It appears that corrugated cardboard has found an unlikely place in health care.

WellSpan Health officials last week announced York Hospital's plans to completely rebuild its emergency department, a $50 million, 46,000-square-foot project.

To better plan out the design, WellSpan rented a warehouse in Manchester Township and hired Consolidated Medical Services, Inc. to build a mockup entirely out of wall-height cardboard.

The mockup -- two-thirds the size of the department -- is a labyrinth of inch-thick cardboard with signs denoting different parts of the future emergency department. And it has been integral in improving the design of the new facility, said James Amsterdam, M.D., chair emeritus of the hospital's Department of Emergency Medicine.

WellSpan constructed a mock Emergency Department of heavy cardboard in a warehouse to simulate scenarios and walk through.
WellSpan constructed a mock Emergency Department of heavy cardboard in a warehouse to simulate scenarios and walk through. (Bil Bowden)

The department: Construction on the new emergency department will begin next summer, and the finished project is expected to open to patients by fall 2017.

The current department cares for about 78,000 patients a year in a facility designed to treat about 50,000. The new department is projected to serve 88,000 patients annually by 2025.

This is the first time WellSpan has done a cardboard design, Amsterdam said, and it got the idea from Akron Children's Hospital. It chose to do the mockup to make the building's design complement its processes, rather than adjusting its operations to fit the facility, he said.

About 300 staff members and patients generated 1,700 comments and suggestions for improving the design, and redesigns of the building were constant, Amsterdam said. Wheelchairs, stretchers and other medical equipment were also brought in to make sure there was enough space to maneuver safely, he said.

"So it was a very dynamic process," he said.

After all, he said, building a facility straight from a blueprint means that issues could go unaddressed until the last minute.

"And then you walk in, and you go, 'Uh-oh,'" he said.

Changes: Designated areas in the new department will treat patients with minor injuries and illnesses, as well as pediatric, cardiovascular, orthopedic and behavioral health patients. The rapid-care section will see about half of the emergency department's patients, Amsterdam said.

An acute-care section will feature "pods" with three resuscitation rooms inside. CAT scans will be located nearby.

A pediatric area for sicker children will feature noise-blocking and line-of-sight adjustments to isolate them from the more frightening aspects of an emergency department, said Dr. David Vega, a department physician.

"This really gives a lot better privacy and also protects children from seeing things you really don't want them to see," he said.

And the behavioral health unit will provide more comfort and dignity to patients who, because of a nationwide shortage of treatment facilities, tend to wait for long periods of time in the current department's hallways, Amsterdam said.

The new unit will feature eight waiting stations with privacy screen, comfy chairs and a couple of spots to lie down.

Perhaps most crucially, pilot programs the hospital is undergoing now are installing new processes, such as a "quicksort" process, in which a nurse designates which unit each patients goes to depending on what level of care they need, he said.

Another pilot results in 30 hours during which no patient who entered the department had to wait to be seen, Amsterdam said, and the hospital has never had a pilot that effective.

"We intend to come in here with all these processes perfected," he said.

-- Reach Mollie Durkin at