LEXINGTON, Ky.—On Aug. 23, Kentucky Children’s Hospital (KCH) will celebrate its 25th anniversary of serving the children of the Commonwealth. The hospital has grown since 1997, in both physical capacity and in the types of specialty care for every child, from infant to young adults.

Physician-in-chief Scottie B. Day, M.D., reflected on how KCH has expanded over the years to provide highly specialized care to children in Central and Eastern Kentucky.

“Before KCH, families would have to travel hours, sometimes to other states, to get the help their kids needed,” said Day. “This is a place that centers on family care, and keeping families together and close to home is essential to care and healing.”

Carol Steltenkamp, M.D., chief medical officer for external affairs for UK HealthCare, had completed her pediatrics residency at UK’s Chandler Hospital just prior to the establishment of the children’s hospital. When she returned as an attending pediatrician in 1995, the planning for the new space was underway.

“The fourth floor of Chandler was already designated for pediatrics,” she said. “It looked just like the other floors. But there was a focus; our region needed a children’s hospital, our state needed it, and they needed UK to be the leader.”

In 1997, the renovations were complete, and this “hospital within a hospital,” then called UK Children’s Hospital, had a total of 50 beds in its acute and intensive care units. The rooms were bigger and brighter with a child-friendly décor. In keeping with the commitment to family centered-care, each room has a sleeping space for a family member, and parents were encouraged to stay with their children overnight in the rooms.

Over the years, the hospital expanded, not just in capacity, but in its ability to treat even the most medically complex cases. At the time of its opening, KCH employed 70 pediatric specialists and 200 nurses. In 2022, there are more than 150 pediatric specialists and more than 405 pediatric nurses as well as dietitians, licensed clinical social workers, genetic counselors, child-life specialists, pharmacists and physical, occupational, speech and respiratory therapists. KCH now has a total of 220 beds, including:

• 90 neonatal intensive and neonatal abstinence care (NICU) beds;
• 16 pediatric intensive and cardiac intensive care (PICU) beds;
• 43 acute care beds;
• 12 progressive care beds;
• 26 newborn nursery beds; and
• 12 adolescent psych beds.

“The majority of children’s hospitals are located within larger adult hospitals, which gives us even greater access to specialties and facilities,” said Steltenkamp. “A number of our subspecialists have dual appointments in both adult and pediatric areas, so having everyone in the same building gives us a huge advantage in multidisciplinary care.”

In 2005, UK Children’s Hospital was renamed Kentucky Children’s Hospital, a change that reflects service to all of Kentucky’s kids, not just those in the Lexington area. But the changes didn’t stop there. Other expansions include:

• The opening of the Makenna David Pediatric Emergency Department in 2010. Adjacent to Chandler Hospital, it’s the only Level 1 pediatric trauma center in the region and has a dedicated entrance with child-friendly waiting and treatment areas and staff trained to address the specific needs of pediatric patients.
• The DanceBlue Kentucky Children’s Hospital Hematology/Oncology Clinic expansion in 2017. Supported by the UK student-run DanceBlue 24-hour dance marathon, UK students have raised nearly $20 million for the treatment of patients with cancer and blood disorders.
• Joint Pediatric Heart Care Program, a “one program, two sites” collaboration with Cincinnati Children’s Hospital that is one of the top-ranked pediatric heart programs in the country.
• The partnership with Shriners’ Childrens Lexington on an outpatient surgical and rehabilitation center that is among the top pediatric orthopedic programs in the country by US News & World Report.
• The 36,000 square foot neonatal intensive care unit, where the tiniest and most vulnerable newborns are treated. The changing landscape of public health, including the opioid crisis, necessitated advanced facilities to manage complex care.
• Children’s Sedation and Procedure Unit, which provides outpatient services in a child-focused environment. It was recently redesignated as a center of excellence by the Society for Pediatric Sedation. KCH is only one of four institutions in the world to receive this designation twice.

In 2018, KCH got the ultimate makeover in the form of a new 11,000 square foot lobby and welcome center that includes patient registration, gift shop, family education center, conference rooms, interactive digital wall, and large-scale art installations. The welcome center also includes the Simpson Family Theatre that hosts events, movie nights and special visitors. Prior to 2018, KCH was accessed by a single elevator and had no central waiting or registration area.

