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Jefferson closure, St. Luke’s new model of service feature at Boise City Council workshop

A Boise City Council workshop brought no decision, but several hours of discussion Tuesday night, as representatives of St. Luke’s Boise Medical Center discussed their hopes for and concerns about the hospital’s proposed expansion.

Another council meeting to discuss transportation impacts of the proposal is scheduled for May 19.

Around 200 people attended the City Council workshop, but no public comments were allowed.

Obviously, this proposed expansion is big and complex, so there are a lot of components to think about. The main sticking point – so far, at least – is a proposed closure of Jefferson Street between Avenue B and 1st Street. People who live in the East End are worried about losing one of their most direct walking, biking and driving connections to Downtown.

St. Luke’s counters that its slate of proposed alternative routes – a 10-foot path on the same block of what was once Bannock Street, a two-way cycle track around the hospital campus, wider sidewalks, improved intersections, etc. – will more than make up for the loss of that section of Jefferson.

Meeting underway

First up is Hal Simmons, Boise’s planning director. Simmons outlined the basics of the St. Luke’s proposal and answered a few questions from council members and Mayor David Bieter.

St. Luke’s representatives are next. They admit that the process they’ve gone through, which includes a denial recommendation by the Planning and Zoning Commission and additional transportation improvements, has resulted in a better plan.

Councilwoman Elaine Clegg asked St. Luke’s representatives if they designed their expansion plan in a way that would promote good health. They said it wasn’t a planning component outside of the hospital.

St. Luke’s doctors related stories highlighting the importance of top-notch services and care in a regional hospital. Every second a stroke is active, 30,000 brain cells are killed, one doctor said.

“That tells us time is brain,” the doctor said.

Council break

St. Luke’s continued its presentation after the break.

One St. Luke’s representative discussed the importance of a physical environment that works hand-in-hand with the treatment. For example, having a family surrounding a baby in the neonatal unit helps it grow strong, and not having to move patients of all types reduces risk of infections, mishap, overexertion.

One of the major needs St. Luke’s says it wants to address with this expansion is to be able to keep as many related services – say, ER and X-ray – on the same floor and near each other to minimize unwanted movement.

Design

An architect for St. Luke’s said the hospital is moving to a horizontally integrated model of care, trying to put related services on the same floor. That fosters collaboration between doctors and other healthcare professionals, he said.

Letting patients have access to nature, making the hospital easy to navigate may help patients heal faster, the architect said. Speed of service is key to proper treatment and recovery, he said.

This is why St. Luke’s says it needs to do this expansion in the way it’s proposing. Closing Jefferson Street would allow the hospital to build a much broader floor on the first five stories, enabling that horizontal model St. Luke’s wants.

Jefferson Street: To close or not to close?

Almost two hours after the St. Luke’s discussion began, Mayor David Bieter nudged hospital representatives to address the main question: Why is a closure of Jefferson Street necessary?

The hospital analyzed four alternatives: expanding north, south, east and west, a representative said. A slide claims the north expansion, which means closing Jefferson, is the only one that meets all of the hospital’s service objectives.

The expansion component that would close Jefferson would include part of the expanded ER, as well as other services such as interventional radiology (not sure what that is) and other diagnostic services.

South alternative

Councilwoman Lauren McLean asked: Why can’t you just expand southward instead, covering the section of Bannock Street that St. Luke’s closed in the 1990s?

St. Luke’s architect Jeff Hull said the hospital would have to rework the entrance to its emergency room, which would disrupt patient care during the construction period.

Also, Hull said, building over the parking area south of Bannock would necessitate building parking elsewhere, which would add greatly to the cost of construction.

West alternative

Hull said expanding the St. Luke’s campus to the west would greatly increase the distance patients have to travel between services. There wouldn’t be a natural connection between the existing and new buildings, undermining the hospital’s goal of making it easy to move patients between services.

East alternative

This is the worst option of all, Hull said.

First, every new facility would have to connect to the existing hospital via sky bridges across Avenue B. Second, the hospital doesn’t own all of the land it would need, Hull said, and acquiring some of it might be complicated.

Impasse

Councilwoman Elaine Clegg said the lack of details the St. Luke’s has published so far led to an impasse between the hospital and community.

A St. Luke’s representative said the hospital doesn’t take closing a street lightly and has held dozens of meetings to discuss details and alternatives for closing Jefferson.

Clegg said she wants to facilitate St. Luke’s expansion, “but I want to do it in a way that I don’t feel I’ve created a wound in the community that won’t heal.”

Clegg’s fellow council members said they don’t agree that there’s an impasse. They said they’re glad for the process that led to Tuesday’s hearing.

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