LVH May Add Children’s Hospital: Institution Studying Need

By Ann Wlazelek, The Morning Call, Allentown, Pa.

Apr. 26–Lehigh Valley Hospital wants its own children’s hospital.

The region’s largest health-care provider is exploring whether to create a "hospital within a hospital" dedicated to newborn and pediatric care.

LVH-Cedar Crest already offers intensive care, trauma and burn care for children at its expanding Salisbury Township medical complex. Now, officials say they seek to further develop those services without competing against the state’s free-standing children’s hospitals in Philadelphia, Pittsburgh and Erie.

"We are not looking to do everything," said LVH’s chief of pediatrics, Dr. John

VanBrakle, noting the hospital does not intend to provide pediatric heart surgery or bone marrow transplants for children. "But there is still a lot of room between what we do now and what we can do."

VanBrakle wants to add a neonatologist, two to three more pediatric intensive care specialists and at least one pediatric neurologist to the staff. The hospital already has recruited two pediatric gastroenterologists, a child neurologist and pediatric rheumatologist, sub-specialists in short supply nationwide.

VanBrakle envisions the volume of pediatric patients, which grew more than 50 percent since LVH opened its seven-bed pediatric intensive care unit in 2000, continuing to grow. He wants to expand on the multi-specialist team approach to care.

Early feedback suggests families would welcome an expansion of basic and special pediatric services already available at hospitals in the Lehigh Valley, if it means fewer trips and overnight stays away from home to visit sick and injured children.

Yet competing hospitals, community leaders and LVH trustees want to know if the potential patient volume and revenue warrant the cost of added equipment and staff.

Six free-standing hospitals dedicated to children’s care operate in Pennsylvania, according to the Department of Health. Children’s Hospital of Philadelphia, the largest with 430 beds, reported operating expenses in fiscal 2005 of $837 million, or $130 million more than LVH-Cedar Crest and LVH-Muhlenberg spent to operate their combined 800 beds.

Other free-standing children’s hospitals in the state are St. Christopher’s Hospital for Children, also in Philadelphia, with 161 beds; Children’s Home of Pittsburgh, the smallest with 11 beds; Children’s Hospital of Pittsburgh, with 260 beds; Shriners Hospitals for Children in Erie, 30 beds; and Temple University Children’s Medical Center, Philadelphia, 68 beds.

Several other hospitals also offer large pediatric units with a wide array of services, including Penn State Hershey Medical Center and Geisinger Medical Center in Danville, Montour County.

LVH contracts with Children’s Hospital of Philadelphia, also called CHOP, to provide pediatric intensive care specialists at LVH-Cedar Crest as well as visiting outpatient specialists to LVH-Muhlenberg in Bethlehem.

No special license or permission is needed to start a children’s hospital, according to Richard McGarvey, spokesman for the state Health Department. And definitions of a children’s hospital vary, even among members of the National Association of Children’s Hospitals and Associated Institutions.

The national association lists three major types: free-standing acute care with a full range of sub-specialty services, trauma care and a residency program; similar specialty services offered within a general acute-care hospital rather than in a separate building; and children’s long-term rehabilitation hospitals.

VanBrakle said he wants for LVH’s pediatrics care what parents want for their children: appropriate growth and development. He acknowledged that the undertaking could be expensive, but said it could be more cost-effective and efficient to care for children close to home than at some distance. More beds would be needed, he added, but no specific number or location have been decided.

Plans are preliminary, said Dr. Ron Swinfard, chief medical officer at LVH and its network. "We are soliciting opinions, what kind of support there is."

At least one local businessman supports the broad concept and agreed to give $2 million toward pediatrics in general, officials confirmed.

The Rev. Dan Gambit, a member of LVH’s capital campaign committee and former trustee, said the children’s hospital could cost about $50 million.

That’s about the same amount of money it cost St. Luke’s Hospital to build a five-story addition at its Allentown campus but less than the $60 million LVH-Muhlenberg spent on a seven-story addition.

Gambit said hospital trustees hired a consultant to do a feasibility study. "It would be a very big step, wonderful for families in the Valley," he said.

A family that has taken advantage of local pediatric specialists wholeheartedly supports such a concept.

"Any sort of expansion that serves our children is wonderful. They need to be able to be near home," said Lynne Reitz of Allentown, whose family spent many days traveling back and forth to CHOP for their daughter’s leukemia care.

Happy to report that her daughter Claire, now 8, will be considered cured this fall, Reitz said LVH needs to separate pediatric oncology patients from the regular pediatric patients, whose common illnesses could be life-threatening to those with depressed immune systems.

CHOP’s Dr. Mark Helfaer, who supervises the pediatric intensive care specialists employed by CHOP and working at LVH, said he does not view LVH’s plans as competitive. "The idea is to bring care to the children rather than the reverse," he said.

Helfaer said he foresees the cooperative relationship between LVH and CHOP continuing in some way because both organizations benefit. CHOP admitted more than 200 children from Lehigh and Northampton counties last year and saw even more during 1,900 outpatient visits.

While the number of children living in those two counties can support quite a few neonatal and pediatric services, Helfaer said the community probably does not have sufficient volume to do the best job in pediatric heart surgery, brain tumor operations or kidney transplants.

Sacred Heart Hospital’s pediatrics chief, Dr. Leslie Carroll, said she had heard word of LVH’s plans and wondered what additional services were needed to denote a children’s hospital: 24-hour intensive care? Research? A residency program for pediatricians?

Such services exist within an hour’s drive, she said. Sacred Heart in Allentown refers eight to 10 children with rare or life-threatening conditions to the Philadelphia and Hershey centers each year, she said.

Easton Hospital spokeswoman Ayn Carey said that considering the population growth in the Lehigh Valley, "I don’t think it’s a bad idea" to have a children’s hospital in the Valley.

So far, LVH’s feasibility study has revealed a need for further education, Swinfard said. "We are finding the community in general is not aware of what we already have, the diversity of pediatric specialists."

ann.wlazelek@mcall.com

610-820-6745

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