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Phyllis
Hospital seeks heart care edge in $350m center
Brigham and Women's starting high-tech project
By Christopher Rowland, Globe Staff | October 8, 2005
Brigham and Women's Hospital will break ground next week on a $350 million, 136-bed cardiovascular center that will be among the most advanced of its kind, giving the hospital a major advantage as it competes for patients.
The 10-story, glass-and-steel building will be the most obvious and expensive indicator of a growing race among Boston's teaching hospitals to increase their profitable cardiovascular business. It will be stuffed with the latest technology and offer amenities such as single rooms for all patients that will include fold-out couches for visiting family members and large windows to enhance natural light.
Beth Israel Deaconess Medical Center, the Lahey Clinic, and other hospitals are also improving their cardiovascular-treatment facilities, but on much smaller scales.
''It's going to raise the stakes around New England, particularly in Boston, which is such a competitive place," said Dr. Kenneth L. Baughman, who directs advanced heart-disease treatment at Brigham and Women's.
Eight miles of fiber-optic cable will snake through the walls. An electronic tracking system will monitor the flow of patients and equipment through the building, which will be connected by a bridge across Francis Street to Brigham and Women's existing complex, part of which dates to the early 1900s.
The center will include a ''hybrid" operating room so angioplasties and bypass surgeries could take place in the same location, reducing the need for seriously ill patients to be moved. Hospital officials are also setting aside space for future advancements, such as procedures that will use robots and real-time body scans.
''This ensures that we will stay at the forefront, because we are creating the innovations," said Kathleen E. Walsh, the hospital's executive vice president and chief operating officer, who is leading the construction project.
Outside the Boston area, the concept is not new. Some academic medical centers around the country have established dedicated, stand-alone heart centers. For-profit specialty heart hospitals have also sprung up, particularly in the South.
The hospital said the care it is able to give will be further enhanced through its affiliation with Harvard Medical school. There is a business risk, however: Health insurers and federal healthcare regulators could cut future reimbursements for cardiovascular procedures, said Glenn Melnick, a University of Southern California professor and a healthcare economist at the Rand Corp., a nonprofit research organization.
''The cardiac market has been a very lucrative part of the healthcare system, partly because of growing demand, partly because of new innovation, and partly because the system has overpriced the services," Melnick said. ''To what extent are their plans predicated on continued high prices?"
Brigham and Women's said it will maintain the profitability of complex procedures by increasing efficiency. For example, with all of its heart patients under one roof, procedures and discharges can be scheduled more accurately, reducing long stays that drive up costs.
And because of doctors' proximity to one another, collaboration will be improved, officials said. For instance, physicians who perform cardiac angioplasties will be able to work closely with heart surgeons who perform bypasses to determine the best course of treatment. Now, communication between doctors in different sub-specialties can be made difficult because they are in different parts of the hospital.
''We believe that will distinguish us in the market," said Dr. Gary Gottlieb, chief executive of Brigham and Women's.
''One doesn't have to run from place to place to get various kinds of care," he said. ''This gives us a real opportunity of giving patients one-stop ability to see multiple specialists without getting lost in the system."
The building, to be completed by the spring of 2008, will be named the Carl J. and Ruth Shapiro Cardiovascular Center -- after the philanthropists who contributed $25 million toward its construction. It is being designed by the Boston office of architects Cannon Design/Chan Krieger. Although a formal ground-breaking ceremony is scheduled for Wednesday, construction on below-ground operating rooms began during the summer.
To alleviate crowded conditions at its existing facility, the hospital began planning years ago for an outpatient center on the same Francis Street site where the new center is being built. When Gottlieb arrived in 2002, he scrapped the plan after deciding the area was too congested to handle the traffic it would generate. With the cardiovascular center, the number of beds at Brigham and Women's overall will rise by just 30, to 765, because the hospital plans to convert double rooms in the main hospital to singles.
The cardiovascular center fit Gottlieb's vision for the hospital's future. He wants to focus care in five specialties -- cardiovascular, oncology, musculoskeletal, neurosciences, and women's health (The hospital still delivers 10,000 babies a year.).
Moving cardiovascular care out of the main hospital complex frees space to accommodate improvements for other specialty areas, starting with a multi-floor cancer center.
Twenty-four of the new building's 136 beds will be in a luxury ''pavilion" for patients who want to pay more for amenities such as better food and wood paneling.
Single rooms in the new building will be about 350 square feet -- about double the size of those in the existing cardiac intensive care unit. A small nursing station will be attached to each room, with windows to allow nurses to see patients and let natural light penetrate interior hallways. Rooms will be designed for quick conversion into ICUs.
Administrators said they have sought input from the nursing staff through brainstorming sessions held in a mock-up of a patient room. Nurses have debated the positioning of the bed, the location of the sink -- even where to place the trash can.
Meanwhile, doctors and radiologists are trying to anticipate what technology will be available in the future and build it into the design.
''Part of the challenge is knowing where the technology will be," said R. Morton Bolman III, chief of cardiac surgery. ''We have to engineer the building so it can be modified to stay on the cutting edge."
Christopher Rowland can be reached at [email protected].
