Hello, it's time to be well with your health. I'm Shana. I'm Tina. Special guest.

So happy to be here.

Yep. I'm excited as well. We'll miss Nimit, but I'm excited to welcome Tina back to the podcast, one of my favorite people.

It's always so great to be here, Shana, and especially talking about this topic today.

Yes. So we are gonna talk about the new tower at Shady Grove Medical Center.

And we have two very special guests to help us out today. Welcome Dan Cochran, president of Shady Grove Medical Center. Welcome, Dan.

Thank you. Appreciate being here.

Thank you. And we are also excited to welcome Todd Cohen, who's vice president of facilities at Adventist HealthCare. Welcome, Todd.

Thanks. Thanks for having me.

You're welcome. This is your first time on the podcast.

It's really fun.

So welcome. Time. Alright. Shady Grove opened in nineteen seventy nine and has transformed care throughout the community, since then, and now it's about ready to do it again. So let's get into it.

We are so excited. We are, at the time of this recording, about a month out from opening our new Horizon Tower. Shade Grove has grown tremendously, as you said, Shanna, since we opened our doors in December nineteen seventy nine. And the new tower really is just taking us up to the next level. Dan, I want to start with you. Talk a little bit about what this building means for the hospital.

Well, I think there are a lot of things that when we talk about a construction project like we've gone through for the past three years, it's really the largest project on our campus since the original hospital building was built. So it's a major change for our campus and what's going on at Shady Grove Medical Center. But the reality is it will give us the world class environment to provide world class care our team members are already providing.

Quick question, Dan. Is this one of the biggest construction projects you've ever been a part of in your career?

I would say it is one of the biggest. Yes.

Okay. Nice. And how long have you been at Shady Grove?

I've been at Shady Grove Medical Center for fifteen years. I've spent the last seven years as president of the hospital. Prior to that, I served as the chief financial officer and chief operating officer.

Okay. So how has it been managing a project like this or being a part of a project like this?

Well, it's it's definitely being part of because it takes a team of teams to pull off something like this. And it has really been impressive to watch. You know, unlike building a hospital in a new location where everything's new, we're tying into an existing hospital while that hospital is still providing all the services it always has. So it's been challenging at times, but everybody has really come together to make it all work.

That's wonderful. Well, Todd, welcome again to the podcast.

You are one of the leaders on this project. And how long have you been at Adventist HealthCare and what's this construction project been like?

Sure. So I've been at Adventist HealthCare for twelve years.

And I came actually twelve years ago to be a project manager to help lead the renovation of the emergency department at the time. So we were going to renovate it for a time until Dan, myself, John Sackett, a few others, we got together and we came up with this idea for a tower. I've been here for about twelve years and I serve as vice president for facilities at the system level.

It's been really fulfilling to see the iterations of design through White Oak and its influence is here, and just to bring that systematic approach, that standard management sort of system approach to design.

Dan alluded to this a little bit in his answer earlier. White Oak Medical Center, we built that a few years back here at Adventist HealthCare, Totally separate job site, whereas the tower is hooking on to the existing hospital.

How difficult is that? You've been involved in a lot of hospital projects for different health systems. Talk a little bit about the challenges that come with this sort of project.

Yeah. So there are some things that are in common with White Oak, but they're certainly very different projects. New construction is challenging, but it's got challenges that are different than building in an active place. So while it felt like at times we've been building out in the parking lot, it used to be a parking lot, we've been building and borrowing systems that are shared with existing spaces. So Dan talked about occupied construction being next to places where we're taking care of patients. It's very challenging. So the idea around infection control and being near sterile processing or near the operating room, the idea of how people approach the hospital, how do they drive up and drop off their loved ones, how ambulances interact with us, how the police interact with us.

It's all very challenging. It's just very, very different. White Oak was more isolated and there was a separate property, a separate address. It requires a challenge to our teams to move people, so the day that we start the service or we activate the hospital in an occupied place is a lot different than a new campus. Know, moving people via ambulance versus rolling them down the hall into a new wing. Just two very, very different propositions.

And to any of our employees who are listening, just kudos for their and all that they've done to help us throughout this construction project. We know it's not easy working through something like this, but everyone's just done a tremendous job to bring the new building to life.

