Hospital Prez D’Aquila: A “revolution” is happening here.
Without a public announcement, Yale-New Haven has begun building a “groundbreaking” research and treatment center at its St. Raphael campus aimed in part at aging baby boomers battling bad hips, broken backs, multiple sclerosis or Parkinson’s disease.
A ribbon won’t be cut until 2016 or 2017. No single major donor has emerged to have his or her name in the title. An initial-stage $15 million fundraising campaign is getting underway.
But the center has already started taking shape, with two new units open and more on the way.
Hospital officials describe the emerging center, which will include Yale School of Medicine physicians and researchers, as similar to Smilow Cancer Hospital: a “destination” center drawing patients from near and far with top-level physicians, researchers and technology.
Yale-New Haven President Richard D’Aquila predicted the musculoskeletal center, once completed, will advance the field beyond where the current institutional leaders—New York’s Hospital for Special Surgery, Philadelphia’s Rothman Institute, Washington University, and the University of Rochester —have taken it.
“We think there’s a next step, like with cancer, bringing all the components around musculoskeletal disease together,” D’Aquila said Wednesday in an interview in his office together with Senior Vice-President Abe Lopman, his point person in developing the new center.
Teams of specialists from the center will handle a patient’s case from diagnosis to treatment to rehab. With baby boomers living longer, the ranks of the elderly are expanding — along with the market for treating people with bone, joint and muscle problems. D’Aquila said Yale and Yale-New Haven doctors are “leading a revolution” in musculoskeletal care.
“If you think cancer is a big issue — which it is — musculoskeletal health disease is four to five times the size of cancer,” observed Lopman, who has overseen the integration of the St. Raphael Dwight neighborhood campus into Yale-New Haven.
Though officials have made no public announcements about the center, they revealed the plan to state regulators during the process of approving Yale-New Haven’s 2012 takeover of the fiscally ailing Hospital of St. Raphael. Yale-New Haven promised to pump $130 million overall into upgrading St. Raphael’s campus. The news about the planned musculoskeletal center appeared in paragraph 53 of a 29-page June 27, 2012, settlement between Yale-New Haven and the state Department of Public Health’s (PDH) Office of Health Care Access that led to the approval of the takeover. (Read the document here.)
Now, as the center’s first two in-patient units have opened in the St. Raphael Verdi wing, officials have begun discussing the emerging center more with city leaders. They have no solid figures yet on how many millions of dollars they hope eventually to raise or on specific jobs created. They said they do expect to lure leading surgeons from other states and to create hundreds of supporting medical positions.
“I think it’s great,” Mayor Toni Harp said Tuesday. “I’m excited about the prospect of jobs. I’m excited about that we can do work here to contribute to the health of the country.”
The “Wall Of Knowledge”
VP Lopman: “4 to 5 times the size” of the cancer field.
One major difference: Rather than build a new $498 million, 14-story building like Smilow Cancer Hospital, Yale-New Haven is carving the new center out of existing space at the Hospital of St. Raphael campus.
As a result, it won’t have to go through the public regulatory dramas that accompanied the quest to build Smilow.
“They don’t need” approvals because the 2012 settlement covered it, confirmed Christopher Stan, a spokesman for the state Department of Public Health.
The eventual idea is to centralize the two hospital campuses’ muscoloskeletal operations in the emerging St. Raphael’s center. That will occur in existing space, according to hospital President D’Aquila. All orthopedic and elective spine surgery will move from the original Yale-New Haven Hill campus to the St. Raphael campus beginning in early 2015. The hospital created an initial 20-bed inpatient unit in unused space in the St. Raphael Verdi wing, then opened a second 17-bed unit several weeks ago. Now it’s building a third 17-bed unit. All have private rooms.
This fall the center dedicated two operating rooms there for musculoskeletal-related surgery, with an eventual goal of six to eight rooms. They are to include two new “super high-tech” specialized operating rooms aimed at minimizing infections and incorporating the latest technology in orthopedic or spinal procedures, or hip or shoulder replacements. The new rooms will include a 15-to-20-foot high “wall of knowledge,” flat screens that display diagnostic information, MRIs, X‑ray scans, and other medical records in real time for surgeons as they work. Architects hired by the hospital began designing the futuristic rooms six months ago. As part of their work they observed mock procedures performed by Yale neurosurgeons and nurses (on mannequin-“patients”) at the hospital’s simulation center inside a former Sealtest factory warehouse on Howard Avenue.
“The real fun here is to take a hospital [St. Raphael] that had a great history and heritage and bring it back better,” D’Aquila said, “to bring St. Raphael’s back into something cutting-edge, going forward.”
The philosophy overall is to avoid in-patient stays in favor of pain management, outpatient surgery and rehab. If this center were emerging ten years ago, D’Aquila observed, it might have entailed building a large new edifice. Instead, he envisions a “hub-and-spoke” system, with central work taking place at the St. Raphael campus and coordinated rehab and doctor’s visits and surgery occurring at satellite offices throughout the state, closer to where some patients live. For example, Yale-New Haven expects to rent a floor being redesigned at Milford Hospital for inpatient rehab.
Good Timing
Yale-New Haven is stepping into the market at a propitious moment, in the view of one independent observer, orthopedic surgeon Michael Connair.
“There is a need in central New England for a place like that. If we can bring all of the subspecialties involved in musculoskeletal care into one place with good-quality criteria, I think it can do a great job” as an alternative to facilities in Boston or New York, said Connair, who runs a local practice, is a past president of the Connecticut Orthopedic Society, and currently serves as vice-president of the National Union of Hospital and Health Care Employees.
“It sounds great. It sounds pretty expensive.”
Connair said he remains “wary and vigilant” of Yale-New Haven’s “huge” and increasing “market power,” which can “crush little guys” like him.
“I think they have to be careful not to inadvertently brush [out] little guys who aren’t part of that Yale complex,” Connair said. “I am going to give them a chance to prove that my wariness and vigilance is not necessary.”