Through almost 20 years of continuous growth, the grounds surrounding Howard County General Hospital, off Cedar Lane in Columbia, have featured a disconcerting set of landmarks: construction trailers.
Residents of the neighborhood say they love all the improvements that have come at the hospital, but they are getting a little impatient about the trailers.
Some who live in the Barnside community across the street feel that the trailers detract from the aesthetics of new facilities the hospital has built - the smooth facade of the new emergency room, for example, and the lobby's portico.
"We all want a top-flight hospital in the county, but we must also protect the neighborhood," wrote Jane Parrish, Hickory Ridge village manager, in a December letter to Victor A. Broccolino, hospital president and chief executive oficer.
Hospital administrators agree that it is time for the trailers to go. Just wait a few more months, they say.
Broccolino promises that beginning in the fall any trailers that may be needed for new hospital projects will be placed out of sight.
Trailers will be "in an area of the hospital campus which will be minimally (if at all) visible from either Hickory Ridge Road, Cedar Lane or Little Patuxent Parkway," Broccolino wrote in a response to Parrish Jan. 22 .
Trailer complaints are not new to the hospital administrator. Within a week of his arrival at Howard County General in 1990, he received a phone call from a community resident asking when the the trailers would be removed. At the time, they had been there about five years.
"I thought, 'How much longer can this be?' " Broccolino said.
But, year after year, construction projects have been started just as others are completed, and the trailers have remained.
The hospital's new emergency department opened July 2. "On July 3rd, they were in there gutting" hospital space to make room for a new diagnostic imaging center, said Paul M. Gleichauf, senior vice president of managed care, planning and marketing.
The hospital has increased its square footage by a third and redeveloped more than half the existing building, he said. In addition to the emergency room, Howard County General opened a new intensive care unit, the labor and delivery and neonatal intensive care units within the past three years alone.
Since opening in Columbia in 1973 with 59 beds, the hospital has mushroomed to become the fourth-largest employer in the county - a 187-bed acute care medical facility. Each expansion of space and services has come fast on the heels of another project - close enough for Howard County General to continuously occupy construction trailers off Cedar Lane.
Since 1995, the hospital opened its ambulatory surgery center, pediatric service center, an additional nursing floor and the maternal/child health unit.
The hospital also recently opened centers focused on the needs of women and seniors.
In January, the Breast Health Center began coordinating care for its first breast cancer patients.
When diagnosed with breast cancer, patients experience a lot of confusion and shock, said clinical program manager Tina Beerman. As a breast cancer survivor, she said she knows that "when there's no one to guide a woman through the process ... it can be very difficult, very disruptive."
Beerman, a registered nurse, offers advice and helps patients negotiate care among surgeons, radiologists and oncologists, she said. She also refers patients to support services as needed.
In February, The Center for Wound Healing began half-day clinics, offering comprehensive care to patients with nonhealing wounds.
Compounding health problems such as diabetes arise as some people age, reducing the ability for their lacerations and surgical incisions to repair themselves, said Eileen Harrity, a physical therapist who serves as director of the center.
Patients with nonhealing wounds usually require longer hospital stays and are at greater risk of amputation or death, Harrity said. In addition, the cost of home care and dressings for such wounds is tremendous, she said.
The center brings together disciplines such as plastic surgery, physical therapy, podiatry and vascular surgery to provide a care plan for such patients.
Growth of new facilities at the hospital, which was purchased by Johns Hopkins Medicine in 1998, is expected to continue.
The population of Howard County has grown by 30 percent over the past 10 years and is expected to grow 20 percent more in the future. Gleichauf said the challenge will be "right-sizing" the hospital to accommodate increasing demand.
In June, the hospital acquired about 10 acres, doubling the size of the campus. Plans for the space include medical office space for physicians and surgeons treating patients at the hospital, Broccolino said. Gleichauf said that as the hospital serves more patients, some support services, including medical records and the laboratory, would need to expand.
The recent growth has moved some departments from the main building on occasion. A trailer housed parts of the hospital's maintenance department from 1987 until last year. Human resources temporarily also was housed in a trailer.
Since receiving recent calls and letters from Hickory Ridge, Broccolino said he has cleaned up some trailer sites, but he estimated that most would remain until at least August.
"We tried to enhance the appearance by putting up shrubbery," he said.
But on a recent visit, a line of nine young evergreen trees and some small shrubs did little to obscure the view from Cedar Lane of hospital trailers.