STANFORD HEALTH CARE
A PUBLICATION FOR EMPLOYEES OF STANFORD HEALTH CARE
FALL 2019
Look Inside the New Stanford Hospital
Around SHC Stanford undergraduate students (left, bottom) worked with master painters to paint a mural for the new Stanford Hospital based on a drawing by the late artist Sol LeWitt. The mural fills an 18-by-10-foot wall on the third floor. The Life Flight team (left, middle) celebrates after the Life Flight helicopter touched down on the new Stanford Hospital helistop during the first test landing. The new Stanford Hospital reached a major milestone in July, receiving a Temporary Certificate of Occupancy (TCO), employees celebrated by taking their hard hats off at events throughout SHC (top, middle).
from the CEO Dear Colleagues, We often measure our success by the outcomes that we achieve—in this case, we have hit it out of the park! Our shared journey on the road to this amazing new hospital has reached its destination. It’s been a rewarding experience for me to work side-by-side with you who have enthusiastically invested your ideas, time and energy in the hospital’s planning and construction. Our spectacular new Stanford Hospital fills me with tremendous pride. Inside this edition, you’ll read about the impressive state-of-the-art technology that assists our patients and better enables our caregivers from the moment they step through the front door. You’ll also learn
more about the building’s remarkable sustainability features, stunning interior design and easy access to the natural environment. As I spend time in our incredible hospital, I envision the extraordinary care our patients will receive within its walls. I think about the dedicated doctors, nurses, care teams and staff who will be providing that high-quality care each and every day. And I think about how it will be the kind of healing place where we can make a meaningful impact on local, regional and global health through the practice of Precision Health. I greatly appreciate each one of you for your efforts during this momentous time in our history; you have made a lasting impact on Stanford Health Care. I am especially grateful for your steadfast partnership on this milestone project, which could not have been completed without you.
I feel so fortunate to work alongside such talented and committed colleagues. Thank you for your hard work and remarkable spirit. Let’s celebrate our achievement and look forward to the future with energy, conviction and optimism. The best is yet to come! DAVID ENTWISTLE PRESIDENT & CEO
SHC PEOPLE is produced by the Internal Communications Department and photography is by Luke Girard, Will Pryce and Darius Riley. Send comments to communications@stanfordhealthcare.org.
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ROM A DEMOLISHED PARKING STRUCTURE TO AN ERECTOR SET OF STEEL TO THE GLASS-COVERED TOWERS SO HIGHLY VISIBLE TODAY, THE NEW STANFORD HOSPITAL SITS READY FOR OCCUPANCY, JUST WEEKS AWAY FROM OPENING ITS DOORS TO PATIENTS, FAMILIES, VISITORS AND THE COMMUNITY LATER THIS FALL. AFTER MORE THAN A DECADE OF PLANNING, DESIGN AND CONSTRUCTION, THE HARD HATS ARE FINALLY OFF AND THE FINISHING TOUCHES ARE BEING COMPLETED AS STAFF MEMBERS READY THEMSELVES TO WORK IN THE NEW SPACE. CONTINUED ON PAGE 4
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“Our new hospital will be a place for firsts. New discoveries will be made here. New procedures will be performed. And through this remarkable state-of-the-art facility, we will be able to revolutionize the way that patient care is delivered at Stanford.”
This issue of SHC People is dedicated to telling the stories of the new hospital— its history, its patient- and caregivercentered approach to care, the advanced interventional platform that revolutionizes how surgeries are performed, the four acres of gardens and 400-plus pieces of original artwork, the digital tools and technology guiding patients through their recovery, the greatly expanded emergency department and emergency readiness capabilities, and the nice-to-have extras such as locally sourced food, coffee kiosks, gift shop, interfaith chapel and florist “Our new hospital will be a place for firsts. New discoveries will be made here New procedures will be performed. And through this remarkable state-of-the-art facility, we will be able to revolutionize the way that patient care is delivered at Stanford,” said David Entwistle, president and CEO. “It’s wonderful to see our vision for the future of patient care coming to life, and I am grateful for the exceptional team who helped us reach this point.”
< THE 30-FOOT ILLUMINATED BUCKYBALL SCULPTURE IS THE CENTERPIECE OF THE ENTRANCE PLAZA.
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A Decade-Plus Vision The decision to build a new hospital began more than 10 years ago in response to stricter seismic regulations following the devastating Northridge earthquake. Like most hospitals in California, Stanford decided to build from the ground up rather than attempt to retrofit its existin hospital while remaining open for patient care. By starting with a clean slate, the medical planners and architects were able to accommodate their vision for bringing the most technologically advanced care to patients today, with the flexibility t incorporate technologies not yet invented. The 824,000-square-foot facility also greatly increases capacity for patient care, with an emergency department that’s more than twice as large as the current facility and the addition of 368 all-private patient rooms.
Blending Humanity and Technology Visitors entering the new hospital will be greeted by the 30-foot Buckyball sculpture outside the entrance, the creation of artist Leo Villareal, who is best known for his lighting installment on the Bay Bridge. Just inside the front doors, a sunlit grand atrium with a criss-crossed steel dome welcomes visitors and patients. In the atrium’s center, Liquid Light by James Carpenter uses waves of glass that interact with the sun to create a virtual reflecting pond. The mai cafeteria, gift shop, Café Parisien, frozen yogurt café and florist round out the street level public offerings at the new hospital. Also on the street level is the new emergency department (ED), more than twice the size of the current space at 300P. As a Level 1 trauma center, Stanford Hospital must be prepared to deal with mass casualties. The new 900-car parking garage adjacent to the ED is equipped with emergency response equipment and can be quickly converted into additional emergency room and triage space in the event of a mass-injury event such as an earthquake. The garage also includes four decontamination showers and is equipped with WiFi to allow staff to register and admit victims into the facility remotely.