We've learned this at White Oak. Construction fatigue is a real a real thing. Even after you open a new campus or a hospital, there's still things to do and to tweak and fine tune. It's just different at Shady Grove. We've been doing it all the while just right next door to our patients and our staff.

And patient care, the regular flow work processes, none of it has been compromised. Everybody's just been making it happen.

They have. It has required changes to a lot of those workflows. Most importantly was the access to our emergency services for walk in patients to the hospital, and that we had to set up a whole different location and process to receive those patients and then transport them to the emergency department. So that has required additional staff and additional work to do that, but there have been no issues or problems. Everybody's really worked well together to have that process work seamlessly.

And that's no small feat. Shady Grove Medical Center is one of the busiest EDs in Montgomery County, if not Maryland, correct?

It is. We see more EMS traffic than any other hospital in the county.

And so making that happen and doing it well has been wonderful to look at from the side, from outside of it, and just seeing the accomplishments happening.

Dan, why was it so important to build this tower?

You know, it gets back to Todd's commented about earlier, we had started a process to look at just replacing the emergency department knowing that and anybody that's been in our emergency department understands it's been well used over the decades it's been in place, but it is not a monitored emergency department. Patients are separated by curtains. There's a lot of space issues. So, really solving for those problems was what we looked at initially.

But we realized with the scope of the project to build an emergency department and solve those specific problems, it left too many other problems unanswered. So we really wanted to focus on, is there a project we can do that would not only take care of the emergency department, but also getting to all private rooms for our inpatients. Also getting our intensive care to right sized rooms for the equipment that they use in a high acuity ICU in today's environment. So looking at those things, bringing our critical care services together, we really tried to solve all of those issues with one project by going through this tower.

And then after the initial conception of this project, something really big and interesting happened, and that was COVID. And this building is unique in that it is one of the first hospital projects in the United States informed by our learnings from the pandemic. So Todd, can you talk a little bit about, one, what that was like to bring a building plan to life during that time and what we'll see in the building that is a result of those lessons?

Yeah, it's a great question.

You know, when we designed the project, usually when you do big projects like this, you have a big table and you have lots of people in the room. This is really an interesting process because while we had a lot of people around the table, we had a lot of staff that represented important inputs and insights that were upstairs, that were in units that were hot and they were not able to leave their patients. And so we had a really interesting design process. But because of the pandemic, we really learned a lot around you know, preparedness and being ready for the next pandemic.

And so there are influences that you'll see that are very deliberate, but there are, you know, we're tempered by the realities of the day. So on the fifth floor, for example, you'll see a unit that could be made into an all pandemic ready unit. Every room is negative pressure, or at least it's capable of it. And the unit itself could be made negative pressure.

So this is something that hospitals around the country are starting to do in response to two thousand. Sat around the table in twenty nineteen, twenty twenty, and you'll see some of those, you'll see the imprint of that moment. I would say that the negative pressure rooms are probably the most obvious influences in the emergency department. There are more negative pressure rooms that we might normally design.

The spaces around the intensive care unit bed really were influenced by pronating patients and having a number of clinicians around the patient physically to make that pronating work. So flipping somebody onto the rally takes a lot of people. So the rooms are designed to be bigger for that kind of moment. The other influence that you'll see is teaching is very important.

Line of sight is very important. These are normal evidence based design tenants that we would do in a project, but it was really I think we were really more intentional because of the moment that was twenty twenty. The pace with which we did it may have been a little bit longer than we probably would have liked. But, you know, it's interesting.

Original project that Dan and I looked at to renovate the emergency department was thirty six months, eighteen phases. And it would have looked pretty much the way it looks today. So let that sink in for a minute, eighteen phases. Instead, we did it over three and a half ish years.

We built outside and now we're going to open it and it'll be completely new. That moment is to me the most exciting thing is to watch the staff go from what is today to what is tomorrow.

It's right there in front of them.

And for the community as well. Yeah.

That's exciting. And may we never visit those dark days again, but it's nice to know we're ready.

There are some other really interesting parts that maybe we could reflect on. The investment in our staff, the experience that they went through.

Classically when we build hospitals, they're built on a racetrack configuration. And in the middle where there aren't any windows is where we put materials, supplies, and sometimes our staff. In this project, we've made a double down investment. We've really acknowledged what they went through during the pandemic.

