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Building a World-Class Children's Hospital
By Michael Felber
Dick Bennett, former Wisconsin Badger men's basketball coach, vividly recalls the anxious time in 1999 when his one-year-old granddaughter, Sara Stieber, of Green Bay, Wisconsin, was diagnosed with a life-threatening E. coli complication known as hemolytic uremic syndrome. Bennett's daughter and son-in-law received alarming advice from their local pediatrician: "If it were my child, I would get her on that helicopter and get her down to Madison."
It was not long before Sara boarded the Med Flight helicopter for the 45-minute flight to University of Wisconsin Children's Hospital, where she was placed on kidney dialysis in the pediatric intensive care unit. After two extremely anxious weeks, Sara's condition began to improve, allowing her to move to a regular inpatient room. Under the care of a UW pediatric nephrology team led by Sharon Bartosh, MD, Sara made an excellent recovery and was discharged after four weeks of hospitalization. Today, she is a healthy preschooler who soon will turn four years old.
While Bennett did not know it at the time, Sara's treatment at UW Children's Hospital would be followed seven months later by another success--a trip for his 1999-2000 Wisconsin squad to the National Collegiate Athletic Association's Final Four basketball tournament. To get there, Bennett's scrappy Badgers would knock off the likes of heavily favored Arizona, Louisiana State and Purdue to advance to college basketball's pinnacle stage.
As emotionally fulfilling as it was for Bennett to reach the Final Four after 35 years in coaching, it paled in comparison to seeing his little granddaughter recover from a very serious illness. "When it became clear that Sara was going to make it," Bennett says, "that feeling surpassed the Final Four qualification. I cried faster when I heard about Sara than I did when we won that game against Purdue."
Sara's recovery is the kind of success story that makes UW Children's Hospital one of the leading pediatric health providers in the region. Originating in 1920 as the Mary Cornelia Bradley Hospital for the Study of Children's Diseases, UW Children's Hospital today is a 62-bed, full-service medical and surgical center that attracts patients and families from across Wisconsin, northern Illinois and beyond.
In the past four years, the hospital has experienced a major growth spurt, a trend that administrators say will only continue for years to come. One long-awaited milestone occurred in February, when the ribbon was cut for a $5.4 million, 18-bed pediatric intensive care unit (PICU). Bennett and his granddaughter joined many others at the opening ceremony. More than four times the size of the previous unit, and much more aesthetically appealing, the new PICU offers the most acutely ill children and their families an environment that soothes rather than stresses.
"While this is a place no family ever wants to be by choice, parents will appreciate knowing that this incredible, family-focused facility is here if their child should ever need first-in-class critical care," says Aaron Friedman, MD, medical director of UW Children's Hospital and chair of UW Medical School's Department of Pediatrics. "We view this new unit as a quantum leap forward in the care of critically ill and injured children from the region."
Constructed over 28 months, the new PICU provides a setting for the most advanced care that puts families first. It offers substantially more privacy than the old unit and is designed with a "through all seasons" theme.
"This is the nicest PICU I have ever seen, period," says Dennis Lund, MD, surgeon-in-chief of UW Children's Hospital, who adds that he has visited a large number of the pediatric intensive care units in the country. "Before, there was no space for parents to be with their child, and staff were on top of each other like sardines. Our new PICU has sleep space for a parent in each patient room, plus a set of five separate family sleep rooms. It also includes showers, storage space and a waiting room with kitchen and computer facilities for families."
While the additional space, privacy and child-friendly interior design are all striking, the most notable change is the lack of noise, says Lund. "It is very calm, even when there is something frenzied going on," he says.
In addition to constructing expansive intensive care facilities in recent years, UW Children's Hospital has been building in another area, increasing the number of pediatric surgical specialists required to handle every possible case presented by young patients throughout the state. That began to happen in 1999 when Lund was recruited from Harvard Medical School and Children's Hospital, Boston, as the first UW Children's Hospital surgeon-in-chief. Lund says that the subsequent ramp-up of surgical services has helped turn the flow of surgical traffic toward--rather than away from--Madison.
In the past few years, UW Children's Hospital specialists have performed surgery annually on approximately 4,000 children 18 years old or younger. Since Lund's arrival, pediatric specialists have been recruited in general surgery, anesthesiology, cardiothoracic surgery, orthopedic surgery, plastic/reconstructive surgery and urology. Other pediatric surgeons on staff specialize in burn surgery, gynecology, neurosurgery, ophthalmology, otolaryngology (head and neck) and transplantation.
With these capabilities, says Friedman, "virtually every child, regardless of the complexity of his or her case, can now be treated here. Moreover, the strengths of the university, especially in the biological and medical sciences, enhance our ability to translate the very latest research advances into our clinical care."
Perhaps no cluster of diseases bears out Friedman's point better than childhood cancer. As little as 30 years ago, only three in 10 childhood cancer patients appeared to survive their disease-and then only for an uncertain time. Today, nearly 80 percent of all children diagnosed with cancer will be cured. Several of the treatments responsible for this astounding improvement in survival rates--especially for leukemia patients--are direct outgrowths of research protocols led by Paul Sondel, MD (PG), PhD, and other members of the Pediatric Hematology/Oncology Division that he heads at UW Children's Hospital.
"People like Paul and Dr. Joe Matloub, who is clinical director of the UW Children's Hospital childhood cancer team, are consistently involved on the national scene in the types of clinical trials that are done in the children's cancer study groups," Friedman says.
