Proposed Escondido hospital taking shape
By: ANDREA MOSS - Staff Writer | ∞
This artist's rendering shows what the proposed Palomar Medical Center West could look like when it opens in early 2011. Architects are still fine-tuning the building's overall look and some design details but already know the hospital's height and floor layouts.
Rendering courtesy of CO + Architects
ESCONDIDO ---- A bigger and faster emergency department, more patient beds and operating rooms, and an in-house restaurant are some of the features planned for a new medical center to be built in this city, hospital officials said last week.
Palomar Pomerado Health is deep in the design phase of planning for the medical center, scheduled to open in early 2011 in the Escondido Research and Technology Center industrial park on the city's west end. Michael Shanahan, director of facilities planning and development for the public health care district, and its spokesman Andy Hoang shared details of the design during a lengthy interview. The 360-bed design includes elements contributed by all levels of district employees.
"The emergency department is extremely challenged with space," Hoang said about the facility at Palomar Medical Center in Escondido. "We had to take one of our old security offices and convert it into a triage room. That helped with the wait times. But space is definitely a challenge."
He and Shanahan said the opening of the new hospital, which district officials are calling Palomar Medical Center West, will solve the problem.
"We're looking at 48 treatment rooms for the emergency services, or close to 48,000 square feet," said Shanahan. "We currently have about 26 bays and 8(,000) or 9,000 square feet (at Palomar)."
Multi-use patient rooms, community meeting rooms and two outdoor terraces were some of the other features he and Hoang said are included in the new hospital's design.
11 stories high
The new medical center is the cornerstone of a master facilities plan that calls for a districtwide expansion of Palomar Pomerado's facility. Property owners within the 800-mile-area public health care district will help pay for the project, under a $496 million bond measure that voters approved in 2004.
The new hospital will go up on 52 acres the district owns in the industrial park. Originally set at $753 million, the project's price tag was recently revised to $983 million, with officials attributing the increase to rapidly escalating construction costs.
Designing Palomar Medical Center West is complicated because of the new hospital's size, the need for it to be usable for several decades, and state requirements for acute-care hospitals. Those requirements include the ability to withstand major earthquakes.
California's Office of Statewide Health Planning and Development must therefore approve every aspect of the design ---- a process that typically takes 18 months to two years. Palomar Pomerado got a break earlier this year, when the state agency agreed to use the district in a pilot program crafted to streamline the approval process.
State officials began reviewing parts of the hospital's design last year and have told Palomar Pomerado officials they can expect the facility's first building permit in January, said Shanahan.
"I can start my hospital at that point," he said, adding that state officials will continue to review plans for other aspects of the medical center before and after that point. "The further down this road we go, the more detailed it becomes. Eventually, you get down to the actual nuts and bolts that go into the steel."
He said the new medical center will be about 753,000 square feet and stand 11 stories tall at its highest point, which will be atop a patient tower.
Floor layouts mapped
The design sets aside most of the hospital's first two floors for a diagnosis and treatment block that will include the emergency department on the first floor. The plan includes 12 outdoor ambulance bays, each of which will be large enough to accommodate up to three emergency vehicles in the event of a disaster, said Shanahan.
Unlike Palomar Medical Center's three ambulance bays, which share an entrance with the public, those at the new facility will be separate, he said.
A 12,000-square-foot imaging department that will provide radiology and other diagnostic services for trauma cases will be next to the emergency department. A small business center that will give visitors access to a computer, a copy machine and similar services, and a conference center will fill the rest of the first floor, under the plan.
Other floors' layouts include:
- Second floor ---- a surgery center with 18 operating rooms and patient staging areas that double as both pre- and post-operation areas on the second floor, which will also house a pharmacy and a library/resource center that will be open to the public.
- Third floor ---- a restaurant/cafe that spills out onto an outdoor terrace, which overlooks a garden area atop the diagnosis and treatment block's roof. Mechanical systems to support higher floors will also be on the third level.
- Floors four through nine will comprise most of the patient tower, with each level containing 60 beds.
- 10th floor ---- 24 patient beds plus a community room with its own terrace.
- 11th floor ---- another 24-bed unit. Shanahan said hospital officials believe the floor would be a good place to isolate patients who need to be in a more controlled environment, because they have communicable diseases or need extra protection from them.
