News

Technology makes hospital more efficient — and safer

New Stanford Hospital features lots of high-tech, but some older systems still remain

Many new technologies have been built into the new Stanford Hospital at 500 Pasteur Drive to make care more efficient than at the old hospital.

If a big earthquake or a pandemic strikes, staff can add a second bed in each of the emergency department's 66-single-patient rooms, and the ambulance bay can be converted into a triage center. The new 900-space employee garage can also be converted for triage, emergency department staff said during a recent tour.

Intensive-care unit rooms, equipped with medical gases, can be used as operating rooms so that patients in critical condition don't have to be moved, Jennifer Winder, public relations manager for planning design and construction, said during a recent tour.

At 700 to 800 square feet each, the 20 operating rooms are nearly twice the size of the old ones. Video screens are a common fixture, useful for surgeons who need to view their operations close up or communicate with specialists and staff. The operating suites are set as pods around a central sterile core where staff prepare for surgeries. Green lighting enhances image-guided surgery to reduce the glare from video screens, said Chad Reeder, controls manager at the new hospital.

A hybrid operating suite, with an adjacent MRI room, allows doctors to wheel the patient directly from the surgery to MRI machine to scan the patient and see the results of the operation thus far.

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In keeping with Stanford's role as a teaching hospital, surgeries can be streamed using cameras in each operating room to anywhere in the world for consulting and teaching purposes. Surgery at Stanford on conjoined twins could be viewed simultaneously in China, Reeder said by way of example.

In the basement, robots control the flow and delivery of materials, equipment and medicines. The robotic carts — "tugs" — are programmed to transport hospital equipment and supplies from the pharmacy to elevators and even to locations around the hospital.

The building is also wired with a 3,000-beacon real-time locating system, which electronically tracks equipment. Staff can quickly locate machines, IV stands and other devices from an iPad or mobile computer screen.

As in the old hospital, pneumatic tubes snake through the ceilings, transporting medications mixed in the basement pharmacy. Blood samples, medications, lab specimens or anything small and packaged travel quickly to their locations through the tubes, Reeder said.

Deep beneath the basement, a sophisticated roller system of 2.5- to 4-ton steel plates on metal bearings allow the rigid building to sway three feet in any direction without concern of a collapse during an earthquake up to magnitude 8.

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The California legislature passed the law mandating that hospitals meet seismic standards after the 6.7- magnitude Northridge earthquake in 1994 did more than $3 billion in damage to southern California hospitals.

Crews will begin seismic retrofitting and renovations at the old hospital, located at 300 Pasteur Drive, after the new hospital opens. The two hospitals are connected by an enclosed bridge.

The old hospital's renovations are scheduled for completion by 2025. Staff will use the old hospital largely for cancer patients. The old emergency room, which is currently used by adults and children, will be used as a dedicated pediatric emergency room.

"It's been long in coming," said Patrice Callagy, executive director of emergency services.

This is part of a larger story on the new Stanford Hospital that can be found here.

A Q&A video with CEO David Entwistle is available here.

Dr. George Tingwald of Stanford Health Care, joins Weekly staff to discuss the planning that went into building the new Stanford Hospital on an episode of "Behind the Headlines," now available on our YouTube channel and podcast page.

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Technology makes hospital more efficient — and safer

New Stanford Hospital features lots of high-tech, but some older systems still remain

by / Palo Alto Weekly

Uploaded: Fri, Sep 13, 2019, 6:51 am
Updated: Thu, Sep 19, 2019, 9:33 am

Many new technologies have been built into the new Stanford Hospital at 500 Pasteur Drive to make care more efficient than at the old hospital.

If a big earthquake or a pandemic strikes, staff can add a second bed in each of the emergency department's 66-single-patient rooms, and the ambulance bay can be converted into a triage center. The new 900-space employee garage can also be converted for triage, emergency department staff said during a recent tour.

Intensive-care unit rooms, equipped with medical gases, can be used as operating rooms so that patients in critical condition don't have to be moved, Jennifer Winder, public relations manager for planning design and construction, said during a recent tour.

At 700 to 800 square feet each, the 20 operating rooms are nearly twice the size of the old ones. Video screens are a common fixture, useful for surgeons who need to view their operations close up or communicate with specialists and staff. The operating suites are set as pods around a central sterile core where staff prepare for surgeries. Green lighting enhances image-guided surgery to reduce the glare from video screens, said Chad Reeder, controls manager at the new hospital.

A hybrid operating suite, with an adjacent MRI room, allows doctors to wheel the patient directly from the surgery to MRI machine to scan the patient and see the results of the operation thus far.

In keeping with Stanford's role as a teaching hospital, surgeries can be streamed using cameras in each operating room to anywhere in the world for consulting and teaching purposes. Surgery at Stanford on conjoined twins could be viewed simultaneously in China, Reeder said by way of example.

In the basement, robots control the flow and delivery of materials, equipment and medicines. The robotic carts — "tugs" — are programmed to transport hospital equipment and supplies from the pharmacy to elevators and even to locations around the hospital.

The building is also wired with a 3,000-beacon real-time locating system, which electronically tracks equipment. Staff can quickly locate machines, IV stands and other devices from an iPad or mobile computer screen.

As in the old hospital, pneumatic tubes snake through the ceilings, transporting medications mixed in the basement pharmacy. Blood samples, medications, lab specimens or anything small and packaged travel quickly to their locations through the tubes, Reeder said.

Deep beneath the basement, a sophisticated roller system of 2.5- to 4-ton steel plates on metal bearings allow the rigid building to sway three feet in any direction without concern of a collapse during an earthquake up to magnitude 8.

The California legislature passed the law mandating that hospitals meet seismic standards after the 6.7- magnitude Northridge earthquake in 1994 did more than $3 billion in damage to southern California hospitals.

Crews will begin seismic retrofitting and renovations at the old hospital, located at 300 Pasteur Drive, after the new hospital opens. The two hospitals are connected by an enclosed bridge.

The old hospital's renovations are scheduled for completion by 2025. Staff will use the old hospital largely for cancer patients. The old emergency room, which is currently used by adults and children, will be used as a dedicated pediatric emergency room.

"It's been long in coming," said Patrice Callagy, executive director of emergency services.

This is part of a larger story on the new Stanford Hospital that can be found here.

A Q&A video with CEO David Entwistle is available here.

Dr. George Tingwald of Stanford Health Care, joins Weekly staff to discuss the planning that went into building the new Stanford Hospital on an episode of "Behind the Headlines," now available on our YouTube channel and podcast page.

Comments

Anon
Another Palo Alto neighborhood
on Sep 13, 2019 at 10:29 am
Anon, Another Palo Alto neighborhood
on Sep 13, 2019 at 10:29 am

I'm very glad about the new ER and the seismic safety of the new building at 500 Pasteur. I hope that the seismically unsafe 300 Pasteur will eventually be removed/replaced. I have the impression that parts will remain open to staff (not the public). I hope for the sake of the staff and community that my impression is incorrect, and that -all- earthquake-vulnerable structures will be removed.


Resident
Registered user
South of Midtown
on Sep 13, 2019 at 10:50 am
Resident, South of Midtown
Registered user
on Sep 13, 2019 at 10:50 am

All well and good, but since Stanford and Anthem apparently could not come to a deal, anyone that has Anthem health insurance can no longer go to Stanford. I’ve been using them for 30 years (ER, to have my kids, etc) since grad school, but I guess now I can’t. Just got the letter this week.

If you also have Anthem, I guess I’ll see you at El Camino Hospital next time I’m there.


Local
Another Palo Alto neighborhood
on Sep 13, 2019 at 1:26 pm
Local , Another Palo Alto neighborhood
on Sep 13, 2019 at 1:26 pm

I love the emphasis on connection with the natural world and how important it is for healing. The down side is that patients will be sent home in bumper to bumper traffic to their airplane-noise- and pollution-filled neighborhoods and schools with less and less connection with nature LOL....

@Resident,
Stanford has agreed to honor insurance prices during negotiations, so hopefully you don't need to interrupt your care.


