New Hospital Project Archive

Photo taken by Chris Hapel, Perham


Roofing is nearly complete over therapy, pharmacy, kitchen, clinic, lab, ambulance and emergency.


Interior concrete floors are progressing as expected.


The door frames and windows are in fabrication. 



New Hospital Project





The Perham Hospital District has embarked on its most aggressive building project since the hospital was first established over 100 years ago. Continuing our tradition of medical excellence, the construction of a new hospital and clinic will begin Fall 2009. The new, state-of-the-art facility will provide patients and their families the support and care they need in a comfortable healing environment and help staff focus on what is really important - delivering the care you need.

Why is a new hospital needed?  

The current hospital is 50 years old. It was built for a much different patient population than we see today. For example, in 1959, a new mom stayed in the hospital for more than a week after delivering a baby. Today, it is only one to two days. There was very little technology in patient rooms 50 years ago. Now, our rooms are much too small for all of the technology required to be a state-of-the-art hospital. We still have double rooms and shared bathrooms that are not accepted standards of today's care.

The design of the current hospital creates significant noise and privacy concerns. The layout is very inefficient and sometimes can compromise the care we want to provide. As an example, our patients are concerned when they come to the emergency room and no one is there to meet them because the emergency entrance is not visible from the nurses' station. Along with the need for additional surgery space, the large growth in outpatient services - physical, occupational, and speech therapy, chiropractic, and massage therapy - we are in desperate need of more space for these services. Clinic exam rooms are very small and there is a need for more rooms as a result of all the new physicians we have added.

The most significant issues with the hospital are those that cannot be seen. Most of the plumbing, heating, and other infrastructure is original and needs to be replaced. The air handling does not meet today's building codes for hospitals.

What were the key elements considered in the design of the new building?

There were four overriding goals that went into the design. The first was supporting patient and family- centered care. The second was to make sure the building was designed for future growth. Third was to support the caregivers and provide efficiency. The final goal was sustainability, more commonly know as building “green." Some of these goals are discussed in more detail below.

Did you visit other facilities in preparation for the hospital design?

Yes, we put together a team that included staff, managers, board members, and community members to participate in these tours. We originally identified nine newly built or remodeled facilities to visit. That eventually grew to fifteen facilities across Minnesota, North Dakota, Wisconsin, Iowa, Montana, and Colorado. We gathered lots of helpful ideas and learned from other peoples' mistakes. These tours were extremely helpful to our design process. 

Are you building green? 

Yes, we are trying to follow as many requirements for building green as possible, but have not applied for any formal certification. In addition to energy efficiency, we are trying to bring as much nature into the building through natural light, wood, water, and vegetation. In our research, we learned that many commercial grade building products such as floor covering, wall covering, and other material contain PVC, which emits harmful volatile organic compounds into the air and compromises indoor air quality. We have carefully selected products for our new hospital that are environmentally friendly and will not negatively impact indoor air quality, offering a healthy environment for patients, families, and employees. 

We also spent considerable time researching new technologies such as wind energy, solar hot water, and geo-thermal heating. Unfortunately, these are very expensive and all of the incentives available today involve tax credits. We were disappointed to learn that there are currently no incentives geared for non-profit organizations such as ours. Therefore, there was no justifiable payback in implementing these great new technologies.  

What do you mean when you say the building is designed to support Patient and Family-Centered Care?

First, let’s explain what patient and family-centered care is. Staff-centered care is when you design all of your care delivery, policies, and procedures for the ease of the providers, such as physicians, nurses, and therapists. Patient-focused care is when you develop all of your care delivery, policies, and procedures truly keeping the best interests and desires of the patients in mind. Most hospitals in America today have transitioned from staff-centered care to patient-focused care. Patient-centered care is when you include patients as part of the care team at the time of delivery and include them on your teams as you develop policies and procedures. They direct their own care and are an equal member of the team. Patient and family-centered care takes this one step further by including families as an equal part of the care team, and they are included in the development of design, policies, and procedures from the very beginning. Very few hospitals today have made this leap.

Most of our efforts to date have been around changing our operations, such as nurses giving report about a patient’s condition at the bedside and including the patient and family in this discussion. In a patient-focused model, they would truly consider all the best interests of the patient, but the discussion would be held at the nurses' station or a conference room with only caregivers present.

In designing our building, we included patients and families in the design and asked what kinds of things would help support this model of care. We added a number of things such as family rooms, private consultation rooms, a family resource center, a family kitchen, a meditation chapel, and outdoor garden areas close to the patient unit. We expanded the size of the patient rooms to have a dedicated space for families that includes a fold out couch, recliner, and space for families to keep their personal items. We have incorporated some unique art features and design elements into the building to help families get a mental break from the anxiety of caring for a family member. As each and every space was planned and designed, we asked patients and families how things would work for them and what they felt was important.

Why can't the new hospital be built on the same site as the current one?

To fit on our existing campus, it would require the purchase and removal of six to eight neighboring houses and the closing of a street. At that point, any future expansion would require the purchase of more houses in our neighborhood. We believe being land-locked to that degree would not be beneficial for the future of healthcare in our community.

Why don't you add on and remodel the existing building?

The mechanical issues are so significant it would take millions of dollars to bring the current building to code. Because of this, there is only a 10 percent cost difference between building all new and adding on to our existing facility.

Phasing of a remodeling project would be nearly impossible with the layout of our current building and the mechanical issues mentioned earlier. All departments need to be fully operational and capable of caring for people every day. Finally, an addition/remodel would take three years to complete versus a year and a half for a new facility. We worry greatly whether all our patients would stay with us for that length of time.

Is the hospital built to accommodate future growth?

Yes. Every department is built to accomodate a minimum of 25 percent growth in volume. Many departments can go much higher. The building is designed such that every department can be added on to, if needed. Some non-patient care departments have also been designed that they can move entirely and make way for new patient care departments that don’t exist today. For example, we currently have eight physicians in the MeritCare clinic. The new building is designed for 12 and there is a plan in place to increase this to 20 when needed in the future.

Will there be any new services added in the new hospital?

We are adding new services all the time. For example, just this past year we have added cardiology, podiatry, and oncology to our list of specialty providers. However, we are very limited on space so we have had to restrict growth of additional new services. The new building allows us much more opportunity for growth. For example, we currently have MRI services available only one day a week through a mobile truck that comes to our community. In the new hospital, we are able to have MRI in-house available to our patients every day of the week. 

Will you have an Intensive Care Unit?

No, our current plan is not to add this service. However, we don't know what the future will hold. Therefore, we put our sleep studies lab in the center of the patient care area, so it could be converted to an ICU in the future, if that ever becomes part of our plan.  &nbs