Rebuilding Joplin

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R E B U I L D I N G

The story o Mercy in Joplin


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2012 Mercy. All rights reserved.


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Table o Contents

Preace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Five hospitals, continuous care . . . . . . . . . . . . . . . . . . . . . . 7

A closer look | Demolition sets stage or rebirth . . . . . . 17

Why rebuild? Its the Mercy way . . . . . . . . . . . . . . . . . . . 21

A closer look | The recovery takes root . . . . . . . . . . . . . 30

New hospital leads the way . . . . . . . . . . . . . . . . . . . . . . . .34

A closer look | Mercy mission: Beyond a hospital . . . . 44

About this series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47


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16613611186 200+Winds in mph

EF4EF3EF0 EF2EF1 EF5

TORNADO STRENGTH

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P AT H

O F T O R N A D O

Sunday, May 22, 2011, at 5:41 p.m.

A direct hit

A twister strengthens into an EF5 just as it tears into

St. Johns Regional Medical Center. At the hospital, 117 co-workers

rescue 183 patients. Five patients and one visitor die.

The storm kills 161 people and destroys 8,000 structures, including 7,000 homes.

7144

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The deadliest U.S. tornado in modern times descended on

Joplin, Mo., in May 2011. Winds churning at 200 mph leveled

nearly every home, school and business in a path six miles

long and nearly a mile wide.

Amid the destruction stood the ruins o St. Johns Regional

Medical Center, a part o Mercy since 2009 and whose nine stories

o shattered windows and crumpled metal became an iconic

image o the broken city. For 90 minutes, Mercy co-workers and

volunteers evacuated 183 patients rom their rooms, carrying them

down dark, debris-strewn stairs to saety.

The people o Joplin have ought to recover and rebuild their

Midwestern homeland. In their progress emerge tales o inspiration

and hope. The Mercy hospital is one, a story that reaches acrossmedicine, aith and community.

Just days ater the storm, Mercy leaders heartened the battered

community with a promise to build a new hospital, now expected

to open in 2015. A week ater the storm, the ministry established

a tent hospital, months later replaced it with temporary structures,

and the ollowing spring built a ull-service hospital in record time

with groundbreaking component technology.Now called Mercy Hospital Joplin, the lie-saving organization

will have occupied ve structures in less than our years. The

ministry will have invested nearly $1 billion in Joplin buildings, and

in its people by continuing to pay 2,200 Mercy employees. Mercy

moved decisively because it is committed to the community and to

the legacy o the Sisters o Mercy, whose care or those in need led

to Joplins rst hospital in 1896.

This is the story o Mercys rebuilding in Joplin.

Preace


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Five hospitals,

continuous care

Even as their sta cared or patients and co-workers in the

tornados atermath, Mercy leaders wondered what to

do with their wrecked hospital and how to provide the

quality care or which St. Johns Regional Medical Center was

known.

Within days, Mercy announced it would build a new

hospital. But that would take years. The ministry needed toprovide or patients, co-workers and the region until then.

What it did would not only dier rom anything Mercy had

ever done. It would dier rom what anybody had ever done.

Let: The tent hospital was a network o arched,

white canvas tunnels with rooms divided by curtains.


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2011 2012 2013

MercyDiscoveryCenter(day care)

Temporarydoctors offices

Main

hospital

Medicaloffices

BradyRehabCenter

O R I G I N A L

C A M P U S

The five

hospitals

1

1

Hospital

complex

Main building

and nearby

clinics and

offices are

destroyed.

Mc

CLELLANDBLVD

.

ST.J

OHN

SBLVD

.

Destroyed

by tornado

Modular buildings

By fall, portable buildings replace

the tents on the same lot.

3Tent hospital2

Within a week,

a military field

hospital is up and

running a block

away.

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N.

S

P ATH O

F T O R N A DOOriginal

hospital

Futurehospital

4

71

Joplin

5

2014 2015

2 3&

Tents andmodularbuildings

Mercy Village(retirement community)

MercyHospitalJoplin

Mercy Hospital Joplin Future Mercy Hospital Joplin

T E M P O R A R Y

C A M P U S

Eleven months after the storm, the

hospital reopens in a structure built

with ground-breaking technology.

A new hospital is scheduled to

open three miles from the

original site.

28THSTREET

4 5

4

Imaging

Lab

Emergency ICU

Cafe

Pharm.

Operatingrooms/cath labs

Patient wings(2 stories)

Entrance

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Original building

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Im fne here

First came a military tent, which was renamed St. Johns Mercy

and which the co-workers later took to calling Mercy M*A*S*H.The oer or an 8,000-square-oot eld hospital came rom nearby

Branson, where a state disaster team had erected the 60-bed tent

in an earthquake drill.

The tent raised concerns or Lynn Britton, Mercys president

and chie executive ocer, who had arrived on the scene the day

ater the tornado. But he realized that Mercy had ew options.

