Children's Hospitals Today - Winter 2018 - 4

ROUNDS COMMENTARY

Building for the future
Plan for changes in the industry, technology and demographics when tackling a
multi-year building project. Here's what one hospital learned during the process.
BY CHRISTOPHER G. DAWES

M

ore than 15 years passed between the time the
administration at Lucile Packard Children's
Hospital Stanford made the decision to build a $1.2 billion,
521,000-square-foot extension to when it opened at the end
of 2017. That's a lot of time for the industry, technology and
demographics to change. With this project, we knew there
would be significant challenges along the way. As a learning health system and part of Stanford Medicine's academic
medical center, our goal of continuous improvement was put
to the test. Here's what we learned:
ENVISION A FUTURE YOU CAN'T PREDICT. Technology
changes rapidly. For example, the iPhone, which debuted
in 2007, didn't exist when we began this project, but it has
changed the way the world connects, communicates and
functions. To anticipate leaps in progress, the management
and architectural teams made flexible design a top priority.
For example, the latest MRI equipment is just six inches
larger than the equipment it will replace. Accommodating
those six inches could cost hundreds of thousands of dollars
in renovations if not for the flexibility of our new design.
CONSIDER THE DRAMATIC CHANGE IN THE GEOGRAPHY
OF PEDIATRIC CARE. Like adult care, children's care continues to shift from the inpatient to the outpatient setting. In

4

CHILDREN'S HOSPITAL S TODAY Winter 2018

2004, we were one of the first hospitals to obtain FDA approval for the Berlin Heart ventricular assist device (VAD) to support children awaiting transplant. But the device could only
be used inside the hospital. Today, kids awaiting transplant
can go home on supervision with a small, portable VAD. This
taught us that building a hospital expansion would, by necessity, also require us to develop into a multi-site pediatric and
obstetric health system with new locations and partnerships
to serve the needs of inpatients and outpatients.
In the last six years, we grew from Lucile Packard
Children's Hospital into an enterprise now known as
Stanford Children's Health. We simultaneously built an
80,000 square foot outpatient clinic, developed seven pediatric specialty clinics around the Bay Area, and developed
partnerships with community hospitals to increase our
presence in San Francisco and other Bay Area locations.
BEWARE OF BUDGET AND LABOR ISSUES. Growth looks
different for every hospital depending on the challenges
presented by location, business model and other factors.
Hospitals are complex to construct and they are especially
expensive undertakings in California due to compliance
with seismic performance criteria, rapidly evolving medical technology, and strict patient safety standards. We also
built during a construction boom in the Bay Area. This



Table of Contents for the Digital Edition of Children's Hospitals Today - Winter 2018

Contents
Children's Hospitals Today - Winter 2018 - Intro
Children's Hospitals Today - Winter 2018 - Cover1
Children's Hospitals Today - Winter 2018 - Cover2
Children's Hospitals Today - Winter 2018 - Contents
Children's Hospitals Today - Winter 2018 - 2
Children's Hospitals Today - Winter 2018 - 3
Children's Hospitals Today - Winter 2018 - 4
Children's Hospitals Today - Winter 2018 - 5
Children's Hospitals Today - Winter 2018 - 6
Children's Hospitals Today - Winter 2018 - 7
Children's Hospitals Today - Winter 2018 - 8
Children's Hospitals Today - Winter 2018 - 9
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Children's Hospitals Today - Winter 2018 - 19
Children's Hospitals Today - Winter 2018 - 20
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Children's Hospitals Today - Winter 2018 - 30
Children's Hospitals Today - Winter 2018 - 31
Children's Hospitals Today - Winter 2018 - 32
Children's Hospitals Today - Winter 2018 - Cover3
Children's Hospitals Today - Winter 2018 - Cover4
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