Ward Rounds

Ann & Robert H. Lurie Children’s Hospital of Chicago will become part of Northwestern University’s Chicago campus later this spring with the goal to provide world-class pediatric care.

When it officially opens in early June, it will create an exceptional continuum of patient care and research with the Feinberg School of Medicine (FSM), Northwestern Memorial Hospital (NMH), and the Rehabilitation Institute of Chicago – all located within steps of each other.

Operating independently from Northwestern, Lurie Children’s will bring unprecedented opportunity at both institutions for research collaboration and the ability to follow disease progression across a lifespan.

The new hospital is the transformation of Children’s Memorial Hospital in Chicago’s Lincoln Park neighborhood, which will close when Lurie Children’s opens.

The celebration is bittersweet. Patients, families, physicians, and staff have shed tears of heartbreak and joy at Children’s Memorial. For them, the move represents more than a brand-new building. It’s transferring their culture, which earned the hospital No. 1 regional ranking, to an extraordinary new building in Streeterville.

A Vertical Hospital

Due to space constraints in this prime spot, the building is 23 stories high and is widely recognized as the world’s tallest pediatric hospital.

That claim to fame presented challenges as well as advantages.

“I have never worked on a building where I have been more proud of what we have done,” says Bruce Komiske, MHA, FACHE, chief of new hospital design and construction at Lurie Children’s.  “It is such a spectacular building.” Komiske brings a wealth of international experience building hospitals to his role, including leading the early design process for Sidra Medical and Research Centre in Doha, Qatar, site of Northwestern’s Middle East campus.

Infection control and optimum use of space heavily influenced the layout, materials, and mechanical systems. All 288 patient rooms are private with living space for patients and families plus ample room for caregivers. A sophisticated HEPA filter system traverses the sensitive surgical and oncology areas to keep air purity high, aiding healing.

The hospital is split into two main sections. Procedure rooms, outpatient facilities, and the Kenneth and Anne Griffin Emergency Care Center occupy the bottom half. Inpatient rooms are on the top floors. (The emergency center will include 45 exam rooms, compared to the previous 25.)

TO HELP CONTROL INFECTION AND REDUCE NOISE, ALL 288 LICENSED INPATIENT BEDS WILL BE PRIVATE, INCLUDING THE NEONATAL INTENSIVE CARE UNIT

A bridge will connect the second levels between Lurie Children’s, Prentice Women’s Hospital,  the Feinberg School of Medicine, and the parking garage. Another bridge will connect the fifth floors of Lurie Children’s and Prentice, the state’s highest-volume birthing center, to expedite neonatal care for critically ill newborns.

Supporting aspirations to be an acclaimed academic-medical center, technological capabilities will link the hospital with medical professionals across the world for education, research, and patient care. They will be able to view surgeries in progress and conferences on the Web from the hospital’s 400-seat conference center and in more than 80 other conference rooms.

For Lurie Children’s, access to the medical school and the rest of Northwestern’s downtown campus is key. Every year, members of the McGaw Center for Graduate Medical Education and the pediatric hospital train about 200 physicians, including pediatric residents and fellows in pediatric sub-specialties.

Thomas Green, MD, chair of the Department of Pediatrics and professor of pediatrics, notes that physicians and staff have been able to hop on a shuttle between Children’s Memorial and Feinberg, “but it’s just not the same as working next door to each other. I am expecting a much higher number, and more intense, collaborations between physicians and researchers.”

Lurie Children’s hopes its grand plan will attract more top talent. John Costello, MD, MPH, medical director of the Regenstein Cardiac Care Unit at Lurie Children’s, and associate professor of pediatrics, recently came from Boston Children’s Hospital and Harvard University. In addition, 40 more pediatric sub-specialists have come to Children’s Memorial in the last three years in part because of the new hospital on Northwestern’s campus.

“The hospital’s proximity to Prentice is a major advantage,” Dr. Costello says. “This location will enhance our ability to care for newborns with serious heart conditions who need urgent cardiac care. Northwestern Memorial will also facilitate our ability to transition care of our patients as they grow into adults with congenital heart disease.”

Joint Ownership

Komiske stresses that a bunch of guys huddled over blueprints are not making all the decisions.

Physicians, nurses, staff, patients, and families have had considerable input into the design and operation of clinical units and public areas. Kids even tested the patient furniture and rejected some of the artwork.

Ann Lurie, the hospital’s major benefactor, knows how a pediatric facility should work. A former critical care nurse at Children’s Memorial, Lurie donated $100 million for the new facility. She serves on the hospital board’s oversight committee for the new facility and visits the site frequently, even for the “bend-and-stretch” exercise breaks, when patients lead hundreds of construction workers.

The new hospital will improve workflows by condensing clinical units into one floor, instead of spreading patients around as Children’s Memorial is forced to do because space is tight, particularly in cardiac care.

