Following recently completed projects off-campus, Saint Peter’s Healthcare System is embarking on a multimillion-dollar effort to completely overhaul its Intensive Care Unit.

The original ICU was built at Saint Peter’s main hospital building in New Brunswick in 1989. Plans for the new project will expand the critical care unit to about 25,000 square feet, covering nearly the entirety of the fifth floor.

“This is probably the most substantial project that we’ve done in many, many years,” Saint Peter’s Healthcare President and CEO Leslie Hirsch told NJBIZ.

The approximately $25 million to $30 million update aims to match the quality of care the Saint Peter’s team delivers with the environment it operates within. The work will likely take about two years to complete.

“It’s a space where we take very excellent care of our patients,” Hirsch explained, but the design of the unit and its amenities are no longer contemporary. “And there’s no modernizing it in its present envelope. If you’re going to do it, then you really need to do it right,” he said.

The fifth floor will almost exclusively house the ICU. The Cardiac Progressive Care Unit, which Hirsch described as a complimentary department, is the only other group that will remain on the level.

The significance of the project is underscored by the steps it took to get to this point. “Even though we’re not working in the ICU proper, we actually have begun the project in terms of enabling projects that have to occur and be accomplished to even allow us to get to the ICU,” Hirsch said. “There’s a number of dominoes that have to fall into place to be able to get to the actual physical space on the fifth floor.”

Last year, Saint Peter’s celebrated the opening of its new Health and Wellness Center in Somerset. The $6 million project consolidated outpatient rehabilitation services in a single location covering 22,000 square feet. The office houses adult and pediatric programs for physical, occupational, and speech and language therapy as well as audiology.

Now more deeply embedded within the community, one of the highlights of the project was how the move off campus increased accessibility for patients. Interestingly, it did the same thing on the fifth floor in New Brunswick for Saint Peter’s.

“That project had to be done so that we could relocate certain services from the hospital to make way, ultimately, for the ICU,” Hirsch explained.

Also moving from the fifth floor to elsewhere within the hospital are an outpatient cardiology unit, a medical surgical nursing unit and an acute dialysis department. “It’s not like we have an abundance of space. So, we really do a great job of optimizing the space that we have to move things around,” Hirsch said.

Knocking all those other dominos down will allow Saint Peter’s to demolish the area for the new ICU. Hirsch said it’ll be taken down to the studs and rebuilt from scratch. The new ICU will support the same number of beds – or fewer– as the current department (26).

According to Saint Peter’s website, the 100-member ICU is staffed by 80 registered nurses and three advanced practice nurses.

Growing demand

On the third floor, Saint Peter’s will also build a new pediatric intensive care unit, Hirsch said. There, the bed count will expand from its current eight to 14. According to the state’s approval of the plan, the work will be completed in two phases.

The $10 million project is necessary to meet demand. Hirsch expressed gratitude to the governor and lawmakers for an appropriation in the Fiscal Year 2024 state budget that will cover costs.

“As the demand for Saint Peter’s specialized services continues to grow, it is anticipated that the number of patients requiring PICU beds will continue to increase over the next five years,” the letter from the New Jersey Department of Health letter reads. “With the increase of 14 beds, and utilization statistics estimating a straight-line increase in PICU days of 6% per year, the facility occupancy rate will match the 70 to 75% average occupancy target.”

Hirsch said Saint Peter’s is hopeful that work will start either later this year or in 2025.

According to the NJDOH approval, in the first year of operation total estimated revenue and operating income for overall hospital performance is $567.69 million with a projected revenue of $18.76 million within the 12 months.

“If you’re going to be in business taking care of sick patients, you must have an ICU,” Hirsch said. “And so, then the decision to do that is, are you going to have one that really provides for the state-of-the-art facility and the amenities that patients want today and should have today, in terms of their privacy. And those become easy decisions as far as things moving out of the hospital.”

Moving out

Advances in health care and its delivery are also helping to drive services off campus.

Over his more than 40 years in hospitals, Hirsch has seen that evolution firsthand.

The Roundup

Recent developments at health care systems around the state:

• 30 NJ hospitals earn A grades for patient safety in spring Leapfrog report
• Children’s Specialized Hospital launches enhanced autism program
• Valley Health opens 2nd Montvale primary, walk-in care center
• Hackensack University Medical Center 1st in NJ to use da Vinci 5 robotic system
• 3 NJ hospitals recognized for Black maternal health care

“Conditions that patients would otherwise be in the hospital for a long time, today—they’re not,” he said. Back in 1979, someone undergoing hip replacement surgery, for example, might have stayed in the hospital seven to 14 days.

“Now, you have your hip replaced—you might not even be in the hospital,” Hirsch said, for patients whose health could allow for a trip to an Ambulatory Care Center instead.

“It’s really a result of pain control, surgery technique … and then the hardware—everything has changed. And so, if the patient’s health warrants it, and they’re healthy and it’s safe for them, they literally go home that day,” he said.

