Obstetrics admissions doubled over the next few years. And along the way, not only did most of the nurses get used to the extra demands of the wing, but they started to like them. Turnover among the nursing staff, always a problem at Griffin, started to drop. And the nurses were even taking it upon themselves to find more ways to cater to the patients. For example, they came up with a program that offers a free exam of mother and baby back at the hospital three days after discharge--or at the mom's own home, should a hospital return be inconvenient. Ninety-six percent of mothers were soon availing themselves of that exam, and in one-third of the cases a nurse identified a problem that might have otherwise gone untreated, such as jaundice or lactation difficulties. Perhaps most amazing of all, only a small percentage of the patients asked to have a nurse come to their homes to conduct the exam; they all seemed perfectly happy to drop back by the hospital.
Some of the obstetricians never did get used to the new order, however, and they moved on. In the past, such doctor vacancies were crises for Griffin because of the difficulty in attracting good physicians to a tired, old-fashioned facility. But now the hospital found that top-notch obstetricians, including younger and female doctors often favored by expectant mothers, were actively seeking Griffin out. What's more, because the new unit's philosophy was clearly established, the doctors who signed on tended to be physicians who preferred working in this new "patient driven" model. "Our environment was becoming a recruiting tool," notes Lynn Werdal, vice-president of patient-care services.
None of which meant that Charmel's next suggestion didn't come as a surprise when he threw it out to the executive team, in 1990.
"Can we build an entire hospital like this?" he asked.
Yes. They could.
As I stand at the edge of the Griffin Hospital parking lot, listening to the classical music being piped through nearby loudspeakers, someone approaches and cheerily asks if I've forgotten where I've parked. This is Phil Landona, an outgoing, middle-aged man who serves as a parking-lot guard and, given that he's often the first Griffin staff person a patient sees, as a general putter-at-ease. He often personally leads people into the hospital and then back to their car when they leave. He strikes up an easy conversation before wishing me a good day.
No matter how much you've been warned that Griffin doesn't look like an ordinary hospital, or how carefully you've followed directions inside, or even if Landona has personally led you by the elbow, you can't help wondering if you've made a mistake when you enter Griffin's lobby. Think of the lobby of a high-powered law firm: expensive-looking wood; curving, sophisticated structures; and an energetic, pleasant, and efficient-looking young receptionist sitting alone behind a massive desk, smiling at you as if you were the moneyed, tough-to-please client whose arrival the firm has been frantically preparing for over the course of weeks.
Speaking up a little to be heard over the near-concert-quality player piano that's running through a light jazz number off to the side, I tell the receptionist the name of the person I'm there to see, and she enthusiastically suggests that I simply keep walking straight ahead down the one corridor leading out of the lobby until I come to the central registration area. As I walk along the handsomely appointed hallway, I notice there are no signs on the wall to direct me to any of the various wings or specialties. At the central registration area, which resembles a bank president's waiting room, I ask a man in a suit to direct me to an office. "Sure, follow me," he says.
This is pretty much the experience any patient has when he or she shows up at Griffin. The outer lobby and central registration area act as a pleasant funnel in which it is virtually impossible to become lost or to avoid being greeted. Once you've registered, someone will lead you to the appropriate wing--it's not good enough to merely give you directions. Pointing is actually banned in hallways. All this, of course, is in place of the more common experience of entering a crowded, noisy, disorienting lobby and trying to follow signs to a particular ward. "No one's going to give you high marks for having good signage," explains Powanda. "Being taken to your unit by a person is something you remember."
Throughout the hospital, corridors are generously trimmed in maple and nicely carpeted (special wheel bearings were brought in to keep gurneys from bogging down in the thick pile), and they feature warm, indirect lighting. There are no gurneys, wheelchairs, crash carts, or food-tray dollies lining the corridors. There are no public-address-system pages or announcements or gongs. "Pat hates noise and clutter," says one nurse, "Pat" being Charmel. "He gets really annoyed if he sees a piece of equipment sitting outside a room."
The rooms are furnished at a level of taste and comfort roughly equal to that of a typical upper-middle-class hotel. Some rooms are outsized, with couches that fold into double beds. Those are the "care partner" rooms, in which family members who help provide care are allowed to stay with the patient. None of the rooms is more than a dozen feet or so from a nurses' station.
