Entering the new outpatient facility built for kids and families is a breathtaking experience. The 15-story, glass-faced building sparkles against the traditional brick facades of downtown RVA. Its architecture celebrates color, light, air, and art.
For Stephanie Rasmon, mom of 2-year-old Luca, the outpatient facility for children goes beyond beautiful – it’s a dream come true. In the thirteenth week of her pregnancy, Stephanie’s doctor advised her to have an amniocentesis test performed to check for Down syndrome. She did, and the results were daunting. Stephanie was told her baby had a one in ten chance of having spina bifida, a birth defect in which part of the spine is exposed, frequently causing paralysis of lower limbs. Furthermore, there was only a one percent chance he would survive at all. She and her husband struggled with the devastating health news.
Months later, little Luca was born with spina bifida, but contrary to all odds, he lived. He had a host of other problems too, including hydrocephalus (fluid accumulation in the brain), which required a permanent shunt. Born with hip dysplasia, he had to wear a body cast for seven months of his young life. He had gastroparesis (a disorder in which the stomach empties too slowly) which made feeding difficult. And the spina bifida meant he might never walk. The Rasmon family’s life became all about seeing specialists.
Because of the complexity of the buildings and the distances between various doctors’ offices, not to mention the challenges of parking, going to the VCU Medical Center downtown was complicated and difficult. For Stephanie, having to transport Luca in his wheelchair and bring along her 8-year-old daughter, Lily, made each trip an ordeal.
While Stephanie and Luca were going through all this, the Children’s Hospital of Richmond at VCU’s Children’s Pavilion was under construction. The $200 million outpatient facility was built with patients like Luca and his family in mind. It took five years of planning and then seven years of construction to build the facility, which opened in spring of 2016. With 640,000-square feet of space, offices for more than a hundred faculty and physicians, and eighty-three exam rooms, it was a mammoth undertaking. The Pavilion includes a surgery level, three levels of pediatric clinics, and a faculty and research floor. Parking, which has always presented unique challenges downtown, is no longer an issue with the facility’s new 7-level, 600-space parking garage, including valet and self-parking options. All within the building.
Each floor has a south-facing wall of glass showcasing the city skyline. The afternoon sun pours through the glass making everything seem bright and alive. The walls are painted in brilliant shades of lime green, aqua, and yellow. Seating and furnishings are in soft, friendly colors and situated for optimum viewing pleasure. Floor-to-ceiling wall murals depict huge trees full of birds against a field with small animals scurrying about.
Touted as one of the top healthcare architectural firms in the world, HKS designed the building in an effort to create what they call an oasis for children in the midst of a busy urban setting. Nature is the theme, drawing on Richmond’s River City identity and the area’s great parks and gardens. The designers describe some of the building’s features as “symbolic gestures to nature, including natural groves, stepping stones, and tree canopies incorporated in the tile flooring, wood ceilings, and feature walls.” The glass walls reflect the sky and shine like water in the sunlight. Paving stones and containers filled with local plants remind you of the James River, just a few blocks to the south of the building. Outdoor benches and seating areas, surrounded by trees, plants and soothing wind chimes, provide patients, families and staff members a quiet space in the middle of the city. An area on the ground floor is available to showcase artwork and local performers.
But architecture and aesthetics aside, Stephanie says CHoR’s Children’s Pavilion is a practical and positive change. “It’s so easy to navigate, and all the directions are clear. The kids love the Sky Lobby with its views. They also love the big interactive digital screen with fish on it.” The family actually arrives early for appointments to give the kids time to play, and the children look forward to coming. Big sister Lily plays in the Ronald McDonald House Sibling Center, a beautiful space with toys and games for sisters and brothers of patients, complete with adult supervision. This service allows parents and patient advocates to meet with doctors and therapists to be able to pay full attention during the meeting knowing that their children are well-supervised. Stephanie says, “One day, Luca had a seizure. I was trying desperately to get him in there to see his doctor. Miss Joy was so nice. She took Lily and entertained her. It was a blessing, in the midst of an emergency, to have that helping hand.”
Because Luca has so many specialists and therapists, the setting is particularly helpful to him and his mom. “He has an orthopedic doctor, a neurology team for seizures, a neurosurgeon to deal with his hydrocephaly, a urologist, and a speech pathologist who has helped us so much with feeding,” says Stephanie. “I can come into this one building and see virtually all Luca’s doctors in one day.” Stephanie describes an environment in which she is able to speak with the nurses, the doctors, and the therapists all in one setting. “I feel they can really listen to me.”
