Economic Prognosis: Plenty of Health Care Work Ahead

Hospitals are expanding services in the Northwest faster than an internist can order tests.

Providence Health System is the main player in the region, with improvements planned at its hospital in Medford, Ore., a $300 million investment planned at campuses throughout the Portland area, and a new cancer center in Everett, Wash.

Green field projects - hospitals being built from the ground up are under way in Eugene, and Salem Ore., and Gig Harbor, Wash.

The prime factor for the rash of building is aging, of both the population and existing facilities. Many Northwest hospitals were built in the 1940s and 50s, according to the Washington State Hospital Administration Board. "Health care standards have changed dramatically since then," said Robb Menaul, WSHAB senior vice president. "Patients aren't happy with four people in a room, and medical science is much more advanced."

The Northwest is also one of the fastest growing areas in the country, further feeding the need for updated facilities.

The growth in services is offering health care professionals the chance to bring the latest technology into the mix. Patient records can now be accessed at the touch of a keyboard everywhere from the physician's office to the surgery to the recovery floor, providing instantaneous communication between the medical team. Wireless communication between the patient and nursing staff is also possible.

Architects are using creative design to enhance healing by use of natural sunlight to dramatic use of artwork.

These elements are the same, but hospitals in urban areas also rely on the above to market their services and attract patients, and retain professional staff.

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Evergreen Hospital

Work on the eight-story patient tower at Evergreen Hospital in Kirkland, Wash. is 60 percent done, with completion set for the end of the year. The building includes a steel-framed tower and a concrete parking garage. Funding for the project came from a $120 million bond issue passed by King County voters.

"The work is pretty standard," said Dan Nelson, project manager with Turner Construction, Seattle the construction manager on the project. Howard S. Wright, Seattle is in charge of building the shell and core of the building and Aldrich and Associates, Bothell is building out the interior. The building is completely self-sufficient and doesn't tie into the existing facility, making construction easier, Nelson said.

The tower will include a new Emergency Department and the expansion will provide more than 570,000- sq. ft., surgical and patient space and support, including underground parking. Construction began in spring of 2005, and the buildings are scheduled to be operational in early 2007. Initially, only three floors of the patient facility will be completed. The remaining floors would be finished and equipped from hospital operating funds as they become needed in the future.

The first phase of the project will provide adequate space for the rapidly growing number of emergency cases and new technologies.

The facility will include:

• 28 acute care rooms
  
• 4 trauma rooms
  
• A separate 10-bed unit for less-urgent patients
  
• Private rooms for increased patient privacy
• Easy access to adjacent radiology/CT/lab
  
• Multiple and private triage areas for faster patient assessment grams.

The original rooms are too small for current treatment methods, and it is more cost-effective to replace outmoded patient rooms than to modernize them.

Patient rooms will be designed to a "universal room" standard that is flexible to serve standard medical-surgical or intensive-care uses, including new and emerging medical technologies. A hub-style floor plan will locate nurse stations for optimal patient visibility.

Overlake Hospital

Overlake Hospital will increase its capacity by 80 beds, based on a certificate of need from the State of Washington. The emergency room will more than double.

"It's now configured to allow staff to more efficiently operate," said Janet Donelson, facilities manager at Overlake. "You can't schedule use in the emergency room; it can expand or contract in minutes.

"We do have primary single rooms that can accommodate the necessary equipment and electronic information," Donelson said. All patient information will be available electronically from charts to X-rays. The $125 million cost includes equipment purchases.

Group Health Cooperative broke gr0und on the Overlake campus in June. It will provide outpatient services, and contract with Overlake for in-bed care.

"We will have a covered, enclosed tie-in, but they are two separate facilities," Donelson said.

The patient tower will have four floors when it is completed but the structural design allows for four additional floors to be added, according to Greg Lee, a senior associate with ABKJ in Seattle. The structural design makes use of a patented system called Side Plate that was developed in California after the Northridge earthquake.

Side Plate is designed to make the moment frame more flexible. Instead of the flanges of the columns and beams being welded together, they are connected with larger plates. The plates allow a longer weld and a sturdier structure. "We will save $900,000 on steel costs on both phases because of the design," Lee said.

The facility is designed to deliver health care services during and following a catastrophic event, as a result of built-in support systems (alternate power and water sources) and the highest design standard used in any urban area. The seismic hazard for the project was determined using the latest ground motion data from the US Geological Survey, taking into account the most recent earthquake findings for the Puget Sound area. When completed, it will likely be the best seismic designed building on the Eastside.

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