Many other UW pediatric clinical researchers--investigating topics ranging from asthma/allergy to juvenile diabetes to cystic fibrosis and pulmonary disease--contribute regularly at the national level to the advancement of new and more effective treatments for seriously ill children. (See Article 2a)
With a strong clinical and research team now on board, and the new PICU up and running, UW Children's Hospital leaders believe that the time has come to address the one remaining obstacle: the rest of the physical facility itself.
"While the quality of our physicians, nurses and staff is incredibly well regarded, the physical facility is inadequate," says Donna Sollenberger, president and chief executive officer of UW Hospital and Clinics. "At 125 square feet, inpatient rooms are simply too small. Young patients come with families, and there is not enough room to get a parent's bed in the room. Parents don't have a place to shower or eat. The facility just does not support what you need to care for children in 2002."
With some children's hospitals building inpatient rooms as large as 300 to 400 square feet, the growing obsolescence of UW Children's Hospital's physical plant becomes more pronounced. The lack of space can be inordinately difficult for leukemia patients and other children recovering from bone marrow or stem-cell transplants.
"It is very emotionally and physically difficult to go through the transplant process as it is," oncologist Sondel says. "To minimize risk of infection, our patients are typically confined to their rooms for between three and eight weeks. It would make it much easier if we had a brighter, larger facility with room for parents, visitors, exercise equipment, computers and so on."
Added to UW Children's Hospital's hunger for more space is its need for a stronger identity--an essential prerequisite to developing a strong bond with the community. Such as bond is needed to engender sufficient support to remedy the existing space shortage. Because UW Children's Hospital is located within the much larger UW Hospital and Clinics structure, many Madisonians are not even aware of its existence as a full-service children's healthcare provider.
To address the need for more space and a stronger identity, hospital leaders are in the early stages of planning for a new facility that would be attached to UW Hospital, but would clearly have a distinct entrance and child-like look and feel. The goal would be to build rooms approximately 250 to 300 square feet in size--more than double the size of the current rooms.
Says Sollenberger, "Although things are still very preliminary, our UW Hospital and Clinics Authority Board has approved plans that--if everything falls into place--could result in a $55 million, 80-bed UW Children's Hospital tower within four to six years."
She cautions that several UW-Madison and municipal approvals will be required before ground is broken. Moreover, she says, the authority board's funding plan calls for the hospital's $25 million contribution to be matched by $30 million from private philanthropy. "Our hope is that there are enough donors out there who agree that this is the best way to care for children in this community," Sollenberger says. "We believe there are many supporters who want to see such a dream become reality."
While fundraising efforts for the new facility are still in the early stages, the University of Wisconsin Foundation is actively recruiting a full-time development director whose first major task will be to spearhead the UW Children's Hospital capital campaign.
"The fundraising effort is still in the quiet phase," says Nancy Dohm of Madison, who chairs the 16-member UW Children's Hospital Advisory Board, a panel of prominent community and business leaders committed to growing the facility. "We are working with the UW Foundation to help identify potential major donors who could help create this incredibly valuable community asset." The goal, Dohm says, is to raise a significant amount of funds before launching the public component of the capital campaign.
Perhaps few are as anxious to experience a new hospital as are the staff members, who are unstinting in their dedication to patients despite the condition of the current facility, which clearly shows its age. "It is time to put our children's services into a setting that patients deserve, that the staff will be proud to call their workplace and that the community recognizes," Friedman says.
Despite having only 80 beds--much less than the nation's largest children's hospitals--the new UW facility would be a healthcare resource unlike anything in the Midwest, adds Lund.
"We're never going to be the size of children's hospitals in Boston, Philadelphia or even Milwaukee, and we shouldn't try to be," he says. "But what we can do here is marry a first-class clinical facility for children to a world-class research university. That would be something unseen anywhere in this part of the country."
Acknowledging that many challenges lie ahead before construction begins, Lund has little doubt that the dream of a new UW Children's Hospital will come true. "It's kind of like the alignment of the planets," he says. "All of the pieces are coming together. We have the clinical piece in place. We have the research piece in place. We have the administrative piece in place. Now we need to finish the puzzle; we need the new hospital facility."
More than a hospital: Special services for families and patients
"Children are not supposed to get sick," says Dennis Lund, MD, surgeon-in-chief of UW Children's Hospital. If they do, however, UW Children's Hospital offers families a number of services designed to alleviate some of the stress that naturally comes with the situation.
- Family Housing: Many families travel considerable distances to UW Children's Hospital. The Ronald McDonald House of Madison, located one block from the hospital, offers comfortable, inexpensive lodging for families of children being treated at UW Children's Hospital and other Madison-area hospitals. The 18-bedroom home has a shared kitchen, dining area and living room. Ronald McDonald House Charities of Madison also helped launch a Sibling Care Program, which offers free child care for young siblings (ages 3-7) of patients.
- A Child Life Program: Kids don't stop being kids just because they are admitted to the hospital. The Child Life program seeks to provide as much normalcy during the child's hospital stay as possible. From holiday celebrations to picnics to a "pet pals" program that brings animal visitors to the pediatric unit, certified Child Life specialists help children return home both emotionally and physically healthy.
- UW Children's Hospital School: Unique to the region, the Hospital School ensures that hospitalized children keep up with their studies. Staffed by three Madison Metropolitan School District teachers, the program offers individualized instruction to patients in a nurturing environment.
 Children's Hospital researchers contribute to clinical advances |
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