Although the design calls for a total of 360 beds, sections of some floors in the patient tower probably would be "shelled" to begin with and finished inside as they as needed, thereby allowing for future expansion, said Shanahan.
Employees contributing ideas
While the architectural team focuses on the overall design, Palomar Pomerado employees at every level are weighing on in the finer details. The employees spent months researching design elements that have proved their value in other hospitals before recommending those they think make sense for the new hospital.
Using infection rates as an example, Hoang, the district spokesman, said studies have shown that hospitals that mounted hand-washing stations at various points within their walls saw their patient infection rates go down.
The nonprofit Center for Health Care Design advocates the approach, known as evidence-based design. Palomar Pomerado is a member of the Concord-based organization, which has made the new hospital one of the projects the nonprofit holds up as an example of how well the approach works.
Carrie Frederick, director of performance excellence for the district, oversees the teams, which have studied everything from how floor layouts can make nurses' jobs easier, increase communication and decrease medical errors to environmentally friendly features that cut a facility's energy costs and make it more pleasant or healthy for employees, patients and visitors.
The job turned out to be immensely challenging but very rewarding, she said. Many of the results ---- including rooms that are flexible enough to accommodate patients needing all levels of care so they do not have to be moved around ---- have been incorporated into the new hospital's design, Frederick said, adding that there are fringe benefits as well.
"What the staff said when we did the research is now they realize they can make a difference," she said. "If they see something that needs to be improved, they now feel more empowered to address the issue."
Contact staff writer Andrea Moss at (760) 739-6654 or amoss@nctimes.com.
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Inefficient hospital wrote on Jun 17, 2007 8:16 AM:PPH CEO Covert previously said that anything over 6 stories high is "inefficient" for the "hospital of the future". The new hospital was to be lower and more spread out and that was the reason they needed the 52 acres at ERTC. Now its design is 11 stories high, very "inefficient" by Covert's previous standards. Now they don't need all 52 acres, right?? Or was that just a ruse to get the Escondido City Council to allow them to move to ERTC?
PPH PR Ploy wrote on Jun 17, 2007 8:29 AM:How kind of PPH to share "details of the design during a lengthy interview" with the North County Times. Don't you think it would be nice if they shared some of their plans with the City of Escondido? When PPH releases information or gives an interview, it is their intent to "spin" information, not a genuine desire to let the public know what is happening. Despite a previous agreement with the city, they haven't kept the city informed as to their progress in completing the Memorandum of Understanding. The MOU was a critical item for the City to allow the hospital to build at ERTC. Once PPH got the approval, they have all but ignored the city. This interview was obviously to try and improve public relations after PPH found that they were way over budget. It will only get worse from here.
Simon Says: wrote on Jun 17, 2007 8:58 AM: The new hospital will be a good thing if the planner go at it with two things upper most in their minds: First - Quality of service. Second - profit. People do not realize that profit feeds off quality of service;e.g., I recently had an operation and was visiting the surgeon. In the rest room the paper towel dispenser was set to deliver one half a towel. My first thought went to the Hospital Administrator. To the receptionist at the surgeons office, I said, "I want to talk to the hospital administrator." After I told about the paper towels the three of us had a "bust the Hospital Administrator" fest. They also had noticed and had talked about it. Of course, as far as I was concerned, it went no futher than the check in window. However, little things like a half a paper towel begins a mind set in each individual toward a busness. I know that for sometime after the incident when I thought of my medical group and hospital of choice, the first thing that came to mind was the cheap paper towel trick. It caused me to pick apart the quality of medical service I was getting. If you are looking for perfection you should look to God, not another human being. However, If you are providing a service for profit, you should look to your customers for approval. Everybody stands on the receiving service side of the counter at one time or the other. Dealing with the public is a skill that is well worth developing.
Escondeeter wrote on Jun 17, 2007 1:28 PM:I wonder if the 'Center for Health Care Design' has done any studies on how building gardens on rooftops produces leaky roofs?
