A hectic but focused scene unfolded early Friday morning inside Women & Children's Hospital as medical personnel buzzed around the pediatric intensive care unit to prepare the first group of patients to move to the new John R. Oishei Children's Hospital.
Twelve-year-old Olivia Reger, who was admitted Nov. 2 with aspiration pneumonia, was the first to leave in one of 15 ambulances making round trips throughout the day to relocate 125 young patients.
Her mother, Erica, a human resources consultant from West Seneca, didn't expect to be part of the massive operation and braced for it with the nervousness any parent with a sick child would feel. Olivia has epilepsy and cerebral palsy, and was receiving oxygen and intravenous medication at the hospital. Still, Erica voiced confidence in the staff's preparation.
"So much thought was put into this. Her safety is a top priority, and that has helped me," said Reger, who noted that five hospital employees had stopped by on Thursday to reassure her.
Reger, wrapped in blankets and wearing a hot pink hat, made the move shortly after the new hospital opened at 7 a.m.
It was only a five-minute trip. But it took Olivia from a hospital that got its start in the 19th century to one built for the 21st.
Design incorporates new ideas
Oishei Hospital was planned to accommodate new ways of providing care.
Today, newer pediatric facilities incorporate features based on studies that show how the physical environment can improve patient healing, reduce stress and prevent infections.
Designed by Shepley Bulfinch of Boston, Mass., and built by Turner Construction Co., the 12-floor, 185-bed facility at 818 Ellicott St. cost $270 million. It has 410,000 square feet, in addition to about 100,000 square feet Kaleida Health leases for outpatient services at the Conventus medical building next door. That compares with 200 beds in 608,830 square feet of combined space at the seven-building campus on Bryant Street.
Among other features, Oishei includes a neonatal intensive care unit with single-family rooms instead of the current open pods. Studies show single-family rooms add privacy, parental involvement in care and infection control.
It also attempts to fix major wayfinding problems. In the old hospital, for instance, families headed for outpatient surgery arrived at admissions on the first floor. From there, they headed to the ninth to presurgery. They then returned to the second floor to a surgical holding area. After surgery, they headed back up to the ninth floor for recovery. In the new facility, families walk from a covered parking ramp into the second floor for bedside admission and all surgical and recovery needs.
As for aesthetics, the design emphasizes respite spaces and natural light. Patients encounter outdoor spaces, a winter garden and solarium, large rooms and playful colors.
One of the challenges as the move approached was keeping the facility up to date with medical changes after work on the building began.
"One of the benefits of the new hospital is that it was built to be flexible," said Dr. Stephen Turkovich, chief medical officer.
Experience with transports
Friday was the first big test of the new hospital as it opened its doors to patients.
Children's Hospital staff transports hundreds of premature newborns and sick children each year to the hospital from other locations. It's not a foreign concept. But transporting 125 in less than 12 hours is a different story.
Relocating Women & Children's en masse, including 1,500 employees, from its Elmwood Village campus required a complex logistical effort that began shortly after 7 a.m., with families following in shuttle buses to Oishei Hospital a little more than a mile away on the Buffalo Niagara Medical Campus.
Meanwhile, with the help of hundreds of others in Kaleida Health, workers simultaneously operated two major pediatric facilities while the move proceeded.
A command center inside the old Bryant Street facilities coordinated operations, waiting for "go or no go" designations from medical teams that prepared patients for transport, and word that they safely arrived in the new location. The most fragile patients went first, with patients from the pediatric intensive care unit and hematology/oncology units moving in the first two hours.
The back-and-forth ambulance trips continued throughout the day.
"We're not going to rush this," Turkovich said. "It's a significant number of patients in one day, but we do this every day, and we're trained for it."
Kaleida Health officials said it devoted 75,000 staff hours to training for the move, including 12 mock moves of patients, equipment and technology.
"We have staff that have been here 55 years," said Women & Children President Allegra Jaros, noting the long history of the hospital on Bryant Street. "But the people here are ready for the new hospital."
