Expanding Physical Space, Focus

Although the freestanding Monroe Carell Jr. Children’s Hospital at Vanderbilt debuted less than a decade ago, physicians and administrators quickly realized the hospital’s rapid growth meant expansion was inevitable. This spring, the Children’s Hospital launched a $30 million, phase one expansion project that will increase space and enhance programming.

Luke Gregory, Children’s Hospital CEO, noted that within a year of the hospital’s 2004 opening, the facility was essentially running at full capacity. “We’ve run high occupancy since the very, very beginning,” he said. In addition to much needed space and beds, Gregory said an added impetus to undertake the current project was the need to expand focus on select critical access areas including pediatric oncology, cardiology and prematurity.

Gregory, who initially joined Vanderbilt in 2007 as chief business development officer, was active in the completion of Vanderbilt Health at One Hundred Oaks and has extensive experience in managing health systems and overseeing construction projects. In total, he said, the construction part of this project will add 30,000 square feet to the hospital and build out 25,000 square feet in the adjacent Doctor’s Office Tower (DOT). All floors have been built out in the 11-story DOT, which houses clinic space and physician offices, with the exception of the tenth floor. Once that space is completed, Gregory said it would house the pulmonary clinic, nephrology, gastroenterology, hepatology and nutrition.

As for the hospital, Gregory said, “The footprint of the building is not becoming larger, but we’re taking some vacant ‘air’ space.” He explained the hospital currently has a tiered appearance so the new construction will rise from what is now a patio on top of the third floor surgery area in the facility’s northwest corner. The addition will expand floors four through eight, he continued, adding a total of 33 new beds. “Each nursing floor will be expanded by 6-to-8 patient rooms along with a nursing station, family and common areas.”

“We never turn anybody away but this will allow us to have more flexibility in terms of where we have patients. This will allow us to have more dedicated bed space,” explained Meg Rush, MD, acting chairman of the Department of Pediatrics and chief of staff at Children’s Hospital. For example, she continued, the expansion will add approximately six rooms to the heart floor so that more space will be available for children coming out of the ICU who need to be in a cardiac-focused unit for continued monitoring.

To a large extent, the space woes are a direct result of the hospital’s success as children from across the region … and sometimes the nation … come to Nashville for specialized care. “We’re the first children’s hospital in the state to have a robotics program, and that program is rapidly growing,” said John W. Brock, III, MD, the Monroe Carell Jr. professor and surgeon-in-chief for Children’s Hospital. He said kidney surgery and reconstruction procedures began in February and added plans are underway to expand the robotics program to gastrointestinal surgery and other venues within the next year.

In May, U.S. News & World Report ranked Children’s Hospital among the best in the country, continued Brock, who also serves as director of Pediatric Urology. The 2011-2012 rankings recognized top performers among the nation’s 177 designated pediatric hospitals. Brock noted the pediatric urology program was ranked fifth in the country, neonatology 11^th and cardiac programs in the top 20. In fact, he said, of the 10 pediatric specialty programs reviewed, Children’s Hospital achieved a top 50 ranking for all programs.

To continue to build upon that success, the current physical expansion project is complemented by a major endowment endeavor to bring additional physician-scientists to Nashville. “There’s a $20 million campaign for programmatic enhancements,” Gregory said of the push to advance science and treatment protocols around cancer, heart disease and prematurity.

“We have great people in these programs already, but we’re going to add from a clinical, research and education standpoint, as well,” said Brock. “Our first goal is to take care of the children who come to this hospital,” he continued, “but we also look at how we can take care of those children in the future by understanding diseases and making some of those diseases go away.”

Rush, whose specialty is critically ill neonates, said that in recruiting physician-scientists, the Children’s Hospital really lives up to its new tag line … ‘where discovery brings hope.’ She explained it is by moving from bench to bedside that scientists and physicians have the opportunity to really change outcomes. “It’s really a story of discovery. It’s through the discovery of how a disease happens — and that starts in the lab most of the time — that really enables you to push your field along.”

Although there won’t be research space built into the expansion, Rush said the physician-scientists being recruited will have ample lab space on the Vanderbilt campus and noted some of the hospital’s young patients “may wind up being in clinical trials that help to drive forward improvement of therapies.”

Both Brock and Rush said recruitment is already underway. While that recruitment is focused on the three specialty areas highlighted, Brock said the hospital is also actively recruiting in other disciplines, as well.

The physical addition, designed by Earl Swensson Associates and headed by Balfour Beatty Construction, is scheduled for completion by spring 2012. However, Gregory readily recognizes this latest project is just the first phase in an ongoing effort to serve children regionally and nationally. “We have projected that 33 beds will meet our needs for about the next five years,” he said. “This building is landlocked, but Vanderbilt has a great reputation for creating space where it doesn’t exist,” he added with a laugh.

Gregory noted Vanderbilt has been innovative in finding efficient ways to deliver healthcare, which could include complementing pediatric services with outpatient satellite facilities such as the successful One Hundred Oaks project. However, Gregory stressed that no hard plans are in place at this point. When the time comes, though, he pledged Children’s Hospital would find a viable solution to ensure children and families have access to the highest quality of care.

Brock echoed those sentiments, adding the integrated nature of the entire Vanderbilt system is not lost on the physician-scientists being recruited. He credits the support from Vice Chancellor of Health Affairs Jeff Balser, MD, PhD, and Vanderbilt University Chancellor Nicholas Zeppos as helping the university and allied medical centers garner a national reputation for collegial cooperation. “Their commitment is unwavering in allowing us to have the tools and personnel to make this hospital the best it can be,” he concluded.

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