The room was bare with white plaster walls, a cold concrete floor and wires dangling from the unfinished ceiling.
But Larry McAndrews was still impressed, especially by a bed that wasn't even there.
Pausing in a patient room on the fifth floor of the unfinished Medical College of Georgia Children's Medical Center, Mr. McAndrews listened Friday as intake director Barbara Meeks pointed out where a trundle bed that can sleep two parents will sit in the child's room.
"Sleeping two family members is very important," said Mr. McAndrews, president of the National Association of Children's Hospitals and Related Institutions, who has visited 120 during his career. "I don't think I've ever seen one with space for two."
"It's the family support," said Patricia Sodomka, executive director of MCG Hospital and Clinics.
Though the building won't be finished until April 1, which MCG officials insist they are not kidding about, Mr. McAndrews and others got a chance to tour it and see innovations built into the new center.
The fish, for instance. Mrs. Sodomka stared around one partially finished room and wondered, "Where's the fish? I keep hearing about the fish."
Each room will have a different animal or plant in it, such as the grouper etched into a block of reinforced concrete that leaned against one wall. Throughout the building, officials are trying to incorporate both high technology and touches of nature, Mrs. Sodomka said.
From a bank of video aquariums in the lobby to simulated trees and leaves in corridors to drawings on the wall, the natural touch is designed to provide a soothing and comforting environment.
Other design features, from slightly slanted walls to a long bank of etched glass panels covering one side of the building, also add to the effect, Mr. McAndrews noted.
"It adds a lot of interest and not a lot of money," Mr. McAndrews said, looking at the panels, which were covered with white markings to resemble a giant computer circuit board.
The effect, however, may be lost on some people, Ms. Meeks said.
"They keep saying, `When are you going to wash the windows?"' she said.
While MCG officials admire their new creation, they are taking a chance in investing so much in a specialized facility in the era of managed care, Mr. McAndrews acknowledged.
His organization and others pushed Congress to put $24 billion earmarked this year for uninsured children into expanding Medicaid, which often cares for the type of seriously ill child that a children's hospital would see.
Instead, Congress put the money into block grants and left it up to each state to decide how to spend the money. A task force studying the issue for Georgia is leaning away from putting the money into Medicaid, said William Kanto, chairman of MCG's pediatrics department.
Instead, the task force is leaning toward a system of buying private insurance for roughly 200,000 uninsured kids, Dr. Kanto said.
That presents a special challenge to children's hospitals, which typically have been shunned by managed care companies leery of higher costs. The Children's Medical Center must have access to all children and attract all kinds of cases, not just the most serious, Mr. McAndrews said.
That way, the high cost of some illnesses can be spread over a greater volume of cases.
If all that comes in are the most desperately ill, the public "could not afford us," Dr. Kanto said.
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