Phoenix Children's opening 2 children's hospitals as part of $400 million expansion
Phoenix Children's is undergoing its largest expansion in 12 years to keep up with rapid local population growth.
Phoenix Children's Hospital is making big changes as it completes a $400 million expansion that over the next two years will add three new pediatric emergency rooms and two hospitals to fast-growing areas of the Valley.
The expansion represents the locally owned organization's biggest project in 12 years. Specifics of the projects include:
- The five-story Phoenix Children's Hospital‑East Valley is a joint venture with Dignity Health in Gilbert. The hospital is scheduled to open later this year on the campus of Dignity Health Mercy Gilbert Medical Center, 3555 S. Val Vista Drive. The hospital isn't a separate building but rather attached to the main 219-bed medical center. It will include 24 inpatient pediatric beds and a pediatric emergency department plus a Women's and Children's Pavilion with 24 labor and delivery rooms, 12 antepartum beds, 48 postpartum beds and a 60-bed neonatal intensive care unit (NICU).
- A new, three-story hospital in the northwest Valley, including a pediatric emergency department, is expected to open in Glendale in 2024. The location will be known as the Phoenix Children's Hospital-Arrowhead Campus and will have 24 inpatient pediatric beds, with room to expand to 48 beds. The land for the new hospital was obtained through a long-term lease with Tenet Healthcare, which owns the nearby Abrazo Arrowhead hospital at 18701 N. 67th Ave.
- A free-standing pediatric emergency room is slated to open in Avondale, in the southwest Valley, later this year, likely during the late summer.
- The existing 11-story hospital tower on the main Phoenix Children's Hospital campus at 1919 E. Thomas Road on Feb. 1 opened up 48 new beds in private rooms on the 10th floor. When the tower opened in 2011, the top two floors of the hospital tower were left empty to allow for more growth. Additional beds on the 11th floor are expected to open in 2024, which would bring the total bed count at the main Phoenix Children's Hospital campus at 1919 E. Thomas Road to about 500.
- A new parking garage and health administration building are under construction at the main campus.
'The biggest challenge is to keep up with the growth'
To many Phoenix residents, Phoenix Children's Hospital is known by its main hospital, which is an 11-story tower visible from State Route 51 and noticeable for its white heart-in-a-hand logo and red lights that glow at night. But the 40-year-old nonprofit has grown much larger and far-reaching than one hospital. Phoenix Children's is a health system, with clinics throughout the Valley and two mobile units that deliver health services, including dental and psychiatric care, to kids experiencing homelessness.
Expansion of the pediatric health system is essential to keep pace with rapid population growth and an influx of young families in the East Valley and West Valley, CEO Bob Meyer said last week in an interview with The Arizona Republic.
Recent U.S. census data puts Phoenix as the fifth-largest city in the U.S. behind New York City, Los Angeles, Chicago and Houston. Between 2010 and 2020, Phoenix grew at a faster rate than any other major city, the data shows.
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"Access is a big deal. Traffic matters now. We're a big city. The parents wanted care closer to home if we could do it," Meyer said. "The biggest challenge is to keep up with the growth."
The hospital system is a busy one and sees patients from all over the state, as well as from across the U.S. and from several foreign countries. Its only emergency room in 2022 had 106,314 patient visits and the hospital had 15,525 inpatient admissions, leaders told The Republic. In 2022, the Phoenix Children's health system took care of about 41,000 kids per month, officials said.
About half of Phoenix Children's patients are covered by Medicaid, a government insurance program for low-income people that in Arizona is known as the Arizona Health Care Cost Containment System.
While children's hospital care does not have a reputation as a money-making venture, Meyer said that in Arizona, reimbursement levels from AHCCCS are keeping pace with cost, which is not the case in all other states. Some hospitals have closed pediatric units because it is less lucrative than caring for adults, the New York Times reported Oct. 11.
The last major expansion project at Phoenix Children's was a $588 million project in 2011, when the hospital's 11-story tower opened, said Meyer, who has been CEO at Phoenix Children's for the past 20 years. The emergency department in the 11-story main hospital tower is a Level One Trauma Center, which is the highest designation for trauma care, for the most serious and life-threatening injuries.
The three new pediatric emergency departments will not be Level One — they will be for lower-level trauma cases, Meyer said. The Phoenix Children's main campus on East Thomas Road will remain the place to go for the most severe emergency trauma cases among children.
'Safer rooms' added for kids at risk of harming themselves
Leaders on Wednesday began moving kids into 48 new beds in private rooms on the 10th floor of the hospital tower, which had been previously empty. And they are looking forward to opening 48 new beds on the 11th floor in the near future.
The new 10th floor beds include eight rooms designated as "safer rooms" for kids hospitalized with physical ailments but who have psychiatric issues, too. The rooms, also known as "med psych beds," are designed to prevent kids from hurting themselves, with door locks and locked closets for hospital equipment. Meyer said young patients at Phoenix Children's who have chronic illnesses may understandably also have behavioral health issues, including depression.
"While they are here and they are here for a medical reason, that doesn't change the fact that they have an underlying behavioral health need," Meyer said.
An example of a patient with medical and mental health needs could be a child who has autism with aggressive behavior, as well as asthma. Another might be a patient with an eating disorder who needs hospitalization because of an electrolyte imbalance and slow heart rate, said Dr. Jared Muenzer, physician-in-chief at Phoenix Children's as well as the chief operating officer for its medical group.
