100 Years

1974 to 1978: The Reorganization


STRIDING Forward Breaking ground for the new wing  

The Boeing Bust levels off by 1973 and the Puget Sound economy begins to rebound, thanks to federal funds for public works and services projects pumped in by the state's U.S. senators — Henry M. "Scoop" Jackson and Warren Magnuson.

Children's Orthopedic is once again bursting at the seams. Operating rooms strain to accommodate the 15- to 20-member teams now needed for complex procedures such as organ transplants. The original "in and out" board at the main entrance can only accommodate half of the 600 physicians with hospital privileges.

It's been six long years since consultants recommend many improvements so that the hospital can keep pace with regional demand. The trustees are eager for another expansion. In 1974, they kick off a new fundraising campaign with a groundbreaking for a new five-story wing that will double the hospital's floor space.

Named STRIDE — Surgery, Treatment, Rehabilitation, Intensive Care, Development, Education — the campaign raises $15 million, which is more than six times the next largest amount raised to that point in the Northwest.

In 1976, the hospital celebrates the amenities of the new wing, including a swimming pool, 12-bed psychiatric ward, new pediatric and neonatal intensive care units, improved radiology facilities, remodeled surgical and emergency facilities, new clinic spaces, a model home to help train disabled children and a 24-hour pharmacy.

By 1978, the construction is finished with a complete retrofit of the original building. The whole project tops out at $33.4 million, but the region has a new medical center with 193 beds and specialty and outpatient clinics that can accommodate more than 100,000 patient visits per year.

Operation Saigon

Operation Saigon Many American families adopt Vietnamese orphans  

On April 3, 1975, a chartered flight sponsored by Holt Children's Services in Eugene, Oregon, lands at Seattle-Tacoma International Airport. Onboard are more than 400 Vietnamese children orphaned during the Vietnam War.

After finishing their 9,000-mile journey, the children — mostly infants and toddlers — receive medical exams. Within hours of arriving in Seattle, 16 babies are sent to Children's Orthopedic with ailments including pneumonia, malnutrition, congenital heart conditions and meningitis.

One pneumonia patient dies, but the others survive and make their way to adoptive parents all over the United States.

A Formal Relationship

A Formal Relationship Leaders of Children’s Orthopedic and the University of Washington School of Medicine  

Since 1953, when Children's Orthopedic moves to within two miles of the University of Washington School of Medicine, leaders from both sides try to figure out a reasonable affiliation between the two institutions.

Children's Orthopedic benefits from the University of Washington's academic medical faculty and student interns from nursing, medicine, dentistry, pharmacy and social work.

The University of Washington benefits from having a well-established pediatric facility so close for teaching and patient referrals.

In 1971, after years of tense discussions leading nowhere, representatives from both organizations resume talks in Clearwater, Florida, where the American Association of Medical Schools hosts a program to help medical schools solve problems.

There, far from daily distractions and internal politics, the two groups spend five days listening to each other, working on the 29 items on their joint list and gradually building trust.

Over those five days, the group builds a cohesive team, then returns to Seattle to share their work with their respective institutions.

For the trustees, some of the elements of the agreement are easy to accept: University and Harborview Hospitals will move their pediatric inpatient and most outpatient services to the Orthopedic, making it the pediatric center of the Pacific Northwest; basic research will remain at the University of Washington.

There are also financial advantages for the Orthopedic. Affiliation with the university opens the door to new research funding and other government subsidies. And, the University of Washington promises to pay Children's Orthopedic for its educational services to medical students and interns.

The trustees also reject some points: that a representative from the university will sit on the Orthopedic's board, and that the University's chief of pediatrics will automatically serve as Children's chief of staff.

On this last point, the trustees counter that the same individual can hold the post of chief of pediatrics at both institutions, which the university ultimately accepts.

At a March 1973 board meeting, chairman Kate Webster puts it to the trustees plainly: the affiliation agreement will improve the quality of patient care.

The debate continues for more than a year, but in the end the trustees formally adopt the affiliation agreement by unanimous vote on September 11, 1974.

Despite many bumps in the road sorting out titles and lines of authority, Children's Chief of Staff Jack Docter reports an improvement in patient care in just two years after the agreement is adopted. He attributes this fact to Children's physicians having university medical experts to call upon in many different fields, especially for difficult cases.

The Reorganization

The Reorganization Young patient on Children’s Infant Intensive Care Unit  

In 1978, the University of Washington School of Medicine dean convinces Dr. Ron Lemire to give up his office and lab at the university and take a job at Children's Orthopedic, where he becomes director of Inpatient Services, reporting to both the dean and Children's Medical Director Jack Docter.

One of Lemire's first acts is to insist that community physicians assigned to the Orthopedic's Intensive Care Unit (ICU) be physically present to care for patients... or stop working there. Lemire argues that if a critically ill child's condition worsens, he or she cannot wait until the volunteer physician is able to drop by the hospital.

The volunteer physicians try the new rules for a month and find that they cannot keep up with their work and with their private practices. The end result is that in-house physicians take over the ICU — a change that signals a big step away from "volunteer" charity care.

At the same time, board Chairman Kate Webster begins promoting the idea that the board should hire a single individual — a chief executive officer or CEO — to run the hospital.

In the late 1970s one cannot turn a corner without finding a trustee conferring with a doctor or nurse, comforting a patient, delivering a food tray, painting a wall or pruning a shrub. In between chores, the trustees set policy and make all of the financial decisions for an organization with a $30 million annual budget and nearly 1,000 employees.

Facing the retirement of four key administrators, the board agrees to appoint a single "executive director" to run the entire operation with authority to hire his or her own management team: medical director, chief financial officer and chief administrator. Further, all hospital departments will report to the executive director.