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Q&A: With Our Neurosurgery and Neurology Chairs
The new Stanford Neuroscience Health Center is a 92,000-square-foot building completely devoted to the outpatient care of adults with neurological disorders. Within the Center’s five floors will be physician experts and care teams in 21 neuroscience subspecialties. These clinicians are concentrated in the new Center to provide the most coordinated and collaborative leading-edge treatment options for highly complex neuroscience conditions. In one convenient location, patients can receive a complete range of care that includes some of the most advanced imaging and treatment technology, therapeutic support, neurodiagnostics, interventional procedures, research clinical trials, and education.
The new Center, whose interiors were designed with extensive input from a neuroscience patient advisory board, represents a unique approach to care that supports patients at every step in their journey through care. The volunteer members of the Center’s patient advisory board have all experienced neurological conditions and through their unique perspectives, give input on issues that impact care, ensuring that the next patient or family member’s journey is easier. Their advice had a profound impact on how the building was designed and how patients will experience care at the new Center. The group will continue to meet regularly as ongoing advisors to ensure that the patient and family point of view, perspective and experience are not only heard, but also integrated into service and patient care.
The new Center’s co-leaders are Frank Longo, MD, PhD, the George and Lucy Becker Professor in Medicine and Chair of the Department of Neurology and Neurological Sciences, and Gary Steinberg, MD, PhD, the Bernard and Ronni Lacroute-William Randolph Hearst Professor in Neurosurgery and the Neurosciences and Chair of the Department of Neurosurgery. They recently answered some questions about the new Center, its key features and the many clinical services available to patients in one unique building.
Longo: Many of our neurology and neurosurgery patients often need care in several ways—maybe a CT scan, a visit with a doctor, and a session with a physical therapist. The traditional version of that care has been to have services at different locations, but that can become highly fragmented. We saw that happen as Stanford Health Care grew and expanded. Getting to services in several locations is often especially difficult for a patient with a neurological disorder who may be easily confused or have difficulty moving around. Stanford’s size can be overwhelming.
We also felt it was important to have all our specialized care teams together in one place. We knew that could not be done with a remodel or even in the new hospital that will open in 2018. We needed more space than that building could have allowed us.
We also wanted to include the feedback of our patients and our neuroscience patient advisory board regarding the standard of care they receive. Understanding their unique perspective and hearing their ideas from the very start, before interior layouts were finalized was a key factor in designing a patient-centered building and care experience.
Steinberg: I’ve been at Stanford for 41 years and it has long been apparent to me that the system we had was not ideal for patients with neurologic disease and illness. The impairments that accompany those conditions can make it difficult for them to navigate to different places. As a leader in patient-centered care, we wanted to integrate all our services into one location to create an optimal patient experience where people feel that doctors are coming to them, not the other way around. We couldn’t have done that without this kind of building.
Steinberg: When the development of the Stanford Neuroscience Health Center was first being discussed, we talked about creating an environment that would not only provide comprehensive care in a single facility, but one that would be developed with a deep understanding of the special challenges faced by neurological patients. The building was designed in a very intentional and strategic manner with all of our neuroscience services, supportive services, imaging, and infusion all under one roof. We have created an environment in this building that offers our most physically challenged patients, those with neuromuscular and movement disorders, the full continuum of care—from their initial treatment to lifelong living, including a balance and gait lab, mobility garden, speech, occupational, and physical therapy.
In developing this building our goal is to be a leader in the care for people with neurologic disorders and to translate innovations into cures. To that end, the facility will also be a hub for research and clinical trials. Often those clinical trials are important opportunities for patients because the trials test the latest treatments not available anywhere else.
Longo: The Center has a very special feeling to it. It’s something you’ll notice as soon as you walk in. There are wider hallways and door openings. The colors and textures on the walls and floors have been carefully selected for the safety for our particular patients and their specific conditions. There are larger exam rooms, a selection of chairs to serve the needs of patients with different disorders, and floors organized logically to reduce the need for patients with movement disorders to move around too much. An infusion area with chairs that swivel 360 degrees and a pharmacy located in the infusion area.
