Founded in the late 19th century by Jewish philanthropists looking to care for those being turned away for treatment elsewhere in the city, the Montefiore Medical Center quickly evolved into a leading health facility, integrating itself with the nearby Albert Einstein College of Medicine and developing a reputation as one of the premier teaching hospitals in the nation. It has since served residents of the Bronx for more than 125 years, changing and adapting to keep its medical facilities and technologies on the cutting edge. It’s also expanded to become the Montefiore Health System, comprising seven hospitals, 150 ambulatory-care offices, and dozens of other neighborhood health-care facilities and specialized medical clinics throughout the Bronx, Westchester County, and the greater New York City metro area.
While some nearby medical institutions have closed their doors since the recession and ended up in bankruptcy court, Montefiore seems to have found a recipe for fiscal sustainability and has even integrated failing hospitals into its network while continuing to take on numerous capital improvements to meet its community’s growing needs. Last fall, the health system cut the ribbon for its newest facility, the 11-story, 278,000-square-foot Hutchinson Campus. It’s an ambulatory-care center that reflects the changing landscape of the health-care industry and epitomizes Montefiore’s system-wide strategies regarding streamlined operations and patient-centered care.
Emphasizing Outpatient Services
“The Hutchinson Campus is what we call a hospital without beds,” says Ed Pfleging, Montefiore’s vice president of facilities and real estate. With 12 ambulatory operating rooms, four procedure rooms, and seven floors of medical specialties, “the Hutch,” as it’s known to Montefiore staff, represents a logical next step for a health-care system that prides itself on “keeping people healthy and out of the hospital,” Pfleging says.
The Hutch and many of Montefiore’s other recent expansions are meant to address the chronic health problems of the system’s constituents and improve the quality of service it offers. In the health-care industry, an increase in chronic health problems within a community often equates to a need for more beds in local hospitals, which quickly becomes a poor approach to public health overall. Montefiore thus emphasizes little things that will keep people from falling into more severe health problems that are likely to result in extended hospital stays. For example, it has specific processes in place to ensure people have regular health screenings, take their medications correctly, and adopt healthy lifestyles. “It’s a lot about staying in touch with people,” Pfleging says.
In short, prevention is key, and Montefiore’s approach reduces the overall cost of health care per person so that a greater portion of the population can have access to high-quality services. But, “people still get sick,” Pfleging says, “and when they get sick, they need to see specialists.”
This is where the Hutch comes into play. “Everything in health care is moving to an ambulatory environment,” Pfleging says, so the Hutch puts an emphasis on specialized, high-tech outpatient services. And, many of the medical specialties now housed at the facility, from cardiology to urology, were formerly spread out among Montefiore’s inpatient hospitals. Bringing them under one roof streamlines the experience for both patients and caregivers.
Designed for Patient Comfort
The Hutch site was originally slated by the developer, Simone Development, for a hotel, but that plan was later nixed in favor of the medical center, even though zoning approvals had already been granted. The city’s planning commission allowed the change under the condition that the setbacks and footprint for the building would not be altered, and this allowed Array Architects, the principal designer, to get started quickly.
“The challenge of the planning process was to merge ambulatory specialty practices from a multitude of campuses, outpatient facilities, and clinics together while increasing throughput and productivity, eliminating waste, and enhancing the patient experience,” says Jeffrey Drucker, AIA, vice president of Array’s northeast region division.
“One of the largest design challenges was adjusting the building layout for ambulatory use,” adds Jason Lee, Array’s senior project manager for the Hutch. “It was originally envisioned and filed for office and hotel use, so adjusting structure, floor-to-floor heights, egress routes, vertical circulation, and entry had to be completed within the original approved zoning but required code compliance for ambulatory use.”
Now, when patients and their families arrive at the Hutch, they are greeted by valet parking and a sleek, understated white façade. The lobby still has a hotel-like feel, with serene lighting, an artistic undulating ceiling, and a lack of the austere functionality expected of a medical facility. And, there’s a coffee shop that offers a place for visitors to relax while they’re waiting for loved ones. There are also separate elevators for patients and staff, helping to smooth the flow of internal traffic, and when visitors exit the elevator on any of the building’s 12 floors, there’s a greeter there to point them to where they need to go and to provide other basic information. Keeping patients and visitors well informed is one of the practices that has made Montefiore one the highest-ranked hospitals in the New York area.
“The dynamics of the construction process played out with a collaboration by the entire team—users, architects, engineers, contractors, and managers—resulting in a finished product that is unified, seamless, and entirely consistent with the initial vision,” says Ronald Evitts, AIA, project architect for the Hutch.
After visiting the facility, patients can also stop by the built-in pharmacy on the ground floor rather than navigate the streets of New York to get the medication they need for recovery. It’s just one more of the small things that Montefiore tries to build into the design of its facilities to provide the well-rounded care it hopes will keep patients from needing to come back time and again.