The Pavilion provides same-day surgery, infusion therapy, radiology, and lab tests. Wei Zhao, MD, medical director and chief of allergy and immunology of CHoR’s Children’s Pavilion, is enthusiastic. “This new building has enabled us in so many ways. Formerly, patients who came to VCU Medical Center had to park at a distance, walk, then try to find several physicians’ offices, clinics and labs, often going to three different buildings.” Dr. Zhao says patients requiring wheelchairs had a very difficult time.
As he explains, the building is designed to accommodate many specialty providers – up to 127 specialists and sub-specialists. “Now we can see more complicated cases. Some patients may need to see as many as six or seven different providers.” In the Children’s Pavilion, patients can now see several physicians in one day, instead of having to make multiple appointments over the course of days or weeks. Dr. Zhao remarks that there is a synergistic effect in having all the patient’s physicians in one place. An example he gives is a patient needing oral and maxillofacial surgery, which may involve the collaboration of a plastic surgeon, an oral surgeon, and an orthodontist. “Here, they can see the patient and coordinate treatment strategies together.”
When it comes to specialized children’s healthcare, imaging is another important component of diagnosis and treatment. According to Dr. Zhao, while the Pavilion already has X-rays, computerized tomography (CT scans), and ultrasound, in time, it will have the most advanced magnetic resonance imaging (MRI) available. There is also space for a new infusion center for rehydrating, chemotherapy treatments, and other complex medications that require infusion.
One of the therapies the infusion center will provide is kidney dialysis. Dialysis, involving hours of sitting or lying down, is a particularly difficult treatment for young children. Jules Goble, BSN, RN, was recruited to start the pediatric nephrology program at VCU Medical Center six years ago. She was thrilled to make the move to the new Children’s Pavilion.
“In the past, parents had to bring their children to the Nelson Clinic [a VCU Health building with limited children’s services], then go to the main hospital for radiology, and then to a third building to get their lab work done,” Goble says. It could be exhausting, and in bad weather, especially aggravating. Plus, the children were in a dialysis unit with older adults, some very ill, for hours each day. In the Pavilion, they are with other children in a much brighter, more interesting setting. “We had a little 3-year-old girl coming in five days a week for dialysis. She was in the adult dialysis section. Now she is in this beautiful setting with other children. Kids love it here.”
Dr. Zhao adds, “Since dialysis takes so much time, we gave the children’s dialysis unit the best views in the building.” While having treatments, kids can now scan the Richmond skyline, watch pigeons, see an occasional falcon, and fantasize about the gothic, castle-like Old City Hall Building.
Plans for the Future
Dr. Zhao explains that the VCU Health System mission is threefold: patient care first (and always the priority); research to develop better
ways to provide treatment and new therapies second; and third, the education of a new generation of pediatricians, nurses, and therapists. “We have state-of-the-art educational conference rooms. Conferences can be held on-site, making it feasible for more staff to attend and participate.” Dr. Zhao says a benefit of having so many providers working in one location is that there is a lot of cross-training and shared communication. The building, in both construction and spirit, has been designed to fulfill the values of the Children’s Hospital of Richmond at VCU. Dr. Zhao says that means “providing exceptional service by treating the whole child and family, not just the illness or injury, in order to create a comfortable, caring, healing experience, and to respect the role and contribution of every member of the health team and all individuals who work to better the lives of children.”
With its many specialists, modern equipment, and layout, CHoR’s Children’s Pavilion is among the most progressive children’s outpatient centers in Central Virginia. Dr. Zhao says, “We are proud of it. It took only two months to reach full capacity and above.” He adds that the building has a great deal of space set aside for expansion, too. “The sixth floor has six more units and we can open forty more rooms.” The Children’s Pavilion will soon welcome a VCU School of Dentistry pediatric dental unit and a pediatric ophthalmology department. As Dr. Zhao looks ahead, he says, “Since this center is outpatient only, our next project in the VCU master plan is to build a new inpatient pediatric building.”
Stephanie, whose husband Russell works two jobs so she can stay at home with the kids, and more specifically, care for Luca, is very pleased with the new outpatient facility. For the health and well-being of her family, this mother of two takes things one day at a time.
“I feel Luca has beaten all the odds. And this place, and these people are helping him do that.”
Photos: Allen Jones, Diane York