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The heart of the Medical Campus
This article was presented in the Buffalo News on January 11, 2012, 8:33 PM
Four years ago, Dr. L. Nelson Hopkins III gathered experts in every aspect of vascular medicine from around the world and asked them what they would want in their dream place to work.
Then the group brought in a star architect to turn the ideas into a building.
More than $291 million later, the result is nearing completion next to Buffalo General Hospital on the Buffalo Niagara Medical Campus.
The goal was to do more than transform metal and glass into an eye-catching design. It was to make a facility that conformed to how the physicians thought patient care should be practiced in the future and marry it to a state-of-the-art research center focused on quickly translating research into new therapies and medical tests.
"What you see is exactly what we envisioned," said Hopkins, chief of neurosurgery at Kaleida Health and chairman of neurosurgery at the University at Buffalo.
The 10-floor building, which is scheduled to open fully in April, represents a collaboration between Kaleida Health and the University at Buffalo.
As workers continue to paint walls and install flooring, hospital officials express excitement over the facility. But they also acknowledge it has caused turmoil and anxiety among employees.
The project means 1,000 physicians and employees, as well as thousands of patients, will shift from Millard Fillmore Hospital to the new building and other Kaleida Health locations. Millard Fillmore at Gates Circle then will be closed.
"In 37 years in the business, I have never gone through anything as complex as this," said James Kaskie, chief executive officer of Kaleida Health. "We're taking two organizations and making them one, changing the landscape for doctors and staff. That creates job uncertainty."
Four lower floors of the building, above a new emergency department for Buffalo General on the ground floor, will consolidate Kaleida Health's heart, stroke and vascular care services in one location called the Gates Vascular Institute.
The UB Clinical and Translational Research Center will take up the top four floors. It reflects a nationwide push to remove barriers to collaboration among researchers and to do a better job of taking ideas from the laboratory to the patient's bedside.
The middle floor will house the Jacobs Institute, partly funded by a $10 million gift to UB from Jeremy M. Jacobs, chairman of Buffalo-based Delaware North Cos., and his family.
To Hopkins and others, the Jacobs Institute could be a game-changer.
A new model
With an atrium, coffee bar, small gym and glass-walled spaces that overlook procedure rooms on the floor below, the Institute is meant to foster interaction among doctors and researchers who don't ordinarily mix at work.
But it will also offer such services as specialists to seek company-sponsored research funding, a fabrication shop and labs to make and test prototype medical devices, and an editorial staff to help physician-researchers publish their work in journals.
"We can vet ideas, do market research, handle intellectual property issues and have people who can help guide new tests and treatments through the FDA process," Hopkins said.
Hopkins said the building represents the infrastructure needed to get more studies published in journals, attract more research projects and bring new medical technology to Western New York sooner.
Advances have allowed doctors to thread tiny tubes called catheters through blood vessels to treat problems, such as blockages, that in the past required open surgery or for which no good solution existed.
The lines have blurred between the doctors who handle conditions in the body's vascular highway, including neurosurgeons, heart specialists, radiologists and vascular surgeons. Many of the best medical centers are bringing together specialists who deal with the same diseases in different parts of the blood system and putting them in one building.
One of the orders to Mehrdad Yazdani, the Los Angeles-based Cannon Design architect who also designed the Hauptman-Woodward Institute, was to create a building that forced doctors and researchers who historically never worked together to run into each other.
"We need to break down the silos we all work in and realize that we all deal with the vascular system," said Hopkins.
Similarly, the Center for Translational Research Center is an attempt to veer away from past practice.
The center, which is scheduled to open in May, is working with major medical institutions here to coordinate a research strategy and offer help for promising initiatives, including lab space.
"Over the last 30 years, we have seen enormous advances in the basic sciences, but we have not seen advances to the same degree in clinical medicine. Consider new drug approvals, for example. They have been relatively flat," said Dr. Timothy Murphy, who was recently named director of the Clinical and Translational Research Center.
UB received $118 million from the state for its portion of the building.
Kaleida's cost, $173 million, came from a $100,253,000 loan insured by the federal Department of Housing and Urban Development. Financing for the loan came through taxable Ginnie Mae securities that Kaleida Health got at a good interest rate, officials said. Other funding came from a $65 million state grant and $8 million of cash.
Kaleida Health officials have said collaborating with UB saved about $18 million.
In 2006, the Commission on Health Care Facilities in the 21st Century, also known as the Berger Commission, ordered the closure of Millard Fillmore as part of its attempt to restructure the state's health system.
The shift of Millard Fillmore's services and staff would be difficult under the best of circumstances. It is also taking place as Kaleida Health responds to business issues, including cuts in reimbursement.
For many employees, the transition is a source of concern and confusion. It's still unclear how it will play out.
"Many people feel like they are being uprooted," said Norma Adams, who has worked in patient registration at Buffalo General and is moving to Women & Children's Hospital.
"I'm not complaining because Kaleida has been good to work for, and I realize this is a huge undertaking. But it's sad for a lot of workers," she said.
Employees at Millard Fillmore may not get the same job they had before. But more senior staff can bump Buffalo General or Millard Fillmore Suburban staff out of jobs as units are blended.
Meanwhile, Kaleida Health, also in response to separate business issues, has offered early-retirement incentives, eliminated 300 vacant positions, laid off about 40 managers, made some full-time positions part-time, and closed certain services and merged others. Overall, in recent months, as many as 150 employees have left the hospital system, according to Kaskie.
"I made a pledge that no one would lose employment from the Berger Commission recommendations, and I am holding to that," he said. "But that is different from how we need to respond to changes in patient volume and other aspects of the business. We can't guarantee employment."
Talks between the union that represents about 4,800 workers at Kaleida Health and the hospital system over the transition have been positive, according to John Klein, president of Local 1168, Communications Workers of America.
He stressed that major concerns include job security and staffing levels.
"People want to know whether they will have a full-time job, preferably similar to what they were doing," he said.