McCandless council's zoning committee has endorsed the seven-floor UPMC Passavant pavilion project that doubles the size of the emergency and cancer centers, adds a 16-bed cardiac care unit plus six operating rooms, and increases the number of beds from 311 to 399.

Groundbreaking is set for the fall, pending final approvals from town council and the state Department of Health.

The estimated $100 million expansion would increase the facility's size by more than a third, or about 188,000 square feet. The new tower would connect to the East Wing at the atrium lobby. It is expected to open by mid-2010, leaving room for UPMC Passavant to grow into a full-scale, tertiary care facility.

What that means, said UPMC Passavant President Teresa Petrick, is that fewer advanced-care procedures would have to be diverted elsewhere. That shrinking list primarily involves organ transplants, multiple trauma injuries and cranial surgery.

Even with the new tower, only 56 of the campus' 132 acres would be developed, she said, leaving room for exploration of a different venture, a 55-plus housing community.

"It's really very exciting to have a hospital campus that has a senior living campus built right into it," Ms. Petrick said. The plan for patio homes and condominiums is in the design phase with groundbreaking possible next year.

Although UPMC operates several independent living communities, including those at Sherwood Oaks in Cranberry and Lighthouse Pointe in Fox Chapel, she said the one at Passavant would be the first to be on a hospital campus.

With the growth of the northern suburbs, both the number and complexity of procedures have increased at the Babcock Boulevard medical center.

"We're pushing tertiary care services north, up to Mercer and Erie, so I-79 is the corridor we're following and that's where the population is moving," said UPMC Passavant's Robert Henderson, assistant vice president of strategic planning.

"Every day this becomes more of an imperative for us," echoed Ms. Petrick, citing recent daily census figures that approached 350 during the first quarter. Four years ago, comparable inpatient figures peaked between 200 and 220.

Not only have the total number of procedures and emergency visits this year gone up by roughly 4 percent, she said, but the average time per case has risen 10 percent -- to 94 minutes.

"Our volumes continue to explode," Ms. Petrick said. "The need for the tower has been more of an imperative this year than even last," which is when the proposal was first outlined.

Floor-by-floor details show revisions affecting everything from traffic flow to nurse stations, outpatient cancer care to image-driven spinal surgery, private pre-operation rooms to an easier-to-find sleep clinic. Most new facilities will incorporate existing East Wing space already used for similar services.

Highlights include:

Ground level -- Cancer-related needs will be based in a "one-stop-shopping" unit. A separate entrance will lead patients downstairs to an area that will hold chemotherapy and radiation pods overlooking the front lawn.

"There's a well of windows, lots of glass, so they will have lots of daylight," said Donna Jasko, vice president of ancillary services. A cancer-care-specific CT scan and an appearance center for wig and prosthesis fittings will be moved here. Room for a soft-tissue PET scan has been set aside.

First floor -- The emergency department will be reconfigured to direct patient flow by level of acuity.

"We really wanted to design this to make sure those patients can move quickly into the right area," said Chief Nursing Officer Cheryl Dodson. Common needs such as imaging and stitch-or-fracture care will be fast-tracked, putting those closest to the main entrance. A new feature will be a 10-bed observation area, she added, for people who might need to be admitted.

In addition, the sleep study area will be moved closer to the lobby, and it will be expanded from four beds to six. Former patients still drowsy from a night's sleep have complained about finding their way out from the lab's present location.

"We thought that this was the ideal place to put the sleep lab. It's easier to get them out in the morning," Ms. Dodson said.

Second floor -- Six new operating rooms would complement the present 15. Three will focus on image-guided, minimally invasive oncological, spinal and vascular procedures; these include liver resections, tumor excisions and ruptured disc repair.

The number of pre-op rooms will increase from 18 to 25. According to patient surveys, officials said Passavant's are popular because they afford more space, privacy and include individual bathrooms and TVs.

"It looks like a regular patient area, not like a holding area you see in most hospitals," said Sanjay Saha, vice president of surgical and cardiovascular services.

Third floor -- All cardiac intensive-care patients will be placed in a dedicated 16-bed unit, complementing the existing 32 beds.

Floors four through six -- Nurse stations will be reconfigured to reflect more open space and interaction between staff and guests. Gone is the long, high-counter work station that some visitors found to be imposing. A workers-only area will be put in the back to meet staff concern for some privacy, Ms. Dodson said.

"It'll be more like an open, carpeted living room, with work space tables and chairs," she said, and "not this barricade [that visitors] can't cross over."

Plenty of changes will be made outside, too.

The pavilion will be constructed in what is now a parking lot, one of several that sit in front of the hospital, on its flanks and in the rear. Parking, in fact, was the last issue that had to be resolved before the plan was handed over to town council, which could give its final approval by the end of the month.

The zoning committee signed off May 1 after a compromise was reached on the number of parking spaces the pavilion will require. Bruce Betty, McCandless land use administrator, said 2,098 spaces will be provided, but UPMC said only 500 of that total require room not already set aside for parking.

Mr. Betty said the town initially disagreed with how the UPMC traffic engineer calculated parking needs. Once the two sides agreed on a more accurate methodology, he said, a consensus fell into place.

Short-term parking will be expanded and valet services will continue. All parking will remain free, while separate ports for arrivals and discharges will ease rotunda traffic flow.

As part of the expansion, a private stretch of Cumberland Road on UPMC grounds will be extended to Peebles at Sample roads. A traffic light is likely as well as turning lanes.