By Brian J Pape, AIA, LEED-AP
Superstorm Sandy hit Manhattan hard in 2012, two days before Halloween. East River hospitals were crippled, transferring patients to other facilities. But transportation was hit too, so commuters mostly stayed home from their hospital jobs. My West Village home was at the edge of the flooding and without power, but my wife found a non-medical volunteer opportunity at Lenox Hill. I recall the congested streets filled with transfer vehicles, and the labyrinth of hallways as I got my necessary vaccine shots and filled out paperwork for the few days of work until the city recovered a little. Lenox Hill opened its facilities to all—patients, family, and neighbors in need of a meal or medical help. It was a rewarding experience, but I saw the aging of the facility first-hand.
News of rebuilding Lenox Hill Hospital left many West Villagers wishing the hospital would invest in a full hospital here, despite the public outreach efforts by Lenox Health Greenwich Village to explain progress toward better and more complete services here. But what does it take to plan a new hospital?
The example of the $2.5 billion 10-year plan for the Upper East Side Lenox Hill Hospital, at that original location since 1857, where they accommodated growth until they owned the entire block and beyond, hints at the complexity. This article can only touch on the highlights of the plan process but it is instructive nevertheless.
First, a multi-year strategic planning effort based on future health needs and services, as well as inspecting the existing structures and layouts to determine their usefulness, was conducted by Michael Dowling (president and chief executive officer of Northwell Health), hospital staff, Ennead Architects (formerly James Polshek Partners), which has extensive experience designing public institutions in historic neighborhoods, and EwingCole, a firm with extensive hospital design expertise. That research serves as the basis and guide for ongoing design work and the overall size and shape of the proposed facility.
Lenox Hill Hospital merged into the Northwell Health system in 2010. Even though Northwell has invested over $200 million to upgrade the existing hospital, the outdated aspects of the facility make it exorbitantly expensive and inefficient to operate. “The $200 million could have been $1 billion spent on renovating an old place, and we still would not have the result we wanted,” said Dowling.
The complex task of figuring out how to build a new hospital while the fully accredited acute care hospital still functions means the work will encompass three phases, so only a part of the facility is off-line at any time. Other nearby buildings will be utilized for the campus so that some physician medical offices and outpatient care facilities can be added.
Besides enlarging the emergency department (ED), traffic congestion at the 77th Street entrance to the hospital’s ED will be decreased dramatically by providing more off-street ambulance parking, which now exposes patients to vehicular traffic and sidewalk pedestrians.
Plans call for larger service departments, only single-bed patient rooms, more beds than before, state-of-the-art equipment and technology while providing flexibility for future technology advancements, and more operating rooms. They will also establish a dedicated “mother-baby” hospital wing to accommodate mothers and family members in an elegant private setting with its own separate entrance on Park Avenue. Plans also include shared programmable community spaces. In total there will be 1.3 million square feet, up from 780,000 square feet including the 30-story tower.
Joshua Strugatz, vice president of Northwell’s Manhattan Redevelopment, was appointed as the hospital’s liaison to field questions and provide updates to the community; email firstname.lastname@example.org.
Northwell has established nearly 80 outpatient facilities in Manhattan since 2010. This financial investment would be difficult to achieve without “monetizing” a portion of the hospital’s valuable real estate. Therefore, a 41-story residential building on the Park Avenue corner, with about 200 units, was added so “we could offset costs for rebuilding Lenox Hill,” said Dowling. The costs and returns from the condos have not yet been established; it is totally separate from the hospital buildings.
Every planning decision mentioned here is highly regulated by government agencies, including having to justify any change based on community needs. It will take many more months to wind their way through many bureaucracies at state and local levels. You can contact Northwell directly with your comments.
Brian J. Pape is a LEED-AP “green” architect consulting in private practice, serves on the Manhattan District 2 Community Board, and is co-chair of the American Institute of Architects NY Design for Aging Committee.