Sure, lets go take a look, he said, and drove the 90 minutes to

Branson with Mike McCurry, Mercys chie operating ocer, and

Dottie Bringle, chie nurse at the Joplin hospital.

As they stood looking at the tent, McCurry turned to Bringle.

So? he asked. You think you can turn this into a hospital?

Bringle didnt hesitate: You betcha.

The return drive allowed time to sketch out a rough design, led

in good part by Dr. Bob Dodson, the hospitals chie o sta. By

1 a.m. on Thursday, only days ater the storm, the tent stood in the

parking lot across the street rom the emptied hospital, erected by

the National Guard and Missouris Disaster Medical

Assistance Team. Ten arched sections comprised the

tent hospital, with a common area linking them.

Mercy had to gure out the electrical service,

plumbing and where new equipment would come

rom to ulll Dodsons plan. Co-workers arrived to

help with setting up, using local contractors when

they could. Mercy structural engineers rom St. Louis

and elsewhere joined the eort.

Besides the much-needed beds, the tent included a small

emergency department, a pharmacy and mobile surgical units.

More sophisticated departments, such as obstetrics and heart

surgery, would have to wait. We were designing on the fy, saysJohn Farnen, a Mercy leader who helped oversee construction.


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Tents

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Much o the equipment came rom Mercys other

hospitals. I we had been a standalone hospital, we

would have had nothing, says Shelly Hunter, the

hospitals chie nancial ocer. Communications

remained spotty, with cell phones working

sporadically. Finding a colleague to talk ace-to-ace

was oten the only choice.

On Saturday, the re marshal gave his OK, and the

hospital opened at 7 a.m. that Sunday, with Mercys

electronic health records helping ensure seamless patient care. The

rst patient arrived at 7:03, less than a week ater the tornado struck.

We worked like crazy to get that up, Bringle recalls. We were

exhausted; we were running on adrenalin. Everybody elt a major

sense o accomplishment.

Mercy co-workers prepare or

the opening o the tent hospital.

Aaron DuRall - DuRall Photography


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Even as they readied the tents, Mercys planners considered

how they could house doctors oces. They set up modular

clinics in nearby portable buildings. The hospitals lab went intoa Winnebago trailer. As temperatures outside approached 100

degrees, the sta worked uriously to keep it cool enough inside to

protect sophisticated equipment. Mercy, meanwhile, bought a drug

treatment center in Joplin and eventually converted it to a 30-bed

acility or behavioral health patients.

The tent hospital presented a marketing challenge, to say the

least. It was dicult to get people to understand they could even

go and get care there, says Dick Weber, a Joplin businessman who

serves on the local Mercy board.

Some patients didnt need convincing. They had been treated

at St. Johns their whole lives and didnt want to go anywhere else.

One was the mother o Rob OBrian, president o the Joplin Area

Chamber o Commerce. In her 80s, she insisted on going to the tent

hospital ater suering a racture in a all. She would stay a week,

with summer temperatures rising and the roar o air conditioningunits outside her room. At one point, nurses asked i she would be

more comortable elsewhere.

Im ne here, she told them. This is the place I go to and Im

perectly ne here. OBrian says his mothers care didnt suer

under the conditions. The level o care provided even in those

dicult circumstances it was the same.

Moving to The Ritz-Carlton

Mercy knew that as winter came, patients would need

something warmer.

By now, Dr. Glenn Mitchell had stepped orward. A career Army

medical administrator, Mitchell brought invaluable experience in

quickly deploying mobile hospitals, including ater disasters such

as 1998s Hurricane Mitch in Central America. He helped lead

Mercy executives to a Michigan company that made modularbuildings o Styrooam compressed between sheets o metal. While


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Inside the portables

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the company had never built a ull hospital, its

portables slowly replaced the tents throughout the

summer and early all.

Primitive by conventional standards, the

hospital seemed a big leap or Mercys co-workers.

It elt like we were at the Ritz Carlton, says Missy

James, a nurse manager.

In early November, when it was nished,

one co-worker asked Sister Cabrini Koelsch, the hospitals

ministry liaison, to bless the new structure. When the Sister

arrived, the worker showed o a new eature or which she

was especially grateul. Sister, weve got fushies! she said,

reerring to the ull toilets that replaced portable versions that

accompanied the tent.

While still temporary, the hospital

comprised o portables was quieter

and less crowded than the tents.


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Module en route

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An eight-month miracle

As contractors installed the portables, Mercy planners thought

ahead, pushed again by the weather. The portables would suceor winter, but nobody wanted patients in trailers when spring

storms returned. Engineers considered alternatives, and Mercy

solicited bids rom several companies, choosing a Caliornia rm

with a actory that builds component structures.

