Columbia St. Mary’s will raise the bar in Milwaukee
By Steve Jagler, of SBT
The architects haven’t designed it yet, and groundbreaking won’t happen until 2004, but Leo Brideau has a conception in his mind of what the new Columbia St. Mary’s Hospital will look like and how it will operate.
Brideau offers the following projections about the first new hospital to be built in the city of Milwaukee in decades:
- It will be about 1.4 million square feet.
- It won’t be taller than nine stories, so as not to overwhelm the neighborhood.
- It will have 350 beds and will make use of its lakefront view.
- It will be more efficient than the current system of operating two hospital campuses a mile apart.
- It will be a state-of-the-art health-care facility.
- It will be spectacular.
True, only the first five objectives will be easy to document. But Brideau, president and chief executive officer of Columbia St. Mary’s, is convinced that last description also will be the consensus opinion of the community when construction of the hospital is completed in 2009.
"We’re going to work with vendors around the country to make the hospital a national showcase for the latest, in terms of technology," Brideau said. "All four finalists of the architects told us this is the most exciting health-care project in America today. … I’m not overstating this."
That might be debated, but the new hospital’s impact on the community cannot be denied.
In contrast to tomorrow’s hospitals, the hospitals of today are built "by department," Brideau said. A patient is admitted, taken to a room, taken to an operating room, taken to a recovery room, taken to an intensive care unit, taken to a stepdown unit and finally back to the original room.
Meanwhile, the patient encounters different nursing and technical service in every room along the way, increasing the margin for error, he said.
At the new Columbia St. Mary’s, the patient will be admitted into a "universal patient room," which will be private and much larger than today’s hospital rooms. The patient would then go to an operating room and return to the original room, rather than being "wheeled around," Brideau said.
The universal room will have connections in a track along its ceiling. Medical equipment, the "expensive toys" that are constantly changing and evolving, will be connected to that track and be out of the way, Brideau said. "What our process is …. Let’s take the services to the patients. The patient (and the family) don’t get lost, because they’re not going anywhere. Their room becomes an intensive care unit. The technology will be there," Brideau said.
"It will be off the floor, so the staff and the families can get to the patient without tripping over all the chords and equipment," he said. "And the rooms will be standardized, which will reduce errors." Further, the nursing staff will be consistent throughout a patient’s hospital stay, minimizing the risks of miscommunications among staff.
The floors of the new hospital will consist of harder, more seamless surfaces that will be easier to sanitize than those in the former St. Mary’s Hospital at 2323 N. Lake Dr. or Columbia Hospital at 2025 E. Newport Ave.
The new Columbia St. Mary’s will continue to excel in the market as a provider of obstetrics and gynecological services and muscular-skeleton care and will continue as a regional burn-care center, Brideau said. However, the new hospital may expand its presence in caring for patients with cancer, he said.
Over the next few years, Brideau intends to "steal" as many good ideas from other hospitals that are being built across the nation as he can.
Brideau is promising the new Columbia St. Mary’s will blend in well with the adjoining neighborhood.
The hospital has decided to leave in place the 1910 east infirmary building north of the popular water tower at the intersection of Lake Drive and North Avenue. The building is considered an historic site by the City of Milwaukee.
However, all of the other buildings at the current St. Mary’s campus "are fair game" to be torn down and replaced, including the administration building, the Seton School building, the Seton tower, the parking structures, the power plant and the west and Northpoint buildings, Brideau said.
In their place will be a new hospital, medical office buildings, a new parking structure, new ambulatory diagnostic facilities and new educational space for the Columbia College of Nursing.
"It’s got to be classy. It’s got to be right in scale, and it’s got to be a real symbol. If the Calatrava is the symbol of art in Milwaukee, we want this to be the classy icon for health care in Milwaukee."
The main architect for the project, Hellmuth, Obata + Kassabaum (HOK), Inc., is a national player in new construction for the health-care industry. The St. Louis-based firm also is designing the Long Island Jewish Medical Center in New York, the Northwestern Memorial Hospital in Chicago, the LAC/USC Medical Center in Los Angles, the Barnes Jewish Hospital in St. Louis and the Toronto Hospital in Canada.
HOK intends to make the new Columbia St. Mary’s hospital its national showcase piece, according to Paul Strohm, senior vice president of the firm.
"We will develop a unique aesthetic that will fit with its mission, the neighborhood and the community at large," Strohm said. "It has just a wonderful site that has this context of history and yet looks to the lake and the city. It will absolutely take advantage of that location."
The new hospital will be constructed to accommodate meteoric and ongoing advances in technology, Strohm said.
"There’s a revolution going on – a drastic change in how care is delivered," Strohm said. "Technology is a wave that is hitting the health-care industry in a very significant way that will transform the need and the requirements of a hospital."
The hospital of the future
Imagine the year is 2009, and you’ve just checked into the hospital. If you haven’t been in a hospital since 2002, you aren’t going to recognize what you are about to see.