And we've created staff lounges that are really appealing. Lots of natural light, lots of beautiful views that they, when they're off having a sandwich or they're taking a break and catching their breath, it's really an immersive experience. They're not just in a closet or inside of an internal corridor. They're really able to see outside.

It's gonna be helpful for them.

Yeah. I love that. You've all thought of everything, thought of every person that would experience this from the team members to patients and families. That's amazing. And watching it being built, just like little like, floor by floor. It's enough. I haven't been over there in a couple months and I go and I'm like, oh, this is a real building.

That's been amazing to see.

Dan talked about the triage experience to staff that, to change our process.

That didn't just happen. Yeah. It took about a year of Like how do we do this? How do we take a risk when people come driving around the other side of the hospital?

Yeah. And I think with that theme, when we think about all the different things you said, we thought of everything. Well, we didn't think of everything. We enlisted the input of all of our team members, our physicians, employees, obviously, with the architects, designers, and everyone really all together coming up with what we believe will be the best solution for our community for decades to come.

I love it. Well, Tina, I know you have some thoughts on this one, but what's that day like? What's the day that's coming up soon of opening it? What's that gonna look like?

Well, I'm really eager to hear from our guests on But already, you know, like I said, we're about a month out from the project. It is really, really busy in the new building.

We're right in the middle of training staff in their new spaces, turning on the new technology in there, and just watching everyone in there, really working with focus, but also enjoying some of these amenities.

And it is a completely immersive experience with light filling the rooms, with the views of greenery. I think one of the things that I'd really love to hear from Todd and Dan more about is just the ties of this building to both the roots of the Adventist HealthCare System and our tradition of holistic care, but also its ties to the history of our campus with the materials. There's just so much connection to the health system's work and to the history of our campus that I love in this facility.

So I think initially when you look at it, you get to our holistic care approach. And I think that's one of the intentional designs, the the light, the nature, the ability for family members to get outside, get fresh air without actually leaving the hospital so they can be near their loved ones. All those things were very intentional. And doing all of that while building it to look like it belongs against a building that the original portion of was built in nineteen seventy nine, is quite a challenge. And, Todd, I know you've worked through quite a number of things to get the the right set of appearances throughout that.

Yeah. The the original structure in nineteen seventy nine involved these really large bricks and they're brown and they were probably in the day they were all the rage. I find that hard to believe, but maybe they were.

But those were the '70s, right? And then you see manifestations of different eras. There's the two thousand and four project. There's the introduction of the Alcolino Cancer Center.

There's consideration for the rehabilitation hospital. And so we tied all of those finishes together. You see the carrying of the brick. Maybe it's not the same brown, but it's a brick.

It's close to what that original brick looks like. But you see other things like some of the concrete sort of facade elements. You see some of the metal cladding and panels that you see at Aquilino. All of this sort of cascade of different eras and vintages of structure come together in this tightly woven you know, the parking garage is right next to it, and there's some connection with that.

And so the the terracotta panels that are on the side that both collect water and distribute that better also has a tie in the way that its colors reflect back to the cancer center. So it all is tied together. So it's the seventies, it's not much in the eighties, but nineties, two thousand, and then there's this sort of moment where you can really tell where we were invested at White Oak and and we were designing Shady Grove, now here comes Shady Grove. And it's sort of that's what I love about Adventist HealthCare.

We we sort of have these moments where we, with intention, push forward and you would bring in innovation or what's current today. So it's this idea of this renaissance. I really call it the renaissance of Shady Grove. I'm a lifelong Rockville native.

And so watching it grow through these eras and now the architecture supporting that progress has been really cool to be a part of.

When you mentioned that Adventist HealthCare Rehabilitation is there, the Aquilino Cancer Center is there, we have the medical office buildings all right there on campus as well. I mean, it's a really active campus and managing construction along a very busy roadway like that probably has not been easy either.

Yeah.

I think the construction The collaboration with the construction and with the county has all taken a lot of work.

I'll certainly let Todd talk about collaboration with the county and with Woodland Roads. But I will say that interior to the building and all the connection points of the existing building, we had to build adjacent to our current operating rooms.

Yeah.

And assortment of other areas that are really special spaces that have to be well kept from a temperature and humidity and all sorts of issues that need to be maintained while building this new building, starting with digging a huge hole in the ground right next to the existing hospital. So all of that happening really took a lot of coordination between the contractors that were involved, the team at the hospital, the clinicians at the hospital, and they stayed connected throughout the process to make sure that we didn't have anything missed or any problems. There were times, though, that vibration got too much or something was happening. And the contractors, they would stop work until we could make space for them to do that so it was safe for our patients.

