City council votes to proceed with negotiations on medical center rebuilding

Stanford University Medical Center's leaders underscored the need to expand and rebuild the medical center in a presentation on Nov. 26 before the Palo Alto City Council. About 145 members of the public packed the council chambers to listen and comment.

As part of the city's approval process, the council heard a report on the proposal from an independent reviewer and listened to more than 40 people speak.

The envisioned medical center would meet state-mandated seismic safety requirements and keep pace with the challenges of patient care, research and medical education. The medical center's leaders hope to begin construction in 2010 and complete the project by 2025. As the land under discussion is within Palo Alto city jurisdiction, the medical center needs the city's approval.

"We want to be here for the community. We need to be here for the community," said Martha Marsh, chief executive officer of Stanford Hospital. "But the current size of the hospital and the patient needs we're facing do not always allow us to do that."

The proposal calls for replacing the 50-year-old Stanford Hospital building, built during the Eisenhower era. The new hospital—a seven-story structure with some buildings up to 130 feet—would be nearly twice as large, offering single-bed rooms for patients and increasing its total beds from 456 to 600. Also, Lucile Packard Children's Hospital would increase its capacity by 104 patient beds for a total of 361 beds on site. The medical school would replace and renovate 400,000 square feet of outdated laboratories and related facilities.

A top priority is expanding the emergency department, which serves both Stanford and Packard Children's hospitals and is the only level-1 trauma center between San Francisco and San Jose. It was built to serve 70 patients per day but now serves 125 to 150. The emergency department planned for the new hospital will more than double the existing space. Marsh noted that on the afternoon of Nov. 16, there were 18 patients waiting up to 44 hours in the emergency department for admission to the hospital because of a lack of available beds. Christopher Dawes, the Packard Children's Hospital CEO, also recounted a single evening last week when the hospital turned away two boys with head injuries because no beds were available.

The council first heard an encouraging report from Marlene Berkoff, a California architect specializing in health care who was hired by the city to conduct a peer review of the project.

Berkoff evaluated Stanford's design concepts and found them within norms for comparable hospitals, including academic medical centers nationwide.

"The numbers Stanford is proposing for the size of the rooms are very consistent with their peers across the nation," Berkoff said. "If you stack up three floors, you're pretty much at a 50-foot height limit," she said, referring to Palo Alto's citywide construction ceiling. Stanford is requesting rezoning to build higher and more square feet.

The meeting also aired the city's "issue and community benefits and mitigation list"—a collection of about 75 topics, ranging from improving flood control to building day-care facilities, that some people want considered in an environmental impact report that is under way.

At the council meeting, several public speakers raised concerns about increased traffic and other potential impacts. Palo Alto resident Tina Peak remarked: "This is not an appropriate venue for a large regional hospital. I think many residents like myself in Palo Alto want Palo Alto to stay a local community, and not be a regional center," she said.

Most speakers supported the project. "One of the things that makes this area so desirable is its incredibly good health care. We don't want to mess with that," said Kathleen Much of Menlo Park.

At the end of the evening meeting, the council voted to proceed with the list of negotiation issues and to initiate rezoning consideration for the project.

Palo Alto will hold future meetings related to the project on topics ranging from land use, housing and transportation to sustainability and open space. The draft environmental impact report is expected in June 2008 and final action on the report in December 2008.

"I think it is incumbent upon all of us to not only think about the need for bed capacity, or to think about emergency treatment of patients," said the medical school's dean, Philip Pizzo, MD, "but also about the unique and important underpinnings of science and knowledge that will change the way we think about medicine in the future."

Project updates are online at and