Corrections or additions?
This article by Barbara Fox was prepared for the May 21, 2003
edition of U.S. 1 Newspaper. All rights reserved.
Building Boom For Children’s Healthcare
In Victorian times, children were treated like miniature
adults. They dressed like adults, were expected to behave as sedately
as adults, and often worked in adult jobs. In today’s child-centered
age the exact opposite is true, and the child-centered attitude has
trickled down to healthcare. Pharmaceutical companies are being pushed
to study the correct doses for smaller bodies, and there seems to
be a building boom in children’s health care facilities.
Traditionally central New Jersey pediatricians sent their toughest
cases to the Children’s Hospital of Philadelphia (CHOP). Now the
Wood Johnson hospital system has opened the first freestanding
hospital in New Jersey, and the Children’s Specialized Hospital (CSH)
is exporting its services to a new facility on Quakerbridge Road (page
Not only did the RWJ system acquire a special child-sized vehicle,
a $500,000 "super ambulance" that acts as an intensive care
center on wheels, but it has also just broken broke ground on the
Child Health Institute in New Brunswick. Meanwhile CHOP strives to
maintain its patient base by maintaining a pediatric outpost in a
small office on Alexander Road.
It’s getting to be a child’s world in healthcare.
Children are different," explains Phil Toussaint,
the Hillier architect who was the project manager for the
Squibb Children’s Hospital at RWJ University Hospital in New
"Children need an environment designed to their scale that won’t
intimidate them. When you are going to the hospital, it is a stressful
experience, and we don’t want to magnify that for the child."
Unlike the Children’s Specialized Hospital, which was built for
with special needs and needing rehabilitation, the B-MS hospital
sick children in general. The 150,000 square-foot building cost $42
million to construct and has 70 private rooms. It offers same day
surgery, critical care, oncology, and more than 45 pediatric
The hospital has even commissioned its very own ambulance, to be both
medically advanced and child friendly.
Architect Toussaint, the son of marketing researcher at Merck, is
a 1977 graduate of Virginia Tech who has been with Hillier since 1994
and has done other healthcare projects, such as Mountainside Hospital
in Englewood. Jan L. Bishop was the principal in charge at Hillier,
which collaborated with Boston-based Shepley Bulfinch Richardson
Before this structure was built in 2001, children had their own
within Robert Wood Johnson University Hospital with all of the
specialties. But the perception was that really sick children would
go to children’s hospitals in Philadelphia or New York. So the two
goals were to design a hospital of international acclaim for New
and to provide a home for New Jersey children — a freestanding
building dedicated only to them.
Another goal was that the hospital be well connected to the community.
"Working with the hospital we organized focus groups with
previous patients and families, and with physicians," says
"We went into two different schools, asking kids what they were
looking for in a children’s hospital and they did sketches."
The children asked for — and got — beds for their parents
to stay in the room with them (the parents even have work areas in
the rooms), interactive areas for fun and education, and a computer
gallery with play stations.
The hospital sponsored a street fair where children were invited to
put on masks and gowns and participate in mock procedures, and this
concept transferred to the family resource center and child life
which has masks, gowns, surgical equipment, and dummies for playing
doctor. "Usually if you know more of what to expect you will be
more relaxed, which promotes healing," says Toussaint. "We
also wanted to intellectually stimulate them, and make it an
process as well as a healing process, so their minds wouldn’t be
up in their illness."
Carrying out the theme of exploration and discovery is the giraffe
in the interactive gallery. Stand under it and it measures your height
and talks to you. A harp looks as if it doesn’t have strings, but
if you stick your hand through it interrupts one or more laser beams,
and it plays those notes. As you walk by the animal heads on the wall,
they ask you questions.
Specialties include pediatric kidney transplant, pediatric dialysis,
pediatric urology, child psychiatry and behavioral pediatrics, and
Implicit in the fanfare that accompanied the christening of the
super ambulance for the RWJ University Hospital in New Brunswick is
the clear message that New Brunswick should be the destination of
choice for premature babies and very sick children who might otherwise
have been helicoptered to Philadelphia.
The new "super" ambulance, called Pediatric Critical Care
Transport, is the only hospital vehicle of its kind, because it serves
only children and has its own team of pediatric medical specialists.