© Copyright 2005 The New York Times Company
Brigham and Women's starting high-tech project
By Christopher Rowland, Globe Staff | October 8, 2005
Brigham and Women's Hospital will break ground next week on a $350 million, 136-bed cardiovascular center that will be among the most advanced of its kind, giving the hospital a major advantage as it competes for patients.
The 10-story, glass-and-steel building will be the most obvious and expensive indicator of a growing race among Boston's teaching hospitals to increase their profitable cardiovascular business. It will be stuffed with the latest technology and offer amenities such as single rooms for all patients that will include fold-out couches for visiting family members and large windows to enhance natural light.
Beth Israel Deaconess Medical Center, the Lahey Clinic, and other hospitals are also improving their cardiovascular-treatment facilities, but on much smaller scales.
''It's going to raise the stakes around New England, particularly in Boston, which is such a competitive place," said Dr. Kenneth L. Baughman, who directs advanced heart-disease treatment at Brigham and Women's.
Eight miles of fiber-optic cable will snake through the walls. An electronic tracking system will monitor the flow of patients and equipment through the building, which will be connected by a bridge across Francis Street to Brigham and Women's existing complex, part of which dates to the early 1900s.
The center will include a ''hybrid" operating room so angioplasties and bypass surgeries could take place in the same location, reducing the need for seriously ill patients to be moved. Hospital officials are also setting aside space for future advancements, such as procedures that will use robots and real-time body scans.
''This ensures that we will stay at the forefront, because we are creating the innovations," said Kathleen E. Walsh, the hospital's executive vice president and chief operating officer, who is leading the construction project.
Outside the Boston area, the concept is not new. Some academic medical centers around the country have established dedicated, stand-alone heart centers. For-profit specialty heart hospitals have also sprung up, particularly in the South.
The hospital said the care it is able to give will be further enhanced through its affiliation with Harvard Medical school. There is a business risk, however: Health insurers and federal healthcare regulators could cut future reimbursements for cardiovascular procedures, said Glenn Melnick, a University of Southern California professor and a healthcare economist at the Rand Corp., a nonprofit research organization.
''The cardiac market has been a very lucrative part of the healthcare system, partly because of growing demand, partly because of new innovation, and partly because the system has overpriced the services," Melnick said. ''To what extent are their plans predicated on continued high prices?"
Brigham and Women's said it will maintain the profitability of complex procedures by increasing efficiency. For example, with all of its heart patients under one roof, procedures and discharges can be scheduled more accurately, reducing long stays that drive up costs.
And because of doctors' proximity to one another, collaboration will be improved, officials said. For instance, physicians who perform cardiac angioplasties will be able to work closely with heart surgeons who perform bypasses to determine the best course of treatment. Now, communication between doctors in different sub-specialties can be made difficult because they are in different parts of the hospital.
''We believe that will distinguish us in the market," said Dr. Gary Gottlieb, chief executive of Brigham and Women's.
''One doesn't have to run from place to place to get various kinds of care," he said. ''This gives us a real opportunity of giving patients one-stop ability to see multiple specialists without getting lost in the system."
The building, to be completed by the spring of 2008, will be named the Carl J. and Ruth Shapiro Cardiovascular Center -- after the philanthropists who contributed $25 million toward its construction. It is being designed by the Boston office of architects Cannon Design/Chan Krieger. Although a formal ground-breaking ceremony is scheduled for Wednesday, construction on below-ground operating rooms began during the summer.
To alleviate crowded conditions at its existing facility, the hospital began planning years ago for an outpatient center on the same Francis Street site where the new center is being built. When Gottlieb arrived in 2002, he scrapped the plan after deciding the area was too congested to handle the traffic it would generate. With the cardiovascular center, the number of beds at Brigham and Women's overall will rise by just 30, to 765, because the hospital plans to convert double rooms in the main hospital to singles.
The cardiovascular center fit Gottlieb's vision for the hospital's future. He wants to focus care in five specialties -- cardiovascular, oncology, musculoskeletal, neurosciences, and women's health (The hospital still delivers 10,000 babies a year.).
Moving cardiovascular care out of the main hospital complex frees space to accommodate improvements for other specialty areas, starting with a multi-floor cancer center.
Twenty-four of the new building's 136 beds will be in a luxury ''pavilion" for patients who want to pay more for amenities such as better food and wood paneling.
Single rooms in the new building will be about 350 square feet -- about double the size of those in the existing cardiac intensive care unit. A small nursing station will be attached to each room, with windows to allow nurses to see patients and let natural light penetrate interior hallways. Rooms will be designed for quick conversion into ICUs.
Administrators said they have sought input from the nursing staff through brainstorming sessions held in a mock-up of a patient room. Nurses have debated the positioning of the bed, the location of the sink -- even where to place the trash can.
Meanwhile, doctors and radiologists are trying to anticipate what technology will be available in the future and build it into the design.
''Part of the challenge is knowing where the technology will be," said R. Morton Bolman III, chief of cardiac surgery. ''We have to engineer the building so it can be modified to stay on the cutting edge."
Christopher Rowland can be reached at [email protected].
© Copyright 2005 The New York Times Company