Marleta Reynolds, MD, Children’s Memorial surgeon-in-chief and professor of surgery, is ecstatic. Lurie Children’s will have 21 suites for minimally invasive procedures, compared to two at Children’s Memorial. At 600 to 700 square feet each, they will be considerably larger than the current operating rooms. Each suite has its own equipment including monitors, lights, cameras, and anesthesia gases that lowers from the ceiling, freeing up the floor so teams can move around unencumbered.

THIS SURGICAL WAITING ROOM IN THE SHAPE OF A TRAILER SHOWCASES PHOTOS FROM AFRICA IN TRIBUTE TO DONOR ANN LURIE’S WORK THERE

“The advantages in this larger space are astronomical from all perspectives, and the capability to create real-time educational materials is phenomenal,” she says.

With video integration in each suite, residents and fellows will be able to watch procedures live. Different surgeries can be streamed simultaneously for different courses.

The hospital added imaging equipment with improved capabilities including three MRIs, three CTs, one PET/CT, and two nuclear medicine imaging rooms. The new equipment will be housed on the floors below surgery so patients can be moved from imaging up to procedure rooms, and from there up to inpatient rooms.

To step up research, a dedicated Clinical Trials Unit will replace patient beds scattered throughout Children’s Memorial. The unit will be staffed with grant administrators, statisticians, patient recruiters, research designers, nurses and others dedicated to facilitating research and developing more competitive grant applications.

The latest technology that will support these state-of-the-art units is also integrated into building systems. These include remote patient monitoring, security, and climate control. Implemented in 2006, electronic medical records at the current hospital will be enhanced in the new location.

Since no building style dominates the campus, a lot of thought went into choosing a design that would integrate with other buildings, yet still identify the facility as a pediatric hospital. The university’s Architectural Committee worked with the pediatric hospital to create a look that incorporates the disparate building styles on campus. The result is a contemporary-style facade with windows resembling blocks, distinguishing the structure as a pediatric hospital, adding of course that trademark tiny child’s hand in the window.

To avoid potential problems and keep construction rolling, the hospital is being built using Building Information Modeling (BIM), a sophisticated system that creates a real-time 3-D computer construction model including ventilation, plumbing, steel and other systems. It is one of the largest projects of this complexity that has been constructed using BIM technology and it has paid off: the project is estimated to come in $60 million under budget and six weeks ahead of schedule, according to Komiske.

The Exodus Has Begun

It’s a once-in-a-lifetime event to physically move a hospital. Lurie Children’s begins accepting patients as an officially licensed hospital at 6 a.m. on June 9, but the move has already begun.

In March and April, physicians and staff will revisit their departments and train on workflow processes, including equipment and code simulations.

“Our people will have gotten very good exposure to this building prior to opening, and they should because they know their business better than we do,” says Maureen Mahoney, RN, chief of transition and occupancy planning for Lurie Children’s.

The hospital is also utilizing a computer program, Virtual Path to the Future, to orient its 4,000 physicians and staff.  It uses avatars to guide viewers through the new hospital in 3-D – from nurses’ stations, procedure rooms, hallways, safety features, computer stations, and patient areas. Staff will take additional online courses for department-specific training.

THIS FIRE TRUCK CAB, FEATURING FUN EDUCATIONAL ACTIVITIES FOR KIDS OF ALL ABILITIES, WAS BUILT AND DONATED BY PIERCE MANUFACTURING IN RECOGNITION OF THE HOSPITAL’S LONGSTANDING PARTNERSHIP WITH THE CHICAGO FIRE DEPARTMENT

As the big day draws near, a carefully crafted schedule of equipment and supply deliveries orchestrated down to the hour continues. Only 15 percent of equipment at Children’s Memorial will be used at the new hospital.

Opening Day: June 9, 2012

Anticipating the transition a few years ago, staff at Children’s Memorial observed moves of 13 other hospitals across the country, including Prentice Women’s Hospital, Elmhurst Memorial Hospital, Texas Children’s Hospital, and New York-Presbyterian Morgan Stanley Children’s Hospital.

“The biggest lesson we learned was to involve as many people as possible so everyone knows what they are doing,” says Mahoney. “That has cost us more time, but it is going to serve us well in the future.”

Staff will participate in several mock moves where both hospitals, streets, and toy ambulances are laid out on a tabletop, and transport and command teams must direct the action. Trial runs will include best- and worst-case scenarios.

The three-mile route from the old to the new hospital is plotted to move as quickly as possible and minimize stress for the estimated 160 patients who will be transported. Fullerton Avenue in Lincoln Park will be closed up to Lake Shore Drive, where ambulances will head south to Lurie Children’s on Chicago Avenue.

Immuno-compromised children will be moved first to reduce risk for infection. One parent, at least one nurse, and possibly a physician will accompany the medical team in each ambulance.

Command centers at Lurie Children’s and Children’s Memorial will oversee the entire move, expected to take between 10 to 18 hours. Thanks to early and extensive planning, Mahoney hopes the day will be uneventful because caregivers will be ready for anything that happens.

However, Lurie Children’s will be in the spotlight on June 9 for other reasons as a new era of pediatric healthcare begins.