As Mercy readied the site, the contractor began abricating

224 modules o the same steel, concrete and drywall ound in

conventional construction. Essentially large slices o

a building, modules reached 14-eet wide and high,

and up to 60-eet long. Shipping them cross-country

raised tough challenges, with a ew units traveling

by train and most on trucks cautiously navigating

roads that suddenly elt narrow. Some modules

arrived more than 80 percent complete, as local

workers waited to join them together and stitch in the

necessary plumbing and wiring.Early on, Mercy leaders considered the component hospital

a temporary structure. But as it took shape, interior and exterior

touches smoothed the slices into a hospital that looks no dierent

rom any other. A consensus emerged that the sturdy and good-

looking acility should be called nothing other than Mercy Hospital

Joplin, with its 150,000 square eet o space, a ull-size emergency

department and room or 100 overnight patients. Instead o


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New interior

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something temporary, the structure may have a long-term role at

the site, says Britton, Mercy CEO. Its a building that could serve

Joplin or decades to come.

The largest acute care acility built with modular construction,

the Mercy hospital is twice as large as any the Caliornia

contractor had abricated beore. Mercy brought in its own

roong consultants and other quality control specialists to ensure

it would meet the ministrys standards. Room also had to be

made in the actory or state and local inspectors who wanted to

see the modules assembled. Hundreds o workers

labored tirelessly, many pulling double shits to getthe hospital in place. At one point, 150 electricians

scrambled past each other as they pulled wire

through the state-o-the-art acility.

You go until you get done, says Andy Bowers,

o Neosho, Mo., one o 300 local workers hired or

the project. He recalls that one day ater it rained,

workers tracked red clay down the hallways whileothers ollowed, cleaning up behind them. People are

everywhere, Bowers said during the nal rush to nish.

No one welcomed the component hospital more than the

medical personnel who had practiced in tents and trailers. Its

a wonderul thing, says Dr. Charles Ro,

a surgeon who moved to Joplin two

years ago. He notes that

Mercy Hospital Joplin came

together quickly using

pre-abricated components

transported by tractor trailer.


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Future hospital

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the hospital allows or sophisticated procedures, including a

resumption o open-heart surgeries. It also brings back a Mercy

obstetrics unit that reassembles co-workers scattered acrossJoplin and elsewhere, says Kathy Cowley, a nurse who manages

the unit. And we get to start delivering babies again.

Along with its new challenges or his company, the project

has brought an added level o satisaction, says ounder Charlie

Walden o the Caliornia contractor, Walden Structures. Hes

sensed what he called a devotion o Mercy co-workers and their

commitment to Joplin. Theres a eeling youre adding back to the

community.

Mercy opened the new hospital to tours in early April and to

patients by the middle o the month. To get all that done in eight

months is remarkable, Farnen says.

The eort by Mercy co-workers and contractors was nothing

less than a marvel, aided by good weather and what hospital

President Gary Pulsipher calls the Mercy Machine rom across

the region. We wouldnt have been able to do any o this without

the help o the rest o Mercy. Everyone at Mercy stood up in a way

that surprised us.

The uture

Mercys next and greatest challenge is already

underway: Building another hospital big enough

to ully replace St. Johns. Mercy broke ground inJanuary 2012, just as its leaders had promised

in those dark days ater the tornado. It will carry

orward the new name, Mercy Hospital Joplin.

At the groundbreaking, dozens o Mercy

co-workers and their amilies showed up with

shovels. They hugged as they celebrated the beginning o a new

hospital and their accomplishments o the previous months. And

or Farnen, it marked the end o juggling multiple, consuming

projects needed to restore Mercy to Joplin. Building just one

hospital itll eel like a break.


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Demolition setsstage or rebirth

It took minutes or a tornado to knock St. Johns hospital out

o commission. It will take a year to demolish whats let and

remove the rubble.

Mercy co-workers and contractors are taking care to prepare

the roughly 50-acre site in the heart o Joplin or a rebirth that will

leave the community even stronger.

The winds that tore through the campus blew out windows

and tossed equipment blocks away. Some paper records landed

near Springeld, Mo., 75 miles to the northeast. Structurally, the

750,000-square-oot building held up better than could have

been expected. But everything inside was wiped out walls,

windows, stairwells. There would be no keeping out moisture,

and with it, mold. Mercy leaders quickly determined the damage

made it too costly to gut and retrot the building. They would

instead build a new hospital at the citys southern edge.

A CLOSER LOOK


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Meanwhile, Mercy wanted to erase the visible signs o the

tornados devastation rom the landscape and prepare the site or a

brighter uture, says Gary Pulsipher, president o the Joplin hospital.That revival began at the south end o the property, where several

medical buildings stood near the main hospital. Workers began the

demolition there to make room or a new elementary school. Mercy

is donating 12 acres to help Joplin replace classrooms wrecked

by the storm. Other parts o the site might become a theater, a

small woods and memorial gardens to lives lost in the tornado.

Community members, starting with a open meeting that evolved

into an advisory board, are working with Mercy leaders to ensurethe results will respect and honor the sites role in Joplins history o

growth and resilience.

