New patients get toy hard hats as welcoming souvenirs. Life-sized posters of smiling children point the way to temporarily relocated services.
R.J. Solano, a patient at Children's Hospital of San Antonio, and nurse Amy Sandoval sport souvenir hard hats.
The transformation is underway at Children's Hospital of San Antonio, formerly called CHRISTUS Santa Rosa Children's Hospital, where $135 million in renovation is creating the area's first free-standing hospital for children. Children's Hospital of San Antonio also is busy building its new partnerships with Baylor College of Medicine and Texas Children's Hospital, both based in Houston, 200 miles to the east.
CHRISTUS Santa Rosa Health System is remaking its campus in downtown San Antonio — home of Children's Hospital and the former City Centre Hospital, which was closed in July 2012. The result will be a new 200-bed Children's Hospital of San Antonio, with plans for at least four satellite clinics and an expanded network of area pediatricians.
Completion of the construction and full integration of the new partnerships are expected in 2014.
CHRISTUS Santa Rosa Children's Hospital opened in 1959, and it has been partners with the University of Texas Health Science Center medical school in San Antonio since the school opened in 1968. There has been public discussion in San Antonio for more than a decade about building a new children's hospital. In 2010, CHRISTUS Santa Rosa Health System and the university's Health Science Center began formal talks toward that goal.
But the university said in April 2012 it was exploring a deal with Vanguard Health Systems of Nashville, Tenn., the for-profit parent of the Baptist hospitals in San Antonio, to build a new $350 million children's hospital 11 miles northwest of downtown. Construction is scheduled to begin early next year.
A few days after that announcement, CHRISTUS Santa Rosa Health System forged ahead with its own modernization plan. It changed the name of the children's hospital in September 2012 and announced its new affiliations in February. Baylor will provide doctors and a residency program; Texas Children's Hospital will share research and clinical expertise. The change in the academic partnership, including faculty physicians and residents, will begin this summer.
Meanwhile, the reconstruction of Children's Hospital of San Antonio is requiring some changes in getting around in the downtown hospital campus. All care and services are being provided as before, but locations are being adjusted to accommodate the demolition and remodeling.
Moving parts
"It can be noisy and a bit challenging, a bit like a chess game," said Marcy Doderer, vice president and administrator for Children's Hospital of San Antonio. "We escort all of our patients to their locations. And to make it fun for the kids, we give them the plastic hard hats."
Construction began in August with interior demolition in the former City Centre Hospital wings of the downtown campus. Doderer said the plan is to complete all renovation by late 2014. The exterior of the buildings will have some modifications, but most of the work is in the extensive reconstruction of the interior.
Doderer said the transition from the University of Texas Health Science Center to the Baylor College of Medicine will begin July 1, and the last Health Science Center physicians and residents will leave in the fall. She said the plan is to have the first full class of pediatric residents through Baylor beginning July 1, 2015. Some Baylor doctors, including faculty members, already are working at the hospital in San Antonio.
At the same time, the children's hospital is in the midst of a leadership change. On July 1, Randall Wright will step in as interim vice president and administrator, replacing Doderer, who is leaving to become president and chief executive of Little Rock's Arkansas Children's Hospital. Wright comes to Children's Hospital from Texas Children's Hospital, and his post as chief operating officer.
Changing partners
The Health Science Center made formal its new partnership with Vanguard last September. Patrick Carrier, president and chief executive of CHRISTUS Santa Rosa Health System in San Antonio, expressed disappointment in that decision but pledged that CHRISTUS will move forward with its plan for the new children's hospital. He also announced that it already was in discussions with the two future partners in Houston.
Carrier promised that the new hospital "will be the crown jewel, anchoring children's health care in San Antonio's urban core." With the partnership announcement in February, Dr. Paul Klotman, president and chief executive of Baylor College of Medicine, said the new partnership will allow for the speedy creation of a health-care system "that otherwise would take decades to build."
Doderer said the affiliations already have been good for Children's Hospital of San Antonio.
"A moment of adversity can lead to a terrific end result," she said. "Baylor and Texas Children's Hospital bring to the table incredible experience and expertise. Through our new partnerships, we will be able to work with the best and the brightest in pediatric medicine."
Adaptive planning
Doderer said the reconstructed hospital still will have plenty of space set aside for clinical research, but some of the original plans have been modified. She said the number of beds was reduced to 200 from as many as 275, although room is available for more beds in the future. And there is more emphasis now upon developing satellite locations for outpatient and some emergency care.
"The new partnerships have helped us define and refine what we want to do in providing ambulatory care," Doderer said. "With federal health-care reform, we need to manage large numbers in cost-effective ways, with many access points across a broad geography. We can provide strong ambulatory care with outpatient subspecialties, and then bring patients to the main campus for more major procedures."
She said Children's Hospital of San Antonio will continue the CHRISTUS tradition of caring for the poor and uninsured. "As a Catholic hospital, our service is first and foremost to the poor and underserved. That is who we are, and we won't change that," Doderer said. "We have an obligation to make sure that kids don't get kicked to the curb."