The New Stanford Hospital at a Glance
GOLDMAN GARDENS
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The new Stanford Hospital offers the most advanced care in a healing environment created to meet the needs of the whole person—socially, emotionally, spiritually, and physically.
HYBRID OPERATING ROOMS
LEVIN ATRIUM
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2
8 PATIENT ROOMS
3 HELISTOP
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5 9 JOHNSON WELLNESS CENTER
DINING ROOM
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IN-ROOM DIGITAL TOOLS
10 BUCKYBALL
ANDREESSEN EMERGENCY DEPARTMENT
1
2
Gardens Promote Healing
New Hybrid Operating Rooms
The new Stanford Hospital places equal value on the healing qualities of art and nature. It includes four acres of outdoor gardens and floor-to-ceiling windows in every patient room. (More on Pg 10)
The largest floor of the hospital is an integrated surgical, procedural and imaging space. Covering three acres across the entire second floor, the interventional platform includes 20 ORs, two hybrid ORs, and eight interventional/radiology imageguided rooms. (More on Pg 14)
3 Helistop As the only Level 1 Trauma Center between San Francisco and San Jose, critical care patients from throughout California will be transported to this new rooftop helistop once the hospital opens to patient care this fall. The helistop location is elevated with perimeter lighting so it’s easier to see at night.
4 Third-Floor Wellness Space The third floor of the building is dedicated exclusively to wellness and includes a welcoming respite for patients, families and hospital staff. Amenities include the Lynne and Roy M. Frank Family Resource Center, Health Library, interfaith chapel, roof gardens, art and music. (More on Pg 6)
5 Technology Transforms Patient Experience
6 New Level 1 Trauma Center
In-room digital tools are transforming the patient experience, and patients can learn about their care team—the doctors, nurses and other service providers coming into their room using the MyHealth app.
More than two-and-a-half times larger than the current space, the new ED will serve all adult and trauma patients in private and semi-private patient bays. The existing ED will be renovated and will serve pediatric patients.
(More on Pg 12)
(More on Pg 18)
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8
9
10
Atrium
Patient Rooms
Dining
Buckyball
As patients and guests walk through the main entrance of the new Stanford Hospital, they enter the atrium featuring terrazzo flooring, limestone wall, a wood ceiling and an information desk. The Stanford shield is featured prominently on the walls.
All 368 patient rooms, located primarily in the Patient Pavilions on levels 4–7, are single occupancy with sleeper sofas so that loved ones can stay in the patient’s room during treatment and recovery.
There will be a variety of new dining options in the hospital. In addition to the main cafeteria, private dining will be available on the third floor of the building. Two local eateries will be setting up shop on the ground floor promenade. Fraiche will be serving homemade organic frozen yogurt and grab-and-go snacks, and La Baguette will be operating Café Parisien. (More on Pg 8)
Leo Villareal brought his passion for form and geometry to his largerthan-life buckyball sculpture. The 30-foot illuminated sculpture is the centerpiece of the entrance plaza and one of more than 400 works of original art in the new hospital. (More on Pg 11)
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JUST INSIDE THE FRONT DOORS, THE ATRIUM WELCOMES VISITORS AND PATIENTS.
FOUR ACRES OF GARDENS, FILLED WITH TREES, FLOWERS AND WALKING PATHS, SURROUND THE NEW STANFORD HOSPITAL.
Above the staff parking garage sit the executive suites and a conference center that holds 350 people, part of the third- floor garden-level. An outdoor terrac and indoor lounge give providers a space to relax, with expansive views of the surrounding campus and foothills. Space is abundant throughout the new facility. The entire second floor i dedicated to surgical and procedural suites, with large rooms that can flex a new technologies are introduced. Patient rooms are all private, with ample space for a family member or friend to spend the night. Four acres of gardens, filled wit trees, flowers and walking paths, roun out the hospital campus, giving patients, caregivers, staff and visitors access to nature and fresh air.
Readying the Staff As the final touches are made to the ne hospital, Stanford Health Care is beginning the extensive operational training and preparation necessary to license a new hospital facility. “It’s quite an extraordinary process to bring a new hospital like this online,” said Helen Wilmot, vice president of facilities services and planning. “More than 4,000 physicians, nurses, staff and volunteers will undergo rigorous training to familiarize themselves with the new hospital before it opens to patient care this fall.” It also begins a new chapter for the existing hospital. Renovations have already begun to modernize the hospital at 300 Pasteur (see story page 19). Combined, the two hospitals will have a total of 600 patient beds, with two emergency departments—500P serving adult and trauma patients and 300P serving pediatric patients. Walkways and a pedestrian bridge connect the two adult hospitals, creating a world-class medical center campus serving the immediate Palo Alto community and patients from around the world. The new Stanford Hospital was open to the public for the first time in Septembe for a two-day community event, and then closed for final preparations befor opening to patients in November.
“It’s quite an extraordinary process to bring a new hospital like this online. More than 4,000 physicians, nurses, staff and volunteers will undergo rigorous training to familiarize themselves with the new hospital before it opens to patient care this fall.”
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3rd Floor:
A Place for Healing New Hospital Pays Homage to Families and Caregivers
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THE THIRD FLOOR OVERLOOKS THE ATRIUM AND THE MAIN ENTRANCE.
