- The Washington Times - Monday, January 31, 2005

Laura and Douglas Mills sit in a recovery room at Children’s National Medical Center, quietly talking as their 9-month-old son, Jacob, sleeps.

Mrs. Mills says she had a hard time letting her son go into surgery, but this time, she and her husband were reunited with Jacob more quickly than during their last two trips to the pediatric hospital, located in Northwest.

Jacob, who was born with a cleft lip and palate, had lip adhesion surgery when he was 3 months old to stretch the muscles of his lip and had lip closure surgery when he was 5 months old. The Millses, who live in Mechanicsville, Md., took Jacob back to Children’s Hospital, as it is commonly known, last week for cleft palate closure surgery, planning to stay with him during his two nights of recovery.

“We walked into a whole new process,” Mr. Mills says. “We used to go to three to four rooms before the surgery. Now, it’s in one area. It streamlined the process a lot.”

The “new process” began Jan. 18 with the opening of the Joseph E. Robert Jr. Surgery Preparation and Recovery Center, an updated facility named after Mr. Robert, owner of the J.E. Robert Cos. real estate investment firm in McLean. He contributed $25 million to the hospital’s Center for Surgical Care.

The Center for Surgical Care, which conducts 10,000 operations a year, is located in the new east wing addition, scheduled for completion in 2007. The addition will house primary care clinics, emergency services and inpatient care.

“What we had before was a traditional setup of different rooms. Children and families moved from one room to the next as they moved through the system,” says Dr. Kurt Newman, chief of surgery and executive director of the Center for Surgical Care.

The building housing Children’s Hospital, which has been located in the District for the past 130 years, was built in the 1970s. Then, most surgeries were inpatient experiences with children admitted the night before surgery and staying a few days afterward, Dr. Newman says.

“What’s happened in the last 30 years, children come in the same day of surgery. There is a whole process of getting families and children ready for surgery that has evolved from an inpatient experience to most surgeries being an outpatient experience,” Dr. Newman says. “What this facility does is reflect that trend, so we are much more able to take care of patients and families the same day of surgery.”

Located on the second floor of the new five-story wing, the 12,800-square-foot Surgery Preparation and Recovery Center allows families to be with their children during the anesthesia induction process before surgery and again afterward in the recovery area.

“We had the good fortune to design something specifically for kids,” says Beryl Muniz, a registered nurse and director of perioperative services. “We wanted to reunite families quickly.”

In the past, parents would have to wait until their children emerged from the acute recovery room before reuniting with them in another recovery room.

“Unfortunately, with children, if they don’t see their mom and dad, they’re frightened,” Mrs. Muniz says. “We try to have parents with them as soon as possible so they recover better.”

The surgical process is initiated at the registration area, which, like the rest of the center, has a nautical theme. Fish are pictured swimming along a bright blue wall, and the vinyl floor looks like waves.

“The idea is to create a soothing and calming environment that also is interesting for children,” Dr. Newman says. “I love the idea that [the center] is big and spacious, but there are spaces for intimacy and privacy for patients and families and where nurses can focus on individual patients. … It’s not just a space where you’re going to be processed in, where a number is put on you for surgery.”

While waiting for the anesthesia and surgery process to begin, families can accompany their children to a playroom equipped with child-size tables and chairs, tricycles, books, games and toys. Families are called to one of five private induction rooms, where their children are given anesthesia before heading on to an operating room. The ceilings of the induction rooms are adorned with tiles featuring tropical fish.

The fish and ocean theme appears in other places, too, such as on wall borders, around ceiling lights and on the floors. The nursing station is designed like a submarine, with portholes along the front. One of the portholes has movable marbles children can play with while they wait.

“We love it,” says Diana Solomon, a registered nurse. “We feel like there is more control with our patients. We can give them better care because we can involve the parents as well.”

The nursing station is six times the size of the previous station, Mrs. Solomon adds.

“It was like a table,” she says. “This is more classy.”

Registered nurse Haeok Chung says the layout of the nursing station allows needed items to be kept close by. “You don’t have to run for everything,” she says.

The nursing station includes a new central monitoring system that tracks the patient beds, which have their own monitors. Nurses can work with the patients at all stages of the process and, like the rest of the staff, have access to new, state-of-the-art monitoring and anesthesia equipment.

“We want to design the anesthesia process so that anything that involves pain is after the child is asleep,” Dr. Newman says.

The anesthesia process for a child differs from that of an adult, Dr. Newman says. An IV is started and blood is drawn, if needed, when the adult is awake, but children are put under anesthesia right away. Children do not see the operating room.

Adults typically can handle the pain and anticipation of surgery better than children can, Dr. Newman says, adding that being able to spend time with their families helps children relax and feel more comfortable.

Once surgery is completed, children are reunited with their families in one of 24 recovery bays, a system that eliminates moving them from room to room.

“It was hard to watch [Jacob] go back for his surgery. This young, it’s hard for moms to let them go,” Mrs. Mills says. “Doctors can come out and tell you he’s OK, but until you can make sure …,” she says, her voice trailing off as she rubs Jacob’s cheek as he lies sleeping.

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