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Rooms Fit for a Kid: CHaD Renovation Project Is Almost Complete

  • Hannah Smith, 12, of Lancaster, N.H. helps Dr. Shawn Ralston find a comfortable place for her stethoscope in order to listen to her lungs on March 7, 2018 at Children's Hospital at Dartmouth-Hitchcock in Lebanon, N.H. Smith has cystic fibrosis and is in the hospital for a couple of weeks at a time a few times a year. When she comes she brings things from home for her stay. Her mother Jessica Smith sits by the window. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to Valley News — Jennifer Hauck

  • Children's Hospital at Dartmouth-Hitchcock Physician in Chief Keith Loud is interviewed in a treatment room at CHaD at DHMC on March 7, 2018 in Lebanon, N.H. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to Jennifer Hauck

  • Volunteer Claire Weaver, of Hanover, N.H., puts toys out in the playroom at Children's Hospital at Dartmouth-Hitchcock on March 7, 2018, in Lebanon, N.H. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to Valley News — Jennifer Hauck

  • During her stays at the Children's Hospital at Dartmouth-Hitchcock Hannah Smith,12, of Lancaster, N.H., spends a lot of her time making crafts. Many of the things she makes are for the people who care for her at the hospital. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to Jennifer Hauck

Valley News Staff Writer
Published: 3/7/2018 11:48:06 PM
Modified: 3/8/2018 9:18:26 AM

Lebanon — The Children’s Hospital at Dartmouth-Hitchcock is nearing the completion of an approximately two-year renovation project aimed at integrating pediatric inpatient and intensive care units.

The $2 million project, funded primarily through philanthropy, began with the aim of creating a larger play space for patients, and then broadened to include moving nursing stations closer to patient rooms; increasing the size of a room used for treatments such as dispensing intravenous fluids; and relocating the pediatric intensive care unit, known as PICU, to the same floor as the other pediatric inpatient beds.

“We adapted the design as it went along based on various needs, but also opportunities,” CHaD Physician-in-Chief Keith Loud said, during a Wednesday tour of the unit.

On Tuesday, most of the pediatric intensive care unit moved to CHaD’s inpatient unit, leaving just three pediatric intensive care beds on the lower level. Once those three beds move upstairs this summer, all 21 inpatient pediatric beds will be located together in one unit.

The integration of the units reduces the number of beds available for pediatric patients to 21 from about 30, Loud said. Though there were more beds, Loud said, CHaD has not been staffed to cover 30 beds in recent years. This move, he said, will allow CHaD — the only comprehensive children’s hospital in New Hampshire — to meet the needs of the population with less space.

The change reflects broader trends toward increasing outpatient treatment of pediatric conditions that previously might have required hospitalization, such as asthma and Type 1 diabetes, Loud said.

Once this integration is complete, it will free up the former pediatric intensive care unit for as many as 10 adult critical care beds, Loud said. Given the aging population of northern New England, there is increasing demand for inpatient adult beds, he said.

For pediatric patients and their families, the change may mean less movement between levels of care and providers, said Lisa Mitchell, CHaD inpatient unit nurse manager. In connection with the renovation project, CHaD nurses also have been trained to treat a range of degrees of acuity, which enables the same care team to continue to treat a patient as his or her condition worsens or improves, Mitchell said.

“That flexibility will allow us to rise to meet the needs of a patient at any given time,” she said.

Pediatric patients tend to get worse or better more quickly than adults, Loud said. On average, CHaD discharges about a third of the unit’s patient population each day, he said.

In addition to gaining flexibility to match patient needs, an additional perk from a staffing perspective is that the work might prove itself more satisfying and help to attract and retain nurses, Loud said.

“They want to continue to learn and grow,” Mitchell said. Young nurses “want to make sure that they have other opportunities down the road.”

The renovation — the larger play space in particular — has pleased at least one patient.

Twelve-year-old Hannah Smith, of Lancaster, N.H, has cystic fibrosis, an inherited disorder that causes mucus to build up in organs such as the lungs. As a result, Smith spends a couple of weeks at CHaD a couple of times a year, she said in an interview on Wednesday in her room at CHaD.

“Even though there’s a lot of color in this room, we like to add a lot more,” said Smith, who brought a salt lamp and colorful tapestry from home to decorate her room.

While she’s at CHaD, she likes to use the arts and craft supplies available in the new play space. Paper chains she had made adorned one wall of the room and, on Wednesday, she was painting certificates to give to hospital staff as thank-you gifts.

“I like that you can go out there and you can get games or arts and crafts and bring it into your room,” Hannah said. “ ... I think it’s made a difference for a lot of other kids, too.”

Nora Doyle-Burr can be reached at or 603-727-3213.

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