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At the center of the new Stanford Hospital lies an oasis, a floor dedicated to providing support and comfort to the unsung heroes of healing—families and caregivers. Located on the third floor, the caregiver center, health library, interfaith chapel and roof garden combine to create a place for people to pause and reflect, to take a break from the clinical setting of the inpatient rooms above and the demands of the outside world beyond the hospital entrance. “Caregivers are essential to the patient and family experience,” said Alpa Vyas, vice president, patient experience. “The third floor creates this welcoming respite for families and caregivers and for our staff.” Overwhelmingly, research has shown that caregivers are at high risk for burnout and health issues, as they juggle careers, families and home with the responsibility of caring for a sick or injured relative. Nearly half of all family caregivers say they are “somewhat stressed,” and more than a third are “highly stressed,” according to a 2015 Caregiving Report sponsored by the AARP. “National trends and research informed our strategic decision to invest in a dedicated caregiver area,” said Vyas. As the centerpiece of the third floor, the Lynne and Roy M. Frank Family Resource Center, home of the Caregiver Center and the Stanford Health Library, provides compassionate support to caregivers and connects them with resources for wherever they are in their care journey. The Center will be open Monday through Friday, from 9 a.m. to 7 p.m. Through one-on-one conversations with families and caregivers, program managers and care coaches can develop care plans and coordinate supportive services for every unique situation, from an imminent discharge to a lengthy hospital stay. “The goal is to meet caregivers where they are in their journey,” said Rachelle Mirkin, MPH, director, health education, engagement and promotion programs. The team of care coaches, program
managers, patient care navigators and health librarians is crosstrained and collaborative, and works to help connect families and caregivers with other inpatient services, such as spiritual care and social work, and community resources. “We are really trying to create warm handoffs so that individuals don’t feel like they have to keep retelling their story,” said Mirkin. The expansive third floor is also home to the newest branch of the Stanford Health Library, which includes a special collection on caregiving and family health, said its director, Nora Cain. Health librarians provide personal assistance in researching questions about medical issues and help visitors access Stanford’s vast digital resources. The space is outfitted with magazines, puzzles and art supplies, and includes modular furniture that can be reconfigured for small-group discussions and classroom formats. “It’s a really large, beautiful space with lots of room to sit and read and have quiet conversations,” said Cain. Visitors can also sit outside on the patio or walk through the expansive gardens to find a private area to decompress. A circular rotunda at the entrance of the third floor, and the adjacent interfaith chapel and garden, provide additional quiet spaces for reflection and contemplation “I believe we are the first hospital in Northern California to have a dedicated space for caregivers,” said Vyas. “We created an environment that’s supportive, that helps caregivers reduce the risk of burnout and health complications. We just wanted to give people space to breathe.”
Located on the third floor, the caregiver center, health library, interfaith chapel and roof garden combine to create a place for people to pause and reflect, to take a break from the clinical setting of the inpatient rooms above and the demands of the outside world beyond the hospital entrance.
CLOCKWISE FROM THE TOP: • PROGRAM MANAGERS AND CARE COACHES DEVELOP CARE PLANS AND COORDINATE SUPPORTIVE SERVICES FOR PATIENTS AND FAMILIES. •T HE LYNNE AND ROY M. FRANK FAMILY RESOURCE CENTER IS THE CENTERPIECE OF THE THIRD FLOOR. •C ARE COACHES, PROGRAM MANAGERS, PATIENT CARE NAVIGATORS AND HEALTH LIBRARIANS COLLABORATE AND DISCUSS HOW TO CONNECT FAMILIES AND CAREGIVERS WITH OTHER INPATIENT SERVICES AND COMMUNITY RESOURCES.
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THE REGINA K. SKULLY & JOHN H. SCULLY DINING COMMONS IS LOCATED ON THE FIRST FLOOR.
Dining Out Globally inspired flavors. Locally sourced, antibiotic and hormone free, farm-to-table menus. Food as a source of healing punctuates the food offerings at the new Stanford Hospital. From made-to-order salads, sandwiches and wok specialties in the first-floor cafeteria t upscale dining on the third floor to French café favorites and homemade organic frozen yogurt on the promenade, visitors and staff will have a plethora of dining options.
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“The goal is to offer variety and choice at the new Stanford Hospital, continuing our focus on providing local, seasonal, plantforward foods,” said Jodi Krefetz, director of food services for Stanford Health Care. “Food is part of the healing environment.” Starting on the first floor, the mai cafeteria sits just to the right of the hospital entrance, with floor-to-ceiling windows and indoor and outdoor seating that can accommodate over 200 people. Gone are the self-service food stations. Instead, food will be freshly prepared for each patron, including ingredient-driven menus, made-to-order deli sandwiches and freshly tossed salads. Two local eateries are setting up shop on the Stanford Hospital promenade. Fraiche will be serving homemade organic
JODI KREFETZ, DIRECTOR OF FOOD SERVICES, IN THE KITCHEN AT THE EXISTING STANFORD HOSPITAL.
frozen yogurt and grab-and-go snacks, and La Baguette will be operating the Café Parisien, serving French-style baguette sandwiches, soups, salads and pastries. Additionally, Aili Ice Designs, specializing in unique floral design arrangements, will be located on the North Pasteur side of the hospital. The hospital’s main entrance will also feature a spacious, beautifully designed gift shop with expanded selections. On the third floor, patients, families, caregivers and visitors can enjoy a cup of coffee, pastry or snack from the Wellness Kiosk operated by ZoomCaffe, or they can visit the Stanford Dining Room for a relaxed sit-down meal in an upscale environment.
ON THE THIRD FLOOR, PATIENTS, FAMILIES, CAREGIVERS AND VISITORS WILL BE ABLE TO VISIT THE STANFORD DINING ROOM FOR A RELAXED SIT-DOWN MEAL IN AN UPSCALE ENVIRONMENT.
The new hospital’s eateries are meant to complement, not replace, the food options at the existing Stanford Hospital, said Helen Wirth, administrative director, hospitality services. “We imagine people going back and forth between buildings to experience the variety of food choices we offer across the health care campus.”
