Dartmouth-Hitchcock

The 1991 Move to Lebanon

These are common, everyday occurrences at a busy hospital, but on Saturday, October 5, 1991 at Dartmouth-Hitchcock Medical Center, all three events were impressive and memorable – because they occurred in the middle of a massive facilities move. And it wasn’t just any move.

It was the culmination of years of planning that created one of the country’s leading medical centers; a fully integrated hospital, clinic and medical school. Accomplished in phases, the most visible and unforgettable part of the move was completed on M(ove)-Day (10/5/91) when DHMC staff, countless volunteers, Hanover and Lebanon police and firemen, ambulance crews, and professional movers transferred 228 patients from the 100-year-old campus in Hanover, to the new state-of-the-art, million-plus-square-foot complex 10 minutes away in Lebanon.

Planning for the new $200 million medical center building began in the mid-1980s.

“This was a visionary project,” says Gail Dahlstrom, VP of Facilities Management. “The old campus was severely space constrained and there was no way to add on. People saw that a new building offered an opportunity to turn a community hospital into a major medical center. It was a fast-track construction project and really accelerated the development of stronger relationships between the clinic, hospital, and medical school.”

In 1988, planning for the move to the new building began in earnest. Dahlstrom, who was working as an internal consultant, was asked to organize the move in close coordination with Rick Nothnagel, former VP of Facilities Management (now retired), who oversaw construction of the new building.

Together, Dahlstrom and Nothnagel visited other medical centers to learn how they had managed similar moves.

“One medical center had hired over 30 additional staff just to work on the equipment acquisition for their project,” says Dahlstrom. “We left there thinking we couldn’t even afford to move. Another had applied a ‘keep it simple’ strategy and moved for a fraction of the cost. That helped us see that we could do it too.”

Dahlstrom and Nothnage focused a small staff on Activation and commissioned a multi-disciplinary Activation Committee—a group of about 26 staff members representing all DHMC departments—to think through every aspect and detail of the move with their teams.

“We used the word Activation because we quickly realized we were doing more than moving things: we were turning on a new building,” says Dahlstrom.

The group organized their planning and decision-making process around five categories of assumptions; building readiness, furnishings, operating systems, the move, and communications and orientation.

According to Dahlstrom, “The first list of assumptions was maybe three pages long. By the time everyone had thought through problems and detailed plans it was over 30 pages long. It specified exactly what furniture and equipment would be in each room, the exact dates and time of department and patient moves, and how departments would function in their new space. We thought carefully about everything that could go wrong,” adds Dahlstrom. “On M-Day, we had a bulldozer on site in case a tree fell and blocked a road while we were moving.”

M-Day was another organizing principle. To simplify M-Day as much as possible, many people and things moved prior to M-Day, other things and people moved after. For example, “M + 2” were people and things that moved two days after M-Day.

Many things had to happen well before M-Day to ensure its success. “Communications with staff, patients, and the community were critical,” says Dahlstrom. “Hanover asked that we not move on Homecoming or a football weekend when there wouldn’t be adequate police and fire coverage and we warned churches that might be holding weddings on move day.”

While construction was in process, bus tours took interested staff around the site. Every staff member was required to participate in an orientation session that directed them to parking areas, their new workspace, other departments, the cafeteria, and fire exits.

Patients’ families also toured the new building prior to move day. “You can imagine the concerns of parents with a child in critical care,” says Dahlstrom. “We made sure that families of Pediatrics, ICN, and PICU patients had a chance to see the new rooms their loved ones would move to and learn their way to the room and visiting areas. We also told families exactly when their patient would move. On M-Day, we called them when the patient left Hanover, and when they arrived safely in Lebanon.”

Patients were transferred to the new complex in buses, vans, and ambulances. Moving vans were turned into mobile ICUs to transport critical care patients.

“The ICU vans accommodated a patient, a physician, a nurse, a respiratory therapist and all the equipment – oxygen tanks, IV poles, monitors – the patient needed,” says Susan Reeves, RN, DHMC Vice President and Chair of Nursing at Colby-Sawyer College, who oversaw the patient move.

“The move was exciting for staff that was leaving a well-loved, but out-of-date facility, for state-of-the-art accommodations where they could deliver the highest quality of care. It was also exciting for patients,” says Reeves, “because everyone understood that being part of the move was being part of the region’s history.”

“It was hard to say goodbye to the Hanover campus,” says Dahlstrom. “Staff and patients wrote spontaneous and cathartic messages on walls before they left. When people saw the new building though, they were thrilled. The Lebanon building is a deliberate mix of welcoming comfort and high tech design. Patients and their families have more space and the parallel front-of-house/back-of-house areas give them and clinicians the privacy high-quality care requires.”

It’s impossible to quantify the amount of work, cooperation, and collaboration between physicians, nurses, administrators, housekeepers, engineers, movers, town planning boards, police and fire squads, and volunteers that made M-Day a success.

And, by any measure, it was an incredible success.

Twenty-six moving vans hauled equipment, furniture and 40,000 cartons totaling 5 million pounds. Thirteen ambulances and mobile ICUs transferred 228 patients—all in just under nine hours without a hitch.

When the last transport radioed the few staff that remained in Hanover to announce that the 228th patient had made it to Lebanon safe and sound, Reeves recalls, “A cheer went up and we applauded each other. It was an amazing effort and it couldn’t have gone better. We’d made it.”