CHILDREN'S HOSPITAL and Regional Medical Center is planning a 50,000-square-foot expansion on the east side of Lake Washington to build additional pediatric specialty offices, outpatient specialty services, and an urgent care facility to treat suburban kids after hours and on weekends. An additional 50,000 square feet of space may be added within the next decade.

"Our plan is to build a new full-service ambulatory facility on the eastside, and we are in the final steps of evaluating properties," says Dr. Sandy Melzer, vice president of Strategic Planning and Business Development for Children's Hospital. "We hope to have a decision on an ideal site shortly."

The anticipated completion of the initial phase of the expansion is in the first quarter of 2009. Currently, the hospital leases 14,000 square feet from Overlake Hospital Medical Center in Bellevue, treating 8,000 to 9,000 patients a year there. Last year, Children's, which is Seattle-based, provided $36 million in uncompensated care for 57,000 families. "We have 10 different pediatric subspecialties at Overlake, along with an after-hours clinic, and limited radiology services,"says Melzer.

NEW FACILITY
The new $40 million facility will include approximately 15 pediatric subspecialties, ambulatory clinics and two operating rooms. The money will come from hospital reserves and clinical operations, and will also be funded, in part, from Children's $300 million capital campaign, which was launched in 2001.

"The expanded program will include pediatric ambulatory surgery and radiology services, including CAT scans, MRI and ultrasound," says Melzer.

GROWING DEMAND
The expansion, according to Melzer, is in response to the growing demand for pediatric services throughout the region, which increases every year. The decision to locate on the eastside also provides care closer to eastside residents. "Some of this demand has to do with a growing population of children with chronic diseases," says Melzer. Parents also have an increasing expectation to have their child seen by a specialist when they are truly sick, and primary care physicians are increasingly referring children with serious conditions to pediatric specialists, rather than try and treat them themselves, Melzer says. "These factors have driven significant increases in our volume every year, and the expansion will really maximize our Seattle campus for its most high-intensity uses, while providing better access and more efficient services for ambulatory care that can be delivered off our campus," says Melzer.

Additionally, Melzer acknowledges that Children's is under increasing pressure to treat more young adults, although Children's has traditionally limited its care to patients less than 21 years of age. These young adults, says Melzer, have difficulty finding specialists in childhood diseases that are carried into adulthood. "We are expert at treating conditions that affect children, particularly birth defects," he says. "As the technology for treating these diseases gets better and better, we find a growing group of young adults surviving conditions like congenital heart disease or cystic fibrosis. We are having discussions on how best to serve this population."

NATIONAL PROMINENCE
Children's hopes the expansion will help in its aim to become nationally prominent in a number of key areas, while retaining its regional dominance in areas such as neonatology, general surgery, orthopedics and cardiac surgery."We have a nationally known cancer and bone marrow transplant program and are also well-known for treating children who have abnormalities of the head and face," says Melzer. "We are now one of five programs in the country that has the capacity to perform small bowel transplant in children."

Currently, Children's serves primarily Washington, Alaska, Montana and Idaho. A smaller number of patients come to the hospital from around the country. "For the last 10 years, we have progressively made an effort to provide care where the children are," says Melzer. To that end, Children's has outreach clinics as far away as Wenatchee and the Tri-Cities, Yakima and Anchorage. "Our position is to travel to lots of places so that families avoid having to come to Children's."

Children's also has satellite centers in Everett, Federal Way and Olympia. "Once we have completed the eastside expansion, we would like to duplicate that model north and south," says Melzer.

Additionally, Children's has acquired two large buildings in downtown Seattle to beef up its presence in biomedical research. The $145 million Seattle Children's Hospital Research Institute wants to eventually grow to one million square feet of research space with up to 1,500 research staff. This would place the Institute in the company of the University of Washington and Fred Hutchinson Cancer Research Center in terms of size.

Cynthia Scanlon is an Everett-based journalist who writes about health care.