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County-USC prepares to replace its outpatient clinics

Monday's move is the first step toward the opening of the new hospital,
planned for October.

By Rong-Gong Lin II, Los Angeles Times Staff Writer
September 14, 2008

On Monday, the first patients will walk into a gleaming new building in Boyle Heights, the new home of one of nation's largest public hospitals.

Two dozen outpatient clinics are to open at the new Los Angeles County-USC Medical Center, part of a decades-long effort to replace the Depression-era hospital that has long been the linchpin of the region's public health and trauma system.

Monday's opening is the first step in a series of gradual moves into the new $1.02-billion facility, which covers 1.5 million square feet over the length of three city blocks and whose highest tower is eight stories. It is smaller than its cavernous predecessor, which rises 19 stories high and is 2 million square feet -- but the smaller space is lighter, brighter and cooler, thanks to beige-white walls, more windows and central air conditioning.

Still to come is a far more complicated endeavor: moving hundreds of hospitalized patients from the old building into its replacement next door. The move is scheduled for Oct. 17 and 18 and will involve an army of workers, including Air Force personnel.

The focus this week will be on the outpatient clinics, which last year recorded about half a million visits. The California Department of Public Health signed off on the opening of the clinics last week.

"This is a replacement that took 75 years to get to," said Pete Delgado, chief executive of Los Angeles County's LAC-USC Healthcare Network. "This is one of the most exciting phases."

County-USC's clinics are considered some of the busiest in the United States. The vast majority of its patients are uninsured or on Medicare or Medi-Cal, the government insurance programs for the elderly and poor. Only a tiny fraction have private insurance.

The range of outpatient services is broad. Many of the clinics will be housed in the westernmost of the new hospital's three towers, with hallway windows featuring a sweeping view of downtown Los Angeles and beyond, providing a much different experience than the old, mostly windowless clinical tower, said Dr. Stephanie Hall, County-USC's chief medical officer.

"On a clear day, you can see all the way out to the beach," Hall said. "It's light, bright and cheerful."

The interior design of the clinic tower is a big change, Hall said. In the old facility, patients from all the clinics needed to register in one centralized, crowded location, an uncomfortable experience marked by delays. At the new facility, patients will be able to go to decentralized locations to register for their appointments.

County-USC's clinics are scattered now among the old five-story clinical tower behind the hospital and separate trailers on the hospital's sprawling 72-acre campus two miles east of downtown Los Angeles.

With the opening of the new tower, the clinics will be consolidated in two locations. The tower will be home to 24 of them, including the burn, eye, chest medicine, eye, neurology, neurosurgery and urology clinics.

Because the tower is too small to house all of them, 13 will be located in the old clinical building.

Two more, orthopedics and radiology, will move into the new clinical tower Oct. 20.

The move of the hospitalized patients is still a work in progress.

"We've got to make sure the facility meets code, there's signage, that the phones work, that the communication network works. There's a lot of work to make sure the medical equipment is installed right, calibrated, licensed and certified," Delgado said.

The hospital also needs to address long-standing concerns about the new facility's bed space. The number of budgeted beds will drop from 671 to 600, and a report sent to the Los Angeles County Board of Supervisors over the summer predicted that the hospital will open at "the tipping point," saying that the newness of the facility will probably attract more people than normal.

Already, county officials are urging patients to avoid County-USC's emergency room if they can. Many who show up at the emergency room have nonemergency medical issues.

Delgado said said he has been working with community clinics to help patients find primary care physicians, which should help patients get earlier care and cut down on the number of patients who show up at the emergency room having never seen a doctor.

"Even though we've got this new technology for the community, I'm hoping the community doesn't actually need it," Delgado said. "Our goal is to get these patients the right care at the right time, and if they don't need emergency services, we want them to go to their primary care doctor."

Officials are planning a public grand opening Oct. 4.

ron.lin@latimes.com