“Everything from having 24-hour Child Life specialists in the emergency department to Jarrett’s Joy Cart, there are all of these opportunities that makes us different from other hospitals,” said Steltenkamp. “And we’re able to provide a continuity of care for young patients with chronic conditions. So many of our specialists are trained in both adult and pediatric care that patients can easily have their care transitioned as they grow up.”

What does the future hold for KCH? More expansion, but not just the building itself. Access to health care is still a barrier to families in rural areas. The COVID-19 pandemic brought telehealth into the forefront, and with it, care providers into the homes of the patients they serve. KCH has a strong affiliate network where children can see a UK doctor in a hospital in their hometown. Soon, a new mobile clinic will be rolling into the most remote parts of the state.

Over the past 25 years, the providers and staff of KCH have used every available resource to deliver care where it’s needed most. For the next 25 years and beyond, the building, staff and treatments will change, but the mission will stay the same.

“We’re important. Our mission is important,” said Steltenkamp. “We’re leaders in children’s care and education of parents and caregivers. This anniversary is just another stepping stone for us.”

“This isn’t just a hospital, and kids aren’t just small adults,” said Day. “This is a nationally-ranked institution where specialized, complex care is delivered and innovative research is conducted, all with the goal of helping kids get back to being kids.”

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LEBANON, N.H. — Alice Peck Day Memorial Hospital and E4H Environments for Health Architecture of Burlington, Vt., celebrated the opening of the new Alice Peck Day (APD) Memorial Hospital Multi-Specialty Clinic in November 2017. The construction of the 44,000-square-foot facility began in 2014, running a budget of approximately $11 million with the clinic functioning as a multi-specialty operation, providing myriad services all under one roof.

The services of this new multi-specialty clinic include primary and family care, pediatrics, women’s care, diagnostic imaging, phlebotomy, orthopedics, general surgery, and physical and occupational therapy.

One of the key goals of this design is to allow patients, who are often coming from long distances, to complete multiple appointments in one visit, creating a time-efficient service for all patients. For example, a family could schedule annual physicals for both parents and children as well as a physical therapy session for a family member recovering from shoulder or knee surgery. They could also have follow-up imaging or blood work done for a family member who recently had a procedure.

E4H Partner Jennifer Arbuckle, explained that the most important feature of this facility is the organizing principle of convenience, bringing with it a broad range of outpatient services into one building, for the benefit of both patients and healthcare providers.

“This design also makes it much easier for physicians and nurses from different health specialties to consult and collaborate with each other. They’re across or down the hall from each other, not in separate buildings,” Arbuckle said.

The completion of this facility highlights the layout of the exam rooms and the design of the waiting rooms. The layout of the exam rooms are standardized, modular and adaptable so that any exam room can be used over the course of a day by a primary-care doctor, pediatrician, gynecologist, orthopedist, general surgeon or other type of specialist or therapist. Arbuckle explained that this will increase the utilization rate of exam rooms, with positive financial benefits. The waiting rooms, check-in and checkout areas, as well as corridors, have all been situated to maximize the integration of daylight into the interior of the facility, with the hopes of creating a warm and welcoming environment for its patients.

E4H implemented specific design practices to bolster the focus of the facility on patient care and improve the overall delivery of services.

“E4H’s vision is always about creating flexible environments for health that enhance the well-being of patients and families — what we call ‘smart facility design.’ Working with Alice Peck Day Memorial Hospital was a wonderful opportunity to bring this vision to life in the context of bringing a broad set of outpatient services into one New Hampshire location to maximize patient convenience and collaboration among healthcare providers,” said Arbuckle.

When asked about suggestions E4H may have for designing facilities such as these, Arbuckle explained the importance of best facilitating the convenience and collaboration for both patients and clinical staff.

“Translating this principle into design requires thoughtfully bringing together comprehensive, multidisciplinary user groups to develop and come to consensus on facility design plans — particularly flexible, modular design that can accommodate the full range of outpatient services provided in the multi-specialty clinic,” said Arbuckle. “As you can imagine, this requires lots of discussion and many rounds of refining and perfecting designs. Thankfully, we had very strong administrative leadership on the owner’s side that kept these conversations on track, always moving forward, and led to a facility design we believe everyone at APD — and most importantly, all their patients — will greatly appreciate for the convenience it provides and the collaboration in excellent healthcare delivery it promotes.”

The two-story clinic is fully operational and open to patients, centrally located on the Lebanon campus of Alice Peck Day Memorial Hospital.

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