Queen’s Medical Center plans $1B expansion

A $1 billion, 15-year overhaul in four phases at the flagship Punchbowl Street campus of The Queen’s Medical Center will transform the state’s largest hospital and only Level I trauma facility for Hawaii and the Pacific.

Queen’s last week asked the City and County of Hono­lulu for initial approvals to tear down facilities and rebuild beginning next year, with groundbreaking on a new emergency room that will double in size to 75,000 square feet and 90 treatment spaces.

The ER department handles more than 66,000 emergency visits a year, including nearly 3,000 trauma patients.

Officials at Queen’s, a nonprofit hospital and the 162-year legacy of Queen Emma and King Kamehameha IV, say construction costs will require no taxpayer dollars and cause no disruptions on South Beretania or Punchbowl streets, both busy thoroughfares in the heart of Honolulu.

Jason Chang, chief operating officer of The Queen’s Health Systems and president of The Queen’s Medical Center, called the renovations long overdue.

“We have some buildings that are 80 years old that are still being used,” he said. “It’s time to take those buildings down and rebuild new.”

State Sen. Jarrett Keohokalole, chairman of the Senate Health Committee, called the development plans for Queen’s “necessary and appropriate.”

The medical center’s pledge to not seek federal, state or local funding for the project is realistic given low interest rates and the typical practice of floating bonds while raising money through fundraising capital campaigns, he said.

Hilton Raethel, president and CEO of the Healthcare Association of Hawaii, agreed the $1 billion capital campaign can succeed without relying on taxpayer dollars.

“Is it possible? The answer is ‘yes,’” Raethel said.

Keohokalole called the project “very encouraging.”

“It would worry me if they didn’t adapt because of how significant and disruptive the COVID-19 pandemic has been,” he said. “We’ve had plenty of discussions with them, with the Healthcare Association, with all of the hospitals about what they’ve had to do to adapt to the pandemic. This has created a lot of opportunity for innovation and shed light on areas that providers realize need to improve.”

Queen’s has been running at nearly 100% capacity for the last six years. Over the last 90 days, it saw a new patient surge because of the COVID-19 delta variant when demand for its 57 intensive care unit beds increased, requiring the hospital to scramble to convert other spaces into makeshift ICU units to accommodate an additional 30 patients.

“We struggle to make sure patients have adequate space,” Chang said. “Clearly we did not have enough ICU beds with this delta wave. We shut down the (operating rooms) and converted those into modified ICUs. Recovery rooms became ICUs, along with other spaces that were not intended to be ICUs.

“It’s an undersized emergency department that was exacerbated by COVID,” Chang said. “When COVID came through, you had another segment of patients mixing together.”

Raethel has heard various proposals to renovate Queen’s over the years, but agreed the need to expand and update took on new urgency when COVID-19 took hold last year.

“They’ve got some of the oldest buildings in the state and the pandemic just stretched that,” Raethel said. “They were already headed down this direction but the pandemic definitely reinforced the need for a major rebuild.”

Queen’s treats nearly 3,000 trauma patients annually but the recent crush of patients driven by COVID-19 forced it to make critical decisions about which patients to accept, particularly from the neighbor islands.

“With traumas, we had to be very selective and that was challenging,” Chang said.

Plans for the Punchbowl campus follow a similar $500 million expansion unveiled in July for The Queen’s Medical Center-­West Oahu that would quadruple its size over 15 years to address overcapacity and prepare for future needs in a region with an expanding population.

The West Oahu plan includes two new hospital towers with patient rooms, expansion of its overtaxed emergency department, two new physician office buildings with outpatient services, a second parking garage and removal of surface parking to create more green space.

The number of patient beds would grow to 364 from 104.

The expansion of the Punchbowl campus will increase the number of beds to 710 from 575.

Both projects are part of an upgrade and overhaul of Hawaii’s 3,000 licensed hospital beds across all islands that have been stressed during COVID-19 even as health care technology advances, Raethel said.

He called the plans by Queen’s “an investment in the community … that will serve the people of Hawaii for generations to come. It is necessary and appropriate.”

As each phase of construction progresses at Punchbowl, Chang said, “we’re building right adjacent to where we’re continuing to care for patients.” He pledged that “patient care will not be affected.”

“There should be no impact (on traffic),” Chang said. “All of the construction and everything will be encapsulated within the confines of the campus.”

Busy, four-lane Punchbowl Street runs mauka to makai, with Queen’s on the Diamond Head side and the state departments of Health and Education and the main entrance to the state Capitol’s underground garage located in succession on the Ewa side of the road.

The Queen’s Hospital was founded in 1859 in response to epidemics that were sweeping the islands at the time and has grown into a nonprofit health care system.

The Queen’s Medical Center on Punchbowl Street is Hawaii’s largest private hospital, and its proposed expansion is designed to handle future epidemics and medical crises, Chang said.

The planned improvements are intended to keep up with patient needs “for the next 60 years so we’re able to care for the patients that need us,” he said. “When you’re really sick, that’s our place.”

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The Queen’s Medical Center expansion plans

>> Increase bed space to 710 from 575.

>> Double the size of the emergency room.

>> Expand the campus from 1.6 million square feet to 2.1 million square feet by demolishing or renovating older buildings.

>> Build two new towers for inpatient and outpatient services.

>> Construct a new 14-story parking structure.

>> Demolish outdated buildings on Lauhala Street to create a second drop-off and pickup location on Lusitana Street intended to ease traffic flow and improve access.

>> Centralize reconfigured clinical areas in the middle of the campus.

>> Provide shorter travel distances for patients, staff and visitors.