That's excellent.

It was really a lot of coordination across the board.

Yeah. I think from a construction project team perspective, we really wanted, as a leadership team and as a project team, to teach people the Adventist HealthCare mission and the vision for what we were trying to do. So if you ask the permitting services department at Montgomery County, we basically said you're going to be like a caregiver. And so our date and making our date is really important because you're a part of that process.

Or our contractor, one of the superintendents, she was like always on the phone with the charge nurse in the OR. Is it too loud? Like, is so and so operating today? I know that that person is really sensitive about noise.

Yeah. And so we really introduced external stakeholders and internal stakeholders to what I think we all expect of each other as staff and employees here. But like we enlisted that vibe and that moment with others external to the organization and they bought into it.

They really felt like you have to remember, we built this thing as we were emerging from a pandemic and many people were at home for so long that they wanted to help, but they didn't know Oh, yeah.

So all of a sudden we came back into the world, I guess. And people that were aligned with us, they wanted to do something. And this project enabled that, I think, in some ways.

Hospital.

Yeah. Well, and Cheady Grove really is a, it's a community hospital. And these people work and live in the community and will, and may experience the services. So be a part of it. Be proud of that.

We get that all the time. I had my baby there. Yeah. Where it's like, of course you did. Yeah. Come on in.

You know, this your role Yes.

I love it.

So Dan, what are you most looking forward to about opening day?

I think, seeing that first patient in the space is gonna be exciting for everybody involved. I think that that first day is gonna be a challenging day by any stretch. We're gonna have a lot going on. We're gonna start early in the morning. I think three AM, we'll be on-site to stand up the command post and get ready to move. And at four AM, we'll start seeing patients that present to the emergency department in the new emergency department.

And then every few hours after that, we'll be moving one of the other units. So patients that are already in the emergency department at that point will just continue their care there and be discharged from there or admitted from there, depending what they need.

But everybody after that point coming for emergency services will go to the new ED, and then we'll transition to moving the patients from the ICU into the new ICU. Once we get that move done, make sure everything's working well and everybody's in place, then we'll start on the progressive care unit. Once that's all done and moved in, we'll start on the neuro unit and get them moved in.

It is a carefully orchestrated process. And that early call was the request of our ED.

Yes.

Because, you know, we're a twenty fourseven operation and that's Nothing stops.

I'll call it their slow time. Not that they ever slow down there.

But that was the time that they said, oh, we think we can get this done about this window. So, But it's been really fascinating and inspiring to watch the teams in our emergency department, our critical care units, really all of the support services at the hospital plan for this moment.

And we're really excited to open the doors and show the community all the hard work that's gone into this new building.

How excited are the caregivers to move into the new space?

You know, it's been really fun. Know, Dan and I have done a lot of tours and spent a lot of time with teams, and the teams have been able to walk around the units so far. You know, we're just furnishing them this week. But, you know, for me, some of the more memorable moments have been watching Doctor. John or Doctor. Brodsky, you know, be able to see what an idea how an idea took shape.

You know, an idea is sparked, a concept is derived, and then it's rendered. And that image of of a rendering is in your mind until you see it. And watching people kind of look behind the curtains finally and see what we've been doing behind that curtain has been, for me already, has been so rewarding on a personal level, just watching them sort of giddy about their care spaces. The nurses too, watching Obi, you know, places that he really influenced design elements that based on some of his ideas.

You know, these have been really I'm really excited for people in their careers to be able to have had a vision and see it come to fruition. The impacts that they make every day at the bedside are are beyond to me. Like, they're just extra amazing to me. But now they get to see something where they've worked and optimized and said, why not?

Or how come we can't do it that way? Soon they'll be able to see, listen to you.

And to have it last, as you said, Dan, for decades is even better.

And one thing that's just so exciting to me about it is that, you you mentioned our OB, our Director of Critical Care, our Emergency teams, our Cardiac Care teams, our Stroke Care teams, these are all areas that will be in the new tower. They've been delivering nationally recognized care in their current spaces. And so this is really giving them the physical spaces to just take that up an even higher notch. And so I think that's something that everyone's really excited to see now that the spaces are stacked for better efficiency in areas where time really matters. I think, as you said, to talk to the caregivers about this, to hear and see their reaction to this, we're all really excited to see just how much higher they can fly now that they have the physical space to support this outstanding care that they give already.

