After three hours and lots of questions from the Cook County North Shore Hospital board to Administrator Kimber Wraalstad, the board asked Wraalstad to enter into negotiations with DSGW Architects to draw plans for a remodel and renovation of the 16-bed critical access hospital and 37-bed skilled nursing care center.
The estimated cost for the work is $20 million, but Wraalstad said that other than the current levy of $800,000, none of the money would come from county residents in the form of more taxes or an increased levy.
The meeting took place at the hospital boardroom on Monday, February 10.
Negotiations with DSGW Architects could take from several days to a month, Wraalstad told the board. Board President Tom Spence asked Wraalstad to work with an attorney from St. Luke’s. “They have more experience at these [contracts] than probably anyone in the state,” Spence said.
From 2010 to 2014 the hospital board has looked at the pros and cons of renovating both facilities. From a business side, a revenue side, Wraalstad said if she had to pick one or other, she would pick renovating the hospital.
“From a sole business decision, I would say get rid of the care center. But we are the only facility like this within 80 miles and the public has told us emphatically it wants us to keep the care center,” Wraalstad said.
That said, Wraalstad told the board that currently, “We’re [the care center] providing a place to put a person rather than providing a place that is a semblance of home.”
Earlier in the meeting the board selected DSGW over the architectural firm of Horty Elving, out of eleven proposals.
“I felt like they [DSGW] fit into the community. They were very well prepared and enthusiastic,” said Board Member Sharon Bloomquist.
Board Member Howard Abrahamson echoed Bloomquist’s thoughts, and added, “They had a lot of excitement for the project and wanted to work with us. They are also out of Duluth, so they are essentially local.”
Board member Kay Olson said, “They outshined the other firm. They had a model with them for us to look at. They had a lot of energy and enthusiasm and they want our opinions.”
“They have worked in our community and worked with a lot of the contractors here,” said Spence, adding, “They have a 20-year relationship with our facility. It seemed like they were already on the job.”
Only one Board Member, Justin Mueller felt differently about the two architectural firms. “I didn’t think there were any clear winners in the interviews. Horty Elving had more experience but DSGW had more enthusiasm, but I wouldn’t be unhappy with either one of them.”
Following that discussion, Board President Spence called for a vote and the board voted unanimously to hire DSGW Architects.
Some of the areas in the hospital that Wraalstad identified needing work are as follows: The emergency room space is not efficient, she said, offering little privacy if there is more than one person being cared for. There is also no waiting space for families and no appropriate space for computers.
The hospital laboratory needs more space for machines and supplies and regents, while the radiology dark room is obsolete, the CT area too small and there is no appropriate space for computers.
Patient rooms are too small for two patients and equipment needs. The rooms are not uniform and there is no space for computers. The nurses’ station offers no privacy to have conversations or make phone calls regarding patients. The space is not efficient.
The current pharmacy hood and mixing area is outdated.
In general, said Wraalstad, the hospital building was designed as a silo and does not allow for the efficient use of staff to address the needs of the patients and residents. The widespread use of computers is increasing, she said, and the building is labyrinthine and is difficult for patients and guests to find their way.
Dr. Milan Schmidt, who was on hand to listen to the proceedings said, “I’ve been here for three years and I almost know my way around now.”
In the Care Center, Wraalstad said the current situation with four beds to one bathroom and shower is outdated and doesn’t offer enough privacy and the shower mechanisms are old and can’t be replaced.
The dining room and entry to the Care Center also need addressing, said Wraalstad.
“Our large dining room is loud and creates behavior issues for some residents,” she said.
The nursing station and medication room are separated, causing inefficiency, and when visitors enter they can’t see the location to receive assistance.
Care Center rooms need to be created to allow for a feeling of privacy for the residents, noted Wraalstad.
After some discussion the board agreed that if the remodel takes place the hospital and care center patient rooms would be single rooms (cottage style) and each have their own bathroom. “That’s the current standard,” said Wraalstad
“Well if that’s the current standard then we shouldn’t give the public here anything less,” said Abrahamson.
If the renovation and remodel occur, Wraalstad said potentials for increased revenue might exist because of services that cannot now be offered.
“One outcome could be that the hospital could allow for the provision of certain chemotherapy procedures. Right now I know two people who have to travel and spend six to eight hours of their time getting chemo in Duluth, then they have to drive back. If we had that to offer, they wouldn’t have to make that trip,” Wraalstad said.
New space would also allow for a variety of outpatient surgical services, and outreach physician visits and telemedicine services that provide for growth and expansion of services, said Wraalstad.
“Our goal is to be patient and resident friendly. This renovation would make it easier for people to find their way around the facility and we could provide comfort for families visiting or waiting,” she said.
One of the main goals would be to make one very visible entry point into the hospital. Currently there are a variety of doors that can be entered, but for newcomers finding the main door it is often an exercise in frustration. The hospital would also be safer with one main entry point, noted Wralstad.
As the process goes along Wraalstad told the board that they could stop it or make changes to the preliminary plan. Spence asked about down scaling the project, and Wraalstad said that because the components lead into each other, she didn’t see how that was efficient. “You don’t want to take a band aid approach to this,” she told him.
In the end the board agreed unanimously to go ahead with the total project, but if something unexpected comes up, trigger points will be installed in the phases of construction and the work will stop if needed.
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