Inpatient Dining For patients, the “At Your Request” roomservice-style food experience will continue in the new hospital. What is changing is the kitchen where food is prepared. “We have outgrown our 1959 kitchen,” said Wirth. “The team has done a spectacular job in its limited space, but they are moving into a fully modernized central kitchen on the ground floor of the new hospital.”
At more than 18,000 square feet, the commercial kitchen includes eight walk-in refrigerators and freezers and over 800 pieces of new equipment. It will be the central hub of meal prep for patients at both Stanford Hospital locations, with the capability of serving over 1,800 meals to an estimated 600 patients per day. Patients can order from hundreds of menu items simply by dialing direct from 6 a.m. until 9 p.m.
Food menus are integrated with patient records in Epic, so dietetic assistants can guide patients through their appropriate menu selections based on their health needs. “I’m thrilled to give the staff the space they deserve, a workplace reflective of our food program values, which connect to the mission of Stanford Health Care,” said Krefetz.
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THE COMMERCIAL KITCHEN AT THE NEW STANFORD HOSPITAL WILL BE THE CENTRAL HUB OF MEAL
THE MAIN CAFETERIA SITS JUST TO THE RIGHT OF THE HOSPITAL ENTRANCE AND FOOD WILL BE
PREP FOR PATIENTS AT BOTH STANFORD HOSPITAL LOCATIONS.
FRESHLY PREPARED FOR EACH PATRON.
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The Healing Arts Art and Nature Prescribed to Benefit Healin In the early 1980s, a group of volunteers formed to acquire and hang art on the then-empty walls of Stanford Hospital. What this group sensed about the power of art—that it could help improve healing—was proven later that same decade in multiple studies by environmental psychologist Roger Ulrich, PhD. His research findings indicated that art can substantially affect outcomes suc as blood pressure, anxiety, intake of pain medications and length of hospital stay. Similarly, Ulrich found that patients who had hospital rooms with a window required less pain medication and recovered faster than patients in rooms without windows. “Today, every new hospital includes art, and for this new facility, Stanford has embraced a bold vision for the integration of the arts, setting new standards of excellence,” said Connie Wolf, consulting director of the art program for the new Stanford Hospital. “Integrating art into the hospital environment allows us to think holistically about the healing of the mind, the soul and the spirit.” The new Stanford Hospital places equal value on the restorative qualities of art and nature. It includes four acres of outdoor gardens, floor-to-ceiling windows in every patient room and mor than 400 works of original art. “We think about patients, their loved ones and families, and the staff. Those three entities are all important to nurture,” Wolf said. “How can we create an environment that supports the patients’ healing and well-being, provides comfort to their families, and
offers relief to the complex and challenging work of the staff?” Stanford Health Care (SHC) has a dedicated Art Commission, composed of 14 volunteers led by Linda Meier, an original founder of the arts program who also now serves on the Board of Directors of SHC. The Commission strives to find pieces that not only are uplifting, beautiful and inspiring, but also have depth, complexity and layers of meaning. Patients and families can spend long periods of time at the hospital, Wolf said. “We want them to be able to come back to the work and experience it afresh each time.” The committee commissioned seven pieces of art for the new hospital. These site-specific works grace the entrance plaza, the atrium, the walls of the interfaith chapel, and the third-floor galleria and gardens. Along with the hospital’s gardens, the art will help create a mood, Wolf said. “We want people to walk in, feel welcome, and know they are in an environment where their health and spirit matter.”
Commissioned Works Korean artist Jinnie Seo spent two months on site at the new hospital painting Rays of Hope, a mural in the interfaith chapel. Working six days a week, Seo and her assistant brought the curved walls at the back of the chapel to life with a backdrop of cerulean blue layered with a series of fine, straight lines in silver and gold metallic paint For some, the image is reminiscent of butterflies taking flight, S said. “I wanted to give a person a space to pause and be still, even for one moment. That moment can last an eternity and be a lifechanging experience.”
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KOREAN ARTIST JINNIE SEO (RIGHT) AND HER STUDIO ASSISTANT JIHYUN LEE SPENT TWO MONTHS ON SITE PAINTING RAYS OF HOPE, A MURAL IN THE INTERFAITH CHAPEL.
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< FOUR ACRES OF GARDENS SURROUND THE NEW STANFORD HOSPITAL.
The third floor will also be distinguished by a wall mural based o a drawing by the late artist Sol LeWitt. He is best known for his bold, colorful, geometric works composed of straight lines and curves. In July, two master painters who are experienced in making these works, together with two Stanford undergraduate students serving as interns, spent 24 days painting the 18-by-10-foot LeWitt mural. Each of the commissioned pieces for the new Stanford Hospital was fully underwritten by private donors. The other 400-plus pieces of art were either donated works or acquired through private donations.
Healing Gardens
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Leo Villareal brought his passion for form and geometry to his larger-than-life sculpture, Buckyball, a 30-foot metal structure featuring three nested spheres. Villareal was inspired by the geodesic dome popularized by architect and inventor Buckminster Fuller. This same geodesic structure was discovered in a carbon molecule by nanotechnologists, Villareal said. “I thought it would be interesting to take something that you could never see with a naked eye and expand it on this monumental scale.” As he did with the Bay Lights installation on the Bay Bridge, Villareal lined Buckyball with LED lights that are programmed to twinkle, blink and slowly shift in a neverrepeating sequence of colors and patterns. Other commissioned works include two pieces in the atrium. Zadok Ben-David’s Endless Columns presents images of butterflie and the human figure that soar in the space. Artist James Carpente used large waves of tumbled glass woven together to create the Liquid Light reflecting pond directly under the glass dome On the third level, there is a commission in the garden by Ned Kahn. Air Cube, a 1,000-pound metal sculpture, interacts with the wind and reflects light in dynamic and ever-changing ways. Artis Brian Isobe created a series of paintings that feature water and light for the curved walls of the Wellness Center Gallery. A large-scale video installation by artist Jennifer Steinkamp presents California wildflowers as they change through the seasons
Four acres of gardens surround the new Stanford Hospital, including five interconnected rooftop gardens on the third level of the building with walking paths and multiple places to sit. A vertical garden outside the interfaith chapel on the third floor creates an additiona private space for reflection Outside the emergency department on the first floor lies a new planted orchard of 85 deciduous trees, and includes shrubs, rushes, grasses, ash trees and walking paths to create a shady, serene retreat for patients, families, visitors and staff. The gardens on the street level also include a dog park, complete with a water fountain and fire hydrant While art will be available in the corridors connecting the patient rooms, the rooms themselves have a different kind of art on view. By design, every patient room has floor-to-ceiling windows to let i natural light and glimpses of the surrounding foothills and skies.