But aligned with that, and perhaps external to the organization with our partners, we do the same thing. We look at spaces in the same way. So spaces, you know, the the count the timing of of how fast it takes to get from an ambulance bay to being offloaded in a room, the time it takes to get to the cath lab for production of PCI. You know, these are all things that we obsess with.

You know, failure, we think about failure modes. We think about, you know, oversimplification. Some of the things that we're teaching and learning as an organization, we also are manifesting that as designers and builders. And I think in the end when we open, that's kind of nice because there's this synergy and there's this congruence where we're designing something that also works with our organizational philosophies.

And you'll see that in the space. It's very intentional.

And Dan, as if this time wasn't exciting enough, we are just a few days past the announcement that we won our first Leapfrog A safety Yeah, which is also very exciting for our hospital.

And obviously, you know, to reach a goal like that takes a lot of work and a lot of intentional activity. And as Todd alluded to, the process improvement that's gone over the last few years in our hospital really shows. And through awards like that and the others you mentioned earlier, it's really a great place to be and receive care. And right now we're gonna give them the best environment for that level of care that's already being provided. So it really does marry the two together that I think, to your point, will just result in better outcomes both from an experience and clinical perspective.

And that's really what it's all about, giving our patients the very best outcomes.

Really, as beautiful as these spaces are, they're just smart and they're built for better infection prevention and all of the things that make clinical care superior. And so again, just like extending this great record that we've had even further.

When you go to the hospital, you see the surface. You see, oh, it's clean. It's everybody's working together. But to hear all the things that happen behind the scenes and all the thought that goes into it, hope is inspiring for those in the community so they feel even more confident when they come, to one of our locations like Shady Grove Medical Center.

Absolutely. Anything else we want to add before we we end today? I think we covered a lot. Dan, any other final thoughts about the space?

The only thing I would add is one of our challenges over the past three years as we've gone through that, and pretty much any patient or visitor that's come to the hospital will tell you this, parking has been a challenge for us.

We we took a major parking lot out of service to build a tower, and we shifted a lot of the other parking around to accommodate what's happening. But as we move forward, we'll actually be relocating our patient and visitor parking, much of it to the garage adjacent to the entryway that we'll be opening on June fourteenth, which will allow easier access for our patients and visitors into the building. So we'll be shifting some of the employees higher into the garage. We've got ample parking.

It's just not where people needed it before, but we'll be able to realign it now to be much more accessible for where people are going within the building. And we'll actually be putting on our website where to park depending where you're coming to our campus for various services. Whether it be if you're coming in for outpatient surgery versus visiting somebody in the intensive care versus an emergency patient or behavioral health patient. We wanna make sure everybody gets to the right entrance where it's easy to park, easy to get in and see your loved one or take care of your That's right.

Yep. I like that. So AdventistSGMC dot com. It's where you can keep up with all of the tips on visiting the hospital. We always hope people don't have to come to the hospital.

But when they do, that's the place to go to get the information as we open the doors change things for the new tower.

Todd, any final thoughts?

Just really excited to see for when people do come, that they know that they come to a place where people care about them, but also the places and the environments with which they're taken, have taken that sort of extra mile. That good is not good enough that we've really excelled here and taken it to a next level like we've talked about. And after five, six years of planning or building or all the processes, it's really finally here. And I think that's going be really exciting for the staff and for the patients alike.

I agree.

All right. Well, let's wrap it up. Like Tina said, if you want to learn more about the Tower at Shady Grove, visit Adventist SGMC dot com. And then also, we always love to hear from our listeners. You can let us know if you like the podcast by leaving a rating or review, or you can email podcast at Adventist HealthCare dot com and let us know what healthcare topics you want to know more about.

Well, we hope Todd and Dan, you come back and talk with us after the opening and maybe we should have one of our nurses or one of the clinic directors come on and talk about it too. Absolutely. So, we hope you guys will come back and talk with us.

Absolutely.

Thank you. Thank you, Tina. Always great to be here, Shanna. Thank you. And don't forget to subscribe to the podcast so you get all the new episodes. Thank you and be well.