I'm glad for this new facility, but really wish that Stanford would create some kind of interim facility for urgent, non-emergent care that the local urgent care centers can't accommodate, such as imaging on a semi-urgent basis after business hours. Got sent to ER for that very thing, and refused to go if I had to be an emergency patient, but the urgent care team assured me that wasn't the case and that their medical instructions and records would translate instantly to Stanford (they were wrong).

If you go to the ER and it's not an emergency, even if you tell them that up front, and that the urgent care team says everything is in the shared electronic system, they subject you to the whole rigamarole (and say it's necessary, but they don't tell you they are going to ignore why you think you're there) and then treat you like a hypochondriac who self-referred to emergency (including things that are just hell when you aren't feeling well), while also chastising you being a bad patient for refusing the unnecessary perfunctory blood draws and catheter insertions. Then they send you a $5,000 bill without ever giving you the imaging you were sent there for. (To cap the indignities in my case, the security guard wouldn't let me leave because I couldn't walk a straight line, saying I needed my "medication" to wear off -- when I wasn't on any meds, the unsteadiness/dizzyness was one of the symptoms I had been sent there for imaging for in the first place! The perils of medical care while while female...new buildings don't fix that.)

Walk-in family medicine centers and urgent care centers definitely filled a big gap in care, but there is still a big gap between urgent care and emergency care. Emergency rooms should really be there for serious emergencies and traumas, and there really needs to be a separate program/facility to do evaluation for the many situations where one's doctor kneejerk says "go the ER" and as a patient you have to weigh alone whether you are risking a serious consequence by not getting an emergency addressed, or risking your mental health/financial health/getting treated really badly in the future by going to the ER without it ending up being an emergency. Just last week I was advised to go to emergency and gambled that the latter side of the equation would be worse and didn't go. I'm still having trouble with my vision, but don't want to lose their taking it seriously if it turns into a more obvious emergency (and told my doctor so). Their nurse knew exactly what I meant.

It would really help if there was an interim "triage" that could involve real medical evaluation, something between urgent care and emergency, with better coordination of care between local practitioners and medical centers (like PAMF) and Stanford.

Anyway, Congratulations on the beautiful new center, and thanks to everyone who worked so hard to make it happen.


Traffic impacts?
Registered user
College Terrace
on Sep 13, 2019 at 6:47 pm
Traffic impacts?, College Terrace
Registered user
on Sep 13, 2019 at 6:47 pm

The whole area will benefit from this wonderful new facility, most especially when the big earthquake happens. It also sounds as if being a patient in the new hospital might be a completely completely different experience than the 13 hours of sleep I got over one five day visit to Stanford because of a noisy patient in the next bed with visitors talking through the night, to say nothing of the the constant night time clatter and loud voices in the hallway outside the room!

However, since this new hospital will be larger with more employees, can we expect more congestion along El Camino, especially at the intersection with and on Embarcadero during the morning and evening commute? Especially ambulances needing to get through. Or is it anticipated that because so many hospital and clinic staff work different shifts from normal office hours, there won't be much impact?


Jack will not be happy
Another Palo Alto neighborhood
on Sep 13, 2019 at 8:51 pm
Jack will not be happy, Another Palo Alto neighborhood
on Sep 13, 2019 at 8:51 pm

Traffic impacts-- The intersection of El camino and Embarcadero has been screwed up for over a decade and the city has done nothing to address the problems. I guess they believe the old palo alto mantra-- if you decrease lanes and impede traffic the cars will just disappear. That has worked out well.
I think the only person who may be unhappy with the new hospital will be former councilmember jack morton-- he opposed the new cancer center and about a decade ago he paid for a pamphlet attacking Stanford.


m2grs
Midtown
on Sep 13, 2019 at 10:00 pm
m2grs, Midtown
on Sep 13, 2019 at 10:00 pm

They must charge arm and leg for each patient. I suspect that federal and state government will have to pay for most it, through Medicare and Medicaid. It's like building a 5-star hotel and then ask the government to pay for guest stays. Is that a good thing?