OVER THE SUMMER, BUCKYBALL, BY ARTIST LEO VILLAREAL WAS ASSEMBLED IN FRONT OF THE MAIN ENTRANCE TO THE NEW STANFORD HOSPITAL.
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Smart
<
Technology Enhances Patient Experience
BY CLICKING THROUGH THE MYHEALTH APP’S INTUITIVE ICONS, ADMITTED PATIENTS AND THEIR CAREGIVERS CAN NOW LEARN ABOUT THE INPATIENT CARE TEAM COMING INTO THEIR ROOMS.
We are all experiencing the digitization
experience patients have come to expect in
platform in the inpatient setting has made
of consumer services in our lives, from
every other aspect of their lives.”
it seamless for the clinical staff; there is no
The MyHealth digital platform is now
ordering coffee to checking bank balances
onboarding overhead for them. Knowing
or getting directions, all from the comfort
location and contextually aware; it knows
where patients are in the system, we can
and convenience of our smart devices.
when a patient has been admitted to
provide appropriate and timely information
Similarly, the new Stanford Hospital
the hospital and automatically provides
to them across their care continuum.”
is leveraging the latest in advanced
a completely different experience for
technology to transform the patient
inpatients versus outpatients. MyHealth
Smartphones and Devices
experience. Stanford Health Care’s Software
is available both as an app on the iOS
By clicking through the app’s intuitive icons,
Design and Development team worked
and Android smartphones, as well as via
admitted patients and their caregivers can
closely with patient experience and nursing
the web browser on laptops, desktops
learn about their inpatient care team—the
teams to create a personalized, seamless
and tablets, allowing patients and their
doctors, nurses and other service providers
inpatient experience for our patients and
caregivers access via their device of choice.
coming into their rooms. They can see a list
“We wanted to reduce friction for
their caregivers by substantially enhancing the digital platform that powers MyHealth. “For the new hospital, we looked at how
of their medications, learn more about their
patients, to make the experience seamless
medications and understand how they are
across inpatient and outpatient, without
administered.
advanced technology could transform the
having to download and interact with a
patient experience,” said Aditya Bhasin, vice
different application,” said Bhasin. “With
shared at discharge, are now made
president, software design & development.
over 600,000 patients already registered and
available in real time once they’ve been
“The MyHealth app creates the kind of
familiar with MyHealth, leveraging the digital
released within MyHealth,” said Bhasin.
THE PATIENT EXPERIENCE AT THE BEDSIDE.
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IN-ROOM DIGITAL TOOLS ARE TRANSFORMING
“Test results, which were once only
“MyHealth Inpatient makes relevant health education information and instructions available to patients as soon as it is assigned by the care team.”
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TEAM MEMBERS LOOK AT HOW TECHNOLOGY CAN TRANSFORM THE PATIENT EXPERIENCE.
THE SOFTWARE DESIGN AND DEVELOPMENT TEAM WORKS CLOSELY WITH PATIENT EXPERIENCE AND NURSING TEAMS TO CREATE A PERSONALIZED, <
SEAMLESS INPATIENT EXPERIENCE FOR PATIENTS.
“MyHealth Inpatient makes relevant health education information and instructions available to patients as soon as it is assigned by the care team.” Other MyHealth Inpatient features help patients navigate through their discharge planning and pain and mobility goals; understand their fall risk; and order guest services such as art, pet or music therapy. Patients can also grant access to their MyHealth account to a designated (proxy) family member or caregiver to keep them informed and involved. “Providing this transparency of information and availability for patients and caregivers to access it at their convenience is a key feature of the new app,” said Bhasin. “It frees them from focusing on taking notes when talking
system and experience a hotel-like
of the new Stanford Hospital are being
with the care team and allows for a more
digital streaming service. Music, movies,
built into the MyHealth app, and will be
informed dialogue.”
popular television shows and sports are all
available to both patients and visitors.
available at a patient’s fingertips. Patients
“Stanford Health Care delivers cutting-
Smart Hospital Rooms
can also adjust the temperature in their
In-room digital tools are also transforming
room, control the window blinds to let
the patient experience at the bedside.
light in or block out midday sun, or call for
believe our patients’ digital health care
Using a remote or iPad, patients can
a nurse, all without leaving bed.
experience should be just as innovative
access the in-room entertainment
Way-finding capabilities with maps
edge medical care,” said Bhasin. “We
and intuitive.”