There is also a one-time-only check-in system to make visits easier for people with more than one appointment in the building, and much, much more. We want our patients to come to our Center and immediately recognize that it was designed to respond to their unique challenges in ways they have never seen in a care facility. We know, because of our close work with our neuroscience patients and family advisory board, that these features will put them at ease, provide comfort, and improve their overall sense of well-being.
Longo: We created a special neuroscience patient and family advisory council—PFAC—which began meeting very early in the building design and development process. We wanted to know, in as much detail as possible, how we could best accommodate our patients. If you are someone with epilepsy or a movement disorder, or using arm crutches, you’ll have a different view of the physical environment. We had PFAC be a part of meetings with architects, our clinical staff and our space planners. It was a wonderful adventure to have that help and it was a remarkable gift that produced some important changes that have rarely been implemented in a health care center in such detail and with such sensitivity.
Steinberg: As a clinician, you can forget sometimes what it’s like to be a patient—how much time you spend waiting for appointments, traveling to visits, receiving your treatments and waiting again to meet with your team of physicians. We wanted to hear patient input about all those steps in the process so we could alter the old system. We’ve also had many dry runs with PFAC members and other volunteers to see how the new system will work, so we can fix any loopholes before the Center opens. We wanted to do more than just institute innovations; we wanted to make sure they would work from the very first day we welcome patients to the new Center.
Steinberg: Many of our patients want to have family members or friends with them during their visit. Our care team might include me, a nurse practitioner, a doctor receiving advanced training, and a subspecialist neurologist. That number of people can be a tight, if not impossible, fit in a standard exam room. The Center’s new larger exam rooms will accommodate many more people comfortably. Those rooms are another important part of showing our patients we understand how to coordinate their care—and that means including their family and as many of their care team in one place. Questions can be quickly asked and answered, so patients will know their care team is all on the same page.
Longo: The space for support services we now have in this building means our neurological rehabilitation area, which includes a Balance Lab and the Kinematic Lab, can accommodate some of the newest therapeutic equipment available. On the first floor, patients will see a Wellness Room. It’s another beautiful, light-filled room which has many features of a dance studio—a barre and mirrored walls. It’s there to support the physical activity classes we’re organizing (dance and yoga included) because we’ve learned that exercise is an important part of therapy for certain neurological conditions. That room will also host other kinds of educational classes and lectures. Incorporating all of these services into one building is our unique way of making care as easy as possible for our patients.
Longo: The Center brings together people who may have had some interaction before, but never experienced direct collaboration. This will be the first time we’ve gathered all these neurological fields together. I am sure that entirely new approaches to patient care will evolve because we have all of these disciplines together under one roof. We couldn’t have done that in a conventional health setting. Many of our doctors are also involved in clinical research and we wanted them to have a direct connection to patients. These clinicians are motivated every day by their patients to come up with better treatment options—working in closer proximity means they can share their enthusiasm with each other and push the boundaries of what we can do for patients.
Steinberg: One of the advantages of Stanford has always been the presence of people doing groundbreaking work in many fields. New ideas are born because we run into each other by accident. In this Center, it won’t be an accident. There are conference rooms on every floor, and many neuroscience providers will have offices here in the building. Also, for the first time, we’ll have clinical research offices located here, too. The best patient care often involves collaborative work between specialists and care teams in many fields. Sometimes that might mean a research breakthrough that can be available as a clinical trial; sometimes it might mean an immediately available change in care sparked by a different, but well-informed, perspective of a clinician in a related field. It’s a feature of Stanford Health care that continuously renews my drive and passion to create better ways of taking care of our patients.
In January, the new Stanford Neuroscience Health Center will welcome its first patients. This five-story, 92,000-square-foot building includes advanced imaging, patient care technology, and interiors designed to be sensitive to the needs of people with neurological conditions. Longo and Steinberg will be two of the more than 200 expert doctors covering 21 neurological subspecialties providing care for patients at the new Center.