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June 26, 2008

UCLA’s new hospital takes technology to new frontiers

By Nancy Sokoler Steiner

Dr. Peter Schulam demonstrates equipment and technologies used in the operating rooms of the new Ronald Reagan UCLA Medical Center. Photo by Nancy Sokoler Steiner

Dr. Peter Schulam demonstrates equipment and technologies used in the operating rooms of the new Ronald Reagan UCLA Medical Center. Photo by Nancy Sokoler Steiner

More than eight years and $829 million in the making, the new Ronald Reagan UCLA Medical Center is scheduled to open its doors to patients on June 29. The 10-story, 1-million-square-foot complex -- which houses the The Ronald Reagan UCLA Medical Center, Stewart and Lynda Resnick Neuropsychiatric Hospital at UCLA and Mattel Children's Hospital UCLA -- features vast, light-drenched spaces and an airport terminal-sized corridor that connects the three centers.

But what's more impressive about the new center are the elements that most visitors won't see. Many of these features involve electronic gear and wireless technology, particularly in the hospital's 23 operating rooms. Especially striking is how bare the operating rooms look. No equipment sits on the floor. Instead, it is suspended from the ceiling by movable booms. Two flat panel monitors, lights, an anesthesia station and a surgeon's computer control panel all hang down from above.

During a procedure, surgeons can use a touch-screen panel or voice commands to display and control images, adjust room lighting, or phone a colleague. They can access patient histories, X-rays and lab results, and use their fingers on the console to draw -- just like a football commentator -- on images displayed on a screen.

Multiple cameras record activity in the room, the operating site, and -- using an endoscopic camera when appropriate -- the patient's insides. These images can be saved on DVD, shared with a colleague in the next room or across the globe, or transmitted to medical students in a viewing theater two stories below. The fiber optics and other cables necessary for the room's extensive connectivity fill a phone booth-sized box located against one wall.

The hospital was designed for "efficiency, control and connectivity," said Dr. Peter Schulam, chief of the Division of Endourology and a member of the design committee for the operating rooms. He said the design process reflected an unusual collaboration between medical staff and equipment manufacturers.

"The companies we worked with were our partners in designing everything," Schulam said. "Nothing was off-the-shelf."

The new hospital replaces the one built in 1951 to herald the atomic era. That facility was designed and constructed at a time before CPR, kidney transplantation or open-heart bypass surgery, and without magnetic resonance imaging, laparoscopy or the Internet. Then, as now, planners had to anticipate the needs of the hospital decades into the future.

Schulam said it was challenging to plan a hospital that would take years to build, not to mention one able to adapt to future decades of technological innovation. To ensure that operating rooms can change as future needs dictate, they were designed to be physically and technologically flexible, allowing reconfiguration as needed.

Already, new developments have occurred since the planning process began.

"When we started design, high definition didn't exist," Schulam said.

Now four operating rooms feature HD, complete with 42-inch wall-mounted plasma screens.

He said that while UCLA can currently claim the most state-of-the-art hospital in the country, that will change when the next major teaching university builds a new facility.

"It's a leap-frog effect," he said, noting that UCLA benefited from observing previous new research hospitals.

The new medical center came about because of the 1994 Northridge earthquake. The university chose to rebuild, rather than retrofit, the hospital in order to meet new seismic safety requirements. The facility can not only withstand a magnitude 8.0 earthquake, but remain functional after doing so.

The Federal Emergency Management Agency provided $432 million in earthquake relief funding for the hospital, and the state kicked in another $44 million. Private donations accounted for nearly $300 million, and the balance came from hospital financing and bonds.

Reflecting input from more than 500 physicians, nurses and patients, the hospital was designed by celebrated architects I.M. Pei and his son C.C. Pei, along with a team headed by commercial architect design firm Perkins+Will, Pei Partnership Architects and RBB Architects.

Each of the 520 inpatient rooms boasts a sweeping view of Westwood or the UCLA campus, offers wireless Internet and features a fold-out sofa for overnight guests. The rooms can adapt to various levels of care, minimizing the need to transfer patients from one room to another. If patient transport becomes necessary, the patient's bed -- rather than a gurney -- serves as the vehicle. Mobile units featuring medicines and IV fluids are also portable, and travel with the patient from one location to another.

A sophisticated electronic records system provides medical staff with immediate access to patient reports, lab results, clinical imaging and real-time vital sign monitoring from any hospital location.

But with all the technology it contains, the hospital is ultimately about the people it serves, according to Dr. James Atkinson, professor of surgery and senior medical director for the transition from the former facility to the new hospital.

In the medical center's June 4 dedication ceremony program he stated, "Now that we have our building, it is time for us to breathe life into it. It's up to us to walk the halls, to fire up the machines and to start doing what it is we do best here at UCLA: healing people. Once that happens -- once we've saved our first life in the new building -- we'll have fully transformed our original vision into reality."



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