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"They can have a lot of medical complexity to them that requires them to be on a medical unit," Muenzer said of eating disorder patients. "That population is really the one we thought of when we built these safer rooms. ... Their behavior issues and concerns around suicidality and self-harm or aggressive behavior doesn't go away just because they are on the medical side of the hospital."
Patients with dual behavioral health and medical needs have historically been housed in regular rooms, which required more resources, including bolstered staffing and modifications such as removing nearly everything from the room to limit the patient's ability to harm themselves.
Mental health services for kids is a 'huge issue' moving forward
As it looks to the future, Phoenix Children's will be "moving heavily" into behavioral health services, Meyer said. Kids in the Valley need more inpatient care and residential treatment. There's a shortage of both bricks-and-mortar facilities and providers, he said.
"We're trying to do a very community-based model," he said. "It's a huge issue. ... There are too many children that need behavioral health assistance. We can't do it all. Last time I looked, there were 42,000 children in the Medicaid (AHCCCS) behavioral health system in Maricopa County, and I'm sure there are more now."
Pediatric psychiatrists, psychologists and licensed clinical social workers are all needed to meet the demand, he said. Phoenix Children's has a workforce development program with Arizona State University's School of Social Work. Many of the kids needing intensive psychiatric help have experienced three or more traumatic childhood events, such as witnessing or experiencing violence, abuse or neglect, leaders said.
Phoenix Children's has a 22-bed inpatient psychiatric unit on the fifth floor of its old hospital tower in a building known as the "East Tower" on the Thomas Road campus. But the admission criteria leaves out some kids as it's limited to children who are 90 pounds or less and between 5 and 12 years of age, Meyer said. And the treatment model in the psychiatric unit is group therapy, which doesn't always work well for kids with autism, he added.
What Phoenix Children's would like to do is open a separate mental health facility that would meet the needs of kids with eating disorders, as well as kids with autism, Meyer said, adding that he's had a lot of interest from the philanthropic community.
Hospital leaders say they began seeing more kids with mental health issues during the COVID-19 pandemic, and that the need has been particularly high among kids with eating disorders.
"One of the things we talk a lot about in mental health is the care continuum and by that I mean all the way from seeing somebody once a month to a patient who needs inpatient care or a residential facility," Muenzer said. "In Arizona, there are certain populations where we don't have that entire care continuum, and eating disorders is one of them."
Rising mental health needs among children is a national issue, too. A Centers for Disease Control and Prevention report published in February 2022 found that the proportion of emergency department visits by patients with eating disorders doubled among adolescent females ages 12 to 17 during the pandemic when compared with 2019 numbers.
The same report found that between March and October 2020, among all emergency department visits, the proportion of mental health-related visits increased by 24% among U.S. children aged 5 to 11 years and 31% among adolescents aged 12 to 17 years, compared with 2019.
Phoenix Children's began inside 'Good Sam'
Phoenix Children's now has a workforce of about 700 physicians and advanced practice providers, but it began in 1983 with 32 providers working out of leased space inside what was then known as Good Samaritan Hospital, or "Good Sam."
Good Sam is now Banner University Medical Center Phoenix.
Phoenix Children's spent its first 20 years inside Good Sam and moved to its main campus on Thomas Road in 2003. That's when the organization began building its specialty programs, which now include heart, liver and kidney transplants, and a joint bone marrow transplant program with the Mayo Clinic.
Phoenix Children's has a specialized center that does chest wall reconstruction for a condition called pectus carinatum, or "pigeon chest," where the sternum and ribs protrude outward in an abnormal way. The program attracts patients from across the world. The hospital has an advanced program for scoliosis surgery, and does about 250 spine surgeries per year.
"Back in the 2000s, if you needed major heart surgery, any of the transplants, even some of the more elaborate orthopedic procedures, you had to leave town to get them," Meyer said, meaning that patients had to leave Arizona to get the care they needed. "Our first goal was to bring it all in and build those high-end services."
The workforce at Phoenix Children's includes about 6,500 employees plus about 500 contracted employees. Once the expansion is completed, Meyer expects that number will increase to about 8,000 when contracted workers are included, though hiring has been a more recent obstacle.
Leaders look to the West Valley for future expansion
The $400 million expansion follows several new Phoenix Children's projects that opened in the last year, including a new sports medicine and urgent care clinic at Bell Bank Park in Mesa, as well as sports physical therapy clinics in Avondale and Peoria. The hospital system has about a dozen patient and family advisory councils that are constantly providing input on how to improve care, as well as where they think services are needed.
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Meyer said Phoenix Children's always has an eye on new companies moving into the Valley that are bringing young families with them. He cited as an example Taiwan Semiconductor, which recently announced it expects to more than double its Phoenix workforce from 2,000 initially to 4,500 or so within a few years.
"They are bringing over a large group of management folks from Taiwan and they are bringing their families, kids, with them," Meyer said. "We have an active discussion going on around that."
While most Phoenix Children's services are in the central and East Valley, the organization is now looking to the West Valley for continued future growth. Surprise is the fastest-growing area in terms of children in the West Valley, Meyer said.
"We're securing land and looking at how we address that. Some of this is donations. We have donors who have given us land," he said. "We are in the process of closing on a 17-acre gift of land in Buckeye. ... The jobs are going out there, so population will follow."
Reach health care reporter Stephanie Innes at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes.