Click below to view the answers to all questions:
- Why is PACKids doing this?
- What is a hospital for children?
- Why is it important to have a hospital for children only?
- Where will it be located?
- Do you support academic research?
- Do you support the education of future pediatric care givers
- What does independently owned mean
- What will be the Board Structure?
- Will this be an “open staff” model?
- Will the hospital be sustainable into the future?
- What will be the economic impact on our city?
- What is a “free standing” hospital mean?
- What are the advantages and disadvantages of a freestanding hospital for children?
- Why does the PACK support this model?
- Are there any other models that can meet the same goal?
- What is a “hospital in within a hospital”?
- What is a “full service” hospital?
- What is a unified coordinated hospital?
- Why must children leave Richmond for care at other hospitals for children?
- Who are your current partners?
- Why Bon Secours at this point in time?
- Is PACKids in any way financially or structurally obligated to Bon Secours?
- Who do you hope to be your final partners?
- What is Children’s Hospital of Richmond ( CHoR) ?
- What is the difference in CHoR and the hospital the PACK wants to build?
- Are the vision of PACKids and VCU Medical Center mutually exclusive?
- Is VCU Medical Center a part of the conversation?
- Why have these discussions not ended in a resolution or solution?
- What level of endowment will be needed to operate this hospital?
- Of the 27 cities of similar size to Richmond, all have hospitals for children, but only 4 are not affiliated with a university hospital.
- Why has this taken so long?
- Why are the plans for the PACK seem to some so grandiose and bigger than life?
- What is “world class?”
- I read in the paper this hospital will replace Children’s Hospital of Richmond. Is that true?
1. Why is PACKids doing this?
Answer:
Because we believe that we can improve the model of care in Richmond. Our goal is not to criticize any hospital system or the care given in Richmond – it is not so much about what we have or do not have, we simply want to improve care for children and families by implementing a model of care that is now standard across the country. In Richmond, we have great people that care for children – but we don’t have all of the needed subspecialist to care for all of our children. We have the good fortune to have the Children’s Hospital foundation who by an agreement with VCU, over the last two years, has developed and continues to develop quite the cadre of pediatric specialists at Children’s Hospital of Richmond, a hospital within a hospital. We also have the good fortune to have a marked growth of specialists at Bon Secours. We are extremely fortunate to have all of these pediatric physicians in our city; however, even with all these excellent doctors in a survey of over 300 pediatricians when asked, “Do you think the care of children are in our city is good or excellent?”, 78% reported that the care was only good, not excellent.
The reason for that response of only good and not excellent is because our city has a fragmented care model for the medical care of our children. We are passionate about changing that model of care to one that is consolidated, coordinated to provide the best care possible for all children of our region in an environment that is 100% focused on children, and delivered in a way that includes families in their care.
2. What is a hospital for children?
Answer:
A hospital for children is a medical facility where any child with a medical issue will receive ALL of his or her care without ever encountering a patient who is an adult or a staff member who is not trained to care for children.
A hospital where any child can receive all of their care – from entry to discharge, inpatient or outpatient, routine or highly specialized – from a family centered, interdisciplinary team of health professionals, without encountering any adult who is a patient.”
A hospital where:
- All specialty & interdisciplinary caregivers are on staff
- Hospital is a Safety Net with a Mission to care for all children, regardless of ability to pay
- Hospital has SPACE designed for kids and family
- Evidence-based design helps heal
- Family presence everywhere the patient goes
- Living, respite, learning space for family
- Gardens, libraries, entertainment spaces
- Light to heal
- Kid-centric art of all media
- Spiritual space
- Care is Family Centered
- Space for significant family presence during child’s entire visit
- Family involvement in medical decision making
- Family advisory boards that have real influence
- The Hospital is a resource for the community:
- Local hospital – primary care for the local community
- Care extends beyond the walls
- Influences Children’s health policy
- Government advocacy for kids
- Public and preventive health
- Quality achieved by evidence-based “Best Practices” care produces:
- Safer care
- More efficient care
- More effective care
- More cost effective care
- Best outcomes of care
- Benchmarking and collaboration with world leaders in pediatric care – “World Class Care” when measured against others
3. Why is it important to have a hospital for children only?
Answer:
When they need medical care, all children deserve and need a hospital where any child can receive all of their care – from entry to discharge, inpatient or outpatient, routine or highly specialized – from a family centered, interdisciplinary team of health professionals, who are focused 100% on care for children and only children. Children’s units which are a small part of a large general hospital system are handicapped by competing over funds, resources and space, etc. It becomes difficult to provide a facility where every employee is focused on what is best for children, while independent children’s hospitals have a very narrow and focus mission to take care of children and only children.
4. Where will it be located?
Answer:
Children’s Hospital foundation of Richmond recently completed a study in 2012 which outlined and revealed three possible locations for this hospital for children. These locations will provide easy and prominent access to both North and South East and West areas surrounding the Richmond region.
5. Do you support academic research?
Answer:
Absolutely, for the future care of our children to be improved and offer new solutions to old and current problems it is paramount to a hospital for children. It is our hope that our academic partner will also provide pediatric research.
