Eight Years and $456 Million Laterby Natalie Jacobs April 1, 2015
Think for a minute about what it might be like to walk through an empty hospital. You could go the zombie apocalypse route for this fantasy and imagine you see smoking X-ray machines blown into dark corners, wires firing occasional electrical impulses from walls that are barely intact, dust and debris everywhere. In this scene, you’d undoubtedly feel the past and present lives of this hospital combine in an eerie way to create an uncomfortable kind of sadness.
Or, when thinking about yourself walking through an empty hospital, you could imagine it’s a brand new, unopened facility completely unmarred by the difficulties of daily doctor/patient life. It would feel clean in the sanitary way that hospitals are supposed to feel clean, all of the equipment would be state-of-the-art and likely robotic, and every sound would echo. In this scene, it would be the present and the future that you sense as you walk through the vacant halls and operating rooms and recovery rooms, and you might feel an uncomfortable kind of intrigue.
While the first scenario is strictly the stuff of imagination, the second is very real. On Feb. 18, I was invited to tour the newly completed Scripps Health Prebys Cardiovascular Institute, with Scripps Chief Executive Gary Fybel, a member of Congregation Beth Am. On March 8, the hospital began admitting patients. There are 95 beds spread across five floors, including some isolation rooms and two-room suites for patients who require extra security or privacy (Mother Teresa was once a Scripps patient). There’s a nursing station within 60 ft. of each room, and special considerations were made so patients could easily get between the bed and the bathroom. All of the necessary equipment and plug-ins were considered and installed to create maximum efficiency for doctors and nurses. The hospital has four operating rooms, two hybrid operating rooms and three cardiac catheterization labs.
Until now, the Scripps cardiovascular team has been spread across two locations. Under the medical direction of Dr. Paul Teirstein, Scripps has become well-known for its specialty in cardiac care, especially for the interventional cardiology program which Teirstein was brought on to build-up 28 years ago. This is where minimally invasive techniques replace the need for open-heart surgeries. These procedures include implanting stents and replacing heart valves – in most cases, this can be done through a catheter inserted into a patient’s leg.
In the nearly three decades since Dr. Teirstein began studying and utilizing these procedures, the numbers of open heart surgeries have significantly declined.
“My dad is a doctor,” Teirstein says, “and he cautioned me that [interventional cardiology] might not be around. He wasn’t so sure I should spend a couple of years learning this new specialty that might not even survive.”
To date, Dr. Teirstein says he averages about 1,500 noninvasive procedures per year at Scripps Green Hospital. He expects this number to double in the new facility. Overall, Scripps expects all noninvasive procedures to grow at the Cardiovascular Institute with the combination of cardiac efforts of both Green and Memorial hospitals.
“This will be the biggest heart center in California, in terms of volume,” Teirstein, who holds 23 patents related to opening up blocked coronary arteries without major surgery, says.
The pace of innovation in the medical field is increasing rapidly. Although the current Scripps facility at Green Hospital in Torrey Pines was upgraded about seven years ago, Teirstein says it’s already outdated. Included in the $456 million price tag for the new Cardiovascular Institute is state-of-the-art equipment like a giant X-ray robot and a three-tiered wireless infrastructure (to support three different levels of wireless device use within the hospital). But they’ve also taken into consideration that things will change just as quickly, if not more quickly, in the next 10 years. To ease the transitions down the road, Teirstein and the physicians involved in the design team requested cath lab shell space be built into the plan. These rooms will be used for storage until they’re needed at a later date.
“These are $2 million rooms, each one of them [the cath labs],” Teirstein says. “If you want to remodel it, you’ve got to take it down and not use it for six months. So what do you do? You go to the shell space and you build that one up and you make the old one the new shell space. So there’s a lot of thought that went into this.”
So much thought, in fact, that the architects, HOK in Los Angeles, built a life-sized mock-up of each room-type in the Scripps parking lot on Genesee Ave. before finalizing the blueprints. Those on the cardiovascular team were invited to walk through the rooms and give advice on how to improve the design, down to the smallest detail, from switches and valves to hook-ups and machinery, even wall colors and decorative art were considered.
Dr. Teirstein and his physician colleagues started talking about the new hospital facilities eight years ago. From there, it took one year for initial planning, three years of architectural rendering, and three years of construction. Conrad Prebys, the construction and property management tycooon turned prolific philanthropist, donated $45 million to the cardiovascular institute project. It’s the largest single sum Prebys has ever donated, and the largest gift Scripps Health has ever received.
Dr. Teirstein explains that there are three main components to “a first-rate, world-class program:” patient care, which includes leading physicians and caring staff; research and innovation, which, for Scripps, takes the form of clinical research trials; and teaching, which keeps older doctors on their toes and introduces the hospital to a wide talent pool for when openings become available.
While it may be a bit strange to walk through an empty hospital no matter why it’s empty in the first place, it’s undeniable that medical need is skyrocketing. As Dr. Teirstein says, you don’t want to get sick but if you’re going to get sick, you want to do it at a place that offers the best technology and the most knowledgeable staff. His goal is that the Prebys Cardiovascular Institute will be that destination.
“We got to start from scratch with a blank slate and build it the way we want it,” Dr. Teirstein says. “I think that’s an important thing to do in your career. It’s a long-lasting impact.”