Young at Heart
The new Lawrenceville campus of Children's Hospital of Pittsburgh of UPMC offers a 21st-century vision for young patients and their families with greater space, better accommodations and a comprehensive array of services.
With long lines waiting for the parking cashier, the scent of popcorn from the snack bar and a dozen families squeezing wheelchairs and toddlers through the throng, the crowded lobby of the Children’s Hospital of Pittsburgh of UPMC’s old location in Oakland sometimes resembled a bus terminal instead of a healing haven. By contrast, the entrance to the hospital’s new Lawrenceville campus from its parking garage is the vaulting, light-filled Transformation Corridor, with walls full of art. Officially opening this month, the pediatric hospital that annually serves 13,000 inpatients and half-a-million outpatients now has an appearance to match its world-class reputation.
But as any pediatrician will tell you, it’s what’s inside that counts, and the $625 million facility is more than just a shiny new shell. "Our growth is related to cutting-edge clinical services," explains Dr. Andrew Urbach, the hospital’s medical director for clinical excellence and service. "We have been providing wonderful pediatric care in an undersized and antiquated building. In our new building, there is no limit to what we can do."
At 1.5 million square feet, the new campus at the site of the old St. Francis Hospital dwarfs the old facilities at 900,000 square feet. From the sibling day-care center to a gym for parents as well as for staff, from a fireplace-lit library to a meditation garden, the new hospital defines care as a comprehensive array of services for patients and their families.
Stress reduction starts with the campus design created by local architects at Astorino; it’s premised on big windows and plenty of natural light. The expansive cityscape views from patient rooms and playrooms are a bonus of the hospital’s energy-saving design. Two of the eight buildings on campus – comprising three parking garages, two office buildings, a research center, family apartments and the hospital – will be LEED-certified. That’s geek-speak for buildings that meet the highest national standards for energy efficiency.
Inside, families with personal experience dictated design. "Beginning in the late-1990s, we organized an ongoing family forum and asked them for ideas on what parents wanted in the new hospital," says Christopher A. Gessner, who became hospital president in April 2008. Topping the wish list: peace, quiet and choices.
"Families played a bigger role," agrees Urbach. "They said, ‘We want light, we want views, we want to be connected to the outdoors.’ The new hospital also gives them choices – to be alone, to connect with families coping with the same disease, with the hospital public. We offer different levels of privacy."
Privacy was elusive in the Oakland building. The 260 old semi-private rooms offered little space for visitors, let alone two families who wanted to stay at the hospital when their children were admitted overnight. Since children with infectious diseases require isolation, beds at the old hospital often went empty. So private rooms – the case for the majority of the 296 beds in the Lawrenceville site – made sense to both families and hospital staff.
"If families have privacy – in treatment rooms, in patient rooms – there’s less stress. They’re more willing to share information," says Urbach. He offers an example. "In the old building, going to the operating room, a patient would roll through public areas. It was fairly humiliating going through the central elevators. In the new hospital, we have onstage and offstage areas."
To keep the dialogue going, Children’s mocked up layouts for five different types of rooms and invited families, as well as staff, to weigh in. The consensus that emerged resulted in a series of spaces for caregivers, patients and families within each room. Little things mattered. Given a choice between a private shower or more functional space in the critical-care units, for example, parents chose space over showers.
And after bunking on awkward lounge chairs, doled out at one per patient in the old hospital, families advocated two extra sleeping surfaces per room. The clever solution was a 6-foot-long upholstered window seat in each room with a trundle bed stored below. The vivid color palette in corridors and lounges, also requested by families, isn’t just a mood-lifter; research has shown that the bright hues also stimulate the brain.
Color schemes, signage and even furniture convey a playful spirit. "Where there’s a bench, it’s a wave bench, curved like a caterpillar," says Urbach. "A chair in the dental waiting room looks like a tooth. We’re doing everything to surprise and amuse and instruct and entertain."
If guests ranked hospitals like hotels, Children’s might earn five-star honors. The spacious patient rooms, each with bathroom and space for parents, are arrayed on exterior walls, with double-thick drywall partitions from hallways. (To accommodate siblings, 10 percent have two beds.) Wireless pagers and patient sensors will emit silent signals. It’s all part of the hospital’s commitment to a quiet building. Research has shown that it not only aids healing, but improves staff job satisfaction, too.
