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'Child-friendly, not childish'
Nemours facility in Orlando has academic mission

By Andis Robeznieks
Posted: April 27, 2013 - 12:01 am ET

You might occasionally see superheroes washing windows or Star Wars characters roaming the halls at the new Nemours Children's Hospital in Orlando, Fla. But despite its proximity to Disney World, you won't hear robots singing “It's a Small World After All” over and over again in the lobby or be entertained by the Country Bear Jamboree in the cafeteria.

“We're already over-themed in Orlando,” says Michael Cluff, director of facility planning and in-house architect for the Jacksonville, Fla.-based Nemours hospital system. “Too many children's hospitals are themed for 2-, 3- and 4-year olds, but we're seeing patients who are up to 18 years old.”

The 95-bed $397 million facility opened this past Oct. 22. But even before it was finished, its design won a citation in the 2011 Modern Healthcare Design Awards (Sept. 26, 2011). The hospital occupies 60 acres of Orlando's Medical City at Lake Nona development. Located just east of Orlando International Airport, the complex also includes the University of Central Florida College of Medicine (its first class graduates May 17), Sanford-Burnham Medical Research Institute, and the University of Florida Research and Academic Center.

The Veterans Affairs Department is also building a $665 million medical center at the location. The VA says the facility should be completed in July. It will begin occupying the building in phases and it should be fully functioning by the summer of 2014.

Nemours Children's is working with its neighbors at UCF to train pediatric subspecialists and at Sanford-Burnham to conduct diabetes and obesity research. While the hospital might not have a formal arrangement with Disney World, the 1,300-gallon aquarium in the waiting room for its imaging and phlebotomy departments is maintained by staff from another area theme park: SeaWorld Orlando.

The hospital's proximity to both the airport and Disney World could generate some synergies. For example, according to the “DisneyParks” blog, the Disney resort hosted nearly 7,000 children with life-threatening conditions in 2011 through the Make-A-Wish Foundation.

“We're hoping there will be some medical tourism,” says Dr. Kenneth Liechty, the hospital's surgeon-in-chief and chairman of the surgery department. Some of its medical tourism has been of the unplanned variety. A recent case involved a child visiting from Argentina who required an emergency appendectomy.

Liechty says the main goals for now are creating an advanced wound-healing center and building a pediatric subspecialist training program, which he says the state lacks. “Kids shouldn't have to leave the state to get care these days.”

While Florida Gov. Rick Scott has proposed adding $80 million to the state's budget to support graduate medical education and resident training in the state, Liechty notes how the hospital's construction was paid for entirely by the Nemours Foundation, which runs the system.

“This is an outlier; no public money went into this,” Liechty says, adding that the hospital was one of the few large construction projects that kept going through the recession. “Cranes were pretty silent after 2007.”

The 630,000-square-foot hospital has plenty of room to grow, including most of its sixth floor, which remains an empty shell space to accommodate growth. Its first floor emergency department also has room to expand onto property now used as a parking lot.

Also on the first floor is the KidsTRACK (Teaching, Research, Advocacy, Community, Knowledge) area, which Cluff describes as a “family resource center on steroids,” where parents can learn more about their child's condition. It contains a kitchen where parents can learn to cook meals to accommodate any newly discovered dietary needs their children may have.

Cluff points out that the goal behind the hospital's design was to be “child-friendly but not childish.” This manifests itself by having some smaller children pulled in wagons rather than being pushed in wheelchairs and having an ice cream bar in the cafeteria.

While giving tours, Liechty likes to point out the slushy machines located outside the ER and the second-floor operating rooms.

“You've got to have a slushy machine in a children's hospital,” he says, adding that it has medical value as well. Liechty explains how having slushies available helps persuade children who may not otherwise want food to eat something—which lets doctors know whether they're able to keep food down after a procedure.

Paula “Tess” DePalma, the hospital's information technology associate chief, says that—instead of plastering the walls with theme park characters—kids are positively distracted with technology. Patients are given bedside controls for the window blinds and the brightness of their room lights. They can even change the color of the lighting to “paint” their room.

Care was taken, however, to not use paint on the ceiling that could be reflective. DePalma says kids don't want to look up and see themselves connected to tubes. Also, to address patients' need for privacy, separate elevators are used for moving patients to avoid potentially awkward interactions with visitors.

The hospital is filled with natural light and rooftop gardens allow outdoor access on the second and fourth floors. Occupational and physical therapists helped design the fourth-floor garden, which includes areas where kids learning to use crutches can practice navigating stairs or stepping down from a curb.

The concept for the facility was to build a hospital in a garden, Cluff says, and steps were taken to pursue certification under the U.S. Green Building Council's Leadership in Energy and Environmental Design, or LEED, program. It has four levels of certification: basic, silver, gold and platinum. (Only two hospitals have been fully certified platinum. Another had a renovation project certified platinum.) Cluff says he believes the hospital will earn gold or silver certification.

LEED-qualifying environmental elements at Nemours Children's include the rooftop gardens, exterior sun shading features, stormwater retention ponds, the use of native vegetation in landscaping and the recycling program.

Cluff estimates that those elements added about $100,000 to the cost of the hospital. Along with long-term energy savings, he believes the added cost was worth it just for the positive publicity LEED certification will bring.

“The marketing benefit far outweighs the cost,” he says. “Every tour I take people on, they always ask if we're green.”

Follow Andis Robeznieks on Twitter: @MHARobeznieks

Nemours Children's is just one of the facilities in Medical City at Lake Nona.
Photo credit: 2012 Jonathan Hillyer

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