When our new children’s hospital opens, families and visitors won’t share elevators with food carts. Care team members will not share an elevator with other visitors when transporting patients. That’s because our new hospital features two types of spaces: onstage and offstage. Onstage refers to spaces used by the public. Offstage areas are behind-the-scenes spaces limited to use by employees or patients/families escorted by an employee.

On most floors, onstage areas are located along the outer ring of our oval building. These include public elevators, lounges, main hallways, and patient rooms. In the center, or inner core, are spaces designed for employee functions. These include offices, break rooms, and patient and service elevators. The concept of onstage and offstage is based on a model Disney developed for its theme parks. Leading hospitals have adopted this model to increase efficiencies and offer a better healing environment. This concept also guided the design of University of Iowa Health Care—Iowa River Landing, which opened in October 2012.

The onstage/offstage model offers many advantages.

Better patient privacy: Care teams will use offstage patient elevators for moving patients. This will allow patients to be transported between floors efficiently while enhancing their privacy. Also, delivery of supplies and materials will take place using offstage service elevators. As a result, fewer people will walk past patient rooms, enhancing privacy.

Quieter environment: Delivery of medicine, supplies, and equipment will be done mainly offstage. Trash, soiled linen, recycling, and food trays will be stored offstage. Employees will use service elevators to move these items between floors. Fewer rolling carts in hallways means a lower noise level. Care team members will hold huddles offstage, not in hallways outside patient rooms. The pneumatic tube system also will be behind the scenes. Patients will rest more easily since they will be less likely to hear doors to supply rooms or lounges opening and closing.

Better infection control: Offstage elevators will limit patients’ exposure to potential infection risks. How? Patients won’t be exposed as often to members of the public. Patients and families won’t share elevators with trash or soiled linen carts, either. This separation decreases the risk of potential infection.

More open hallways: Offstage storage will cut down on items in hallways. Clearer hallways will offer a more home-like feel. Hallways with fewer carts will be easier for parents and families to navigate.

Faster food deliveries: Service elevators in our new hospital will allow staff to deliver food more quickly. Speedier delivery means food should arrive at its desired temperature. That’s a recipe for happier patients and families.

Reduction in food aromas: The smell of food can make some patients nauseated. Young children who see a food cart may not understand why they aren’t allowed to eat before a procedure. Service elevators will help limit exposure to these sights and smells.  

Less crowded public elevators: Offstage service elevators will help free up space in elevators used by the public. Offstage patient elevators will also reduce traffic in public elevators.

Increased efficiency: Offstage hallways and elevators will help employees get from place to place more quickly. Many work areas for the care team are offstage, too, further boosting productivity.

Better collaboration: Talking and relaxing behind the scenes can facilitate communication among coworkers. Spaces designed for all care team members to gather on a floor should make working together even more enjoyable.