Anon
Another Palo Alto neighborhood
on Sep 14, 2019 at 8:03 am
Anon, Another Palo Alto neighborhood
on Sep 14, 2019 at 8:03 am

Posted by m2grs, a resident of Midtown

>> They must charge arm and leg for each patient. I suspect that federal and state government will have to pay for most it, through Medicare and Medicaid. It's like building a 5-star hotel and then ask the government to pay for guest stays. Is that a good thing?


Google this:

"california state mandate seismic upgrades hospitals"


old enough to remember
Downtown North
on Sep 14, 2019 at 12:58 pm
old enough to remember, Downtown North
on Sep 14, 2019 at 12:58 pm

So this newspaper has an article on the new hospital without even once mentioning the who the architect that planned it is. It is very well planned and for that you need an extraordinary architec.

Rafael Viñoli, the justly celebrated architect who planned so many well thought out buildings is the architect.

Web Link


musical
Palo Verde
on Sep 14, 2019 at 9:16 pm
musical, Palo Verde
on Sep 14, 2019 at 9:16 pm

^ Manhattan's 432 Park Avenue is one of those well thought out buildings. 125 condos.
Same footprint as Palo Alto City Hall. Would please Sacramento for our housing crisis.

Rafael Viñoly: "There are only two markets, ultraluxury and subsidized housing."


Anon
Another Palo Alto neighborhood
on Sep 15, 2019 at 1:46 pm
Anon, Another Palo Alto neighborhood
on Sep 15, 2019 at 1:46 pm

>> Rafael Viñoly: "There are only two markets, ultraluxury and subsidized housing."

Web Link

From the NY Times. Note the date on that: May 2013. While "gentrification" used to be sometimes good and sometimes bad, but, not -always- a bad thing, this new form that New York and SF + Peninsula have been suffering is something else. "Gentrification Squared" I guess, in this new Gilded Age.



Paul
another community
on Sep 18, 2019 at 1:00 pm
Paul, another community
on Sep 18, 2019 at 1:00 pm

Does this, "is equipped to handle a magnitude-8 earthquake and any other mass-casualty incident," mean that they can handle the projected number of casualties (from a magnitude-8 earthquake elsewhere in the area); or that the building will still be usable after a magnitude-8 earthquake which hits Stanford; or both?
As written, it is ambiguous
Thanks


Me 2
Old Palo Alto
on Sep 19, 2019 at 10:35 am
Me 2, Old Palo Alto
on Sep 19, 2019 at 10:35 am

Now you know where all your healthcare money is going.


Anon
Another Palo Alto neighborhood
on Sep 19, 2019 at 10:40 am
Anon, Another Palo Alto neighborhood
on Sep 19, 2019 at 10:40 am

Posted by Paul, a resident of another community

>> Does this, "is equipped to handle a magnitude-8 earthquake and any other mass-casualty incident," mean that they can handle the projected number of casualties (from a magnitude-8 earthquake elsewhere in the area); or that the building will still be usable after a magnitude-8 earthquake which hits Stanford; or both?

Both, one hopes, but, the number of people needing treatment after an earthquake is somewhat difficult to predict. The fate of the old hospital in a massive earthquake was easier to predict. Hospitals all over the state have been undergoing upgrades, rebuilds, and replacements as required by the 1994 version of the Seismic Safety Act -- Web Link -- not easy to do, depending on the site. Lots of status detail here for anyone who wants it: Web Link

I guess it is the Twitter Age that we live in, but, many hospitals seem to be marketing the shiny new aspect to the upgrades, rather than the "seismic" aspect. I guess because people would rather not think about earthquakes and safety. I don't agree with this approach myself. We know that these new facilities are being paid for somehow, and, that the money somehow came out of the cost of care, directly, indirectly, or through charities and wealthy donors who could have spent the money on care. Therefore, I think people should understand that there is a very, very good reason all this money was spent. Google will discover thousands of pages about this, but, here is one regarding the 1971 Sylmar quake, which was a medium 6.5 quake:

Web Link


Anon
Another Palo Alto neighborhood
on Sep 19, 2019 at 10:45 am
Anon, Another Palo Alto neighborhood
on Sep 19, 2019 at 10:45 am

Posted by Me 2, a resident of Old Palo Alto

>> Now you know where all your healthcare money is going.

Web Link


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