"Even the wheels of our carts are designed to be quiet," notes Gessner. He pulls open a cupboard door along the corridor to demonstrate another noise-reducer: a pass-through serving door to each patient room that allows meals and linens to be exchanged without disturbing the family inside. The system also limits infections.
Families control their own entertainment on each room’s flat-screen TV, from cable TV and movies via LodgeNet to video games. Children’s also provides another hotel-style amenity: meals on demand. A child who’s sleeping or not hungry at 6 can order dinner at 9. Parents who need coffee or a snack won’t have to leave their kids for long; each floor has a stocked pantry. An ambulatory patient can accompany her parents to the third-floor cafeteria, where there’s a sunny patio open in good weather. Other incentives to get out of bed include two playrooms each on floors 6 through 9, overlooking a four-story atrium, and sunlit sitting areas with easy chairs and a panoramic view of the city. To accommodate young night owls, the sixth-floor playroom is open around the clock.
For parents who need to keep up with work while staying with their child, each patient room includes a desk with a data port and wireless access. A business center on the sixth floor offers more equipment, and the hospital’s laptop-loan program, with 60 systems that are personally delivered to patients and parents, gives them Web access. "Parents learn a lot [about kids’ conditions] from the Internet," Gessner explains. "They’re incredibly knowledgeable."
Since 1979, the Ronald McDonald House has offered out-of-town families lodgings in Shadyside during long-term stays. Now, the House will be a high-rise. Relocated to the Plaza Building on the new campus (formerly a senior housing high-rise), it provides 60 one-bedroom apartments. Rather than commuting to the hospital by car or bus, parents can walk to the hospital along the connecting third-floor corridor.
Each year, more than 62,000 families enter Children’s through the emergency room. The vastly expanded new version, with 41 treatment rooms, could fit the former ER into its waiting room. Its CT scanner and PET CT scanner make diagnostic images available in seconds, speeding treatment. If a parent is in a child-care bind, he or she can drop off healthy siblings at the adjacent Lemieux Sibling Center for a few hours of supervised care. That space accommodates both inpatients and outpatients (including ER-patient families). Each family can drop off two children there for a maximum of four hours without charge.
The hospital’s busiest corridor is on the third floor, which connects the hospital with the Rangos Research Center and the Ronald McDonald House. It’s also the location of the ambulatory waiting room, where half-a-million outpatients arrive for appointments each year. That makes for a busy thoroughfare that’s a full city block long, but one that’s easy to navigate – even for those too little to read. A new registration system checks families in at a central registration desk. There, families receive a whimsical reminder card that gives them a letter and animal ("A" for alligator, "B" for bear) to the corridor for their treatment rooms. Parents also receive the same kind of electronic "coasters" that summon patrons waiting for restaurant tables, so families can visit the nearby Pop Shop or a restroom without missing their appointments.
On the ninth floor, where all cancer patients are treated, hematology and a chemotherapy pharmacy are close at hand. So are family therapists and social workers, who help parents and children handle the issues of pain and stress.
The sixth floor of the hospital is home to the surgery, trauma and other treatment units. But it is also the soul of the hospital, where nonmedical resources come together. Urbach calls it "the town square," noting that the Oakland building lacked any communal area. "In most hospitals, the family resource center is about 5,000 square feet. Ours is 20,000," he says. "It’s a living room that says to families, ‘You are front and center.’ The amenities can’t be matched."
The new gathering spot provides a venue for visits by professional athletes or Santa, and it turns into a cinema when a screen descends from the window wall. Overhead, twinkling stars light a dark-blue sky at night. Underfoot, a floor-tile maze invites children to find their path. Families may enter the nondenominational chapel for prayer, or they can meditate in the outdoor healing garden, with its southern overlook on the city. The adjacent corridors invite families to browse well-stocked libraries. The space even offers a fireplace, which invites parents to relax and connect with other adults.
"Parents learn from other parents. This new layout facilitates sharing," says Gessner.
For long-term patients, Children’s offers a working classroom with a teacher on-site. The music-therapy room allows children to clap, listen, sing along and make their own recordings. And although nearly 90 percent of Children’s patients are under 12, teens aren’t forgotten: A special young-adult room lures those 13 and over to a casually furnished lounge with computers, video games, and age-appropriate books and magazines.
Urbach is gratified by the reaction of visitors to the atrium. "One little girl was so happy she was hugging one of the big purple columns [in the atrium]," he says with a chuckle. "Watching them discover all the little features – that’s exciting. Families will feel the impact of all the decisions we’ve made."