Dell ChildrenÔÇÖs Medical Center

Prognosis is very favorableBob Bonar of Dell ChildrenÔÇÖs Medical Center explains to Alan T Swaby how it is taking a wider view of healing, and breaking new ground in the process. The staff of Dell ChildrenÔÇÖs Medical Center of Central Texas in Austin is on tenterhooks at the moment, nervously awaiting the outcome of an ongoing evaluation. However, itÔÇÖs not their clinical expertise thatÔÇÖs being assessed.  Rather, they are waiting to hear if the recently completed hospital has been awarded the prestigious Platinum status under the Leadership in Energy and Environmental Design (LEED) program, sponsored by the US Green Building Council.ÔÇ£There are plenty of office buildings with that award,ÔÇØ says president and CEO Bob Bonar, ÔÇ£but itÔÇÖs not easy for a hospital, which has to cope with conflicts between satisfying the overall green objective while giving priority to life safety issues or effective infection control.ÔÇØ When the results are announced in the fall, Dell ChildrenÔÇÖs could become the first hospital in the world to achieve this level of excellence.The hospital is located on the site of the old Austin airport. For years, the 730-acre property had languished and decayed after a new airport had been opened, but the city fathers had a vision of creating a model urban community (not unlike Stapleton in Denver) and welcomed the hospitalÔÇÖs initiative to be the first project undertaken in that locality.The original childrenÔÇÖs hospital in Austin dated back to 1988, when a 100-bed pediatric unit was opened by the local authorities in the cityÔÇÖs Brackenridge hospital. In the mid-1990s, management of both centers was taken over by Seton, a nonprofit Catholic-based organization that returns surplus funds to the community. Presently, projects such as healthcare to 90,000 Austin students, a mobile health van and treating children without the ability to pay are funded in this way.Over the next decade, the childrenÔÇÖs unit expanded several times until it became unrealistic to take over any more space from Brackenridge, and in late 2002 planning began for what would become the only dedicated, standalone childrenÔÇÖs hospital in the region. The final plan was for a 170-bed medical center with an emphasis on critical care for the sickest of the sick in a 46-county catchment area of central TexasÔÇöequivalent in size to the state of Ohio. Patients were transferred in June 2007.ÔÇ£We thought,ÔÇØ says Bonar, ÔÇ£that this capacity would satisfy the regionÔÇÖs needs until 2015. Last winter, though, we were at 100 percent occupancy, and with 60,000 kids a year going through ER, we have already decided to add an extra 10 beds.ÔÇØThe hospital was built at a cost of around $200 million, financed by $125 million of debt and over $75 million of philanthropic contributions. ÔÇ£We found,ÔÇØ says Bonar, ÔÇ£that the ideas we wanted to incorporate into the new building captured the imagination of the whole region, and many of the contributions we received were facilitated by the design concepts behind the project.ÔÇØThe term ÔÇ£green buildingÔÇØ is used to describe design and construction practices that reduce or eliminate the negative impact of buildings on the environment and occupants. Dell ChildrenÔÇÖs incorporates building practices in each of the five categories necessary to be designated as green.An on-site natural gas turbine supplies electricity 75 percent more efficiently than a coal-fired plant. Converted steam energy from a heating and cooling plant supplies all chilled water needs, and, in fact, a partnership between Seton, the City of Austin and Austin Power means a district energy plant on the hospital site will be able to supply the needs of other occupants of the new urban community. All told, efficiency measures save enough power to fuel about 1,800 homes.Rather than simply clearing the old airport site, 47,000 tons of materials from the runway were reused. Similarly, 92 percent of construction waste was recycled on site. Local or regional materials were specified in order to minimize the fuel used in transportation. Irrigation uses reclaimed water, and the landscaping features native plants that require less water. But the concept that a building shouldnÔÇÖt be a place that makes people feel sick goes even further. Special paints and flooring emit low levels of volatile organic compoundsÔÇöin other words, no strong building smells in the hospital. Patients in particular are never more than 32 feet away from natural light. Patient floors have been laid out in three groups of eight beds, with each pod served by a nursing station. Unlike the conventional racetrack layout, nurses have a clear line of sight to each room at all times and are never more than ten paces away from their patientsÔÇöquicker for the patient, less tiring for the nurses.Dell ChildrenÔÇÖs takes the holistic approach to healing to new heights. ÔÇ£Since ancient times,ÔÇØ explains Bonar, ÔÇ£art and the surrounding scenery have been used as part of recovery. Our hospital has 900 paintings and sculptures, both in patientsÔÇÖ rooms and in public areas. A walk through the landscaped gardens canÔÇÖt fail to make you feel at peace with the world.ÔÇØPatients and family members will never feel far from home in the three-acre multilevel healing garden, complete with waterfall, ponds and quiet places to sit and meditate, as it has been designed to represent each of the seven ecosystems found in the central Texas area served by the hospital.┬á Nor will they get lost easily. Rather than masses of institutional-style signs, north-south walkways connecting to the main lobby are outfitted in local wood, while those in the east-west direction are red sandstone, so visitors wonÔÇÖt find themselves going around in circles.Of course, the hospital never forgets that its patients arenÔÇÖt small adults, and all the features that youngsters appreciate to feel at home can be found at Dell ChildrenÔÇÖs. Among the favorite and most often used is Room Service. Within the constraints of dietary requirements, patients are free to order just about anything they want to eat.While Platinum status for the building would be a feather in everyoneÔÇÖs cap, the most important consideration is the ongoing recovery and comfort of children. To that end, the hospital is under constant evaluation, and should any adverse comment ever be made by anyone, Bob Bonar, in his search for excellence, takes a personal interest, regardless of how insignificant the matter may seem.┬á