The campus literally stands atop a part o that history a

matrix o underground lead mines. The Joplin area was known as

the lead mining capital o the world beginning in the 1830s. In more

recent times, the mines were lled in to make way or commercial

growth, which included construction o the medical center in 1968.Under normal circumstances, demolition experts would implode

the main hospital. Because o the mines, experts eared explosive

charges might generate uplit pressure that could damage

neighboring properties. So contractors turned to a traditional

wrecking ball and specialized grappling equipment to nish o the

building. Mercy held a ceremony o remembrance and appreciation

in January 2012, with a bagpiper playing Amazing Grace as a crane

took its rst swings with the ball.

That it took seven months to get to that point would come as

no surprise. In its own way, untangling a destroyed hospital is as

delicate as the microsurgery once conducted there.

When Mercy co-workers returned to the scene ater the

tornado, they donned respirators, hazardous materials suits and

boots. For nearly two months, workers sited through materials

ound in the ruins, including oce urniture, medical equipment,

medications, computers and nancial records. At one point, small

rerigerators that had held medicines lined up shoulder-to-shoulder

in the parking lot awaiting disposal. Fortunately, patient les stayed


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Cross-town journey: A Missouri State Highway Patrol truck carries a

wooden cross rom the debris-strewn emergency department (let) to the

groundbreaking (top right).

sae in powerul computers in Washington, Mo., the heart o Mercys

electronic health records.

Workers inventoried the material, much o which rests in a

warehouse in Springeld. Amid the fotsam are Bibles, artwork and

other decorations. Workers also ound three time capsules one

rom when the hospital was built, another when the east tower opened

in the 1980s and one marking St. Johns 100th anniversary in 1996.

During the demolition ceremony, workers loaded a 4-oot-tall

cross rom the emergency department onto a truck and carried it

to another ceremony marking the start o work on a new hospital.Mercy will nd a permanent and prominent spot or the icon, says

Terry Wachter, hospital vice president or mission.

The cross certainly has scars on it, she says. They just add character.

Courtesy: Eric Rudd


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Why rebuild?Its the Mercy way

Minutes ater learning a tornado had pummeled Mercys

hospital in Joplin, Mike McCurry heard comorting

words rom his boss and the head o the company,

CEO Lynn Britton:

Mike, dont worry, were going to rebuild.

It was a gut response, and or a steward o Mercys mission,

a happy moment or the company and its ministry. Its very

arming, Sister Mary Roch Rocklage, ormer CEO, says o how

Mercys current leadership responded. Somehow, they have the

same calling an attraction to serving in a certain way.


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The impulse to stick with Joplin in its hour o need was a no-

brainer, she says, or anyone steeped in the values and traditions

o Mercy. Still, Sr. Rochs smile grows wider as she talks abouthow the decision was made not by the Sisters o Mercy

who ran the health ministry or more than 135 years, but by the

co-workers who assumed responsibility more than a decade ago.

Its also no accident. When the Sisters o Mercy gave up

the day-to-day management o their hospitals and clinics, they

worked to preserve the values that drove them in their health

care mission. They maintain infuence at the highest levels,

including on Mercys board o directors, though members o the

religious order are a minority. Its the board that chooses Mercys

top executives. Were very selective about who we hire,

Sr. Roch says.

The Sister continues in an ocial capacity as health ministry

liaison or Mercy, which now has more than 30 hospitals,

revenue o more than $4 billion and 38,000 employees in more

than 100 communities. As with other Sisters, her job essentiallyis to preserve within the organization the values and the tradition

o the Sisters o Mercy. And a long tradition it is.

The religious community that gave rise to St. Louis-based

Mercy began with six nuns who arrived in 1856 rom New York

by train and boat. Their Catholic order originated in Ireland,

ounded in 1831 by Catherine McAuley, an orphan adopted into

a wealthy Quaker home. She inherited a ortune. Near a wealthypart o Dublin, she opened the rst House o Mercy that was

dedicated to providing education and social services to the poor,

with a particular emphasis on women

and children.

Church leaders agreed to a non-cloistered institute that

allowed McAuley and her co-workers to become an unusual

religious order, one that provided aid outside a convent. The odd

sight o religious Sisters bustling about Dublins streets earned

them the nickname, the walking nuns. The orders bias or


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Now health

ministry liaison,

Sr. Roch was

Mercys frstCEO in 1986.


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action helped attract hundreds o women to join and remained

a central tenet through the decades.

The six nuns came to St. Louis to start a Catholic school. Theysoon saw a need or health care and by 1871 had opened their rst

hospital in St. Louis, which later became St. Johns Hospital, named

or St. John o God, who had served the sick and poor in Portugal.

Now known as Mercy Hospital St. Louis, the center is Mercys

largest institution with nearly 1,000 beds. Another Mercy hospital

in Springeld, Mo., has about 850 beds, and the Mercy hospital in

Oklahoma City, Okla., nearly 400 beds.

