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.