Most of us do not think about hospitals until an emergency arises. However, as I shared in my article A Hospital Near You, hospitals are critical amenities like schools and parks, especially for families with children. In particular, for those of us who are parents, we must know where the closest hospital with a pediatric emergency department (PED) is. I previously highlighted Good Samaritan Hospital here in Los Angeles and shared how convenient it is to live within walking distance of this facility. Given its central location and fine reputation, I was not surprised to learn that Good Samaritan’s Emergency Department is among the busiest in Los Angeles County, with more than 18,400 visits annually. Its emergency center has a dedicated radiology suite, and offers direct access to operating rooms, the cardiac surgery unit, and intensive care. While Good Samaritan is where I would go in the event of an emergency, I recently found out that it is not a specialized PED. Instead, the closest hospital to me with a PED is the Children’s Hospital Los Angeles, which fortunately is only a 10-minute drive from my home. I say “fortuntately” because I have had to take my young daughter there twice already, including once in the middle of the night. In this article, I would like to feature the Children’s Hospital and its facilities, and share some interesting facts I learned about medical facilities in the age of Obamacare.
Children’s Hospital Los Angeles
Founded in 1901, Children’s Hospital Los Angeles (CHLA) is the first and largest pediatric hospital in Southern California. CHLA is one of only ten children’s hospitals in the United States and the only one on the West Coast to be named to the prestigious U.S. News & World Report Honor Roll. This does not surprise me at all as I was very impressed by both the staff and facilities during my two visits to the hospital. CHLA is home to The Saban Research Institute, one of the largest and most productive pediatric research facilities in the country. It is also one of America’s premier teaching hospitals through its affiliation since 1932 with the Keck School of Medicine of the University of Southern California. According to its website, CHLA provides over 104,000 children with pediatric health care each year.
From a design perspective, the hospital is also very interesting. Specifically, CHLA is home to The Joyce and Stanley Black and Family Healing and Meditation Garden, a 12,700-square foot special space which achieves the near impossible: it shuts out the noisy city to create an oasis of calm and peace amidst crisis and pain. The garden is one of the first major elements in a dramatic transformation of CHLA, which culminated with the opening of its state-of-the-art, 460,000-square foot, 317-bed new hospital building in 2010. It sits at ground level atop an underground parking garage and draws visitors 24 hours a day, seven days a week. Specialists in rehabilitation services regularly use the green space to accomplish physical, sensory and social goals. It is also where children develop gross motor skills with balance exercises and wheelchair maneuvers. They cultivate such fine motor skills as hand-eye coordination by handling seeds and tools and build endurance with bike riding. Children also work on their cognitive skills by following directions and problem solving during planting. The well-used space has also hosted receptions, memorial services, spring carnivals, and lunchtime concerts.
Another unique design element at CHLA is the Sunset Bridge which physically and symbolically unites the entire hospital campus, which spans both sides of Sunset Boulevard between Vermont and Hillhurst Avenue. Construction of this landmark was jointly supported by two Los Angeles philanthropists, Cheryl Saban and Marion Anderson, who, along with their spouses Haim Saban and the late John Edward Anderson, funded the $10 million project. Both ZGF Architects and Traffic Management, Inc., groups that helped move the Space Shuttle Endeavour to the California Science Center, played significant roles in the construction and transportation of the bridge into its current position. Completed in 2012, the 92-foot, 40-ton steel frame of the walkway was built off site and towed in 3/10 of a mile.
Obamacare and Its Impacts on Medical Facilities
While Obamacare is widely discussed and debated, its impact on medical facilities has rarely been talked about in popular media. However, I recently came across an article in Urban Land by writer David W. Myers which does an excellent job explaining what the passage of the Patient Protection and Affordable Care Act (Obamacare) means physically and spatially in terms of medical facilities. In Myers’ words, the passage of Obamacare “unleashed pent-up demand for construction of new hospitals facilities and rehabilitation of older ones, as well as triggered a seismic shift in the way medical services will be provided in the decades ahead.” I would like to highlight the key facts the article provided which many may not be aware of:
- The typical health care system requires about 1.9 square feet of space for each patient. With this in mind, the 32 million Americans expected to become insured under Obamacare would translate into the need for an additional 64 million square feet of medical space.
- Demand for new medical space will be fueled by baby boomers reaching their 60s and 70s and seeing their medical needs increase.
- Spending on new health care-related construction is expected to rise 6 percent in 2014 from 2013.
Myers also pointed out that in high-density urban areas, where vacant land is limited, large physician-owned medical groups and managed-care giants such as Kaiser Permanente are increasingly looking for non-medical building to repurpose in order to accommodate their expansion or merger plans. Architectural amenities and floor plans of hospitals are changing as well. Exteriors now often include such amenities as large fountains and coffee stands to make visitors feel more welcome. Patient rooms are generally getting smaller, a trend fueled in part by Obamacare’s emphasis on preventive-care and outpatient facilities rather than beds for overnight stays. As I shared previously, here in Los Angeles, both Good Samaritan Hospital and Cedars-Sinai Medical Center are developing or have developed additional outpatient facilities. The Good Samaritan Medical Plaza and Outpatient Pavilion which is intended to meet the increasing need for outpatient services will soon be completed.
Planners rarely talk about hospitals. However, as I have shared here and before, hospitals are very important to the quality of life in communities in terms of the medical services they offer, the jobs they provide, and the ways they contribute to the built environment. From a planning standpoint, we must be aware of the changes that are and will be taking place with regards to medical facilities. And on a more personal note, I encourage you to find out where the closest hospital with a pediatric emergency department is if you have children and do not already know.
Note: All photos by author.