By Anthony Gagliardi, MD
St. Vincent’s Hospital Manhattan is about to take a big step into its future with the building of a new state-of-the-art facility to serve the residents of the West Side and Downtown. It will be the first all-digital hospital built from the ground up in New York City, and will be the first hospital in the city that is built to the fullest extent possible consistent with standards for a “green” building.
St. Vincent’s has been a part of the neighborhood for more than 150 years. One hundred and fifty-one years ago last week — April 17, 1856 — the Sisters of Charity moved the then-seven-year-old hospital to W. 11th St. in Greenwich Village from E. 13th St.
And since that time, St. Vincent’s has evolved and changed to meet the needs of the community. Among the services it pioneered over the years include the city’s first horse-drawn ambulance service (1879); the nation’s first automotive ambulance (1899); response to various disasters, such as treating the majority of survivors from the Titanic who required medical care, and being one of the first hospitals to treat gay men affected by AIDS in the 1980s.
None of us will ever be able to forget the role that St. Vincent’s played on Sept. 11, 2001, when more than 800 victims of the attacks on the World Trade Center were brought to our Level 1 trauma center. In the immediate days after the attack, St. Vincent’s established a family center that provided counseling and referral to more than 6,800 families who were searching for loved ones, and later created the World Trade Center Healing Services to treat people psychologically traumatized by the attacks.
St. Vincent’s is the cornerstone of healthcare on the West Side and Downtown. Unlike the East Side, which has a concentration of hospitals sometimes referred to as “Bedpan Alley,” St. Vincent’s Hospital is the only Level 1 trauma center serving the West Side of Manhattan from 59th St. to the Battery and is the trauma center closest to Wall St. and the transit/tourist hubs of Penn Station and Madison Square Garden. And it may be the only hospital serving the West Side from Hell’s Kitchen to Tribeca, if the recommendation by the Berger Commission is implemented to close St. Vincent’s Midtown, the former St. Clare’s.
The future portends that St. Vincent’s will become even more critical to its neighbors on the West Side and Downtown. In planning for a sustainable New York City in 2030, Mayor Michael Bloomberg cites data from the Department of City Planning showing that the population of New York City will grow to 9.1 million — or 1.1 million more people than in the year 2000. According to City Planning, Manhattan is projected to grow by 18.8 percent, the city’s second-fastest growing borough. Added to this is the fact that Manhattan’s elderly population, which often requires the most medical care, is expected to grow 57.9 percent, to 295,000, by 2030.
We can expect a good portion of that population growth to take place in St. Vincent’s service area. Over the past several years, the City Council and City Planning have approved zoning changes for both West Chelsea and the Far West Village. This, along with development of the Hudson Yards, will provide the areas of greatest residential development planned for Manhattan. The “visitor” community will also expand in light of plans for the new Moynihan Station and an expanded Javits Center.
Not only is the area serviced by the hospital changing dramatically, but so also is the delivery of healthcare.
I began my career at St. Vincent’s 26 years ago, and have served as medical director for the past seven years. I have witnessed firsthand the revolutionary changes in medicine due to medical advances. The development of technology in areas such as minimally invasive surgery, interventional cardiology and interventional radiology has had a dramatic effect on how disease is treated, often in an outpatient environment. New drug therapies and techniques have shifted treatment of patients with H.I.V. and cancer from the hospital setting to the outpatient arena. Advanced imaging studies are allowing physicians to make diagnoses earlier, resulting in improved outcomes. Advanced monitoring techniques employed by anesthesiologists at St. Vincent’s allow for patients to receive complete anesthesia without prolonged post-operative drowsiness. Laparoscopic surgery (surgery through a minimal incision) allows for shorter hospital stays, as well as improved quality of care and patient comfort.
Our emergency room, designed in the late 1970s, was built anticipating only 45,000 visits per year. In 2007, we expect to care for 60,000 patients and fully anticipate seeing annual growth. This growth, in part, will be fueled by the increase in Manhattan’s population, as well as the anticipated closings of the emergency departments at both St. Vincent’s Midtown and Cabrini Medical Center in Gramercy Park.
St. Vincent’s remains committed to meeting the challenges and opportunities to serve our neighbors here on the West Side and Downtown. In order to be successful, we need to redesign our medical center to meet both current and future needs.
The sponsors and board of directors at St. Vincent’s have spent an enormous amount of time and energy in vetting options for the “new” St. Vincent’s. The product of this evaluation makes one thing very clear: The only way to continue fulfilling our mission of care is to build a new hospital that meets the complex patient, medical and technological needs of today and tomorrow.
While there are still no design plans, there are certain elements that will be part of the new hospital. The new hospital will house state-of-the-art operating suites with adequate space for the equipment used during image-guided and laparoscopic surgery. It will have “cutting-edge” diagnostic services in the areas of interventional radiology, cardiac catheterization and endoscopy.
Our emergency department will focus on dealing with all types of urgent care, including our “Fast Track” for patients with less severe illness. Meanwhile, we will continue to serve the people of Manhattan by maintaining our Level 1 trauma center with the added capacity to deal with the possibility of mass-casualty events.
There have been incredible advances in medical information technology, as well. Patient records, diagnostic test results and radiological images will be kept electronically and available to physicians not only within the confines of the hospital, but also other locations, such as their offices or other remote sites. Most of the rooms within the new facility will be single-bed rooms, designed not only to afford greater comfort and privacy, but also promote better recovery.
Utilizing green technologies, the hospital’s infrastructure systems will emphasize conservation of energy, water and other natural resources, which will result in a reduction of carbon emissions — one of the goals for new buildings recently encouraged by Mayor Bloomberg.
To help guide St. Vincent’s Hospital during this project, the hospital formed a Community Working Group. This group is comprised of elected officials, representatives of Community Board 2, local block associations, community leaders, patient advocates and physician representatives from the surrounding community. The Working Group’s purpose is to ensure that the community’s needs are addressed throughout the life of the project. It will also serve as a forum for dissemination of information. I do, again, want to stress that while no designs for the new hospital have been developed, St. Vincent’s is extremely mindful of the challenges and considerations inherent in the construction of a building that needs to be consistent with the fabric of its historic surroundings.
St. Vincent’s has come a long way to reach this critical juncture. We have spent the past two years reorganizing our operations and finances under Chapter 11 bankruptcy protection. Our plan of reorganization provides a path by which creditors may potentially have their claims paid in full over time. Pending approval of its creditors and the court, St. Vincent’s anticipates emerging from court protection early this summer with a healthy balance sheet and up-to-date financial systems and controls.
This remarkable new era will not come without sacrifice or consequence for the hospital. St. Vincent’s will need to raise a substantial amount of money. Part of this goal will be reached as we embark on a large capital campaign to raise funds for the new building. The hospital will also use proceeds from the sale of some of its buildings on the current Greenwich Village campus to fund the project.
St. Vincent’s embarks on this new era with a sense of responsibility and excitement. We look forward to meet the ongoing and future healthcare needs of the people of the West Side and Downtown who deserve a state-of-the-art facility. At this preliminary stage, we have shared our vision with the community. Over the coming months, we will share more specific plans, seeking broad community input into the new hospital. We look forward to our continued work with elected officials, C.B. 2, community and civic leaders and area residents as we usher in a bold new era for St. Vincent’s, the West Side and Downtown.
Gagliardi is medical director, St. Vincent’s Hospital
