For years, the Department of Veterans Affairs (VA) has assigned star ratings for its medical centers across the country determined by the quality of care and service they provide. Despite years of refusing to share them with the public, the VA began quietly releasing the ratings in December 2016.
The move to transparency followed a USA TODAY investigation that revealed ratings for 146 VA medical centers for the first time. The agency subsequently posted the ratings on its website, allowing members of the public to see how their local VA medical centers have been fairing over the years.
The VA rates centers on a scale of one to five stars, with one being the worst and five being the best, and bases the ratings on dozens of factors, including death and infection rates, instances of avoidable complications and wait times, according to the USA TODAY report. In addition to star comparisons with other VA medical centers, the data also shows whether centers have improved, decreased or remained the same compared to their previous year of performance.
The Veterans Heath Administration is America’s largest integrated health care system, serving 9 million enrolled veterans each year. In Illinois, there are five VA medical centers:
How do our VA’s stack up?
Edward Hines Jr. VA Hospital, for example, was given a star rating of 3 in 2017, which is considered a “trivial change” from 2016. The hospital, located 12 miles west of downtown Chicago, is on a 147-acre campus and offers primary, extended and specialty care and services. While Hines is not considered one of the under-performing medical centers, it has still taken significant steps to improve the overall experience, and presentation, for visiting veterans.
For nearly 10 years, Epstein’s architects, interior designers and engineers have been helping renovate and modernize the hospital’s campus, resulting in the reshaping of their entire image. These projects have included, among others, additions, facility renovations and roof replacements.
Our most ambitious project, however, is the façade replacement of Building 200, which is the main hospital, the heart of the Hines campus. For this project, Epstein is providing architectural and structural engineering services to replace the existing frontage, or face, of the 13-story building.
“Hines was fighting a building that was not helping them at all, and it’s a very valuable asset,” said John Robertson, AIA, Epstein’s Senior Technical Architect.
Epstein was originally tasked with providing Building 200 with a weather tight enclosure. Due to the poor original construction of the building, it was losing a significant amount of energy through the façade. There was no air and water barrier, which controls leakages into and out of structures. Not only was water getting into the building, air would go right through the exterior façade, making it extremely drafty.
“When it was 20 degrees outside, and Hines was trying to keep the building at 68 degrees, they were losing a ton of heat energy,” John said. “Energy efficiency and occupant comfort was not there.”
After initial exploratory work, Epstein discovered that the existing façade of Building 200 had structural problems brewing. As such, we recommended that action be taken immediately to stabilize the façade.
While emergency stabilization was undertaken, Epstein created a design for the hospital that did not take the hospital out of service.
“We worked out a design where we stripped off the outer half of the façade and left the interior partition in place, which meant we weren’t going to disrupt the rooms, clinics or labs on the inside of the building,” John said of the reskinning.
The façade, built in the 1970’s, is being transformed from outdated brick and concrete fins to beautiful glass windows. The key design feature of this project is to afford Hines more flexibility as they continue to remodel the interior departments of Building 200 in the future. Now, the hospital has the ability to open-up the exterior wall by removing demountable shadowbox panels that were installed during renovation. Upon doing so, brand new vision glass, already in place, will be revealed. Hines then has the ability to transform the existing small punched opening windows into ribbon windows, which are a series of openings set side-by-side to form a continuous band horizontally across a façade. The amount of glass in every space can be more than doubled.
This design strategy was important to Epstein, especially after looking at the affect natural light can have on patient recovery. Studies suggest daylight in healthcare buildings can aid in everything from post-operative care to pain relief.
“Going from a small narrow and tall window that is almost prison-like to a whole strip – it makes a huge difference to one’s connection with the outside world,” John said. “It’s a better overall environment for the patients and staff.”
This new glazing includes frits, which was designed to create irregular patterns across the façade when viewed from the outside. The design solution will mask the random openings of these new windows and Building 200’s façade will therefore not look pock-marked, or odd, to Hines’ visitors.
“We came up with a creative solution that responds to the ever-changing nature of the facility – the way they’re constantly renovating and adjusting the uses behind the façade,” John said. “It gives Hines flexibility down the road.”
In fact, the word about our services surrounding Building 200 has been getting out. Epstein has received multiple inquiries from people who are working on projects for the VA in other parts of the country asking about our design and design solution.
Although it was a challenging project with a few curveballs, Epstein is pleased to have the opportunity to positively impact the patient experience for veterans.
“That was the big motivator,” John noted. “The hospital wasn’t consistent with the regard in which veterans should be held. They perform this tremendous service and then they come to a hospital that’s in rough shape. This is an important facility, it should look important, and we’re happy to assist in that.”
The façade replacement is being completed in multiple phases and coordinated with the ongoing operations of the hospital. Scheduled completion is 2020.