6. Do you support the education of future pediatric care givers?
Answer:
From the very beginning with the PACK has supported both research and education. We know the best pediatric education for future pediatric caregivers occurs in a hospital for children.
7. What does independently owned mean?
Independently owned means the hospital will be a new 501C3 not-for-profit corporation. It will be governed by board that is chosen so that no participating entity will be able to maintain control over the hospital. By this we believe this hospital will truly be community owned and truly focused on children. This is not an unusual ownership structure. In fact the majority of truly world class children’s hospitals (such as Boston Children’s, Children’s Hospital of Philadelphia, DC children’s) are all independently owned and operated.
8. What will be the Board Structure?
Answer:
Because we believe this hospital would be best served by an independent board, it will be composed of members chosen from each participating hospital system. It will also be composed of members chosen from the donor community, the public community at large, the business community, and PACKids .
9. Will this be an “open staff” model?
Answer:
an open staff model means that any qualified physician who wishes to practice at the hospital and can be appropriately credentialed by the hospital can practice there. No appropriately credentialed and qualified physician will be turned away.
10. Will the hospital be sustainable into the future?
Answer:
in 2012 study on the feasibility of hospital for children in Richmond, Kurt Salmon and Associates of Atlanta Georgia clearly showed that all three systems, VCU, HCA, and Bon Secours participated in this hospital for children, the hospital would be profitable after three years and easily sustainable for many years into the future. If one or more entities chose not to participate, the hospital is still financially feasible and sustainability, however the ramp-up period to financial success would take longer. More than 40 children’s hospitals have been built in the last 12 years and none of them have failed financially.
11. What will be the economic impact on our city?
Answer:
To date we have not done a full economic impact study for Richmond. That is planned in the future, as soon as we know the actual partners participating. However, the below links will take you to three well done studies on the impact in Cincinnati, Orlando, Dallas and Dayton.
12. What is a “free standing” hospital mean?
Answer:
Free standing means the medical facility is not attached physically or a part of an existing entity. It may be connected by underground tunnels or sky bridges; however, it is very simply stated a completely separate building.
13. What are the advantages and disadvantages of a freestanding hospital for children?
Answer:
Advantages for freestanding hospital for children:
- Significant improvement in coordination of delivery of care
- Achieve significant critical mass and quality improvements through service consolidation
- Enable convenient consults among pediatric medical and surgical specialists and enhances recruiting and retention
- More likely to be perceived “neutral” (if the site is perceived to be neutral)
- Improved ability to fundraise for single campus
- More likely to meet long-term community needs if it is on a large enough campus
Disadvantages for a freestanding hospital for children:
- Greater expense to build a new facility
14. Why does the PACK support this model?
Answer:
It is the only model where a child can be cared for without ever coming into contact with an adult patient and to insure that all personnel working in the hospital are trained to relate to and care for children. This results in superior care, better outcomes and shorter stays, at a lower cost than when kids are cared for within adult-focused institutions.
15. Are there any other models that can meet the same goal?
Yes, a “lean to” model is physically attached to an adult care facility; however, there are separate entrances and exits and once again, the facility itself is separate internally and no child will come into contact with an adult patient.
16. What is a “hospital in within a hospital”?
Answer:
A hospital within a hospital is just that, a floor or multiple floors, located within an adult care hospital. In the best of these hospitals, all of the amenities that make the care within the adult hospital are present. Dedicated entrances, private elevators to the floor, separate check in, plus all of the requirements listed in what makes a hospital for children a true children’s hospital.
17. What is a “full service” hospital?
Answer:
A full service hospital is just that – it provides all the services a child or patient may need for any and all medical issues. Being a full service hospital means no child or patient will have to go to any other facility for their care.
18. What is a unified coordinated hospital?
Answer:
A unified hospital is where multiple and all specialties’ are represented. It is a hospital where care is handled by the needs of a child. For example, a child with one medical problem is able to see one specialist, no matter the problem, in a timely manner. A child with multiple problems will see multiple specialists on the same day in one location. Their care will be handled by an interdisciplinary team. The key to complicated medical issues for children is the interdisciplinary team. In the case of a child with diabetes, that is one medical problem, yet they may be seen by a nutritionist, a psychologist, a school educator, a medical nurse educator and their physician.
19. Why must children leave Richmond for care at other hospitals for children?
Answer:
care for children with medical problems in the city of Richmond is fragmented. It is not possible for a child that has more than one problem to see different specialists on the same day and at the same location, no less in a consolidated interdisciplinary team setting, which is the standard of care in over dozens of other cities with dedicated hospitals for children. Our system is extremely difficult to navigate both for the physician provider and the parents of the child that needs care-this is all due to fragmentation. We are looking to consolidate and coordinate the care of children so that the specialist are in one place and at one location and an interdisciplinary team can see any child that needs help.
20. Who are your current partners?
Answer:
Bon Secours St. Mary’s Hospital has committed to participate in the hospital for children project as envisioned by PACKids, the philanthropic community has pledged 1/3 of the cost to build the hospital, over 250 pediatricians and pediatric specialists, and over 1000 members of our public community are supporting this goal.