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The Future of Surgery: Interventional Platform Integrates ORs, Procedure Rooms and Imaging. About 20 years ago, medical designers and planners began developing the idea of an interventional platform—co-locating surgical operating rooms (ORs), hybrid ORs, imaging, procedure rooms, endoscopic rooms and cardiac-cath labs, all into one common, integrated space. Many hospitals have begun to add elements of the interventional platform to their existing surgical floors. But to create the integrated platform as conceived requires design from the ground up. “It’s difficult to create this coordinated interventional platform i a renovation,” said George Tingwald, MD, AIA, director of medical planning for Stanford Health Care. “A fresh start is optimal to have the right structural grid to the building. It requires a big enough footprint to put all of the necessary services with their varied functions in the same space.” Tingwald, who helped develop and champion this revolutionary concept, is thrilled to be able to not just conceive of the design, but to see it being built at the new Stanford Hospital. “If you want to know what this building provides that’s different from any other new hospital, the interventional platform is it,” he said. In designing the new Stanford Hospital, Planning Design + Construction worked with the architect to create a dedicated space to achieve this goal. The largest floor of the hospital was devoted to creating this integrated surgical, procedural and imaging space. Covering three acres across the entire second floor, the interventional platform includes 20 operating rooms (ORs); two hybrid ORs; eight interventional, radiology, image-guidance rooms; three MRIs; three CTs; and one intra-operative MRI.
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“The benefits of integration allow Stanford to provide the most innovative care in the most efficient way,” said Sam Wald, MD, MBA, FASA, vice president, inpatient perioperative services and associate chief medical officer, perioperative and interventional services. “Stanford patients gain the most advanced interventional and surgical care with simultaneous state-of-the-art imaging.” The interventional platform brings together multiple surgical and procedural specialties—cardiologists, gastroenterologists, surgeons, radiologists and pulmonologists—into one common area. The space is further integrated with a centralized Pre-Op and Post-Anesthesia Care Unit (PACU). This flexible and nimble area includes 70 private patient bays and a centralized provider workstation and support area. Each patient bay can transition from a pre-operative space into a recovery area to accommodate patients both before and after procedures with a large, comfortable waiting lounge for families and caregivers. The ability to image patients during surgery is one of the most anticipated capabilities of the new Stanford Hospital’s hybrid operating suites. These advanced surgical suites are equipped with an intra-operative magnetic resonance imaging machine (iMRI), a sterile operating room itself, immediately adjacent to the neurosurgical and neuro-interventional suites. This allows patients to be co-located with access to an MRI during their neurologic intervention while still under anesthesia. The physicians have access to real-time images during surgery for immediate attention. Multi-stage procedures that were once performed in separate locations and at separate times can now be done within one scheduled procedure time and location. With this new capability, neurosurgeons capture images of the brain during surgery to determine if a tumor has been removed sufficiently before completing the surgery. By using iMRI, the need for patients to have additional procedures is reduced with the most optimal outcomes for Stanford patients, said Wald.
< THE CENTRALIZED PRE-OP AND POST-ANESTHESIA CARE UNIT (PACU) INCLUDES 70 PRIVATE PATIENT BAYS AND A CENTRALIZED PROVIDER WORKSTATION AND SUPPORT AREA.
“If you want to know what this building provides that’s different from any other new hospital, the interventional platform is it.”
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HISTORY-MAKING
form &
function GROUNDBREAKING CEREMONY PROJECT APPROVED BY PALO ALTO CITY COUNCIL
SITE PREPARATION AND DEMOLITION
SHORING AND MASS EXCAVATION
FOUNDATION WORK/ INSTALLATION OF BASE ISOLATORS FOUNDATION COMPLETE STEEL INSTALLATION
2011 2012 2013 2014 Building the new Stanford Hospital began long before the architect drew his first sketches. The seedlings for a new hospital were planted in 1994 following the devastating Northridge earthquake. That event sparked new legislation requiring all California hospitals to meet a higher standard of seismic safety by 2030: not just to withstand an earthquake, but to remain operational during and directly after an earthquake.
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“That is a very different building type,” said George Tingwald, MD, AIA, director of medical planning for Stanford Health Care (SHC). “It requires a lot more infrastructure and a lot more steel.” Initially, SHC leaders had hoped to be able to seismically retrofit the existin hospital, which includes the original 1959 building and two additions from 1973 and 1983. But the difficulty of completin that work while remaining open to patient care solidified the decision to build new hospital. From that decision, the Stanford University Medical Center (SUMC) Renewal Project was born, a decade-plus, $5 billion effort to expand and modernize Stanford Medicine’s facilities to serve the region’s growing health care needs and accommodate advances in medical technology and patient care. In addition to building a new adult hospital, the
LANDSCAPING WORK CONTINUES TOPPING OFF
CONSTRUCTION OF EXTERIOR AND INTERIOR CONTINUES
EQUIPMENT INSTALLATION BEGINS
CONSTRUCTION OF EXTERIOR AND INTERIOR CONTINUES
CONSTRUCTION OF EXTERIOR AND INTERIOR BEGINS
NEW PARKING GARAGE CONSTRUCTION COMPLETE
CONSTRUCTION OF EXTERIOR AND INTERIOR CONTINUES
EQUIPMENT INSTALLATION CONTINUES
STAFFING, STOCKING AND TESTING OF NEW HOSPITAL BUILDING BEGINS HOSPITAL OPEN TO PATIENTS
2015 2016 2017 2018 2019 Renewal Project included an expansion and modernization of the Lucile Packard Children’s Hospital, renovation of the Hoover Pavilion medical complex, and updated labs and teaching spaces at the School of Medicine. “There was a big vision of where we wanted to go,” said Tingwald, who joined Stanford Health Care in 2008. “We knew at the time that there were things we didn’t know and technologies that would develop,” he said. So the design had to be flexible. “We purposely planned the buildin in a generic fashion. We made the operating rooms big, developed the interventional platform concept, made everything large and flexible to allow us to make change during the design process.” One of the hospital’s first hurdles wa gaining approval from the city of Palo Alto in 2011 to break the 50-foot height limit.