I bet wrote on Jun 17, 2007 4:47 PM:I can still get better service at Sharp. Pomerado lacks in service. (PERIOD)
On a Positive Note wrote on Jun 17, 2007 6:12 PM:The "artist's renderings" of the new hospital look fantastic! I'm glad that PPH stayed in Escondido and glad they are building at ERTC. I think the previous bloggers should get over the fact that they didn't get their way (rebuilding hospital downtown). Get Over It. Just think...this beautiful building almost ended up in San Marcos - that would have been a huge loss for Escondido. Things are moving along and hopefully in January building will start. Additionally, the hospital district is not the only ones who are experiencing increased construction costs...don't you remember the Escondido Police/Fire stations construction costs have gone up significantly also. So...if you want to complain about the costs of the hospital, then you should also complain about the costs of the Police/Fire Stations. I, for one, am happy that the hospital will be built in Escondido! Be Happy. Be Positive.
To Escondeeter wrote on Jun 17, 2007 6:39 PM:As long as it's done right, it won't produce a leaky roof. It's been done other places without a problem.
Former Emp wrote on Jun 17, 2007 6:51 PM:How about getting a left team 24/7 at pomerado. The agreedto a no lift policy about a yearago ans still nothing has been done. maybe timefor new managemant/ administration at pph???
Escondeeter wrote on Jun 17, 2007 7:57 PM:As long as it's done right? Aye, there's the rub.
Been there, done that wrote on Jun 17, 2007 8:56 PM:The most efficient hospital is one that is muliple stories, in fact,as many as the land permits. Elevators travel a lot faster than people walking down lengthy halls. Also the most cost effective because it is only one footprint. If all you side chair experts would get a clue you would know a good plan when you see one.
To Been there, done that wrote on Jun 18, 2007 8:15 AM:If "The most efficient hospital is one that is muliple stories" then why would Covert, prior to passage of Prop BB, use the opposite argument as an reason not to be able to build at the current site? Then, after the passage of BB, he says it's ok to build high. Also, did you forget that a sprawling campus was the reason they gave for needing 52 acres? Now that they need a smaller footprint why do they still need so much room? The PPH administration has not been honest with the voters. Watch for more deception to come as the find out that the won't follow the MOU with Escondido. We "chairside experts" have done our homework. I suggest that you do the same and not blindly go down any path that PPH chooses. Follow the history of this thing and you can see how PPH administration feels they are above everyone else. When the plan is built on misrepresentation, then they are forced to continue that throughout the project.
To "On a Positive Note" wrote on Jun 18, 2007 8:42 AM:I agree with you on one point. "The "artist's renderings" of the new hospital look fantastic!" That's exactly what they want - to get you thinking with your emotions and not with your brain (and wallet). The renderings of the downtown site look fantastic as well. The problem is that PPH is already acting like they are not going to follow through on the plans that they promised. Also, they just don't have enough money to do everything they promised. The problem is that people buy into nice renderings and, when it's too late, they realize that what they were promised isn't going to happen. If you look at the facts, you will find that the PPH costs have gone up many times that of the Police/Fire Stations. PPH has simply promised more than they can deliver. Also, FYI, PPH never had any plans to move to San Marcos. That was just a heavy-handed move to get what they wanted in Escondido.
Escondodo wrote on Jun 19, 2007 3:40 AM:This won't be built at all or new bonds will be forced on the voters to cover PPH egos. The money has to come from somewhere. I dare NCT to do a comprehensive interview with PPH detailing where the money to build this will be coming from!
It never fails! wrote on Jun 23, 2007 7:42 PM:I just spent 3 days at a hospital in the United States.At check out time the feeling that I had just spent those 3 days at a dirty, rundown, under staffed clinic in a Third World country came over me.Three days of people moaning /pleading for care,construction workers working right at your room door,being ignored by people paid to care for the ill,strangers poking their heads past the curtain saying,"I'm your Doctor" when you know you are really just a billable hour! Head spinning I couldnt wait to get back to my world! But I was right here at Palomar Hospital in Escondido where the Doctor is called a "Hospitalist" Someone please wake me up!!!!!!!!!!!!! I am in hell!
Cheer up! wrote on Jun 24, 2007 4:55 AM:To 'It never fails!' What you experienced was the wave of the future. The new hospital will just be a newer structure on a hill next to a power plant. PPH has boasted about their 'Hospitalist' concept. These are the people who will deal with you when your own doctor is no longer in close proximity to the hospital. Relax, the doctor(hospitalist) knows best. Just wait your turn and take a number. And smile because we will be paying dearly for this progress.
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