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Health care built for this century

The plan for the new $762 million University of Kentucky Albert B. Chandler Hospital that towers over South Limestone is for it to remain relevant for a century — an ambitious long-range view.

Rapid technological changes in medicine these days can make a new hospital seem dated as soon as it opens. But UK has built flexibility into its construction to allow for future needs in medical care.

"It was set up to be a 100-year building," said Dr. Michael Karpf, UK's executive vice president for health affairs, after a recent tour of the structure.

The 12 floors are designed in 30-square-foot modular grids, which can be reconfigured easily, he said.

The 15 feet between each floor will allow for high ceilings — about 9-feet high to start — that can be raised to accommodate future technology. And large patient rooms come with extra-large doorways so clinicians may wheel in just about any device needed.

"It's much safer to bring the equipment to a patient than bring the patient to the equipment," Karpf said.

That's not to say the building's designers and stewards, such as Karpf, are just looking toward the future.

After all, the building is one of the most ambitious and expensive that UK has ever undertaken. Constructing the hospital's 12 stories and outfitting the first six floors will cost $532 million. Finishing the upper 600,000 square feet by 2020 will cost an additional $230 million in today's dollars, Karpf said.

The hospital, when it opens in sections during the next decade, will start out with some key innovations that Karpf said will make it one of the most impressive collections of advances in medical design in the country.

"When you add it all up, that's why we're ahead of everybody," Karpf said at the end of a recent walk-through of the building's shell and virtual tour of its features.

The new building has taken some of the best ideas from medical meccas across the country: a waiting area for the children's emergency room with a learning wall and computer toys, a 305-seat auditorium with recording studio quality acoustics for music therapy and performances for children, an electronic board that will give waiting families the status of surgery patients, and an airflow system that converts the 12th floor into a sequestered pandemic area where the air isn't mixed with the rest of the hospital's.

The architecture firm that designed the hospital — Ellerbe Becket — also drew the plans for the Mayo Clinic's Leslie & Susan Gonda Building in Rochester, Minn. That centerpiece structure of Mayo's campus features a three-story foyer with a wall of windows to wash the lobby in natural light.

Patients and visitors at the new UK hospital will be greeted with a 20-foot wide sunlit bridge across Limestone from the parking garage and an open lobby with stone and marble floors and wood-accented walls "to soften it up," Karpf said.

Kentucky artwork, all paid for with private donations, will be prevalent throughout the building.

The patient rooms will seem like hotel suites compared to their cramped counterparts at the existing hospital.

They will have sleeper-sofas for patients' family members and bright artwork. Intensive care unit rooms will have space for medical equipment to swivel 360 degrees.

The architects arranged the building so the elevator banks for visitors are separated from those that will be used by patients.

"You'll never get on an elevator with a patient on a gurney where you feel embarrassed and they feel embarrassed," Karpf said.

UK will take over the Emergency Department, on the south end of the new structure, in April and open it for patients at 5 a.m. June 14, Karpf said.

That department isn't just an ER, but three in one. One section will cater exclusively to children, one will handle traumas and other emergencies, and the third section will be secured for criminals or patients at risk of hurting themselves or others.

The first two floors, with 128 beds including 48 intensive care units, and the hospital's public spaces are slated to open by June 2011.

The rest of the 512 rooms will open gradually. Initially, UK officials had hoped to finish everything by 2015, but the decision in 2007 to add two floors to the project and the onset of the recession delayed the completion to between 2018 and 2020, Karpf said.

This isn't the first major construction project Karpf has overseen.

He arrived in Lexington from UCLA Medical Center, where the construction of a 525-bed hospital ran $230 million over the original $600 million price tag.

It was there he learned that he wanted to have final approval over his next construction project to make sure costs didn't explode.

"When you start getting into change orders, that's when you get into financial trouble," Karpf said, noting that UK's new hospital will be the same size as UCLA's Ronald Reagan Medical Center that opened in 2004. "But UCLA was more expensive because of seismic issues."

UK's builders — New York-based Turner Construction and 72 subcontractors — are right on budget, Karpf said.

Most of the more than 500 workers, such as Turner's senior superintendent, Cliff Applegate, are Kentuckians. Applegate, who said the hospital is the largest medical project he's worked on, is a Lewis County native.

Karpf has been literally overseeing the project from his office window, which faces the construction site. But that view will have nothing on what UK's future patients will see from the new building.

Anyone staying in the southeast corner of the building from the sixth floor up could conceivably catch glimpses of UK football games in nearby Commonwealth Stadium.

Patients in the top rooms will see more.

"You can imagine what the view is from the 12th floor," Karpf said looking out of the open sixth floor. "You can see Keeneland."

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