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Pulse
New strategy for children's hospital care
In a bold initiative that could alter the way many children receive care, Children's Healthcare of Atlanta has announced plans for a new $35 million building at the Hughes Spalding children's hospital in downtown Atlanta.
Hughes Spalding, long outdated and poorly equipped, would become Atlanta's only major specialty center for treating pediatric asthma and sickle cell disease. Eventually, it would be expected to pull patients from around the region for treatment.
In addition, a new emergency department would be built to handle Hughes Spalding's 52,000 annual patient visits, and the hospital would continue to provide primary care.
But some of Hughes Spalding's mostly inner-city patients, including all who need intensive care, would be transferred to Children's Healthcare facilities at Egleston, near the Emory University campus, and at Scottish Rite in Sandy Springs.
And half of Hughes Spalding's 40 general patient beds would be lost in the hospital's transformation.
Dr. Felicia King examines Keniah Stanley, 6, for a nosebleed in the emergency room of Children's Healthcare at Hughes Spalding.
Children's Healthcare's plans for Hughes Spalding come as Grady Memorial Hospital, owner of the adjacent pediatrics facility, struggles under crushing debt. Last year, Children's took over management of troubled Hughes Spalding, which has a long history of serving the city's African-American residents.
James Tally, CEO of Children's Healthcare, said the opportunity "to build a grand new future" for Hughes Spalding represents his organization's "moral and ethical obligation to be doing the best we can, 24 hours a day, to take care of children and their families."
Eve Higginbotham, dean of Morehouse School of Medicine, whose pediatrics students train at Hughes Spalding, praised plans for the asthma and sickle cell clinics but expressed concern about the proposed loss of 20 patient beds and the elimination of the intensive care unit.
"We have to recognize that some of our families who don't have ready access to transportation might have difficulty traveling to Egleston or Scottish Rite," she said. And, she said, the hospital needs some critical-care capacity for patients whose conditions decline while they are hospitalized.
Plans for halving the number of patient beds and eliminating the ICU reflect the reality of the patient load at Hughes Spalding, where fewer than 20 of the 40 general beds and three of six intensive-care beds are usually occupied, Tally said. The new building will include an empty floor for expansion if needs change, he said.
Two committees of physicians have been formed to address concerns about patients, said Kevin McClelland, a spokesman for Children's, and a transportation committee is close to making recommendations to meet families' needs for getting to the other hospitals.
Administrators told Hughes Spalding employees of the plan last month, saying every effort would be made to transfer affected jobs to Egleston or Scottish Rite.
The Fulton-DeKalb Hospital Authority, which governs Grady, must approve the plan and submit an application to the Georgia Department of Community Health for a certificate of need. If the plan is approved, a new building would go up in the current hospital's parking lot to accommodate 20 patient beds and the emergency department, which handles more than 50,000 patient visits per year.
The original 1952 building, built as a private hospital where African-American doctors could treat adult patients, will be torn down once the new one is complete. A 1983 building will be renovated to house clinics, including primary care.
Children's officials have raised $31 million of the projected $35 million cost of the new building, said Tally of Children's Healthcare. Children's has also agreed to find a way to cover much of Hughes Spalding's annual losses, expected to be more than $10 million for 2008. Grady will cover $2 million each year.
"Our board has said our mission is children," Tally said. "We will find a way to do what needs to be done . . . But the board is moving on a lot of faith."
'A wonderful day for children in Atlanta'
Dr. Barbara Stoll, a neonatologist and chairwoman of pediatrics at Emory University School of Medicine, said the announcement of the new Hughes Spalding building and clinic plans "should be remembered as a wonderful day for children in Atlanta."
"We have an extraordinary opportunity to build a premier primary care facility that is a real resource for this community," she said.
The primary care clinic will be unique in the Children's system, and is intended to provide a medical home for patients as well as an alternative to emergency room visits for routine ailments.
Hughes Spalding could set a national standard for sickle cell care, Stoll said.
Tally said he hopes the specialty clinics in asthma and sickle cell will eventually grow into nationally recognized centers that will draw patients from outside the city into Hughes Spalding.
Since they merged Egleston and Scottish Rite into a single hospital system, Children's Healthcare officials have eliminated some duplication of services at the two hospitals and developed specialty areas at each. Scottish Rite, for example, has a new state-of-the-art, comprehensive rehabilitation center. Egleston has nationally ranked cardiac and transplant services.
Children's officials say they hope to have approval by summer and construction completed in 2009.
A tour through the 1952 building still in use shows murals of happy monkeys, bears and clowns over peeling strips of paint. Air-conditioner vents are bent. A single bathtub serves an entire hall of patients.
Ellery Peek of Decatur, a marketing manager with Publix supermarkets, sat in one of the old Hughes Spalding patient rooms with his son, Javante, 10, who says he has had asthma "since I was a little bitty baby."
The hospital has become "more kid-friendly" since Children's took it over, Peek said. But, he said, "it would be nice to have a state-of-the-art facility."
-- This article is a reprint from The Atlanta Journal-Constitution.
