Nearing 125th year, Children's Hospital still 'pushing the limits'
They fill every third bed in Children's Hospital of Pittsburgh of UPMC: desperately sick children who need organ transplants, cardiac work or other critical care.
The Lawrenceville landmark is admitting more dire cases than ever as its 125th anniversary approaches this week, but doctors and nurses say that's no cause for alarm.
Instead, they say, the hospital's growing role as a regional critical care hub shows how much pediatric medicine has advanced — and how many more fragile lives can be saved — since the Pittsburgh Hospital for Children opened June 5, 1890, in South Oakland.
“We're always pushing the limits of what can be done medically. As new therapies become available, we'll be among the first to use them. Or we'll play a role in discovering those therapies,” said Dr. Andrew Urbach, associate chief medical officer of the 315-bed hospital.
The hospital began with 15 beds near Forbes Avenue and McDevitt Place. Doctors pledged to treat all local children, regardless of whether their families could pay.
That commitment is one of the few unchanged parts of the hospital.
It had grown to 100 beds by the 1920s, and it moved to DeSoto Street in Central Oakland in 1926. The hospital had gone regional by the late 1940s, serving patients from Ohio and West Virginia. By the 1980s, Children's had undergone several expansions and renovations. Today, the hospital's service area stretches from Erie to Altoona and beyond.
It was a medical breakthrough in the early years — not bricks and mortar — that helped set a foundation for the multimillion-dollar research center in Lawrenceville, where the hospital moved in 2009 when it merged with UPMC.
University of Pittsburgh researcher Jonas Salk introduced the polio vaccine in 1955 while he was working at Children's. Before Salk's development, the disease had sickened more than 35,000 Americans a year.
“Nobody who really has an appetite to do great things wants to be at a place that doesn't have an appetite to be the best,” said Dr. David H. Perlmutter, physician-in-chief and scientific director at Children's. He said the hospital's research money from the National Institutes of Health has soared from $7 million to $39 million a year since the UPMC merger.
He estimated the hospital has added more than 300 faculty members in the past six years, many of them leaders in their specialties. Together, they have sustained one of the largest pediatric transplant operations in the country, the city's busiest emergency department and more than a million outpatient visits a year.
The focus on undermining chronic disease, mending birth defects and maintaining health marks a paradigm shift from the hospital's origins, when doctors mainly tried to manage infectious diseases, said Dr. Steven Docimo, the hospital's chief medical officer. He said vaccinations and antibiotics helped redefine the profession, allowing a shift from supportive care to more proactive therapy that drives researchers.
“We're now taking care of infants who are being born at extremely young ages and who, in earlier times, weren't viable,” said Dr. Cheston Berlin Jr., a pediatrician and professor at Penn State Hershey Children's Hospital.
He expects improvements in neurology to help mold advancements in the field.
Docimo said personalized medicine, including an emphasis on genetics and disease, will be pivotal.
“Most people would agree that genetics is probably the next big thing, particularly the ability to engineer and find things that are genetic problems. Expressions of genes, perhaps, could be changed in their development,” said Mark Wietecha, president of the Children's Hospital Association in Washington.
“Having said that, most people would tell you this could be a forever number of years away,” he said.
Patient volumes at Children's Hospital's Lawrenceville campus — built at the site of the former St. Francis Medical Center — have outpaced early projections, and administrators could add 12 beds in the next year or so.
A decline in pediatric care at other regional hospitals, innovative treatments at Children's and its development of clinics across Western Pennsylvania all contributed to the growth, including in critical care, administrators said.
“You have to care for these kids like they're your own. There is no more difficult time in a family's life than to have a child in the hospital,” said Diane S. Hupp, chief nursing officer.
She said the 1,400 nurses at Children's have shifted their approach to involve families more closely throughout the care process. That means including parents when nurses brief one another during shift changes and documenting care near the bedside, Hupp said.
While the public celebrates the hospital's anniversary with a string of events, Children's leaders will be crafting their goals in a strategic plan. Docimo said the blueprint could encourage better collaboration with schools and others in a health push for all children.
“The idea is (that) we want to keep them away from here, if at all possible,” he said.
Adam Smeltz is a Trib Total Media staff writer. Reach him at 412-380-5676 or firstname.lastname@example.org.