Most o Mercys hospitals landed in much smaller towns as

the Sisters sought those with the greatest needs. Even Springeld

was just a dusty country town when the Sisters o Mercy arrived in

1891 to start what became another St. Johns hospital. Most o the

In the beginning:

The late-1800s groundbreaking

or Joplins frst Mercy hospital.


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towns that drew the Sisters have remained relatively small. Mercy

primarily operates across our states Missouri, Oklahoma,

Kansas and Arkansas with nearly 30 smaller hospitals in towns

like Lebanon, Mo., and its 60 beds; Independence, Kan., also with

about 60 beds; Berryville, Ark., with 25 beds; and Healdton, Okla.,with about 22 beds.

Joplin sits near the geographic center o Mercys territory,

serving as a commercial and health care hub at the border o

Mercys our states. Joplin has only 50,000 residents, but the city

swells every day to several times that size with those working,

shopping, or seeking medical care.

Like many o the Mercy hospitals, Joplin has a Sister o Mercywho ocuses on the ministrys commitment to serving the poor.

We want to pass on the heritage o Mercy that we dont turn

Tough stu, even today:

Pictures o early Sisters o Mercy

survived the tornado.


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M I S S O U R

K A N S A S

A R K A N S A

O K L A H O M A

44

4

Joplin

uisS . L

klahomaCity

= Mercy locations

The I-44 corridor

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In the process, the Sisters sought to preserve the unique

personality o their order in the work o Mercy. They identied the

values that guided their work dignity, justice, service, excellence

and stewardship. They also gave voice to the orders charism, a

Greek word meaning the graces given to individuals or the good

o others bias or action, entrepreneurial, hospitality, right

relationships and ullness or lie.

Its bias or action, in particular, seems to distinguish the order.

As one priest liked to tell Sr. Roch, he could spot Sisters o Mercybecause as they shook his hand, theyd be xing his hangnail.

A year and a hal ater Mercy came to Joplin, the tornado hit.


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Despite his impulse to rebuild in Joplin, CEO Britton concedes

he wasnt sure how Mercy would aord it. Nobody understood the

ull extent o the damage in those early hours, much less what kindo insurance was available to restore buildings and services. I had

lots o people throwing all kinds o numbers at me about what that

decision was going to cost, Britton says.

McCurry, or one, says he assumed the Joplin hospital had

minimal insurance, which tended to be the Mercy way a

ministry that typically tries to cover its own losses. He also

assumed the hospital had no business continuation insurance

that would help pay salaries o employees while Mercy rebuilt.

But the executives plowed ahead, rming up within the rst

48 hours their commitment to rebuild and to keep all 2,200

Joplin employees on the payroll. We knew we were going to do

it, so why wait to reveal it? Britton says, adding that he hoped

Mercys early announcement might help spur others to step

orward with pledges to help Joplin rebuild.

Deciding to stay in Joplin meant Mercy also had to preserve its

sta, so keeping them on the payroll made business sense. It also

elt true to Mercys mission. There wasnt much brilliance to what

we were doing, McCurry says. It just elt right.

Looking back, he says, it now eels like the most brilliant thing

theyve ever done. It helps that, later that week, Mercy learned it

in act had pretty good insurance on the Joplin hospital, including

some coverage or worker wages. Altogether, Mercy might recoverabout $700 million in insurance payments. That still leaves a hole

o $200 million to $300 million, which McCurry says hurts but

isnt crippling.

Joplin will leap rom a building that was outdated as a medical

center to one that is custom-designed or modern health care, says

Gary Pulsipher, the hospitals president. And the city will have a

striking landmark that should help ease the memory o a ruinedSt. Johns. The new Mercy Hospital Joplin will occupy a beautiul

building on a hill overlooking the regions busiest highway. I love


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the act its on the interstate, Pulsipher says. People wont have

to wonder how they get to the hospital.

He and others agree that another company might have takenthe insurance money and invested it in a major metropolitan

area, leaving behind the less-lucrative market o Joplin. Mercy

wont get back that $700 million in prots rom Joplin, at least

not in the lietimes o its current executives. Then again, says

McCurry, we werent thinking like businessmen.

Pulsipher speaks outside

the ruined hospital less than

three days ater the tornado.


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No one at Mercy had experienced a disaster like the one that

struck St. Johns hospital in Joplin. But everyone thought o theexperiences o others in recovering rom tragedy. Mercy CEO Lynn

Britton remembered Oklahoma City and how citizens created a

memorial that was positive and looked ahead. Others remembered

Hurricane Katrina or other tornados where residents pulled together

to rebuild and restore their communities.

A dierent kind o story came to mind or Terry Bader, who helps

oversee Mercy design and construction. It was 70 miles south o

Joplin where something positive was underway the construction

o a new hospital in Rogers, Ark., that opened in 2008. Mercy was

clearing the site near an interstate highway to replace Mercys aging

hospital in town. In the way stood a stately persimmon tree.

We knew we had to take it down, Bader says. But instead o

turning the tree into mulch, we had a local guy make pen and pencil

sets out o the persimmon wood. We gave those sets to all the leaders

in the community so they could have a part o the sites history.