The 10-ton vehicle, built on a Freightliner truck chassis, can even
take a parent along.
"This vehicle is for all purposes an intensive care room on
says Thomas Bojko, director of clinical operations at the hospital,
when the vehicle was christened on May 13. "Many talented people
spent months designing an ambulance that mirrors the Pediatric
Care Unit, with its child-size ventilators, special gases, and
controlled system to store medications."
In addition to the latest equipment — respiratory ventilation
technology, on-board IV pumps — it has a television with a DVD
player so very sick children can watch the latest Disney movie.
areas don’t usually have these high-tech transport vehicles, but New
Jersey is such a highly congested state that even traveling a short
distance could take you two hours," says John Patella, the
for the hospital.
The Mobile PICU is one element in the push for preeminence that
this past fall with the groundbreaking for the Child Health Institute
of New Jersey, a $72 million, 150,000 square-foot facility that will
do research on such diseases as autism.
For the near future: the Children’s Specialized Hospital will
a rehabilitation hospital — different from the Quakerbridge Road
outpatient facility because it will have 60 beds on the campus. Also
under construction is a place where families of hospitalized children
can stay for a nominal fee: a Ronald McDonald House. Says Patella:
"Any of these are a symbol of New Brunswick as an emerging
center of excellence for the entire state."
— Barbara Fox
Hospital, Box 2601, New Brunswick 08903-2601. Daniel A. Notterman
MD, physician in chief. 732-828-3000; fax, 732-937-8837.
Other than right-sized equipment and child-friendly
decor, the primary reason why children go to children’s hospitals
is for the specialists. And though there are many reasons why the
specialists often prefer to work at the children’s hospitals rather
than the pediatric department of a larger hospital, the opportunity
to do cutting edge research is first on the list.
"Pediatric sub specialists are becoming a scarce commodity,"
says Chris Dougherty, vice president in charge of satellite offices
at Children’s Hospital of Philadelphia (CHOP), affiliated with the
University of Pennsylvania Medical School, which recently opened an
office at 707 Alexander Road. Founded in 1855, CHOP ranks second among
children’s hospitals in the nation (and therefore, probably the world)
in research funding. "With our academic and clinical and research
environment, we are able to recruit the specialists."
Ten years ago families had to drive to Philadelphia for treatment.
"Over time, we have become a pediatric healthcare network,
our services to patients and families," says Dougherty, a 1984
graduate of Allentown College of St. Francis de Sales with an MBA
Now thousands of families get access to CHOP doctors without making
the trip to Philadelphia. "Our patients’ families and referring
physicians have made it very clear to us that they would like to have
the high quality CHOP care closer and more convenient," says
CHOP opened its first satellite center in Voorhees in 1994 and has
a total of four sites in New Jersey, including those in Linwood and
Atlantic City, and six in Pennsylvania, including one in Bucks County
at Chalfonte. Dougherty estimates that Princeton’s outpost of CHOP
is visited by 2,000 patients annually.
In addition to four full-time staffers, Princeton has a total of 18
CHOP doctors in these specialties: cardiology, gastroenterology,
allergy, psychology, developmental pediatrics, and nephrology,
and general surgery. Soon there will be coverage for ophthalmology,
ear nose throat, and pulmonary. The office has enough room for two
doctors to work simultaneously. Except for the specialties of
and psychology, patients must be referred by their primary care
"For the most part we can provide a comprehensive range of
services right there in Princeton," Dougherty says. Children’s
offices offer specially-sized equipment or equipment that has been
calibrated for their size. Also the staff knows how to work with kids.
"There are very few pediatric trained echocardiographers,"
he says. "And not many phlebotomists can do a good job drawing
blood from kids who are kicking and screaming."
Some services still require a hospital visit. A child needing a
catheterization would go to Philadelphia.
Is there any resistance to out-of-state medical centers opening in
New Jersey? "We might be insulated from that, being a children’s
hospital," says Dougherty. "It is my impression that areas
we go into don’t have pediatric sub specialty care available, and
that the authorities are happy we are providing services. We are
an office in Egg Harbor in January, 2004 and they are already lining
up to welcome us in that community. A lot of kids were already coming
Specialty Care Center, 707 Alexander Road, Suite 205, Princeton
08540. Don Nowill, manager. 609-520-1717; fax, 609-520-9333. Home
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