for its growing community. Its specialties include a cardiac catheterization lab, multiple sclerosis center, and brain rehabilitation center.Sand Lake renovated some areas of its pharmacy in 1993 using Herman Miller products. With the recent growth in population and resulting services required, in 1999 the entire pharmacy was renovated, and additional Herman Miller products were purchased to update all areas.
Though the renovation gained not a single inch of new space, Dale Larkin, Pharmacy Manager and Clinical Coordinator, boasts that they have doubled their capacity. How? By using vertical space more efficiently. For example, according to Larkin, “Our old picking station used fixed shelves, so we had to stack the medications in order to fit everything in. Of course, that can lead to picking the wrong strength or dose of a particular medication. So it took us much more time to ensure that the correct medications were being picked.
“Now with our new Herman Miller picking station, we have used every inch of vertical space. We have shelves that adjust to the size of what we are storing. Plus, we have a place for each type of medication which facilitates the picking and helps ensure the accuracy of the process.”
As pharmacists become more and more involved in the care of patients, this increases the amount of paperwork, forms, and journals required. During the renovation, the pharmacists carved out work areas and used vertical space with enclosed storage to house everything.
The effective use of vertical space also allowed the creation of a buyers’ area adjacent to the picking station.
In the 1999 renovation, Larkin documented a cost savings of approximately $10,000 by reusing the original Herman Miller products. The Herman Miller designer worked with the existing colors to develop a compatible color scheme for the new products purchased, so all that needed to be done was to update the colors of a few flipper doors. Gaining more storage, improving the work-flow, and saving money are all important aspects of the renovation, but when it came to employee morale, the staff voted one new area their favorite – a new kitchen/break room. A small alcove houses work surfaces with drawers and overhead storage for kitchen utensils, coffee maker, and microwave. It’s a place where staff can relax, take a break, have a quick conversation, or eat lunch. They no longer need to bring food to their workstations – which makes the inspectors from JCAHO happy too.
Each type of pharmaceutical has its own container suspended at an angle for gravity feed and easy access. Shelves are adjustable to the size of the items being stored so no space is wasted between items. The process table on wheels can be positioned wherever needed and relocated whenever extra work space is required.
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The adjustability of the shelving has allowed for greater density of medications and more accurate and efficient picking of prescriptions.
Orlando Regional South
Lake Hospital was
designed to be changed
The future of healthcare in south Lake County Florida rests on 146 acres in east Clermont, 30 miles northwest of Orlando. That’s the home of the South Lake Hospital campus, a unique community-centered, 68-bed healthcare complex. The first of its kind in the area, the campus combines acute hospital care and medical services with comprehensive wellness programs, fitness training, and community health education classes and support groups. South Lake Hospital serves the south Lake County and west Orange County areas. The South Lake Hospital National Training Center combines fitness and training pro-grams with state-of-the-art equipment and physician offices all in the same location.And who is taking advantage of all these pro-grams? Not the Medicare generation you’d typically think of when discussing Florida. With the growth of tourism in Orlando and the building of new freeways, the Clermont area is transitioning into a mecca for young executives and their families drawn to the area by tourism-related merchants and service businesses.
The shifting demographics of the area have impacted the hospital and the pharmacy. As witnessed by Guy Lillard, Director of Patient Care Services at South Lake Hospital, “When the hospital was built in 2000, it was designed to adapt to the changing needs of this growing population. “In the pharmacy, that translated into ensuring that the layout was flexible enough to change when needed. For example, as more families with children move into the area, there will be a greater demand for pediatric pharmaceutical preparations. Unlike adult medications which are more standardized, pediatric solutions are
compounded more specifically to the needs of individual patients. As a result, we have reconfigured our work areas to make compounding more efficient.
“As the population includes more and more younger people, services will tend to be delivered increasingly more on an outpatient basis. This will mean less IV preparation and more outpatient inventory and packaging.” In response to these predictions, the phar-macy has designed flexibility into the layout. Most areas are outfitted with process tables with casters so that they can be moved where needed as processes change. Other areas utilize Herman Miller’s movable modular furnishings so that changes can be made to work areas as the processes change. Flexible components are much easier to reconfigure than systems that consist of a base cabinet and which require the whole unit to be moved. With base cabinets, reconfiguration often means a new work surface must be cut to fit the new arrangement as well.
Process tables with casters can be moved where needed when processes change.
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The integration and support of technology is made much simpler with modular systems that can be
moved to allow for computers and support equipment.
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The incorporation of a cleanroom into the plan utilized modular products outside to provide needed work space. Inside movable wire storage products and process tables support supplies and hoods.
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The Herman Miller
Answer to Change
There are no clear cut answers to the questions being asked about what the future of the pharmacy or of healthcare will be. But there is one thing that is certain – it will change.Orlando Regional Healthcare takes advantage of Herman Miller’s integrated solutions to respond to these changes – in the immediate future and for the long term.
Orlando Regional
Medical Center
Pharmacy
Clinical areas of the pharmacy being renovated CODE B UYER RECEIVING AREA PICKING COMPOUNDING ORDER ENTRY PRE-PACKAGING
