In the wake of the terrorist attacks of Sept. 11, 2001 and the following anthrax scares, Rush University Medical Center in Chicago used those tragedies to inform its campus-wide transformation.
The vision was to create a medical campus that could not only handle the traditional medical needs of one of the country’s largest cities, but which could also adapt and respond to unique circumstances that might not be an everyday occurrence. A team that included medical professionals, architects and philanthropic development worked together to bring that vision to life.
Oak Parker Sarah Finnegan, director of development at Thrive Counseling Center, was the associate director of development at Rush during the fundraising and planning stages of the project.
She recalls that after 9-11, thinking outside the traditional hospital box was a large part of the redesign of the Rush campus.
“Rush is at the intersection of a highway and an el line,” Finnegan said. “It is a place that people could get to relatively easily if there was a mass tragedy in the Loop.”
Architect Jerry Johnson, who was one of the Perkins & Will architects who worked on the project, says their design was aided greatly by Rush’s Office of Transformation.
“The medical center set aside doctors and nurses to participate in the planning process,” Johnson said. “They understood what was happening in every corner of the building. That decision by Rush made a huge difference, turning something that was ordinary into something that was extraordinary.”
Dr. Dino Rumoro, professor and chairman of the Department of Emergency Medicine and acting dean of the Medical College at Rush, was a key part of the Office of Transformation.
His vision was to create a campus that was prepared to respond to terrorist attacks, bioterrorism or a deadly pandemic.
“In 2006, not everyone was thinking about this,” Johnson said. “Rush was interesting because other emergency departments might try to cover one of these issues, but Rush was the first to say they would take on all of these issues.”
Rumoro recalls that he had just started at Rush in June of 2001 and had been asked to chair the emergency disaster response team. After 9-11, he says that job was like diving into the deep end of the pool, and fears of smallpox and anthrax attacks informed the campus planning process.
As the architects came up with a scheme that would deliver maximum flexibility for different uses, it was clear that the innovations would not be cheap. A sizable donation from the McCormick Foundation as well as grants from the Departments of Defense and Energy and private donations helped make their visions a reality.
Finnegan notes that the entire campus redo came with a price tag of roughly $1.2 billion, with the main tower costing about $650 million. She credited Oak Park resident and recently retired Rush CEO Larry Goodman for guiding the entire project from concept to completion.
When it came to the design of the main hospital building, the 14-story, butterfly-shaped tower, Rumoro says there were three key requirements.
“We wanted to add surge capacity of at least 20 percent, an area for mass decontamination and specialized air flow to help stop the spread of respiratory illness,” Rumoro said.
The tower’s Brennan Pavilion was designed to be easily transformed from an open admitting area to a triage space. The columns of the room open to reveal mechanicals, and the room can be shut off to the public.
“Once the skeleton is there, all we need to add is cots and recliners, which is what we’ve done now,” Rumoro said. “We’re using this room for part of our pandemic response.”
The arrangement, he said, is key for the hospital separating likely COVID-positive patients from other patients needing emergency services.
As another part of the surge capacity, each of the of the rooms in the three emergency department pods has the capability of housing two patients if necessary, building in 100-percent surge capacity in the ER.
The ambulance bay was created to be an area of mass decontamination. Johnson says that the 5,000-square-foot port was enclosed with the idea that it could have a dual use.
It not only provides protected entrance to the hospital via ambulance, but also in the event of an industrial incident, it could be an area where people and vehicles can be hosed down. A 10,000-gallon holding tank underneath the bay provides a safe receptacle for water runoff.
Rumoro said staff have been able to adapt the ambulance bay for the current crisis. It has been converted to a COVID intake area for arriving patients who are likely positive with space to separate patients’ chairs and has its own air exchange.
The third element Rumoro pushed for, the specialized air flow, is particularly useful today. Each of the three emergency pods have separate air flows, and each pod has an anteroom for staff to change into the personal protective equipment (PPE).
Rumoro notes that when they are seeing 70 to ninety 90 a day who might be COVID-19 positive, it takes a simple flip of a switch to make the entire emergency pod go to a negative air flow. Instead of roughly six air exchanges per hour, the rooms experience roughly 18, expelling airborne particles more rapidly.
Rumoro said he thinks this negative air flow, along with a good supply of PPE, has likely made it easier for critical healthcare workers to do their jobs during the COVID-19 crisis.
“We have PPE for our staff, and in reality, you don’t need a space suit to treat this disease,” Rumoro said. “Just telling our staff that the COVID patients will be in a pod with negative air flow makes them feel at ease.”
Johnson notes that even though 99 percent of the time Rush functions as a nicely equipped emergency department, the current crisis reveal how visionary the Rush team who worked on the plan was.
“They have it under control'” Johnson said. “They’re really, really prepared, and it’s a source of pride for our firm to be associated with this.”
For Rumoro all that planning is finally bearing fruit.
“This is our first time with a truly infectious disease, using all the bells and whistles,” he said.
He notes that only time will tell how to best address a disease like COVID-19, but he believes the design of Rush has aided the city’s response to the disease.
“It’s been helpful because we’ve been able to treat and accept a larger number of COVID patients because we have this infrastructure,” Rumoro said. “Some of this is the confidence of the team, saying ‘I work in a place where I feel protected and feel comfortable coming to work every day.’ If we provide a safe place to work, staff will feel like they can go in and continue to perform their ethical duty.”