Celebration Health: Nothing Mickey Mouse about this new paradigm

Walt Disney town uses best practices to design innovative facility

In the new town of Celebration, FL, Walt Disney’s imagination becomes real life. Here, not far from Cinderella’s castle, neat homes with white picket fences and large front porches perch along winding narrow streets, and a brick-paved downtown sports lakefront restaurants and shops. It’s Disney’s vision of the perfect town: the best ideas of the past mingling with the best ideas of the future.

And, taking the same approach, Disney came up with a completely new kind of hospital: Celebration Health, which opened in July. The core of the hospital’s mission is to empower individuals, from Celebration residents to Orlando-area tourists, to take charge of their own physical, emotional, and spiritual well-being.

"We knew from the beginning that we were looking at a completely new paradigm," says Des Cummings, CEO of the development division of Florida Hospital, which includes Celebration Health in its six-campus system. "In the first half of the 20th century, we faced diseases [such as] polio, over which we had little control, but in the last half of the century, we’re facing diseases that we bring on ourselves.

"To gain the best outcomes, we have to engage patients in caring for themselves. The chronic diseases are really the threat of the future. In the old model, we just had to partner with the providers who did everything to the patient. But if you want to change lifestyles, you have to engage people to manage their own conditions."

Determining future health needs

Along with staff from Florida Hospital, the Celebration planners began meeting with the International Health Futures Network, led by Clem Bezold, president of the Alexandria, VA-based Institute for Alternative Futures; Leland Kaiser, president of Brighton, CO-based Kaiser and Associates; Kenneth Pelletier, clinical associate professor of medicine at the Stanford University School of Medicine in Palo Alto, CA; and Kathryn Johnson, president/CEO of The Healthcare Forum in San Francisco. The group worked to define what health would mean in the future and how it could be fostered within a community. And they brought the best of the best from other health care facilities into the plan, Cummings explains.

Since Florida Hospital was already sold on the benefits of benchmarking both inside and outside the industry, the search for best practices was a natural part of the development process, Cummings says. "Benchmarking has to be a mindset that you take to everything you do if you want to see real improvement," he says. "Instead of having our people groan when we say we’re going to do benchmarking, they naturally integrate it as part of the planning process. You have to develop that culture. The next step for the health care industry is to do some serious benchmarking outside the industry."

To that end, Celebration planners worked closely with the Disney "imagineers" to learn what pieces of the Disney approach would work in health care. From Disney, they got the idea to build their philosophy into a facility through innovative architecture. The campus is designed to look like a 1930s Mediterranean resort, featuring a sunlit atrium, art-lined walls, and oversized windows and balconies for fresh-air access. Perhaps even more noticeable is what the hospital lacks: a maze of corridors and that hospital smell. From Disney came the idea of "front stage" and "back stage," in which the unappealing aspects of the hospital business are relegated to back corridors.

"It doesn’t smell like a hospital, and it feels like a hotel," says David Dore, MD, an orthopedic surgeon at Celebration Health. "You don’t see doctors in white coats, lab techs, or even the mailman walking around on the front stage corridors. If I’m wearing my white coat, I always use the back stairs. Those kinds of things make people nervous, and we’re trying to promote an atmosphere of health. Going to the hospital is bad enough."

The other idea from Disney is the emphasis on customer service. A concierge in the main lobby greets patients — called "guests," also in the Disney mode — taking basic information such as insurance from them if it’s a first visit, alerting the appropriate office of their arrival, and giving directions. Patients are given pagers if a wait is required, as are family members awaiting the outcome of a surgery.

"People who are fairly healthy and are just coming to see the doctor don’t feel like they’re in the hospital, and those who are inpatients have privacy by keeping things separated," Cummings says. "We learned from Disney that the first thing you create is an internal expectation of what the experience is going to be like through the architecture. In most hospitals, you think I must be pretty sick if I’m here.’ All the messages tell you you’re sick, and many times those are architectural messages."

But even if the patient is sick enough to be admitted, the positive atmosphere continues. Each of the hospital’s 60 beds is in a private, universal care delivery room. That means the patient stays in the same room the whole time, even if he or she requires intensive care. All the nurses are intensive care unit-trained, and the staff rotate according to the patient’s needs. The rooms accommodate any type of equipment needed, all behind a panel that can be closed for a more pleasing atmosphere. There is no overhead paging to disturb patients, and rooms feature a family area with a sleeper sofa.

"Besides being much easier on the patients, the universal care model is easier on the staff as well," says Kathleen Mitchell, director of acute care and lifestyle enhancement. "The same staff serve the patients the whole time, and physician rounding is more efficient because the patients don’t move. There’s less room for error, less potential for nosocomial infections, and less work for environmental services since they’re not doing as many terminal cleanings."

The setup also helps with staffing requirements, since nurses are rotated based on patient needs. Since all the nurses can handle any type of patient, there’s not much downtime. Also, a priority admissions nurse handles all admissions, doing paperwork, orienting patients and families to the unit, and dispensing initial medications. That takes some of the burden off the patient care nurses, Mitchell says.

Cummings says the hospital’s innovations should be good for patient outcomes as well as the bottom line. It’s too early for much hard data, but he says the hospital is already ahead of the targeted four-year plan to break even.

"Our philosophy is to become a health resource for all of a person’s life," Cummings says. "The difference between this hospital and any other hospital is when you drive by another hospital you look at it and say I hope I never have to go there.’ When you drive by Celebration you say, I’m glad it’s there, and why don’t we go there tonight. We can eat dinner there and work out in the club.’ It suddenly becomes a health resource instead of just a place for sick people."

Editor’s note: Celebration Health has had so many benchmarking requests that they’ve developed a two-day seminar that will be offered four to six times a year. For more information, call (407) 303-4461.