'Able to save more lives': Dell Children's expands capacity with new tower
The fourth bed tower at Dell Children's Medical Center could not be opening at a better time, said Deb Brown, chief operating officer at the hospital.
"In the last 24 hours, we have had a record volume in our hospital," she said this week.
The hospital has been running at capacity as respiratory viruses including RSV and flu have hit Central Texas, said Leah Harris, the interim president of the hospital and chair of pediatrics at Dell Medical School. "Right now is our pandemic. The hospital is full. We are needing more beds."
The Centers for Disease Control and Prevention is categorizing flu cases in Texas as extremely high. In Travis County, Austin Public Health is aware of flu outbreaks in four schools.
The new tower at Dell Children's will add 72 beds, 24 beds on each floor — an intensive care unit on the first level, a cancer and hematology unit on the second level, and an acute care unit on the third level
The hospital will grow to 299 beds, which translates to about 1,500 additional patients a year. Harris estimates Dell Children's will serve about 100,000 children a year.
"We're finally able to save more lives," she said.
A fourth level has been left as a shell for future expansion. The new tower will begin housing patients on Tuesday, but will see its first patients in out-patient care on Monday.
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The need for bigger
Austin's growth in population is fueling this need for more pediatric hospital beds. In the 2000 census, the Austin metropolitan area had 1.25 million people, according to the U.S. Census Bureau. By 2010, the population had grown to 1.7 million, and as of 2020, the population was 2.3 million.
"We had a need in the community and we didn't have it. We were behind," Harris said.
Adding the fourth tower means that Dell Children's has doubled in size since it was built with two towers in 2007. A third tower was added in 2013. The hospital has since built a unit for mental health and a specialty pavilion next to the hospital as well as three parking garages.
The hospital expect to open its second hospital on April 27. Dell Children's North, will be located at Avery Ranch Boulevard and U.S. 183A. It already has opened up the medical office building there.
These projects represent a $750 million investment in growth by the hospital.
Other hospitals also have responded to this growth. St. David's HealthCare opened its children's hospital at its North Austin Medical Center in 2014.
Texas Children's Hospital expects to open its first hospital outside of the Houston area in north Austin in 2024.
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If you build it, they will come
Dell Children's own expansion of programs is also fueling the need for more beds. In the past five years, Dell Children's has started the Texas Center for Pediatric and Congenital Heart Disease, including a transplant program, that is attracting patients from as far away as Germany and Venezuela.
It is now getting referrals from all over the United States, said Dr. Charles Fraser Jr., the head of the cardiac center. "The big centers, we can compete with them," he said.
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Dell Children's has also began its Pediatric Abdominal Transplant Center this year, starting with kidney transplants.
The UT Health Austin Pediatric Neurosciences at Dell Children's, the Dell Children’s Comprehensive Epilepsy Center and the Pediatric Neurosurgery Center of Central Texas have expanded the surgical offerings and treatments now available in neurology.
The Comprehensive Fetal Care Center began doing fetal surgeries last year, and Dell Children's opened a labor and delivery unit to allow mothers of babies with complicated conditions to deliver at the children's hospital. This center is also getting referrals from around the world and leading research in complicated fetal conditions.
The cardiac program and the fetal care center have meant a need for more cardiac intensive care unit and neonatal intensive care unit beds. The cardiac care unit, which opened in 2019, quickly reached capacity and is overflowing. Both of these units will be able to double in size once other areas of the hospital such as the oncology unit relocated to the fourth tower.
"We're able to keep many patients here in Austin than five years ago," said neonatologist Dr. John Loyd. "We have to move very few patients anywhere because of the growth and sophistication (at Dell Children's). It's a great thing for Austin.
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Room for more expansion
The tower took 14 months to build. It was built so quickly, Brown said, in part due to smart design decisions.
The bathrooms were prefabricated elsewhere, which required them to only be moved to the site, unwrapped and the plumbing hooked up. Plumbers could install three bathrooms a day, instead of less than one a day. The room headboards, which have hookups for oxygen and other medical equipment, were also prefabricated.
Dell Children's has planned for flexibility. It built a fourth floor on the tower and left it unfinished for growth.
In the new tower, all of the rooms were designed to be universal, which means that any room can be converted to the highest level of an intensive care unit or drop down to a lower level.
All the rooms have the same basic amenities: patient beds, in-room computer stations to avoid having to have nurses bring in carts to do charting, couches that fold into beds for parents, playmats for kids who are well enough to play. For the doctors, the rooms have surgical lights, which allow for procedures to happen in the room if patients are too critical to move to an operating room.
Dell Children's designed this tower with parent participation, even having them choose which of the four couch beds in the running was most comfortable. It also listened to their feedback, creating space in each room for parents to work or plug in devices.
For the staff, the units are designed like a race track, with all rooms visible from the central nursing station. Conference areas and space for residents and fellows to work have been built in. Dell Children's will be adding a pediatric critical care unit fellowship in July 2023, in addition to the neonatology fellowship it started this year and the craniofacial and plastic surgery, emergency room, and hospitalist fellowships it already has. With its ties to Dell Medical School at the University of Texas, it now has students observing as well as more residents.
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Each floor has different features. On the first level, a sedation and monitoring area will be used for patients who need outpatient procedures such as wound care from a burn.
The third level has a simulation lab with a rooms set up to replicate an operating room, an emergency room and a intensive care unit room. These rooms have monitoring stations and can record the simulations for expanded learning during trainings.
The oncology floor will have eight beds designed with special ventilation for stem cell transplant patients. That program is expected to begin within the next two years. The hospital is in the process of hiring for the head of that program.
Currently, children who need cellular therapies like bone marrow transplants have to travel to places like Houston and Dallas to have those done. They then have to spend weeks to months in hospitals there.
The start of that program, "will allow Dell Children's to be able to care for every child no matter the diagnosis" and "keep them close to home, close to family," Harris said.
This article originally appeared on Austin American-Statesman: 'Able to save more lives': Dell Children's expands capacity with new tower
