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Hospital for Advanced Medicine

Hospital for Advanced Medicine at Mission Hospital in Asheville “Our facilities and processes must act hand in hand to achieve our BIG(GER) Aim is to get every person to their desired outcome, first without harm, also without waste and always with an exceptional experience for each person, family and team member.The combination of our aging population, our new abilities to address both health and illness issues, and the goal of delivering healthcare dramatically more efficiently all require that we do things differently.” – Ronald A. Paulus, MD, President and CEO of Mission Health

MISSION re:DESIGN is a proactive planning approach to address developing changes in community needs, healthcare quality and delivery, regional demographics, and internal Mission health resource requirements. The goal of MISSION re:DESIGN is to provide an exceptional patient experience, supported by optimal efficiency, better technology, and ever-improving quality care. MISSION re:DESIGN identified a critical need the need for a new facility in Asheville that will expand capacity while offering high-quality care to our region. As a result, the Hospital for Advanced Medicine at Mission Hospital in Asheville will be a new 12-story, 600,000-square-foot tower and include: • 220 patient rooms • Consolidated Operating Rooms (ORs) with support space • Expanded Emergency Department space • Interventional Cardiology • Interventional Radiology • Indoor and outdoor gathering space for families and loved ones The new facility will provide a healing environment for patients, families and caregivers. In addition, new equipment and technology will require greater space, and the capacity for increased numbers of patients. The Hospital for Advanced Medicine is designed to offer the best care and experience possible for our region.

Hospital for Advanced Medicine


Asheville Development Creating the most clinically effective and costefďŹ cient buildings supports our future model of care. The new facility will result in cost savings for Mission Health, cutting redundant services currently required to maintain multiple facilities across the same street. Furthermore, it will eliminate the need to transport patients back and forth, improving their safety and overall experience. Given the needs of our increasingly complex patient population, we know this new building is a critical investment in assuring that Mission can continue to deliver high-quality services in an economically sensible way, and assures an exceptional patient experience. More importantly, it ensures deliverly of our services, and provides an essential safety net for the 18 counties of western North Carolina.

Hospital for Advanced Medicine


Description of Space The Hospital for Advanced Medicine is intended to meet the needs of our patient population by providing the highest-quality, most efficient, and safest patient care. Features will include: • A new and expanded 97-bed emergency department featuring a dedicated radiology suite • A radiology suite to include two CT scanners, two diagnostic radiology rooms, two ultrasound rooms, and one MRI suite • Interventional radiology will include four interventional radiology suites, one invasive CT scanner, and two invasive radiology procedure rooms. • The surgery department will be expanded with eight general operating rooms and two vascular/hybrid operating rooms located in the tower, along with a consolidated, sterile processing department. • Interventional cardiology will be expanded with the addition of four new heart catheterization labs, one structural heart lab, and two electrophysiology labs. • To further support quality patient care, a post-anesthesia care unit with 40 beds, a 96-bed preparation and phase II recovery area is proposed. Additionally, 220 inpatient rooms (with 44 rooms designated as critical care) will be included, with remaining rooms designated for intermediate care, with a rooftop helipad attached. • Outdoor spaces, as well as designated indoor space for families to gather, are an important factor in the design of the Hospital for Advanced Medicine.

Hospital for Advanced Medicine


Preparation/Recovery The Prep/Recovery area is located on the ďŹ rst floor of the Hospital for Advanced Medicine. Patients and family arrive through this entrance, which will have waiting areas for families, along with partitioned zones to offer a sense of privacy. This area will provide natural light with pleasant waiting spaces, amenities such as computer and cell phone access, televisions, and refreshments (coffee, vending machines). Once the patient arrives, the goal is for our experts to visit the patient room, and avoid transporting the patient as much as possible. The Prep/Recovery area has 96 “roomettesâ€? to accommodate the patient and family before a procedure and, if applicable, for a period after the procedure. These are private rooms and have a patient, family, and caregiver zone. For every 12 roomettes, there are rooms/alcoves to support the patient, and provide the caregiver with the needed equipment, supplies, and medications for care. There are dedicated patient-belonging lockers so families will not need to carry patient belongings, should they need to leave during the procedure. Many patients will be discharged from this area. The area also has a dedicated SPECT CT for patients requiring this modality prior to surgery.

Hospital for Advanced Medicine


Interventional Platform The Interventional Platform model will relocate the main procedural areas, including new operating rooms, vascular operating rooms, Interventional Radiology, and Cath/EP labs, to adjacent Prep/Phase II recovery, Post-Anesthesia Care Unit and Cardiovascular Operating Rooms. The location of the Interventional Platform modalities will decrease travel distances for patients arriving via the Emergency Department, helicopter, or vertical and horizontal patient care units. The placement of patient care units is intended to decrease travel distances and time for our patients and caregivers, once again promoting the highest-quality, most efficient, and safest patient care.

Support Area

The new Hospital for Advanced Medicine will also contain several areas dedicated to support. On the lowest level of the building, a new loading dock and materials management area will provide efficient and timely supplies to our patient care areas. Also on this level is a new, consolidated Sterile Processing Department with the latest “state-of-the-art” equipment to provide optimal instrument sterilization. Other support areas will be located on the third floor near the Interventional Platform, and will include staff locker and lounge areas for convenient changing or breaks. A new blood bank will also be located on this floor, conveniently near operating rooms and the Emergency Department, to provide faster delivery of service.