Now Mercy has cleared more than 100 acres on the south side

o Joplin or a new hospital. A small woods covered part o the site,

including oak, sassaras, dogwood, redbud and hickory trees. Taking

them down was painul ater the tornado took out thousands o trees

across Joplin just months earlier.

Planners kicked around what they could do to ease the pain,

looking or something that would also t our lean-and-greenapproach to things, Bader says. Along came Joplin resident

The recoverytakes root

A CLOSER LOOK


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Workers identifed saplings that were

most likely to survive transplanting.


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Marcia Long, who suggested at a Mercy community roundtable

that saplings rom the site be saved and replanted when

construction is done in 2015.Jumping on the idea, Mercy and its landscape architects at

SWT Design quickly hired a nursery to save about 470 saplings

rom the construction site and move them to a nearby tree arm.

The arm will nurture the trees or the next three years. When we

get them back, they will be nice and healthy, Bader says. Theyll

join another 1,000 trees along with grasses and wildfowers that

will make the property more abundant than beore construction.

Much o the lumber rom the elled trees will help rebuild

Joplin, going to other construction projects around the recovering

city. Cratsmen will carve some into Mercy crosses.

Saving the saplings is just one way that Mercy is trying to

preserve and restore what its co-workers and the wider Joplin

community hold sacred.

Some artiacts will remain as part o a memorial garden at thesite o the old St. Johns. A ew will become part o the new Mercy

Hospital Joplin now under construction. Designers dont intend

Missouri conservation ofcials applaudedMercy, saying they knew o no other

company that has worked as hard to

reuse trees on a construction site.

Photos courtesy: SWT Design


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REBUILDING

to install them as obvious memorials in the new building, but

incorporate them as subtle and tasteul reminders o the spiritual

continuum that bridges the two Mercy hospitals. The stations othe cross, or example, survived in the ormer hospitals chapel and

can become part o the new.

Also intact and somewhat miraculously were the stained

glass windows rom the chapel. They, too, will help bring a amiliar

and comorting touch to the new chapel.

The new hospital is near the Wildcat Glades and Audubon

Conservation Center. Mercy worked with the Audubon Society andgovernment agencies to ensure that construction would not harm

the centers ecosystem. Now Mercy is working to make its campus

blend comortably with the glades.

Mercy planners envision a day when Joplin students will

conduct science experiments at Wildcat Glades and the Mercy

campus. Perhaps, they will take measure o the saplings that

survived the deadliest tornado in U.S. history and returned to

provide shade and comort to a community on the mend.


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REBUILDING

F

ootsteps haunt hospital designers. Not the sound o

ootsteps, but their tracks. We dont like those ootprint

stickers they put on the foor or people to ollow, saysMercys Cindy Beckham, who helps oversee acility design.

Old hospitals, like the tornado-wrecked St. Johns

in Joplin, needed the stickers to guide patients

through a maze o hallways, oces and

check-in points. Routes get twisted over

the decades as aging, infexible

New hospitalleads the way

The new hospital

entrances include

shelters or patients

and employees

waiting or rides.


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REBUILDING

buildings struggle with new services, specialties and other health

care changes. So its with pride that Beckham and others show o

the simple and fexible foor plans or Mercys newest hospital, parto a $500 million health care campus under construction on the

south side o Joplin.

The new campus replaces the old St. Johns ater it was let in

ruins by the 2011 tornado. Not wanting to wait or demolition to

nish at the old campus, Mercy leaders broke ground or the new

Mercy Hospital Joplin in January 2012. Crews cleared more than

100 acres o land to open a blank canvas or painting the next

generation o Mercy care.

When it opens in 2015, the eight-story hospital will be the

centerpiece o a $1 billion string o investments Mercy is making

in the Joplin area. The outlays include other temporary and

permanent medical acilities, the cost to keep paying Mercy

employees in the interim, and money to lease and expand Mercy

McCune-Brooks Hospital in Carthage, just north o Joplin. The

addition o Mercy McCune-Brooks and the new hospital tothe south promise a dispersed Mercy system that will include

physician oces across the area. Its not just a new hospital,

says Mercy CEO Lynn Britton. Its an entirely new, modern health

care inrastructure that will enable the Joplin area to meet the

challenges o the next 50 years.


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Joplin

Original hospital

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Original hospital

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The future hospital

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REBUILDING

Starting a hospital rom scratch enabled Mercy and its

architects to ponder what would make a model acility. They

enlisted patients, co-workers and community members as anadvisory group or brainstorming sessions on what they wanted

rom a new building. Many Mercy employees had not worked in a

hospital other than St. Johns. Still reeling rom the disaster, some

tended at rst to want to replace what theyd lost. They asked, or

example, or registration areas with the sliding-glass windows that

patients associate with doctors.

The new hospital isrising in a relatively

undeveloped

section o Joplin.


