Garfield’s design of ‘dream hospital’ features unconventional and efficient layout.
1953 was a big year for expansion in Kaiser Permanente. The fledgling Health plan opened state-of-the-art hospitals in 3 communities — Los Angeles and Fontana in Southern California and Walnut Creek in Northern California.
The Los Angeles Medical Center (on Sunset Boulevard) was the first to open, on June 16, 1953. The dream hospital design was inspired by Kaiser Permanente founding physician Sidney Garfield who worked with architect of record George M. Wolff.
The new hospitals debuted the concept of separate corridors for visitors and staff. Visitors could enter a patient room from an outside walkway, staying out of the way of busy medical staff moving along the interior corridor.
Garfield’s design called for decentralized nursing stations with 1 for every 4 rooms (1 nurse per 8 patients) instead of one per floor. Patient rooms had an individual lavatory with hot, cold, and iced water.
The futuristic concept of the "baby in a drawer" — a sliding bassinet that let a tired mom pass her newborn through for care in the nursery — was also introduced in the 1953 dream hospitals.
The Los Angeles Times gushed about the $3 million facility, describing it as “sorely needed.” It also noted: “The Kaiser Hospital, operated by the non-profit Foundation, is open to the public, a fact not generally known. In addition to Health Plan patients, it also accepts private patients and charity patients referred by social welfare agencies.”
But that public aspect did not sit well with the Southern California medical establishment whose members resisted the arrival of prepaid, group practice medicine. The next month the Los Angeles County Medical Association sent out a questionnaire to its members with the header caption “This is the most important notice ever sent to you by the LACMA.”
The cover page made clear the medical association’s concerns:
“Points have been raised as to whether this (Kaiser Permanente) is really a corporation practicing medicine, whether the ‘captive’ patients of the plan forced to join by their union is good for the welfare of the people, whether the patients receive adequate medical care, whether it is proper for a layman to control physicians, etc.”
Opposition reached a fever pitch in August 1953 when Paul Foster, MD, president of the medical association, condemned the Kaiser Permanente program as “unethical.”
These were difficult times for the fledgling Permanente group. The successful practice of high-quality medicine in gleaming new facilities like Sunset eventually wore down the opposition. By 1960, the local medical society attacks on the program had come to an end.