As Penn Medicine’s new Pavilion—a $1.6 billion inpatient building on the Hospital of the University of Pennsylvania’s (HUP) campus in Philadelphia—moved closer to completion, Alyson Cole, associate executive director, HUP transition and occupancy, at Penn Medicine, stepped in with her team to start planning how to operationalize the 1.5 million square-foot building.

In this interview, Cole discusses transition planning during a pandemic, working with staff to modify workflows prior to the move in, and the feedback she’s received since opening day.

Healthcare Design: What was your role and involvement on this project?

Alyson Cole: As a member of the executive team, my role was really to architect the operationalization of the Pavilion. I’ve been a part of Penn for 16 years and have worked at two of our hospitals and came back to HUP [on the Pavilion project] in the summer of 2019.

The pavilion represents really just half of our total hospital operations because we still maintain service lines and services that make up our full HUP campus. My role is shepherding the project to the end of the line.

What are some of the ways you worked with clinicians and staff to get them ready for the new building?

Some of that what was handed off to me was to say “Okay, we have a new space, these were the ideas that we had going into that.” For example, our emergency department has a forward-flow layout, from a smaller check-in into the exam rooms and then utilizing vertical lounges and things like that to keep patients moving.

Using that as an example, what we charged teams to do through our own process improvement, advisors, and operation was to start mapping workflow design, where we knew we had a design that was going to be different in the environment. But we needed to now modify the process because we wanted to bring a new, better process into the building.

They were actually able to modify their existing environment to practice this new way of working, but it wasn’t all in their [existing] ED.

For example, the lounge was in an adjacent building but it worked and then they were able to say, “Okay, when we move in now we’ve had all the pieces together and we’ve been able to practice.” That was probably one of the biggest areas just based on size and scale.

For others, some of it had to live on paper, like our perioperative teams. Their prep and recovery spaces were joined together into one space. We worked with them, starting with mapping out what that new workflow was going to be.

Then we did three full-scale dress rehearsals prior to opening. So it was really supplemental to our training, and they could practice things like the new patient arrival workflow in the [mock-up] space.

The project had to changes gear briefly in spring 2020 at the start of the COVID-19 pandemic. Share what happened.

We were seeing the waves coming of surge needs, and the Pavilion was still very much drywall and studs. But our emergency department actually was a little bit farther along just based on where it was in the construction schedule.

So, in March 2020, the construction team fast tracked and built out completely the emergency department, as well as a third of three inpatient floors to bring up 120 [patient] rooms.

The plans was not to move COVID patients, but to move some of our oncology service line [to the new building] and then free up beds on the existing campus should we have needed them for COVID surge.

We, fortunately, never needed them and by the start of summer, we could decommission the rooms, but we had gone through everything from training staff and thinking that that might have been a location [for patients].

What was the biggest challenge you faced as you operationalized the building?

Team focus because we were operationalizing this in the middle of a pandemic. A move into a building, no matter at any time is a change, so we were prepared with what we had in our toolbox of change management techniques. But this was already a staff that had proven that they could be adaptable and had already lived through so much change.

By the time we really were ready, it was just the capacity and the fortitude and really saying “hang on just a little bit longer, we know you’ve already adapted so much.” That was probably the most challenging, just trying to be mindful [of that] … and so we tried to make things as manageable as possible.

I think the other part of this was being virtual or needing to pivot to so much virtual. Fortunately, we were able to do some of our key training in late summer and early fall, and we were able to at least gather and have masks and do our training safely.

The Pavilion opened in October 2021. What kind of feedback have you received from staff so far?

The built environment, obviously, is different in that it’s a lot larger, so I think that’s probably been the biggest adjustment. I think the biggest feedback, which is very positive, is the natural light and some of the original design principles of how the building is structured definitely came through and the experience that we were hoping for staff and patients.

The onstage/offstage areas that we’ve built, the fluidity of the building .. we’ve eliminated a lot of barriers of divisions between units. Overall, the staff have been positive.

For an in-depth look at Penn Pavilion’s new Pavilion, read “Penn Medicine 17-Story Pavilion Makes Impact In Philadelphia,” here.