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REBUILDING

Conversations, however, soon turned to reducing those types o

traditional walls between patients and caregivers. And instead o

multiple registration desks or dierent departments, as in the oldSt. Johns, conversation turned to the breakthrough idea o a single

place where patients could register or any and all departments.

Gaining momentum, the innovation reached across other areas

including medical records and nancial counseling. They, too, could

rely on mobile technology to bring paperwork to patients rather

than asking them to nd their way to other doors.

Essentially, the hospital and clinic wont have conventional

registration desks. An employee greets patients as they arrive, and

any questions or papers are brought to them. With the modern

technology we have, were able to get rid o a lot o the old barriers

to care, Britton says. The old things that made you eel less

dignied in health care, were rethinking all o that.

Patients have responded warmly

to prototypes or Mercys new

interior design, saying they

dont eel like medical ofces.


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Even the hallway lobby where patients arrive will look

remarkably dierent rom a traditional hospital. Designers talk

o the area as more o a gallery instead o a waiting room, awarm place with soas and tables. No more hard-foor shbowl

with straight-back chairs along the wall. Even the art might be

interactive to help distract patients and amilies rom the concern

behind their visit.

The convenience doesnt stop in the hallway. Increasingly

mobile medical technology means a patient can go to a room or

an exam and stay there or a wide range o tests. A technician

could come to draw blood, or bring a portable ultrasound machine

or heart monitor. A specialist doctor could also come to the room

or consultations. The idea is that the people who work there know

their way around the hospital; the patient wont need to.


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These innovations arent unique to Joplin. Were doing dierent

pieces o this across Mercy communities, Britton says. Joplin is

the rst place where it is all coming together.The new hospital will open with about 600,000 square eet

o space and more than 200 patient beds. Combined with other

acilities and an expansion o the ormer McCune-Brooks, Mercy

plans to have more than 400 beds in the Joplin area. Other acilities

on the new campus will include a behavioral health clinic and

perhaps a rehabilitation center, bringing Mercys new space in Joplin

to nearly 1 million square eet, similar to what it lost to the tornado.

Plans or the new hospital itsel include medical and surgical

care, critical care, intensive care, cancer care as well as greatly

expanded care or women and children, with labor, delivery,

recovery and postpartum rooms and neonatal and pediatric

intensive care.

In addition to clinical space and beds, the building will house

some doctors oces, which typically are ound in other buildings

near a hospital. Specialty physicians and a ew primary doctors

will have their oces in the hospital. Theyll have a short walk to

see patients or an exam or visit them in their rooms, have lab

tests and imaging conducted, or even undertake major surgeries.

Cardiologists will have oces on the same foor where heart

patients rest, obstetricians and pediatricians on the same foor as

mothers giving birth.

Crews will nish the hospital in less than 40 months, andgroundbreaking came ater only a ew months o planning. The

speed is enabled partially because o a design that, while unique

to the site, is ull o standard modules drawn rom a guide that

governs new construction across the Mercy system. That means

we could start building beore it was ully designed, says John

Farnen, a Mercy leader who is supervising construction in Joplin.

A clinic module, or example, can be a reestanding acility, orseveral can come together in a larger clinic. Designers used a passel

o modules or specialty clinics, emergency departments, doctors

oces and others in planning the Joplin hospital.


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Designers didnt even have to know which clinic modules might

be used or what specialties as construction got underway. The

standards allow fexibility as demands and specialties shit,

whole sections can be converted. Even individual rooms can shit

with the seasons, such as those adjacent to pediatric intensive

care. Rooms across a hall can be added to the pediatric ICUwhen winter comes and more kids get sick, and later shited into

something else. Its really about the need at the time, explains

Beckham, who joined Mercy several years earlier to help ashion

the ministry-wide designs.

The hospital, in act, adds a neonatal intensive care unit that

wasnt in St. Johns. Too oten, amilies had to travel to another city

when their newborns were sick. The neonatal care complementsan expanded labor and delivery department in the new hospital

as Mercy aims to better serve Joplins youngest inants and

their parents.

Groundbreaking ater months o planning: Bishop James Vann

Johnston o the Springfeld-Cape Girardeau Diocese, right, and

Father Saari Burusu bless the new site on Jan. 29, 2012.


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43

Parking spaces

radiate outward

Hospital

entrance

Clinic

entrance

Other buildings on the hospitalcampus will include a

rehabilitation center and

perhaps a behavioral health

clinic, among others.

Hospital

building

The new campus


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REBUILDING

Ministry-wide design guidelines include the buildings exterior,

which shares a look with other Mercy clinics, hospitals and

oces. The amiliar appearance is part o a major eort across theorganization to merge Mercys hundreds o sites into a amiliar

brand. Its partly about marketing, but more about patient service.

The same electronic records are available across Mercy and make it

easier to treat a patient at any o its acilities; standardizing buildings

and processes will help patients understand thats possible. Their

experience also will eel amiliar wherever they go within Mercy.