Clearing a site for the new Stanford Hospital was another monumental task, requiring the demolition of offices at 1100 Welc Road and the former 600-car visitor parking garage. Upgrading utilities and widening Welch Road were also part of the Renewal Project’s master plan. On May 1, 2013, the officia groundbreaking took place. By 2015, all of the foundation work was complete, the base isolators were installed and the 18,000-ton steel structure was up. The next two years saw rapid changes to the outer and inner structures. The exterior was covered in glass. The pedestrian bridge connecting both hospitals was built. The new 900-car staff parking structure was complete. Landscape work began. The progress inside was just as impressive. Interiors were built out. Patient rooms began to take shape. The interventional
platform was built, and major medical and imaging equipment was installed. Throughout 2019, furnishings continue to be installed and artwork is beginning to appear in the public gardens and interior spaces. Today, finishing touches continue t punctuate the grandeur of the new Stanford Campus. Pasteur Drive reopened. Signage is in place. The 30-foot Buckyball sculpture graces the front entrance. Most important, the hospital received its Temporary Certificate of Occupancy in early July Just weeks away from welcoming its first patients, the new Stanford Hospita opened its doors to the community for two days in September, a public celebration of the remarkable achievement that’s been more than a decade in the making.
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NEW
ED
Doubles in Size, Efficienc
“The biggest part of moving into the new hospital is having more space,” said Andra Blomkalns, MD, professor and chair, department of emergency medicine. “We will actually be able to take care of patients the way they’re supposed to be taken care of, in a way that’s maximally beneficial for the patien and also for our learning providers.”
Room for Families Of the 66 treatment spaces in the new ED, 47 are private and 19 are semi-private. All of the areas have more than doubled in size from 50 to 120 square feet. “In our current space, we are carrying on very sensitive conversations with only a curtain separating
< SAMUEL SNELL, ASSISTANT PATIENT CARE MANAGER, GABE GAMMON, EMERGENCY DEPARTMENT LEAD TECH, AND VASILIY RODIN, ASSISTANT PATIENT CARE MANAGER, IN FRONT OF THE NEW STANFORD HOSPITAL.
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THE NEW ED WILL SERVE PATIENTS IN PRIVATE AND SEMI-PRIVATE PATIENT BAYS.
us from other patients and families,” said Vasiliy Rodin, RN, assistant patient care manager and 500P operations project manager for transition. “We are creating private space for our patients so they can be treated with dignity and respect.” The larger rooms also provide ample space for providers and families. “With the new layout, we can have two to four family members in the room and still have access to the patient without disrupting patient/family time,” said Rodin. Telemedicine technology will let patients and providers discuss medical treatment decisions with family members who are out of the area through a web link. This same technology will be used to provide translation services to patients who do not speak English. “We have the ability to reunify families across state lines, cities, continents,” said Rodin. “Now families can call into the room, and patients and providers will be able to see them on TV. That’s a big change for us and for the patient experience.”
Dedicated Pediatric and Adult EDs Once the transition to the new hospital is complete, the ED at 500P will become the entry point for adults and trauma patients, while children will continue to be seen at the existing hospital’s ED. This change was made to both improve capacity at the new hospital and provide a friendlier pediatric patient experience for children, said Blomkalns. “By separating children from the adult population, we’re not just creating extra capacity for our adult patients, but also creating a much-needed space for treating kids appropriately in their own appropriate space,” said Rodin. The existing hospital’s ED will be renovated as part of the 300P Renewal Program, incorporating design elements from Packard Children’s Hospital.
New Workspaces Technology is also changing how providers will work in the larger ED space. Lighting that reduces shadows allows more providers to work together in resuscitation bays. Automated Omnicell pharmacies are located throughout the ED, bringing medications closer to care rooms. CT and imaging is adjacent to the ED for convenience and efficiency Access to computers has also been greatly improved in the new space, said Patrice Callagy, RN, MSN, director, emergency medicine. There are 40 computer stations on wheels to provide mobility for staff, nearly 50 workstations in patient rooms, and six nursing stations, each with multiple computers. In all, the new ED will be home to 160 workstations so doctors, nurses and technicians can immediately document actions in the electronic medical record.
New Workflow When a department balloons from 18,000 to 45,000 square feet, and patients move from doubling up in semi-private rooms and hallways to being seen in more private patient bays, standard workflows and staffi must change to accommodate the new space. Rodin is in charge of reimagining how care can be delivered and redrafting workflows for every patient scenario “It’s a huge undertaking,” said Callagy. “We touch every aspect of the hospital, not just at Stanford but at LPCH too.” FOR MORE THAN 40 PERCENT OF PATIENTS, THE ED IS THE ENTRY POINT TO STANFORD HOSPITAL. THE NEW ED IS LOCATED ON THE CORNER OF WELCH RD AND PASTEUR DRIVE. <
One of the most anticipated aspects of the new Stanford Hospital is the new emergency department (ED). More than two and half times larger than the current space, the new ED will serve patients in private and semi-private patient bays, with imaging located right next door for expediency and efficiency. As th entry point to Stanford Hospital for more than 40 percent of patients, the new ED is located on the highly visible corner of Welch Road and Pasteur Drive.
300P RENEWAL A Cinderella Story in the Works As the new Stanford Hospital Planning teams vacate the offices at 1190 Welch Road, a new crew is moving in. Their charter—to renovate and remodel the existing Stanford Hospital to create a cohesive, campus-like experience for Stanford Health Care patients. “We wanted to bring the existing hospital up to the same standard, have it be of comparable fit and finish as the new hospital,” said Carlo Villalva, administrative director of capital initiatives for Stanford Health Care. “We’re trying to make the experience between the two buildings far more integrated, so it’s not a jarring disconnect when you walk from 500 Pasteur to 300 Pasteur.” What’s different about this next group’s task is that the hospital will remain open for patient care throughout the renovation.