The new Interventional Platform space will bring all surgeries and procedures into one area. The space will include: • Eight Operating Rooms • Two Hybrid Vascular Operating Rooms • Four Interventional Radiology Labs • Four Interventional Cardiology Labs • One Structural Heart Lab • Two EP labs • One Invasive CT The Interventional Platform is located on two floors, with multiple first floor waiting areas offering natural light, access to Wi-Fi, close proximity to food and drink, outside garden space, and the chapel. The Post-Anesthesia Care Unit (PACU) is centrally-located between all modalities to decrease travel distances and time for patients recovering from a procedure with general anesthesia, or those needing closer monitoring during the immediate post-operative or post-procedural phase. The location of the PACU offers easy access for families wishing to visit their loved ones while in this phase of recovery. Those patients arriving to the hospital with a time-sensitive illness or injury requiring immediate intervention (such as stroke, myocardial infarction, and traumatic injury) will have direct access from the rooftop helipad or the Emergency Department via a “megavator” to the Level 2 Interventional Platform.

Hospital for Advanced Medicine


Emergency Department The Emergency Department will be divided into pods with rooms sized to accommodate multiple acuity levels, emphasizing the importance of patient privacy. To increase both accessibility and convenience for patients and providers, an Imagining Suite will be located within the Emergency Department, and will include two CT scanners, MRI, Diagnostic Radiology Room, and two Ultrasound Rooms. Highlights of the expanded Emergency Department include: • A dedicated pediatric pod with a separate, pediatric-friendly waiting area • A 12-bed clinical decision and observation pod will accommodate patients who may require longer stays for a provisional diagnosis. • A 10-bed Behavioral Health pod is designed to provide a safe and effective care environment for patients and staff. • A 4-bed Trauma Resuscitation area: These rooms are located near the ambulance entrance, the “megavator,” and the imaging suites. The trauma rooms will be equipped with the appropriate monitoring equipment, overhead large exam/suture lights, booms, portable ultrasound equipment, dedicated and automated medication-dispensing machines, and other pieces of equipment.

Hospital for Advanced Medicine


Medical/Surgical Patient Care Units The Medical/ Surgical Patient Care units will span four floors and feature 44 beds each. These units include: Trauma Care Unit: To provide care to the patient who has sustained a traumatic injury. Spine Unit: To provide postoperative care to the patient who has surgery on their neck or back. General Surgery: To provide postoperative care to a diverse population of surgical patients. These specialties include: • Bariatric • Large/Small Bowel • Urological • Maxillofacial Women’s Surgery: The Women’s Surgical Unit provides family-centered, patient-focused care to female patients experiencing GYN surgery and/or GYN medical issues, which includes women with GYN cancers. Oncology: To provide inpatient hematology, and oncology management, and treatment of the following: • Chemotherapy and biotherapy • Radiation and radioactive therapies • Targeted therapies • Diagnostic services and treatment planning • Symptom management • Palliative care All rooms will be uniform and standardized, meaning all equipment will be similarly-located in each room. Each room will feature three distinct zones: patient zone, family zone, and caregiver zone. Each room will feature a window with outdoors views providing natural light.

Hospital for Advanced Medicine


Roof Terrace with West-Facing Views The Roof Terrace will be a partially-covered, landscaped roof garden on the second floor, with outstanding views toward the western side of Mount Pisgah and the surrounding range. There will be ample seating for visitors, patients, and staff to gain momentary respite. Lush and various plants will be included to create a natural, soothing setting. Walking paths will also be incorporated to encourage movement through the space. Located adjacent to both the visitor elevators and the Conferencing Center, this Roof Terrace is designed to support all who visit, work, or seek treatment at Mission Hospital.

Hospital for Advanced Medicine


Biltmore Plaza The Biltmore Plaza, located at the busy and highly-visible intersection of Biltmore Avenue and Hospital Drive, will be built where Mission Hospital and the City of Asheville intersect. Housing a Transit System Shelter, it is intended to be a welcoming entry to the Mission campus. It will feature lush plants, benches, and meandering paths, and, ideally, it will engage pedestrians, providing them with a pleasant, refreshing experience, in contrast to the city sidewalks. Lastly, being on this highly-visible corner, the Plaza will present an attractive and welcoming face for the Mission campus.

Hospital for Advanced Medicine


Healing Courtyard The Healing Courtyard is ideally situated between the Hospital for Advanced Medicine and the Heart Center, and strategically placed adjacent to the waiting areas for both buildings. This courtyard will contain lush plants, walking trails, benches, a water feature, and other amenities to support our visitors and staff. Additionally, with the courtyard sitting adjacent to the Chapel, patients and families will have the opportunity to enjoy this outdoor space as a complement to hospital services. Lastly, this Healing Garden will be a place of relief for patients in recovery.

Hospital for Advanced Medicine


Naming Opportunities Naming Opportunity Mission Hospital for Advanced Medicine Emergency Department Intensive Care Unit Interventional Platform Prep and Recovery Department Acute Care Unit (four floors total) Biltmore Plaza Healing Courtyard Roof Terrace Sterile Processing Department Blood Bank Suite Conference Center Emergency Imaging Suite Interventional Cardiology Suite Interventional Radiology Suite Vascular Operating Room Suite Post-Anesthesia Care Suite Helipad ICU Patient Room (44 total rooms) Acute Patient Room (176 total rooms)

Cost Per Opportunity $10,000,000 $2,000,000 $2,000,000 $2,000,000 $2,000,000 $1,000,000 per floor $750,000 $500,000 $1,000,000 $1,000,000 $500,000 $500,000 $500,000 $500,000 $500,000 $500,000 $500,000 $550,000 $250,000 $100,000

Hospital for Advanced Medicine


Ham case for support