As the move started in earnest on Friday, Jaros monitored operations by the hospital door where staff wheeled Olivia Reger's gurney into the first ambulance. Her mom headed to a shuttle to meet her at Oishei.
"Everyone seems right on task," Erica Reger said. "There's been no disruption in care."
Reger saw the opening of the new hospital as a positive moment for Buffalo. But she wants to see Olivia feeling better and back home as soon as possible.
"She is the first patient going into Oishei," Reger joked. "I'd like it if she is also the first patient out."
History goes back 125 years
Women & Children’s leaves behind a rich history. It was the first free-standing pediatric hospital in New York State, starting with 12 beds in 1892 in a renovated home on the city's West Side. At that time, a group of women toured Buffalo General Medical Center on High Street and complained that a children's ward was located over a hot, noisy boiler room.
They advocated for a special children's building at Buffalo General, but the hospital's governing board rejected the idea. In response, the women started discussing the formation of a separate hospital for sick and crippled children.
Their actions coincided with a period in the United States when women were fighting for the right to own property and sign contracts without a male relative's permission.
Two women – Harriet Williams and her daughter, Martha Tenney Williams – agreed to purchase a brick home at 219 Bryant St. and pay for the cost of converting it into a hospital for children.
The converted house immediately outgrew the demand for care, leading to expansions over the years.
Not a slam dunk
In 2010, after years of debate about the future of the hospital, Kaleida Health proposed moving outpatient services downtown at the urging of its pediatric physicians. The project ended up inside Conventus, with plans for a new tower to follow.
Still, it building a new hospital was hardly a slam dunk.
Kaleida Health lost $11 million in 2011 and $15.3 million in 2013, leading to the ouster of James Kaskie as chief executive officer in early 2014, the same year the hospital system had hoped to break ground for the new children's hospital.
"We agonized over what to do. It was pretty clear we needed to make tough decisions. Earnings were in free fall," said Frank Curci, current chairman of the Kaleida Health board.
Was the project at risk? To assure doctors and community leaders otherwise, John Koelmel, then the Kaleida Health board chair, declared publicly that the hospital system would get it done – and soon.
"No waffle, no wobble, no wiggle," he memorably told an audience.
"We felt we had to show that Kaleida could deliver on its promises," said Curci, who also is chairman and chief executive of Tops Markets. "We had to show Kaleida was going in a better direction."
But it wasn't so clear inside the organization. The Department of Housing and Urban Development, which was needed to insure a $120 million mortgage loan for the new building, was reluctant to even entertain the idea with Kaleida Health finances in such questionable shape. Without the government backing for the project, the success of a campaign to raise funds from the public might also be threatened.
Jody Lomeo, who replaced Kaskie as chief executive of Kaleida Health, recalled that it took a full-court press on federal officials to get an audience with the department and approval for the loan.
"We went into a meeting with a detailed plan for moving Kaleida forward and the attitude that we were not leaving until they believed in it," he said.
HUD ultimately insured the loan. Kaleida Health's finances turned positive in 2014, and the good performance has been sustained since then.
In addition to the $120 million loan, money for the new hospital came mainly from $35 million in grants from New York State, $55 million from a public fund-raising campaign and Kaleida Health.
In addition to a $10 million donation from the James R. Oishei Foundation, other big donors included $5 million from businessman Sal H. Alfiero, $3 million from toymakers Fisher-Price and Mattel, and $2 million each from the Children's Guild Foundation and New Era Cap Co.
A celebratory welcome
At the hospital on Friday, at the end of the short ambulance ride, the crew wheeled Olivia Reger on a gurney into a new pediatric intensive care unit, where the staff of about two dozen nurses and doctors were waiting to welcome her – their first patient at Oishei.
They gave Olivia a round of applause. Some shot photos from their phones. A colorful ribbon crossed the door to her room, and the entourage broke through it, as if crossing a finish line.