Tuesday, January 15, 2008

You Ain’t Seen Nothin’ Yet: A Hospital Like No Other

Disclaimer: Just three days before this article went to press, the Boca Raton Community Hospital stunningly revealed that as a result of a poor financial year, the hospital posted a loss of $28 million resulting in a temporary halt to the beginning construction of the new hospital. The original targeted opening date (mentioned below) has been pushed back by about one year. There has been no indication that other plans or details have been affected.

If you believe that residing in Boca Raton is akin to living in Paradise, in its 2006 listings of “Best Places to Live,” Money magazine basically agrees with you. Included in its top 100 choices, Boca Raton was ranked as number 30. While one might question the rankings’ degree of accuracy—after all, what’s better than Paradise?—the wide range, and the sheer numbers of detailed statistics backing up the methodology are certainly impressive. For example: within a 15 mile radius of East and West Boca Raton’s 206,000 residents there are 23 movie theaters; an incredible 2,685 restaurants (most, probably with “Early Birds”); 130 bars (we obviously prefer eating to drinking); 29 libraries; 1,696 doctor offices; 4 colleges, universities or professional schools; and within 30 miles, 126 hospitals; 7 accredited museums; and 101 golf courses. (On the downside, there are zero ski resorts).

Unquestionably, the popularity of this type of survey will accelerate, due to the fact that as of January 1 st, 2008, the first of the Baby Boomer Generation (those born between 1946 and 1966) became eligible for early Social Security benefits, and over the next two decades, some 80 million more Americans will follow, each one seeking reliable information relating to retirement location options.

Even now, there are dozens of publications providing opinions on what they consider the best places to retire. Yet, one qualification that is universally assigned considerable weight is the availability of superior health care in the form of hospital facilities and physician skill. Well, Money magazine, and all you other wannabe’s, as Al Jolson sang some 80 years ago, “You ain’t seen nothin’ yet!” What will distinguish Boca Raton by the year 2012 will be the opening of a new academic medical center par excellence.

What exactly is an academic medical center, and why will it further elevate Boca Raton’s desirability as a retirement Paradise? Here is the official description as provided by this new facility: “In America today there are only 151 academic medical centers [out of a total of 5747 hospitals]. They are typically comprised of schools of medicine, nursing, pharmacy, health related professions, public health and, sometimes, dentistry. These schools are physically located on a single campus with a teaching hospital serving as the common intersection of education, research, and clinical service.”

The new medical center will be strikingly different from the original Boca Raton Community Hospital that was originally conceived in 1962 when two young children were fatally poisoned. Swift medical treatment might have saved them, but the closest facility was 30 minutes away in Boynton Beach, and the children died. However, as a result of that tragedy, the Boca Raton community, then consisting of 10,000 residents rallied, forming the Debbie-Rand Memorial Service League (the children’s names were Debbie and James Randall). Despite warnings from outside consultants that a hospital in the area was not warranted, $3.5 million was raised and a 104-bed hospital opened in 1967. That hospital now has half a million square feet of space, 400 beds, and more than 750 board certified primary and specialty physicians on staff.

The new Schmidt Medical Center will be a medical marvel compared to almost any other hospital in the country. The $75 million gift from the Schmidt Family Foundation is the largest ever given to a community hospital, and the third largest among all hospitals and health systems. It will be the first new university based academic medical center to be established in this country in more than three decades, and will revolutionize health care in the area. It will be distinctive in many ways. The $650 million facility initially will have 530 rooms and, uniquely, all will be private. (Ultimately, 712 rooms will be available). The hospital will encompass over 1.1 million square feet; more than double the existing facility. The complex will also incorporate three 150,000 square foot integrated medical office buildings, and parking for 4,600 cars.

Most importantly, it will be a teaching hospital, as part of the University of Miami Miller School of Medicine. In fact, the medical school is already functioning and will ultimately have 256 medical students (64 in each year’s class). Training is already taking place in the new Schmidt Biomedical Science Building. Until now, medical students were schooled at FAU for the first two years and then completed their medical training at the Miller School of Medicine in Miami. Now, they will complete their last two years of clinical rotations at BRCH, and subsequently at the new medical center.

One of the major contributions that can be expected from the presence of a medical school comprised of 264 medical students is the fact that surveys show a high percentage of these students will choose to stay and practice in the geographic area in which they are trained. This will be of critical importance in the future, since several studies have concluded that the United States could face a shortage of between 85,000 to 200,000 physicians by the year 2020.

The intent is to make this hospital uniquely different from all existing hospitals by concentrating on the creation of the safest facility of its kind in the country. Hospital safety has become a critical issue since as many as 98,000 Americans die each year because of medical errors. Here is how it is explained: “To be a best-in-class hospital, BRCH will be able to create an environment and culture that provides patients and their families with more comfortable experiences, attractive settings, and increased privacy. All new rooms in the hospital will be private and fully standardized for maximum safety.”

Just six weeks ago, the Association for the Advancement of Medical Instrumentation announced the publication of a book titled, Safety by Design: Designing Safety in Health Care Facilities, Process and Culture. The author, John Reiling PhD, MHA, MBA, a nationally renowned expert in health care safety design (along with what has been termed a “dream team”), has been chosen to oversee the planning, design and construction of the Schmidt Medical Center. The new medical center will be one of the first to experience the huge advantage of incorporating the concept of complete safety into almost every element of the hospital’s design. Reiling is quoted as saying, “The focus of safety of design improves the care environment for patients and caregivers, resulting in safer care and enhanced safety culture.”

In addition to private rooms that minimize infection risks, other features being considered that promote safety are bathrooms situated at the head of beds to reduce falls; HEPA filters throughout the hospital, not just in operating rooms; an electronic device that will trigger a red light if health care providers don’t wash hands; the basic design will allow for improved visibility of patients to staff; window blinds that are encased in glass; soundproofed walls; infrared technology to track patient movement; certain procedures and tasks that could be standardized and automated to minimize physician fatigue and empower patient’s families to participate in patient care. It is intended that the new hospital will become a model for hospital safety.

In addition to the new (September 2006) Christine E. Lynn Heart Institute added to the existing BRCH, a $75 million, 98,000 square feet Cancer Care Facility, is now under construction, and is scheduled to open late in 2008. It will be the new home for the Eugene M. and Christine E. Lynn Cancer Institute. The Harvey and Phyllis Sandler Pavilion will be located on four acres of land on the South side of Glades Road. It will encompass oncology imaging, radiation, chemotherapy, support services, and clinical research.

The combination of a spanking new academic medical center, a medical school, (Oh yes, also an existing nursing school), a cancer institute, a heart institute, and the safest hospital in the country, situated on the grounds of a university, is a singular accomplishment for a community the size of Boca Raton. Although the Money magazine 2007 list did not include Boca Raton in the top 100, (apparently the entire list changes from year to year; for example none of the top ten from 2006 were listed in the top 10 in 2007), by the year 2012, Money should wake up and include our “Paradise” city in the top 10, because they “Ain’t seen nothin’ yet.”

Author’s note: Thanks to Boca Pointers Vince Losclazo and Art Dermer, both on the Board of Directors of the Debbie Rand Memorial Service League, Auxiliary of the Boca Raton Community Hospital, for gathering and providing much of the information above.

Editor’s note: In the interest of full disclosure, the author’s physician son is associated with a practice that helped create the medical school’s curriculum for the Ophthalmology module in conjunction with the University of Miami Miller School of Medicine at Florida Atlantic University. He is an Affiliate Clinical Associate Professor.

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