Construction continues on the new Crystal Spring tower at Carilion Roanoke Memorial Hospital as drywall goes up and fresh paint is applied to the lower levels.
A topping-off ceremony in December marked the end of upward construction, and around March the exterior work will wrap up. It will take another year to complete the interior utility work, but the tower is on track to open in 2025.
“It’s starting to look like a real hospital now. It’s very exciting,” said Mike Abbott, senior vice president of hospital operations at Carilion Clinic.
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The $500 million expansion was announced in 2019 to address health care access challenges in western Virginia. The project has stayed within the budget, despite pandemic-era supply chain issues, Abbott said. The new construction adds 400,000 square feet to the hospital and topped out at 12 stories, two underground and 10 above ground. The tower will house the cardiovascular institute, an expanded emergency department, new trauma bays, patient rooms and another helipad.
The two underground floors as well as a parking garage across the street will address parking issues that exist at the hospital now, said Hannah Curtis, a spokesperson for the Roanoke-based nonprofit health system.
Part of the space hasn’t been designated for a specific use at this time, but that was by design.
“How do we future-proof it? It’ll be great when it opens, but how do we make sure we don’t outgrow it right away?” Abbott said. “We probably don’t have the demand for an eighth OR today, but in five years we might.”
Roanoke Memorial has become the primary referral center for about 60 hospitals, with patients coming from Virginia, North Carolina and West Virginia seeking health care, particularly for cardiovascular services, Abbott said.
The hospital’s cardiovascular institute has grown, receiving national recognition for excellence in its cardiac catheterization lab, a procedure used to test for or treat certain heart or blood vessel problems. During the procedure, a catheter is guided through a blood vessel to the heart and can detect important information about the muscle or open a narrow artery.
In the new tower, the sixth floor will house multiple cath labs with a PACU, or post-anesthesia care unit, in the middle. There also will be two hybrid operating rooms equipped with imaging capabilities to support a minimally invasive treatment for aortic aneurysms.
Aortic aneurysms occur when the walls of a main blood vessel in the heart are weak, causing a bulge, and treatment for the condition used to require open heart surgery. Over the years, physicians started using stents to keep the vessel open, but when the device slid into place, it would block the vessels that branched off around it.
Now, Dr. Joshua Adams with Carilion’s Aortic Center is able to use the same kind of stent, but he uses imaging ahead of the procedure to build a custom-made graft that can be sewn into all the nearby branching arteries.
Today, the modern imaging and other technology used in operating rooms often hangs down from the ceiling. The new tower was designed to accommodate this, but higher ceilings meant that not all the floors in the new tower would line up with the floors in the old hospital. That’s why the new construction doesn’t have a fifth floor, Abbot said.
The new operating rooms were also designed to be large enough to bring in medical students. In total, the new building will have seven operating rooms.
“In the old building we were just trying to fit that in, you know, take out part of this room, part of that room to put something together,” Abbott said. “This lets us build out where its purpose from the beginning is to be an OR with these capabilities.”
The new cardiovascular unit will have 76 patient beds.
The expanded emergency department and additional trauma bays are other features of the new tower construction that are highly anticipated.
The pressure put on hospitals during the COVID-19 pandemic shed light on systemic weaknesses in health care systems across the country, and the same is true at Roanoke Memorial.
“COVID really showed us where the stress points were. We had 50 people waiting in the emergency room — that’s more patients needing a bed than almost any hospital around us in terms of inpatients,” Abbott said.
Roanoke Memorial offers the highest level of trauma care in the region and the emergency department sees high patient volumes, serving more than 88,000 patients a year, according to data from Medicare.gov.
Right now, the hospital’s emergency department supports 76 beds, but wait times can be long, Abbott said. Patients spend an average of 264 minutes in the Roanoke Memorial emergency department before leaving the visit, according to public data on Medicare.gov. The national average is 193 minutes.
The new emergency department will add 54 more beds for a total of 130 patient beds.
The hospital is also designated as a pediatric trauma care center, offering multidisciplinary services for children and adolescents. The new construction will include a pediatric trauma bay, the first at Carilion Clinic, which will be equipped with instruments used for this particular patient population.
The Crystal Spring expansion is part of a larger effort to improve access that includes investing more than $1 billion in the region through expanding and modernizing other buildings, Curtis said.
Those projects included expansions to pediatric primary care and behavioral health services at the Carilion Children’s Tanglewood Center and Carilion Mental Health Tanglewood.
In 2022, an operating room expansion at Carilion Franklin Memorial Hospital went from having four surgeons on staff to over 25, which led to higher volumes in general surgery, obstetrics and gynecology, ears, nose and throat, orthopedics and more, Curtis said.