As the associate vice president of campus planning, design, and construction at the UConn Health campus of the University of Connecticut, Thomas Trutter has much more than buildings to think about. Sure, he has roughly 2.2 million square feet in 26 buildings to oversee, but the public university’s relationship to a significant state-sponsored economic development and health care initiative means that Trutter has everyone from the governor and legislature to the youngest cancer patients on his mind.
Those thoughts also have to include a good chunk of the Connecticut economy. Several new and renovated buildings under his watch are part of Biosciences Connecticut, a huge program designed to make the state a hub of care delivery, innovation, and medical research that not only serves Connecticut residents, but also fosters private enterprise that can have a global impact. Economic projections of the initiative include 3,000 jobs created during the construction phase (2012 through 2018), 16,400 new permanent jobs, $4.6 billion added in personal incomes through 2037, and net incremental revenues to the state of at least $823 million over roughly the next two decades.
How do buildings foster so much economic activity in an increasingly digital world? “The good story is that global-level research is happening here and is a draw to private industry,” Trutter says, and refers to Jackson Laboratory, a Bar Harbor, Maine-based firm that’s establishing its genomics research institute on the UConn Health campus in Farmington, Connecticut. “They are particularly drawn to the university’s research program. Physical proximity still matters—‘bench to bedside’ is important.”
Trutter also points out how, in the changing world of education, digital is growing in prominence and a different physical structure is necessary. He explains that although lectures might be given online, learning in health care goes far beyond that. “Today’s students have to gather around tables in groups of eight to 10, with big display screens around the room,” he says. “That’s how they work and solve problems together.”
There are eight projects underway in Farmington (which is about 40 miles away from the main UConn campus in Storrs, Connecticut). They include two altogether new buildings, the 11-story John Dempsey Hospital Tower and UConn Health Outpatient Pavilion. Two additions to existing buildings include a research incubator lab and an academic building to accommodate growing class sizes. Four renovations also are underway for existing buildings: a dental teaching clinical facility, an academic building, and two research laboratories.
The projects are bigger, better, and designed for modern health care research and delivery. In the research labs, for example, larger floor-plate designs replace smaller, outdated 1970s facilities that were rigid and failed to foster interdisciplinary research. The Bioscience Connecticut program—a subset of Trutter’s overall responsibilities—encompasses the renovation of 238,000 square feet of existing research facilities that will enable doubling bioscience research’s annual funding to $200 million. Also, the addition of 28,000 square feet of incubator space in the town’s Biomedical Enterprise Zone will host business start-ups in the biotech sector. The Dempsey Tower will have 169 beds, an expanded emergency department, and a surgery suite at a cost of $318 million. The new, privately financed 300,000-square-foot Outpatient Pavilion is estimated at $203 million.
It’s quite an investment, but one that is driven by the two tenets of national health care reform: improved and expanded patient care concurrent with cost reductions.
How does that happen? The basic theory is that patient-centered care, focused on outcomes, reduces the costs associated with re-hospitalizations. This happens in a host of ways in care delivery, but facility design supports all of it. For example, accommodating families in patient rooms that have more space and furniture allows them to spend the night, which can help speed recovery. That means larger, single rooms of about 320 square feet take the place of 260-square-foot rooms that previously were occupied by two patients. This also provides greater privacy while engaging family caregivers to hear patient-physician discussions. Relatives, therefore, are more likely to support the patient in medication and treatment compliance after discharge.
The old hospital model included a single nurses’ station in a central location to serve all patients on a floor. However, with larger rooms and a larger floor, there now are several decentralized stations, which in turn provides different staffing models, different operational costs, and altered operations.
Safety features and the promotion of infection controls are other cost-reducing measures that factor into building design.
It helps too that patient-centered care coincides with green building standards, which include HVAC efficiencies, low-VOC paints, maximal natural lighting, and other materials, along with bike racks that help UConn (and all state-owned structures) achieve LEED Silver certifications. “These elements used to cost more, but those costs are dropping,” Trutter says. “This is a good trend in the industry as green costs are now in closer alignment with traditional materials.”
Even landscaping plays into caregiving. UConn Health’s facilities provide outdoor green spaces as “areas of respite” (usable by patients as well as visitors and hospital staff), and most views from the tower structure overlook the Farmington Valley. Beyond human care, the UConn Health facilities were designed to protect natural on-site wetlands and adhere to a storm water management plan.
Trutter’s technical responsibilities are to oversee the design and construction of complex and interrelated buildings. Given how they affect the education of future caregivers, the development of health-related enterprise, contain health care costs, and improve the health of patients, it’s clear the net effects of this complex go far beyond the walls of the structures.