Indeed, the hospital of tomorrow will be far different than the hospital of today, according to Steven Goe, a principal at HDR, Inc., an Omaha, Neb.-based health-care engineering and architectural company. Here’s his glimpse of the hospital of the future:
Electronic medical record systems eliminate the need for excessive paperwork, charts and files. "Wireless" nurses and doctors walk from patient to patient, with portable data devices that indicate patients’ histories, the results of lab tests, etc. Plasma screens in the patients’ rooms for physicians and nurses to inspect test results. Instead of 3,000 square feet needed to store X-ray films, the hospital of 2009 needs only five square feet to store computer disks. "The old nursing station of today will really be disappearing. The advantage to the patient is the nurse can spend more time right at the patient’s bedside," Goe said.
The emergency department becomes the most prominent area at the front of the hospital, because most of the other patients are receiving care at home. Patients pre-register on the Internet and report directly to their universal care rooms. The hospital has fewer traditional beds and more intensive care beds. Surgeries are done with minimal invasive techniques, often including robotics, and drug-coded stents have replaced catheters. Computerized tomography (CT) machines quickly scan a patient’s entire body, producing images that enable a physician to make an instant diagnosis.
Lab tests are done at the patient’s bed or at home, rather than in another department in the hospital. "The laboratory of today could disappear or become very small in the future," Goe said.
The hospital pharmacy becomes much larger, as advanced drugs and genetic-based compounds have become more prevalent in correcting health problems. Service robots bring supplies to the nurses on the different floors of the hospital. More outpatient services are performed, further reducing the need for overnight stays in the hospital.
Rooms and floors are more flexible to adapt to the quickly changing technology that is available. Genomics, featuring genetic cures, reduce the need for surgeries. "The hospital of the future is going to be reserved for things that genomics can’t cure, like trauma and severe injuries," Goe said.
Just how much will that hospital cost?
By Steve Jagler, of SBT
Leo Brideau knows it won’t be easy. After all, health-care costs in greater Milwaukee already are more than 50% higher than those in other metropolitan areas throughout the Midwest, and local businesses and consumers alike are absorbing double-digit insurance premium hikes every year.
Yet Brideau has the formidable task of convincing the community that the new Columbia St. Mary’s Hospital to be built on Milwaukee’s east side not only is needed, but it will be worth the expenses.
Brideau, president and chief executive officer of Columbia St. Mary’s, plans to hire a research firm to quantify the costs and establish a "true budget" for the new hospital by September 2003.
Brideau refuses to put a price tag on the project until that study is completed, saying only that it will be "hundreds of millions." Other health-care sources estimate the cost of the new Milwaukee hospital could range from $300 million to $500 million.
"We’re going to commission someone to do a credible study on the economic impact on Milwaukee. I want someone with credibility in the business community," Brideau said. "This will come in on budget. Period. Under term of death, it will come in on budget."
Currently, Columbia St. Mary’s and its national sponsor, Ascension Health, Inc., of St. Louis, operate the former St. Mary’s Hospital at 2323 N. Lake Dr. and the former Columbia Hospital at 2025 E. Newport Ave.
"You either keep operating two campuses a mile apart from each other and continue to duplicate services, or you bite the bullet now, close one of the facilities and bring them together, achieving significant savings," Brideau said.
The two hospitals have duplicative management personnel, diagnostic technologies, specialty services, power generation systems and maintenance systems, Brideau said.
"You’ve got a department here and a department there, and at the end of the day, you’re going to have one department," he said. Brideau said the administration will interview current staff members about their future plans and then analyze typical turnover rates over time to determine the staff level at the combined hospital.
Combined, the two hospitals currently have 700 beds. The new hospital will have 350 beds, and patients will be served in private "universal patient rooms" that will accommodate changing medical technology. "We’re not adding more beds (to the market)," Brideau said. "The bigger rooms are more expensive, but as technology changes and improves over the years, that really affects the kinds of rooms you need. Things change, and you’ve got to be ready for it."
The consolidation of Columbia and St. Mary’s into one new campus makes sense to Steven Goe, a principal at HDR Inc., an Omaha, Neb.-based health-care engineering and architectural company that is designing new hospitals throughout the nation. "I think they have an aging facility there that is difficult to retrofit to emerging technology," Goe said. "There comes a point where it is cheaper to build anew, rather than retrofit. It doesn’t surprise me that Columbia St. Mary’s is needing to build a new hospital, because its old chassis cannot accommodate new technology. We’re seeing it across the country."
Columbia St. Mary’s plans to use the cash it has in reserve and the revenue it will generate over the next few years to pay for the bulk of the new hospital’s costs. Additional funds will be raised through philanthropy.
However, about 30 to 40 percent of the costs will likely need to be financed by bonds over a long term, possibly through the Wisconsin Health and Educational Facilities Authority, Brideau said.
Brideau said he is confident that the costs saved by consolidating the two hospital campuses, selling the Columbia campus and eliminating the duplication will enable the new hospital to offer competitive pricing within the Milwaukee hospital market.
"This project isn’t new beds. It’s reduced beds," Brideau said. "It’s consolidating. In the short term, it’s more expensive. In the long run, it’s less expensive." Groundbreaking for the new Columbia St. Mary’s is scheduled for spring 2004, and the new hospital is expected to open in 2009. University of Wisconsin-Milwaukee officials are negotiating with Columbia St. Mary’s with an interest to purchase the Columbia campus.
Dec.6, 2002 Small Business Times, Milwaukee