Groundwork Laid The 300P Renewal work actually began six years ago. There were a number of renovations that had to occur at 300P to support the new hospital when it opened. The existing loading dock was expanded to accommodate deliveries for both hospitals, the liquid oxygen tank farm was expanded, and a new Security Operations Center was constructed to serve the adult hospitals (SHC) and Lucile Packard Children’s Hospital (LPCH). The clinical lab, which also serves SHC and LPCH hospitals, was renovated and automated. The final phase of the clinical lab will be completed in October 2020. The 300P Renewal team also overhauled the waste dock and waste management systems, and moved the ramp and gas lines on the ground floor to accommodate the
underground tunnel connecting both hospitals. Currently under construction is a new collaborative workspace for SHC staff to offset office space lost during renovations. Seismic retrofitting of the remainder of 300P will continue through 2025. With the groundwork laid, and 500P opening later this fall, renovation of the existing hospital begins in earnest in January 2020 with the D, E and F pods; the ORs; and the PACU. “The next phase is about modernizing the existing hospital so our patients have similar experiences whether in the new or existing buildings. We’re also bringing our older buildings up to current seismic requirements,” said Tom Lavin, director of capital projects, 300P Renewal, Planning, Design + Construction. “Our projects are adjacent to patient care areas, which adds another layer of complexity to the work that we’re doing. Protecting the safety of our patients, visitors and staff is our highest priority.” During each phase of renovations, patients will be moved to open pods while the work area is sealed off from the public. Once the D pod is completed in 2021, work will move to the E pod, followed by the F pod. All of the semi-private patient rooms in the existing hospital will be converted to private rooms, with larger bathrooms, space for families, and the same technology, entertainment systems, headwalls and finishes as 500P. Two new extensions are being built onto the D and E pods, four floors each, for a total of 57 net new patient rooms. It was necessary to create this extra capacity to replace the rooms in the original 1959 building, which eventually will be demolished after 2030.
RENDERING OF A PATIENT CARE UNIT AT THE EXISTING STANFORD HOSPITAL, CONSTRUCTION IS SCHEDULED TO BEGIN IN JANUARY 2020.
“The next phase is about modernizing the existing hospital so our patients have similar experiences whether in the new or existing buildings.” Operating suites will also be modernized with the latest-generation of technologies used at 500P. When complete, the interventional platform will include 19 ORs and two new procedure rooms, and an expanded PACU with 72 beds and a waiting registration area. The emergency department will be completely renovated to better serve its pediatric population, incorporating themes from the Lucile Packard Children’s Hospital. Construction of a morgue facility is also part of this third phase of construction. When complete, 300 Pasteur will primarily provide cancer care for Stanford Health Care. Of its 232 rooms, all but 57 will be dedicated to oncology patients. “We recognize that oncology patients tend to have longer hospital stays,” said Villalva, who leads the team responsible for the renovation of the existing hospital facility. “We want to reimagine what can we do with the facility to make it much more comfortable for patients and families. We’re looking at ways to make it more like a home.”
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PAID LAHLOUH
FIRST-CLASS MAIL PRESORTED U.S. POSTAGE PAID LAHLOUH
BURLINGAME, CA PERMIT NO. 1
FIRST-CLASS MAIL PRESORTED U.S. POSTAGE PAID BURLINGAME, CA PERMIT NO. 1
NONPROFIT ORG. U.S. POSTAGE PAID LAHLOUH
N E W S T A NF ORD HOS PITAL BY THE NUM B E ROUR S PATIENTS NOW
824K 640K 402K 245K 200K 69,340 18K 368 28 1
824,000: SQUARE FOOTAGE OF THE NEW STANFORD HOSPITAL—EQUAL TO THE AREA OF APPROXIMATELY 17 FOOTBALL FIELDS.
640,000: WEIGHT IN POUNDS OF LIEBHERR LR1300 “CRAWLER” CRANE USED TO ERECT THE PROJECT’S STRUCTURAL STEEL, EQUAL TO THE WEIGHT OF THREE BLUE WHALES.
402,000: SQUARE FOOTAGE OF THE NEW STANFORD HOSPITAL PARKING STRUCTURE—ROUGHLY SIX TIMES THE AREA OF THE WHITE HOUSE.
245,000: SQUARE FOOTAGE OF GLAZING ON THE HOSPITAL.
200,000: CUBIC YARDS OF DIRT REMOVED FROM PROJECT SITE AS OF MARCH 23, 2015 “TOPPING OUT” EVENT, WHICH WOULD FILL 200,000 HOT TUBS.
69,340: CUBIC YARDS OF STRUCTURAL CONCRETE THAT WAS POURED INTO THE NEW STANFORD HOSPITAL—ENOUGH TO FILL 20 OLYMPIC-SIZED SWIMMING POOLS.
18,000: TONS OF STEEL USED IN NEW STANFORD HOSPITAL PROJECT WHEN COMPLETE—NEARLY TWICE THE WEIGHT OF THE EIFFEL TOWER.
368: NUMBER OF PATIENT BEDS IN THE NEW STANFORD HOSPITAL, FOR A TOTAL OF 600 PATIENT BEDS ON SITE.
28: STATE-OF-THE-ART DIAGNOSTIC AND TREATMENT ROOMS, INCLUDING 20 OPERATING ROOMS AND 8 INTERVENTIONAL/RADIOLOGY IMAGE-GUIDED ROOMS IN THE NEW STANFORD HOSPITAL.
1: LEVEL 1 TRAUMA CENTER IN THE NEW STANFORD HOSPITAL, WHICH WILL BE THE ONLY SUCH FACILITY BETWEEN SAN JOSE AND SAN FRANCISCO.