21. Why Bon Secours at this point in time?
Answer:
Bon Secours Administration has supported the concept all along, even stating their support publically. The staff and physicians provide excellent care in hospital and with their pediatric specialty staff, which continues to grow with new specialists, hospital-based pediatric physicians, intensive care physicians and pediatric emergency medicine physicians.
22. Is PACKids in any way financially or structurally obligated to Bon Secours?
Answer:
No
23. Who do you hope to be your final partners?
Answer:
We will have an academic partner and it is our hope that it will be VCU. If not we are prepared to search elsewhere to fulfill that mission of Virginia Children’s Hospital. We also hope HCA would be a cooperative partner however we understand the difficulty of a for-profit hospital participating with a not-for-profit hospital.
24. What is Children’s Hospital of Richmond (CHoR) ?
Answer:
According to Leslie Wiatt, CEO of CHoR, “Children’s Hospital of Richmond at VCU is the only full service children’s hospital in the community, with over 140 specialists and the ability to care for 98 percent of all pediatric health care needs.”
25. What is the difference in CHoR and the hospital the PACK wants to build?
Answer:
CHoR is a children’s hospital within a large, complex, urban adult-focused hospital. We are planning a facility that is exclusively dedicated to the check care of children, that is freestanding, and a facility where no child will ever come contact with an adult patient our staff member who is not trained to care for children.
26. Are the vision of PACKids and VCU Medical Center mutually exclusive?
Answer:
Both share a vision for advancing the health of children. The dialogue is about how best to achieve the vision.
27. Is VCU Medical Center a part of the conversation?
Answer:
VCU Medical Center is very much part of the conversation. In fact, over the past several months, VCU Medical Center has been in discussions with pediatricians, pediatric specialists and community leaders to develop a sustainable model that will take children’s health in our community to the next level. Unfortunately, to date, problems with the governance and ownership of our proposed children’s hospital seem to VCU’s administrative leadership to be insurmountable at this time.
28. Why have these discussions not ended in a resolution or solution?
Answer:
According to Leslie Wiatt, “It’s important for us to discuss new models of care and the future of children’s healthcare in Richmond. But we have to be grounded in the economic realities of this type of capital investment and declining reimbursement trends that disproportionately affect freestanding facilities.”
The PACK understands this clearly; however, we also believe that decisions made for the healthcare of children must begin with putting the children first. They are our future and they deserve the best possible care they need for a healthy life. In fact, most experts, and real life experience, has shown that hospitals for children are a far less costly way for a community to deliver care to its children. The real question is, how do we want to care for our children when they are in need of medical care?
29. What level of endowment will be needed to operate this hospital?
Answer:
A very large endowment would definitely be nice for our Virginia Children’s Hospital; however, the typical endowment for a freestanding hospital for children is in the $250M or less range. That endowment is built up over years of fundraising. Most hospitals for children are financially viable from operations alone, so they don’t need a lot of funds from the endowment to offset operating losses. They use endowment funds to grow research, to expand facilities, or to support public health/community programs… not for clinical care operations
30. Of the 27 cities of similar size to Richmond, all have hospitals for children, but only 4 are not affiliated with a university hospital.
Answer:
We most definitely will have a university affiliation agreement with our academic partner… it is our hope that VCU will be that partner, but we are aware that there are already multiple interested potential academic affiliates, including several with national prominence. Most of the affiliations are with medical schools and their faculty although in recent years the line between medical schools and university hospitals has been blurred. Affiliation and ownership are two distinct concepts that should not be confused.
31. Why has this taken so long?
Answer:
Because in the words of all involved, “It is complicated.” In the words of a young patient of one of our Pediatricians, “It may be complicated, but it is not impossible.” Some of those involved believe it to be impossible and it is our hope that this mission will complete easily when those folks begin to think possible and not impossible.
32. Why are the plans for the PACK seem to some so grandiose and bigger than life?
Answer:
Daniel Burnham, who created the 100 year old master plan for Chicago said it best… “Make no little plans. They have no magic to stir men’s blood.” Our children do not deserve anything less!
33. What is “world class?”
Answer:
Sadly, this may be another one of those phrases that the PR\marketing firms have rendered relatively irrelevant. The dictionary defines world class as “ranking among the foremost in the world; of an international standard of excellent; the highest order.” Cincinnati children’s hospital considered themselves to be world class until they measure themselves against others. Upon doing that, they discovered they were not as good as they thought they were. Learning that, they took it upon themselves to become world class by measuring themselves against others and achieving that international standard of excellence. To measure quality as poor, fair or good, you must benchmark an organization against some established international or national pediatric standards. World class is something an institution is recognized for by other institutions. It is not something you can designate yourself as, just because you think you are. It will take several years; however, this hospital will do that and will become world class.
34. I read in the paper this hospital will replace Children’s Hospital of Richmond. Is that true?
Answer: No – we hope the staff and faculty of CHoR will join with us and practice at the new hospital, in a new facility and with a new model of care. The NICU and the Burn Unit will remain at MCV/VCU.