Hospital Case Study: Rebirth In New Orleans

New Orleans East Hospital provides complete surgical services, diagnostic imaging, laboratory, emergency services, patient education, and social services (Photos: New Orleans East Hospital).
New Orleans East Hospital provides complete surgical services, diagnostic imaging, laboratory, emergency services, patient education, and social services (Photos: New Orleans East Hospital).

By Anne Cosgrove
From the September 2014 issue of Today’s Facility Manager

Nine years after Hurricane Katrina devastated New Orleans, the eastern part of this city has a full-service hospital back in operation. In July 2014, New Orleans East Hospital (NOEH) opened on the site of the former Pendleton Methodist Hospital, and the 205,000 square foot facility is providing a range of inpatient and outpatient services to the area’s more than 125,000 residents. When the secondary service area is factored in, that number increases by another 45,000.

In August 2005, when Katrina hit the city, the Pendleton facility was put out of operation by flooding. Outside the building, water rose as high as 12′, while inside the hospital there was up to 4′ of water. And until 2010 when various city officials joined forces, a plan to rebuild a medical infrastructure for this area of New Orleans was not set in stone. Today, the two adjoining buildings—a new three story facility connected to a renovated six story tower—represent a revival for the area.

The new facility comprises a $130 million renovation of an existing six story, 133,640 square foot East Tower and the construction of a three story, 71,700 square foot Patient Care Pavilion. The East Tower is part of the previous hospital’s campus and was completely reconstructed to be part of the new facility.

Karl Warner, facilities director at NOEH, also served as construction coordinator during the project. He was distinctly qualified for the role, having been the chief engineer at Pendleton Methodist Hospital when Hurricane Katrina hit in 2005. Having worked at Pendleton since 1984, working his way up the ranks to chief building engineer, Warner was the last person to leave the site after working with his team to keep the facility powered for the week after initial flooding.

Returning to the site, he’s welcomed the opportunity to operate NOEH, supporting the community’s revival. During construction, Warner was the construction coordinator for the hospital, serving as the liaison between the architects, the construction company, and the hospital board. “I was brought in to be a direct report to the board. If issues arose that might cause delays or other problems, I worked to resolve it,” says Warner.

Commenting on the new facility, Warner notes the building management system for the control it affords him and his staff. “From my desk or remotely, I can access any point that I want to read whether it be the chilled water or the temperature in the operating room. We have critical points that are alarmed, so we now have a system that not only alerts me but can also send message to my engineers. We are able to see trends happening and avoid problems.”

The backup power system is another point of improvement. Having spent the days after Katrina walking gallons of diesel fuel to a generator atop the six story East Tower, he knows all too well the impact a flood can have on a facility. In 2005, the only generator not underwater was one on the East Tower roof. But the system that would deliver fuel to the generator was out of service.

Explains Warner, “The fuel pump for the generator on the roof was in the maintenance building and that was underwater. We were able to access the 10,000 gallon fuel tank on the ground, from the top. Using a hand pump, we pumped out fuel into 35 gallon drums, then walked those up to the generator. It took about 100 gallons of fuel a day to keep the facility going.”

Today, three 800kW generators sit on the roof of the new Patient Care Pavilion. The fuel tank is situated on a platform 18′ high, and the pumps are raised.

Designing For Function

The design team, led by New Orleans-based Manning Architects and Eskew+ Dumez+Ripple Architects, made resilience a central part of its approach. But this was not at the expense of aesthetics. Strategies designed into the hospital to mitigate damage from future weather events included locating non-essential services on the first floor, while placing the emergency department and major clinical areas on the second floor and above.

The renovated East Tower features the majority of patient care spaces. Throughout the first floor, there are 56 administrative offices, eight meeting rooms, and a physician lounge. Also on that level is a cafeteria and gift shop. On the second level, there is a 14-bed intensive care unit, a 10-bed intermediate care unit, the 21-bed emergency department, a 10-bed pediatric medical and surgical unit, and an imaging department. On the third floor is a universal care unit, outpatient diagnostic services, clinical lab, pharmacy, the anesthesia and recovery care unit, four operating suites, a cath lab, two endoscopy suites, and central sterile facilities. On the upper levels of the East Tower is a medical and surgical unit, a cardiac rehabilitation, a physical and occupational therapy facility, and fitness center.

On the exterior, the metal and glass façade of the East Tower was built to withstand winds of up to 130 miles per hour.

Aesthetically, NOEH is a contemporary design characterized by modern surfacing and natural light in many spaces. An atrium with a view of a garden courtyard on the first floor features terrazzo flooring, and the chapel incorporates marble salvaged from the previous hospital. And 120 pieces of local artwork displayed provide another connection to the local community.

In April 2014, the facility signed a cooperative endeavor agreement with the Orleans Louisiana Children's Medical Center (LCMC) to be the operator of the new facility (Photo: New Orleans East Hospital).
In April 2014, the facility signed a cooperative endeavor agreement with the Orleans Louisiana Children’s Medical Center (LCMC) to be the operator of the new facility (Photo: New Orleans East Hospital).

New Orleans Mayor Mitch Landrieu made it a priority of his administration to reestablish a full-service hospital in eastern New Orleans. For the past several years, area residents had access to an urgent care center, opened in August 2011. Under the direction of Franciscan Missionaries of Our Lady Health System (FMOLHS), that facility served more than 21,000 patients. With the opening of NOEH, that center was closed in July 2014.

To help fund the hospital development, the U.S. Department of Housing and Urban Development insured a $97.6 million mortgage loan. In addition, the project received an $8.4 million FEMA Hazard Mitigation Grant, $15 million in Capital Outlay Projects funding, and a nearly $1 million federal grant to purchase hospital equipment and ensure completion.

Joint Commission Accreditation

In August 2014, NOEH announced it had earned The Joint Commission’s Gold Seal of Approval for accreditation by demonstrating compliance with The Joint Commission’s national standards for health care quality and safety in hospitals.

Leading the hospital’s administration is Mario Garner, CEO of NOEH. “We are working to be the trusted leader in providing healthcare services to the community,” he says. “We’ll do this by providing superior quality healthcare and educational empowerment not only to our patients but also to the community.”

With more than a decade in healthcare administration, Garner’s experience includes building facilities, establishing service lines, and enhancing existing facilities overall (he was instrumental in building the first hybrid operating room at another facility in the state, a trend continuing to take hold in the industry).

A month into operations, NOEH was staffed with 170 hospital employees and 35 contracted employees. The hospital continues to hire key staff, and as Garner explains, “As services grow and our census grows, we will adjust accordingly to meet the needs.”

In his role as facilities director, Warner is overseeing the operations of the new NOEH campus. The careful planning by multiple stakeholders has resulted in a modern, comprehensive facility positioned to serve residents of the surrounding community for many years to come.

This article was written based on project literature and interviews with Garner and Warner and Manning.