Like a jigsaw puzzle, the design of a well-run medical center involves many pieces. Unlike a puzzle, those pieces shift as time changes. The transition involving space used by our Progressive Care Unit and Outpatient Surgery Unit highlighted teamwork at its best as it forged a new solution for the benefit of Salinas Valley Health Medical Center patients.
Previously, people undergoing outpatient surgery at the medical center shared space with those receiving cardiac catheterization to diagnose and treat heart disease. It involved a constant balancing act depending on which unit had a greater need for beds.
With space at a premium and considering the varying needs of multiple units, the administration decided to move the Outpatient Surgery Unit into a portion of the area occupied by the Progressive Care Unit. The Progressive Care Unit would shift some of its rooms from the first floor to the fourth floor of the medical center.
The effort was a heavy lift for everyone involved. It came together with collaboration, innovation, resilience and perseverance – hallmarks of our culture at Salinas Valley Health.
For the Progressive Care Unit, which cares for some of the most acutely ill patients, it meant putting together a completely new unit on the fourth-floor tower. While the unit gained three beds in the process, the change involved significant work with stakeholders to ensure a fair process for nurses to rebid for their preferred schedules and shifts. The division of the Progressive Care Unit separated people who had worked together for years.
With careful review of workflow, input from staff, consideration for maximizing use of shared space, and a lot of meetings and negotiation, a plan emerged. The Progressive Care Unit would retain first-floor beds in rooms closest to the Intensive Care Unit in case a step-up in treatment was needed. Patients most in need of close monitoring would be assigned to those rooms with other progressive care patients housed on the fourth floor. The Outpatient Surgery Unit would transition from sharing space with holding “rooms” for the catheterization laboratory to 10 private rooms previously occupied by patients receiving progressive care.
Like most compromises, there were benefits and drawbacks for each side. Outpatient Surgery Unit staff welcomed the private rooms for their patients who previously were separated only by a curtain from other patients. In addition, the new setup afforded those receiving care in the Outpatient Surgery Unit with a private bathroom and a television. Drawbacks included a longer distance to the operating room, shared supply space, and a smaller office for the Outpatient Surgery Unit nurses. The Progressive Care Unit gained three beds for patient care but saw a tight-knit unit of staff separated between different floors.
Each unit agrees, however, that while the transition was difficult, it was necessary and, ultimately, of great benefit to the patients. Following months of planning, once the theory became a reality with the transition of the units, it took only a short while to smooth out final details. The changes, which once seemed insurmountable, are now widely embraced.
Indeed, the process prompted the establishment of a gratitude tree to reflect appreciation for the gifts each day brought. The concept proved so popular it grew a small forest of gratitude trees that pay tribute to the work of our teams in building on our vision of a community where good health grows through every action, in every place, for every person.
