By Christian Davenport
Washington Post Staff Writer
Sunday, June 25, 2006
Walk past the free valet parking, past the woman at the front door welcoming visitors with an attentive smile and into the light-filled lobby, where soothing tunes waft from a baby grand piano and macchiatos are brewed at the coffee bar.
The dramatic entryway features seven large sheets of glass with water cascading from the ceiling. Upstairs, the amenities include massages, in-room Internet service, movies and video games.
Only the patients in wheelchairs give away that this is a hospital.
As Shady Grove Adventist in Rockville undergoes a $99 million expansion and renovation, part of a boom in hospital construction across Montgomery County, it is doing more than responding to the region's rapid population growth. The idea is to revamp the model of patient care, hospital President Deborah A. Yancer said.
In an industry long thought of as cold and forbidding, Shady Grove and other hospitals see business opportunities in signaling to patients and their families "that we are going to take care of you in a very human way," she said.
All five of Montgomery's community hospitals are in various stages of expansion. As they increasingly compete with each other, some are emphasizing comforts such as concierges and plush furniture to get an edge.
Flat-screen televisions and CD players are standard in many rooms at Montgomery General in Olney. Janitors at Washington Adventist in Takoma Park do more than clean patients' rooms; they're instructed to ask: "Is the temperature comfortable? Can I open the blinds? Get you a pillow?"
Inova Fair Oaks Hospital in nearby Fairfax County has upgraded room service menus, offering roast pork and lemon meringue pie. Some Inova officials are trained in customer service by the Ritz-Carlton hotel chain.
"We want [patients] to leave here and then brag about it," said John Fitzgerald, president of Inova Fair Oaks. "There's a competitive nature to health care, and we want to be first. And part of that is the service."
This trend has its critics, including industry consultants who caution hospitals to remember that their primary mission is to treat patients, not coddle them. Some hospital administrators, too, are leery of overspending on frills.
Brian A. Gragnolati, president of Suburban Hospital in Bethesda, which is planning an expansion that would add two acres to its three-acre campus, said many of the amenities offered by competitors are "window dressing."
"I would rather put money into nursing care and staffing and making sure our doctors are there," he said. "At the end of the day, it's about taking care of patients."
In Maryland, many of the hospital expansions have been aided by increases in health-care rates, said Robert Murray, executive director of the state's Health Services Cost Review Commission. The commission, which regulates what hospitals can charge, has allowed rates to outpace inflation by 1 to 1.5 percent so that hospitals can improve their finances. They also rely on private fundraising.
As some of the Washington area's hospitals expand at record levels and add amenities, others don't have that luxury. They are buckling under the burden of caring for the uninsured, raising concerns about widening disparities in health-care facilities.
In Prince George's, more than half of the residents with health insurance go outside the county for care, many to Montgomery, said County Council member Thomas R. Hendershot (D-New Carrollton). As a result, Prince George's Hospital Center treats an unusually high number of uninsured patients, which has forced the state and local government to spend millions to keep it afloat.
Officials at Dimensions Healthcare System, which oversees the hospital, aren't able to think about the comforts that others offer. "We're making sure we address our immediate concerns here, and that's keeping these doors open," said Calvin Brown, chairman of Dimensions' board of directors.
Elsewhere in the region, it's a different story. As hospitals embark on multimillion-dollar facelifts, private rooms are increasingly the norm. Patient rooms are often outfitted with lounge areas with pull-out couches for family members to spend the night.
Anne Arundel Medical Center officials hired Walt Disney Co. to help it come up with patient-friendly policies that include a ban on the loudspeaker paging system (except in emergencies). The hospital's leaders say they believe a quiet environment is a healing one, and they've outfitted walls with noise-absorbing tiles.
At George Washington University Hospital in the District, VIP treatment comes at a price. For an extra $200 a day, patients can get "the amenities of a luxury hotel," according to its Web site -- including 300-thread-count sheets. "Pamper every inch of your body with plush towels, and a divinely comfortable robe and slippers," the site reads.
The focus on comfort has changed what it means to be a patient and to visit one. Many hospitals have eliminated visiting hours, so family and friends can visit as they please.
Confined to her bed at Shady Grove Adventist with a spinal infection, Bobbie King of Rockville was beginning to feel cut off from the outside world. "It's very depressing just lying here," she said recently. Then she realized she had access to dozens of movies -- "Batman," "Ocean's Eleven" -- and the Internet through the hospital's "Get Well Network" (Motto: "Healing Through Connectivity").
Using a wireless keyboard, King researched her ailment, using Google to look up medical terms her doctors had used. "It's really good for your morale," she said.
Although many of the region's hospital expansions are fueled by population growth and the need to make room for new equipment, another driving force is the trend toward providing amenities that patients, especially those in wealthy suburbs, have come to expect.
The Washington area is one of the most competitive health-care markets in the country because of its well-educated and affluent population, said David Marlowe, principal of Strategic Marketing Concepts, an Ellicott City-based consulting firm.
"People here are willing to travel," he said. "They don't necessarily go to the closest hospital. They have the smarts to shop around."
But when Quint Studer, a health-care consultant, speaks to hospital officials, he warns them not to get too carried away with the perks and to focus on the basics.
"You can put a fresh flower in their rooms every day, give them special meals," Studer said. "Those are all nice things to do, but it still comes down to real fundamentals of patient care."
Shady Grove, part of the Seventh-day Adventist Church's national hospital system, weathered a period in the late 1990s when its accreditation was threatened by complaints about poor patient care and management problems.
Yancer, who became president in 2000, said that the current push to add fancy amenities does more than just improve the hospital's appearance. The extras provide direct health benefits, she said.
Shady Grove's expansion and renovation project won't be funded through any future rate increases, Yancer said. Many of the amenities were paid for by donors.
"There are a lot of things that compete for hospital dollars, and as the executive of this hospital, I look to find other ways to fund those things," she said. "We don't throw caution to the wind. A lot of this is changing how we think about what we do."
Which is why she forbids clocks in the lobby: "This is not a place where we want people to mark time," she said. "We want people to lose track of time here."
Which is why two hours each day -- 1 to 2 p.m. and 1 to 2 a.m. -- are designated as "quiet times," when nurses speak in hushed tones, the lights are dimmed and doctors are discouraged from doing rounds.
Which is why instead of nursing stations, Yancer said, the hospital will install kitchenlike tables in its new tower because they convey the message: "We're in this together."