It took 14 years of Herculean effort and uncommon commitment to conceive, plan and construct Ronald Reagan UCLA Medical Center. UCLA Medicine invited Dr. Gerald S. Levey, vice chancellor of UCLA medical sciences and dean of the David Geffen School of Medicine at UCLA, Dr. David T. Feinberg, CEO of UCLA Hospital System and interim associate vice chancellor of UCLA medical sciences, and pediatric surgeon Dr. James B. Atkinson, senior medical director of transition, to talk about the project and their vision for the future of the new hospital. The group met several weeks before the hospital’s scheduled opening on June 29, 2008, in the physicians’ lounge on the second floor of the new hospital building, where the operating rooms and interventional suites are located. Richard Azar, head of transition planning for the hospital project, moderated the discussion.
AZAR: We are just a few weeks from opening this new, world-class medical center. What are your thoughts as you walk through this building?
DR. LEVEY:It still is a thrilling experience for me to walk into this hospital because none of us who started this project knew that it would turn out so perfectly. The hospital has come out exactly the way we had envisioned it. And I feel a great sense of pride in the institution, that despite all the hair-pulling and everything else that went on over this project, it really is a testimony to how people who are determined to make something happen could produce this magnificent hospital. I feel all those emotions, and throw in, also, relief because there were times when we had some dark days … when we didn’t know if we would be able to complete the project. I just find my feelings regarding the completion of the hospital are sometimes overwhelming.
DR. ATKINSON: We get lost sometimes in the mass of details that we’ve had to deal with, and don’t get much of an opportunity to step back and look at what’s been created here. When I walk into this building now and I see all the wonderful new spaces and equipment, it is easy to become jaded about how much better it is than our old spaces. The contrast is tremendous when you return to CHS (Center for the Health Sciences) and see our great staff working in very difficult and crowded conditions there. Thinking about how it’s going to be for them when they move into this new building gets you reoriented as to what really has happened here.
DR. FEINBERG:I have a vision of the great hall on the first floor being filled with people and patients coming in and out of the elevators and families and our staff having the facility that they deserve. I show people the ICU and the regular patient rooms and they say, wow, we must have had hundreds of people involved because we’ve thought of everything, and we really did, and now it’s going to be filled with patients and families, and I’m overwhelmed.
AZAR: This hospital is an incredible achievement. How will it affect research and education and patient care?
DR. FEINBERG: This is a gift to Southern California and to the western United States. Patient care is going to go to a completely different level because we have every component in place now – from the physicians and staff to the technology to the surroundings – and that will extend to our teaching as well. We’ll be training doctors and nurses and ancillary staff to deliver care that is completely patient- and family-centered as opposed to what’s convenient for the doctor or convenient for the facility. That’s a dramatic change.
DR. ATKINSON: I believe that the real test of success won’t come in the first week or month or even years. It’s really the durability of what we’ve built. The concept of changing the way that care is delivered – this floor that we’re on right now, for example, the interventional floor, predicts that the standard disciplines that we practice in today are going to disappear. It predicts that surgeons and cardiologists and interventional radiologists will share spaces, and that they won’t have distinct specialties, and that we may have altering needs for operating rooms or cath labs or radiology suites. So, the test of our success may come 20 or 30 years from now.
AZAR: What about its impact on UCLA and Los Angeles?
DR. FEINBERG: We are extremely fortunate that we’re actually on the campus; other academic medical centers are frequently down the block or across town. So, to be on campus really allows us, from an interdisciplinary standpoint, to integrate our research better, our education better, and to provide care to the campus, because we really are the community hospital for the campus. It’s a great synergistic relationship, the south part of campus with the north part of campus.
DR. LEVEY: Some day, this city is going to face a dreadful tragedy of one kind or another. Either it’s going to come in the form of an earthquake or terrorism or some other disaster, and this hospital, which is geared now to convert every room into an intensive-care unit if necessary, will somehow be critical to the survival of Los Angeles. The occurrence of a disaster is not a pleasant thing to contemplate, but this is what we built this hospital for, and this is why FEMA (Federal Emergency Management Agency) gave us as much money as it did, the $432 million for this facility. So, it’s going to have a powerful impact in Los Angeles.
AZAR: The design features – natural light, openness and community space – were intended to create a healing environment. Is it successful?
DR. LEVEY: Yes, I think so. We planned it to have a major impact, to be very patient-friendly, family-friendly. We really worked hard to achieve that.
DR. ATKINSON: Patients who are extremely ill come to us in the existing 50-year-old building from all over the country, and they come because of the doctors and nurses and the research and the educational programs … in spite of the condition of the physical building. Now we are taking the excellence of everything we have to offer and putting that into the right kind of building.
DR. FEINBERG: Our patients and their families don’t really care about the building per se. What they want is to be treated in a way that is compassionate and dignified. That is what they deserve. The building itself, the artwork on the walls, the beautiful views, those are, in a way, below the radar. But in a building where there are stains on the carpet and chips in the walls and the chairs have cuts in them, those are distractions for people that take them away from what they should be focused on. What we’ve done here is to remove those distractions, to create a comfortable environment where we can get down to the business of real healing.
