I'm Not a Doctor

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Blog: Cooper U. Hospital designs its way to more-integrated care

Pathologists are integrated thoroughly into patient care at Cooper University Hospital, Camden, N.J., and this is by design—architectural design, that is.

The new $163.7 million Roberts Pavilion at Cooper was one of 105 entries in the 27th annual Modern Healthcare Design Awards contest. It was one of 11 winning designs, and EwingCole architects took home a Citation award for their work. What caught my attention, however, was that the architects said that special care was taken to locate the "clinical and anatomic pathology departments to enhance increased involvement of pathologists in the patient treatment stream, a fundamental shift in the role of pathology."

"We love it, it's gorgeous," said Dr. Roland Schwarting, Cooper's pathology department chairman and chief. "What I love about it is it's an integrated design.”

Schwarting explained how, typically, pathology departments and hospital laboratories are fragmented into various silos, hindering communication and collaboration. He said that on paper, it would amount to a very confusing "spaghetti diagram," with arrows pointing every which way to connect the various functions. One can still use a spaghetti diagram to illustrate the department's operation at Cooper, but "the noodles are not as long," Schwarting said.

All of the laboratories operate out of a large square in the middle of the department, he said, and are surrounded by pathologist and administrative offices in a horseshoe shape, with most samples delivered by a pneumatic tube system. There are two conference rooms, including one with a 14-head microscope so multiple clinicians can view the same specimen at the same time. A viewing monitor also is available if more than 14 people are working on the case.

Whereas in the past, pathologists worked independently and issued reports to physicians, Cooper's pathologists now are integrated into the hospital treatment teams and hold 41 interdisciplinary conferences a month, Schwarting said. "It's really conducive to the new roles of pathologists," he said of the design.

An orthopedic surgeon working on removing a bone tumor, for example, can get an immediate answer from a pathologist to a question on how to proceed in a surgery.

"He essentially comes down while an operation is taking place," Schwarting said. "It's much more interactive than in the past."

The pathologists were the 12-story pavilion's first tenants, and Schwarting said moving in was a "monumental task" but that it was done incrementally and the department never missed a day of operation.

"I came after the design was created, so I cannot take credit," Schwarting said. But he said he would advise other hospitals in a similar position to follow Cooper's design.

"I can only propose to design (a space) where all the functions are integrated into a single spot—what we didn’t want to have is silos," he said. "When they (clinicians) come down, it's one-stop shopping."

Follow Andis Robeznieks on Twitter: @MHARobeznieks.


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