Pioneering Partnerships: Stanford and Sequoia Enhance Patient Care with New Hospital-Within-a-Hospital
#Partnerships
Staff at the new unit’s ribbon-cutting were excited to launch a hospital-within-a-hospital, a new frontier for patient care at Stanford Hospital.
While the worst of the COVID-19 pandemic is behind us, difficult memories remain. Healthcare providers worked herculean hours to treat the influx of patients, and many contracted the virus themselves. Countless people delayed their routine health care. These factors laid the groundwork for today’s post-pandemic shortages of hospital staffing along with more and sicker patients needing emergency care.
While Stanford Hospital has maintained its staffing levels, closures of clinical programs throughout the region due to medical personnel shortages have meant more people coming to Stanford Hospital’s Emergency Department. Even with the opening of an 824,000-square-foot, state-of-the-art hospital in 2019, which expanded inpatient capacity to more than 600 beds, Stanford had been struggling to keep up with the needs of the community.
The Department of Medicine, in conjunction with Stanford Health Care’s Business Development team, came up with a novel solution to its inpatient bed shortage: a partnership with Dignity Health Sequoia Hospital to establish a new frontier of care for Stanford patients through a “hospital-within-a-hospital.”
A Win-Win for Both Hospitals
“We learned that Sequoia Hospital had not been at full capacity and, like Stanford, is patient-centric, well-run, and has good accommodations. Stanford Health Care decided to approach them to see if we could lease a 24-bed unit,” says Division of Hospital Medicine Chief Neera Ahuja, MD, who specializes in building new clinical programs. Another enticement was Sequoia Hospital’s Redwood City location, just a few miles up the road from the Stanford campus.
“A hospital-within-a-hospital is a new model of care for the Department of Medicine,” notes Thomas Lew, MD, clinical assistant professor of medicine and medical director of the Stanford Sequoia unit. “Instead of acquiring a hospital or building from scratch, we realized we could partner with another hospital system that’s not at capacity. Sequoia had a brand-new ward that had only been used briefly during the pandemic,” he adds.
After a year of discussion, planning, and setup, the Stanford Health Care (SHC) Patient Care Unit at Dignity Sequoia Hospital opened May 8, 2024.
“A hospital-within-a-hospital is a new model of care for the Department of Medicine. Instead of acquiring a hospital or building from scratch, we realized we could partner with another hospital system that’s not at capacity. Sequoia had a brand-new ward that had only been used briefly during the pandemic.”
– Thomas Lew, MD
Designed for a Positive Patient Experience
While not every patient who goes to the emergency room needs to be admitted to the hospital, those who come to the Stanford Emergency Department and require inpatient care for certain types of issues now don’t have to wait for a hospital bed. Instead, they can be quickly transported to the Stanford Health Care Patient Care Unit at Sequoia via ambulance.
Notes Ahuja, who oversaw the clinical buildout of the unit, “We are aiming for a seamless experience for our patients. The unit is staffed by Department of Medicine hospitalists, Stanford Health Care nurses, and other key personnel. Patients have either a private room or a large, shared room that looks just like one they’d have at Stanford Hospital.” The Stanford Health Care Patient Care Unit at Sequoia has 12 private rooms and six shared rooms, all more spacious than comparable rooms at the Stanford campus.
“An additional benefit is that this unit opens up beds on the Stanford campus for patients with more complex and highly specialized conditions who could only get their care at Stanford Hospital,” Ahuja explains.
As medical director of the new unit, Lew designed the new workflow for the offsite location, hired a team of on-site hospitalists, and was the first physician to see patients there. He continues to oversee clinical care to ensure that patients receive Stanford-level quality.
A Novel Approach to Specialty Care
The unit draws from a roster of Department of Medicine specialists from endocrinology, nephrology, infectious diseases, and cardiovascular medicine, who are available to consult with patients virtually via a wall-mounted large-screen TV and a camera.
“We learned during COVID that there are times when virtual interaction is as good as or better than in-person interaction,” says Christopher Sharp, MD, chief medical informatics officer, whose team supported the integration of digital technology into the Sequoia unit. “This is an exciting model that allows us to extend specialty care outside of the Stanford campus by ‘beaming in’ specialists.”
Ron Li, MD, medical informatics director for digital health, designed the virtual consult workflow and helped specialty clinicians learn how to best use the technology to care for patients. As a board-certified informaticist, Li specializes in using technology to improve the care of hospitalized patients.
Stanford has previously used the virtual consult model to bring high-quality specialty care to affiliate hospitals and clinics – in some cases expanding access to specialty care 24/7. Telehealth has proved to be reliable and agreeable to patients. “The expertise and care we bring to patients is at the core of our mission,” says Sharp, “and by being digitally driven, we’re able to scale the reach of this expertise across Stanford Health Care sites.”
Collaboration Is Key
Ultimately, says Lew, “we found a great partner in Sequoia Hospital – a fantastic community hospital – and everyone has been exceedingly kind and welcoming.” He also appreciated the extensive input from Department of Medicine physicians to help make this new frontier of a hospital-within-a-hospital a reality. “This huge collaboration was an innovative process for the Department of Medicine,” he says, “and hopefully just the start for this new model of care.”
Rooms in the Stanford Health Care Patient Care Unit at Dignity Sequoia Hospital are spacious and equipped with cutting-edge technology.
Pandemic Inspires Outside-the-Box Thinking
This wasn’t the first time the Department of Medicine used an unconventional approach to address an increase in patients caused by the pandemic. In 2020, the department formed surge teams, an all-hands-on-deck way to care for waves of COVID-19 patients. Doctors from a variety of specialties, along with residents and faculty, volunteered for shifts working as hospitalists or internal medicine physicians to treat the overflow of patients.
Specialty Care Services Available Through Virtual Consults
Department of Medicine hospitalists partner with physicians from the most-needed specialty care services for non-complex conditions, enabled through a cutting-edge teleconferencing system.
- Endocrinology, Gerontology & Metabolism
- Nephrology
- Infectious Diseases & Geographic Medicine
- Cardiovascular Medicine
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