DR. LEVEY: When we dedicated the building last summer and Nancy Reagan walked through the entrance, her jaw literally dropped, and I think that’s symbolic of every patient who will come here. Patients and their families will feel they are in a special place. Everything really has been designed for our patients and their families in a way that’s exponentially greater than what we’ve been able to offer before.
AZAR: It has been a long, challenging process to get here.
DR. LEVEY: I naively expected that the project was going to be much easier. I never anticipated a project this long. It took us two years just to finish with FEMA. It took us another two-and-a-half years to plan the building, and then once we broke ground, we had issues that slowed the project. To be perfectly candid, I thought we would have been further along. On the other hand, knowing what I know now, and knowing how complicated it is to build a facility like this, it’s probably appropriate in terms of the length of time that it took. I just never anticipated it.
DR. ATKINSON: I recall that our original construction fence listed January 6, 2004, as the completion date, and then we repainted it and put it to 2005, and then 2006, and then we quit putting the date up because it just kept moving. But technology moves, programs move. Did we achieve what we expected? We are opening with state-of-the-art science, state-of-the-art equipment and a physical plant that really works. That’s what’s important at the end of it, not the time it took us to get here.
AZAR: Given what you know now about the complexities of a project of this nature, what would you do differently?
DR. FEINBERG: I’d add more beds – another 200 beds.
DR. LEVEY: We all probably agree about that. We thought in the mid-to-late ’90s that hospitals would be reducing their number of beds because more would be done in the outpatient setting. I think if we had it to do over again, we would certainly have another floor on this hospital. But, you know, that’s life. You can’t always anticipate what will happen. The other thing is, it’s good that we didn’t know how complicated this project would be because we might have made other decisions and found the task too daunting to do it. But having done it, it was worth the effort.
DR. FEINBERG(speaking directly to Drs. Levey and Atkinson, who have been involved from the earliest stages of the project): Your vision has been incredible. This new building is only here because of a level of dedication, professionalism and fortitude that I’ve never seen in my professional life. I’m thrilled to tag along, but to watch you two has been really special. Had you blinked at any point or had you gone fishing, we wouldn’t be here. Obviously there’s a team involved … but the leadership has, to me, been a model that I’m extremely grateful to have witnessed. It has been incredible.
DR. LEVEY(speaking directly to Dr. Feinberg): There’s no such word as undauntable, but you never thought anything was too big a challenge. Your attitude is ‘Don’t worry, we’ll get over it,’ and we sure have. This whole thing has been a special experience for all of us.
DR. ATKINSON: It’s been kind of fun.
DR. LEVEY: We also really owe our thanks to the UCLA community as well. There have been hundreds and hundreds and hundreds of people who have been involved with the project, and everybody has been patient and understanding when they could have been persnickety. They understood how difficult the process was, and they’ve been wonderful. And this couldn’t have been done without the generosity of the donors. They have been truly amazing. They bought into this vision. There aren’t many hospitals that attract $300 million in donations for a specific project. Without those donations, this project wouldn’t have happened. I personally am very grateful to them for what they’ve done. I also hope that (former Gov.) Gray Davis feels a sense of satisfaction because he was a great friend of this hospital, and when we needed some lease-revenue bonds, he stepped right up to the plate to help, and I am very grateful to him for what he did.
AZAR: UCLA and its health system are known for many firsts. Is this another first, a breakthrough in healthcare design?
DR. LEVEY: We believe that that’s a true statement. It is a first.
DR. ATKINSON: An important part of what we did in the design was to think about how we could build for the future. As we went through the whole process, we had to do some “value engineering” to choose where we were going to spend the money that we had. Whenever we had the choice, we always went for more infrastructure. If you think about the type of medical care that was being delivered when the old hospital was designed and built 50 years ago, it’s incredible that we’re able to practice sophisticated 2008 medicine inside that building. The question for us now is, will we be able to practice 2058 medicine inside this new building? My hope is that we will.
DR. FEINBERG: In 50 years, this will be an old building. But it’s our people who make the old building as fantastic as it is, and it is our people who will keep this new building cutting-edge, even when it gets old in decades to come.
AZAR: Do you have any concluding thoughts?
DR. FEINBERG: My No. 1 emotion is, I feel so lucky. I can’t believe that I’m here at this time, that I was given this opportunity at this time. I couldn’t pick better people to do it with, and it came out perfectly. It is so incredible. I just feel lucky.
DR. LEVEY: I couldn’t say it any better. What UCLA gave me, the opportunity to do this, is something I used to fantasize about, heading an academic medical center, and here it is. It gives me a lot of pause everyday to think about it. But, all this is done, and I feel that UCLA has been an extraordinary institution, and everybody has built on the work of the people who came before. I feel that I’ve made my contribution, and my colleagues here, and others who are not here today, have done an extraordinary thing. It is almost overwhelming when you think about the totality of what has been done here.
DR. ATKINSON: As a physician, I’ve always marveled how, when a mother gives me her baby to care for, she has placed her trust in my hands. That is how I felt when I was handed the responsibility for this new building, that so many people had placed their trust in my hands. To have been able to bring this to fruition is a great blessing.
AZAR: Thank you all.