In March, Saint Peter’s celebrated the debut of another expanded and modernized space. Located on How Lane in New Brunswick, the Family Health Center received $12 million in renovations. That work was also funded, in part, by a $5 million state budget appropriation.

The project nearly doubled the size of the facility, which serves a vulnerable population. A $875,000 grant from Robert Wood Johnson Foundation helped launch the soon-to-debut market at the site.

Additionally, in the past six months Hirsch said Saint Peter’s and collaborator Astera Oncology have taken steps to grow their cancer care program. In 2023, he said Saint Peter’s had more than 500 newly diagnosed and high-risk cancer patients go through evaluation.

“So, we’ve expanded right here outside the hospital to have an oncology practice to take care of cancer patients,” Hirsch said, pointing out that developments in cancer care have also allowed this treatment to be delivered easily at the community level.

“We’re also investing close to $5 million in renovating our cancer center where we provide radiation oncology and we’ll have sate-of-the-art radiation oncology equipment,” Hirsch said.

On campus, Hirsch said an expansion in the medical office building also added more clinical space and 10 new exam rooms to the outpatient obstetrical and surgical suite.

Working smarter

Beyond capital improvements, Saint Peter’s is also making new investments in technology. “Just because our facility is older, it doesn’t mean that we’re precluded from implementing state-of-the-art technology,” Hirsch said.

On that front, the system is currently running several pilot programs.

• HelloCare integrates with the hospital TV system. Hirsch said it will provide remote patient monitoring as well as virtual nursing. The platform operates via software, hardware and AI.
• BioBeat is a patch worn on a patient’s chest that wirelessly transmits key vital signs to a central dashboard in real time. Hirsch said it collects information on heart rate, respiratory rate, blood pressure and oxygen saturation.

Saint Peter’s is also using robotic process automation to help take information from electronic medical records to assess perinatal risk using a web-based tool.

When it comes to making changes, patients are at center of the process for Saint Peter’s.

“Really, the driving force is, ultimately all that we do is to keep our patients first and be able to provide them with safe, effective care; high quality care that also goes along with providing excellent service,” Hirsch said.

As for economic headwinds and externalities, he said there’s “no doubt about it, the cost of construction today has also gone up.”

“Costs have gone up across the board, so you have to deal with it,” Hirsh said.

But in the future, Saint Peter’s may not have to deal with it on its own.

Saint Peter’s University Hospital dates to 1907. Situated on 9 acres, the nonprofit acute care teaching hospital has 478 beds. The Children’s Hospital at Saint Peter’s University Hospital cares for 9,000 inpatients and more 45,000 outpatients each year, according to the system.

It’s unique in New Jersey for several reasons. Chief among them – in a consolidating landscape – is its status as a single-hospital health system. It’s also one of just five remaining Catholic hospitals in the state, sponsored by the Roman Catholic Diocese of Metuchen.

After attempts to merge with Middlesex County peer RWJBarnabas Health were blocked, Saint Peter’s is proceeding along an alternate route.

In January, it and Atlantic Health System announced signing a letter of intent to establish a strategic partnership.

“For the past several years, Saint Peter’s has engaged in a Discernment Process, with the support of The Most Reverend James Checchio, Bishop of the Diocese of Metuchen, and Saint Peter’s Board of Governor, to determine the best course for our long-term future,” Hirsch said when the announcement was made. “The most critical objective has been to find a path to secure our Catholic mission of serving the community, especially the most vulnerable, as we have done for more than 116 years.

“Although Saint Peter’s is stronger today than ever, throughout this journey it has become clear that to assure our future success, we need a strategic partner whose resources, capabilities, and values are aligned with our mission,” he added.

Under the terms of the LOI, Atlantic Health would make significant investments in Saint Peter’s and its service area.

Amid a consolidating industry, Hirsch said a partnership offers economic scale, but that’s not all. “It goes beyond just the economics of it. When you merge and become part of a larger system, really your circumstances become enriched with more resources, because there’s a greater ecosystem from which to draw … It means that there’s an opportunity for great collaboration,” he explained.

“Even on our own, we’re constantly focused here at Saint Peter’s. We strive to be excellent in all that we do,” Hirsh said. Those efforts are not unrecognized. Less than 20 countries worldwide have six consecutive MAGNET designations. Saint Peter’s is one of them, and currently working on its seventh. “We’re very focused on quality, safety, service,” Hirsch added.

While Saint Peter’s new ICU marks the first changes to the hospital building in a significant amount of time, with that focus and with its PICU plan on the horizon, it seems likely not to be the last for long.

“When you become part of a larger system, not only does it help you in terms of your strength, in terms of functioning in a competitive market, but it also enriches the organization because of all of the available resources that are there that you would not otherwise have on your own.”

Editor’s note: This story was updated at 9:08 am ET on May 21, 2024, to clarify that estimates from the NJDOH are for revenue and operating income for overall hospital performance, and not just the PICU. Additionally, Saint Peter’s is a nonprofit facility. As such a reference to projected profit was changed to “projected revenue.”