The modern design includes subtle reerences to Mercys

traditions. Entrances, or example, include a prominent glass wall

whose interior lighting serves as a sort o lamp guiding those in

need. The windows mullions orm a cross that is similar to one

Catherine McAuley, the ounder o the Sisters o Mercy, had prayed

to in the window o a Quaker household, where she was not allowed

to display Catholic icons such as crucixes. Employees who know

the story can see the cross, as well as patients who take comort in

the religious symbolism.Convenience or patients at the new hospital reaches into the

surrounding parking lots. Most hospitals have one main entrance,

but the new Mercy Hospital Joplin will have two, one or the

hospital and one or the clinic. The two entrances help divide trac

and bring patients into the building on dierent foors. They also

put parking on both sides o the hospital, meaning smaller lots and

shorter walks. And unlike the grid-like lots at a shopping mall, the

hospitals will stretch across an arc. That will allow the lines at each

parking spot to widen outward, opening more room or those exiting

with canes or wheelchairs.

Whichever door they choose, patients will enter into wide

hallways with an obvious path to elevators or the receiving gallery,

where theyll be greeted and checked in. Designers planned other

foors with similar simplicity in bringing patients to any oce or

service. No more foor stickers to nd their way, Beckham sayswith a laugh:

No ootprints, no way.


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45

We have a nose or need, says Sister Mary Roch Rocklage,

Mercys health ministry liaison.When it comes to health care, that need oten is ound in rural

areas. Only a sprinkling o Mercys more than 30 hospitals are

in major metropolitan areas. The rest are in small-to-mid-size

communities like Joplin. Its who we are, says Mercy COO Mike

McCurry. The community means a lot more to us than the market.

In Joplin, the Sisters o Mercy began providing health care to

those most in need soon ater they arrived, originally to teach. Theysaw a glaring need or a health ministry in the rontier mining town,

and opened the towns rst hospital in 1896.

Today, Mercy helps ulll that mission by extending some o the

most sophisticated medicine in America to rural settings across

its seven-state ministry. It thrills us to be able to do that, says

McCurry. Small communities, or example, oten wrestle with a

shortage o specialists. Mercys system, combined with the latest

technology, has helped developed cutting-edge solutions.

Take neurology, the treatment o disorders in the brain and

nervous system such as those caused by strokes. Rural markets

oten cant support expensive specialists such as neurologists.

Mercy has responded with its telestroke program, which

electronically links patients around the clock to ar-fung

neurologists. Powerul cameras in a rural hospital enable a distant

doctor to diagnose strokes and prescribe medicine that limits thedamage i caught early. Mercy is deploying the technology across

its hospitals.

Mercy mission:Beyond a hospital

A CLOSER LOOK


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M I S S O U R I

K A N S A S

A R K A N S A S

T E X A S

L O U I S I A N A

I S .

O K L A H O M A

t. Louis

Oklahoma

ity

Laredo

New

Orleans

Jackson

Fort

Smith

= Mercy locations

Joplin

44

4

35

5

30

40

40

20

10

Gulf of Mexico

Mercys seven-state ministry

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A similar system called SaeWatch enables doctors to

electronically monitor intensive care units at a distance, and

provides patient access to highly specialized physicians. Mercy hasthe nations largest electronic ICU network.

Mercy oers other advantages to communities like Joplin. The

systems purchasing power and management expertise oer the

benets o size to small hospitals. Also, a more serious gap opens

in a smaller community than in a big city i a specialist leaves.

You have to ll the void in a hurry, says Ron Ashworth, chair o

Mercys health ministry. We oer a large recruiting reach.

McCurry notes that he and Mercy CEO Lynn Britton grew up

in small towns. They take special satisaction in Mercys ocus on

communities like their hometowns. And while he doesnt answer

to the conventional shareholders o a public corporation, McCurry

likes to say that Mercy has three million shareholders its

customers in towns like Joplin: They are people with real needs

who we exist to serve. Or, as Sr. Roch puts it, Were at home in

any community.

Nothing challenged Mercys mission more than the 2011

tornado, which threatened not only the uture o its Joplin hospital

but the uture o Joplin itsel. Mercys decision to stay and rebuild

means the area not only keeps the high-quality care or which

Mercy is known, but it also encourages other residents and

businesses to do the same.

We want to be a permeating presence, Sr. Roch says.How do we become a part o those communities and help

change them?

In Joplin, Mercy is living the answer to that question.


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REBUILDING

About this seriesAs the nation remembers the storm that ravaged Joplin in

May 2011, Mercy has published a series o books on the events

that changed the lives o so many in the community, and how

the health ministry has responded.The books include this one, Rebuilding, which explains

how Mercy has replaced the hospital destroyed in the tornado.

In Caring, Mercy arms its commitment to its workers and

the community o Joplin. In Enduring, Mercy captures stories

o courage in the atermath o the tornado and looks ahead to

Joplin's uture.

The works weave a story o past, present and uture andMercys promise to value all three.


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Documents

Rebuilding Joplin