Landlocked in downtown Baltimore and unable to bear the weight of more floors, the Baltimore VA Medical Center has expanded inward.
The seven-story building, which occupies a city block on Greene Street between Baltimore and Fayette streets, has enclosed its signature glass front and taken footage from its atrium to increase space on every floor for offices, clinics, conference rooms, research labs, and its renowned robotics program.
The $11 million project, which coincides with the hospital's 20th anniversary, gives the acute-care facility for veterans an extra 15,000 square feet.
"The idea is now to make every possible space into a working space," said Chris Smith, the hospital's associate chief of engineering. "We really had no other options but to build inward. The challenge was ongoing construction in an active medical center."
Among the newest amenities is the women's clinic, a second-floor suite dedicated exclusively to female veterans, whose numbers have swelled significantly since the center opened in 1992. Women make up between 9 percent to 15 percent of personnel, depending on the branch of service.
"We have long wanted a separate waiting room for our women vets," said Dr. Catherine A. Staropoli, medical director of the women's clinic. "They are no longer lost in a room full of men."
The room, decorated in soft violet tones, leads to private exam rooms, nurses' stations and offices. The clinic hired more staff, including two more full-time registered nurses, a licensed practical nurse, a health technician and a social worker.
Zelda McCormick, women's clinic program manager, started working at the medical center soon after it opened, as a University of Maryland nursing student. Women veterans accounted then for about 100 of the annual patient census.
"Back then, if we had a woman patient, everyone wanted to see her," McCormick said. "Men were the primary focus for so long. I am happy today to implement the changes."
Last year, the hospital treated about 4,000 women. Among the changes to which McCormick was referring are evening hours for clinics and Saturday hours for mammography; Baltimore's VA was among the first in the area to offer digital mammography soon after it became available.
Women can access in-house primary care and preventive medicine, as well as inpatient services, including surgery and mental health counseling.
The Baltimore VA has not delivered a baby, but that could change in the future, given the increasing numbers of young women now serving.
Sherry LaRose-Cooke, a registered nurse and Navy veteran, transferred to Baltimore recently from a VA facility in Virginia. "I believe in this mission," she said. "We have a great outreach to women going on, and we are meeting the needs of women veterans in the community."
The clinic is working to spread information on its services and extended hours.
"We want women to come here," McCormick said. "There is a misconception that the VA is just for men. We offer women everything they need and want women vets to know there is competent and convenient healthcare available to them."
The expansion has also provided space for a dermatology clinic, the specialty care and anesthesia departments, the public and community relations staff as well as the robotics and education programs. There is also the Office for Returning Veterans from current war zones.
Like many VA centers, the Baltimore facility is attached to an academic center, in this case, the University of Maryland, its hospital and School of Medicine. A covered bridge several levels above the street connects the two facilities, and staff members move frequently between the hospitals.
Construction barriers, which made for a cramped, dark atmosphere at the entrance, came down a month ago and the bustling lobby is back to full use. Sunlight still pours in from skylights and the self-playing piano has resumed its lilting melodies.
With its stunning multi-story window wall replaced by the addition, the medical center may no longer look like the Hyatt Regency of hospitals, as a Sun story described it in 1992. Officials describe it now as a fully functional building that has adapted to 21st-century health care.
The center, built 20 years ago at a cost of $121 million, opened with 314 beds. It has since dropped nearly 200 of those to make room for outpatient clinics and research programs.
"The hospital is much more patient-centric," said Staropoli, who joined the staff in 1995. "Each patient also has a care coordinator, who can often manage a problem by phone or secure e-mail."
VA facilities in Maryland see nearly 54,000 patients annually, with about 47,000 of those veterans visiting the Baltimore location. The system was on the cutting edge 20 years ago with the electronic records now widely employed in hospitals today. Its patients range in age from 21 to 101 and have served in conflicts back to World War II.
"We are proud of what we are making available," said McCormick. "And we want to make sure every veteran knows what we have available."