Feature 42 Consolidate
4
201 1.4.2 Copyr igh t © SpaceMed www .spacemed.com Page 1 of 3 Originally printed in the SpaceMed Newsletter Spring-Summer 2011 www.spacemed.com Case Study: Consolidating Two Acute Care Hospitals By Cynthia Hayward BACKGROUND Ocean Health System includes three acute care hospitals with a total capacity for 670 beds although each hospital staffs significantly less beds: Valley Hospital with 245 beds Coast Hospital with 360 beds Rural Hospital with 65 beds Valley Hospital and Coast Hospital are located six miles apart in a scenic northeast region. Acute care beds are currently located at both sites along with duplicative emergency departments, surgical suites, and various diagnostic and support ser- vices. Both of these facilities share essentially the same market along with a com- petitor hospital to the northeast. Rural Hospital, although only eight miles away from Valley Hospital, requires travel via a congested and winding road with the travel time averaging between 20 and 30 minutes. Rural Hospital also has a distinctly different patient catchment area than Valley and Coast Hospitals. Most of Rural Hospital’s patients come from the west where it competes with hospitals bordering a large urban area. 245 Beds 65 Beds 8 m i l e s 6 m i l e s Rural Hospital Valley Hospital Coast Hospital Other County Hospital 5 m i l e s 360 Beds 245 Beds 245 Beds 65 Beds 65 Beds 8 m i l e s 6 m i l e s Rural Hospital Valley Hospital Coast Hospital Other County Hospital 5 m i l e s 360 Beds 360 Beds KEY PLANNING ISSUES A clinical service realignment plan was developed based on an evaluation of ke y clinical and support services, current resources (staffing, equipment, space, and facilities), patient origin, and other market characteristics. The goal was to eliminate system-wide redundancies and minimize operational costs, while maintaining or increasing market share. Since Rural Hospital serves a distinctly different market than Coast and Valley Hospitals, consolidation of Rural Hospital with the other two acute care facilities would negatively impact market share. Therefore, it was decided to generally maintain the “status quo” as to Rural Hospital's geographic location and current array of services — acute medical surgical beds, full service emergency department, inpatient and outpatient surgery, diagnostic radiology, CT, nuclear medicine, and non-invasive cardiac diagnostics.
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Transcript of Feature 42 Consolidate
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2011.4.2 Copyr igh t © SpaceMed www .spacemed.com Page 1 of 3
Originally printed in the
SpaceMed Newsletter
Spring-Summer 2011
www.spacemed.com
Case Study: Consolidating Two Acute Care HospitalsBy Cynthia Hayward
BACKGROUNDOcean Health System includes three acute care hospitals with a total capacity for670 beds although each hospital staffs significantly less beds:
Valley Hospital with 245 beds
Coast Hospital with 360 beds
Rural Hospital with 65 beds
Valley Hospital and Coast Hospital are located six miles apart in a scenic northeastregion. Acute care beds are currently located at both sites along with duplicativeemergency departments, surgical suites, and various diagnostic and support ser-vices. Both of these facilities share essentially the same market along with a com-petitor hospital to the northeast.
Rural Hospital, although only eight miles away from Valley Hospital, requires travelvia a congested and winding road with the travel time averaging between 20 and 30minutes. Rural Hospital also has a distinctly different patient catchment area thanValley and Coast Hospitals. Most of Rural Hospital’s patients come from the westwhere it competes with hospitals bordering a large urban area.
245
Beds
65
Beds
8 m i l e s
6 m i l e s
Rural
Hospital
Valley
Hospital Coast
Hospital
Other County
Hospital
5 m i l e
s
360
Beds
245
Beds
245
Beds
65
Beds
65
Beds
8 m i l e s
6 m i l e s
Rural
Hospital
Valley
Hospital Coast
Hospital
Other County
Hospital
5 m i l e
s
360
Beds
360
Beds
KEY PLANNING ISSUES A clinical service realignment plan was developed based on an evaluation of key
clinical and support services, current resources (staffing, equipment, space, andfacilities), patient origin, and other market characteristics. The goal was to eliminatesystem-wide redundancies and minimize operational costs, while maintaining orincreasing market share. Since Rural Hospital serves a distinctly different marketthan Coast and Valley Hospitals, consolidation of Rural Hospital with the other twoacute care facilities would negatively impact market share. Therefore, it wasdecided to generally maintain the “status quo” as to Rural Hospital's geographiclocation and current array of services — acute medical surgical beds, full serviceemergency department, inpatient and outpatient surgery, diagnostic radiology, CT,nuclear medicine, and non-invasive cardiac diagnostics.
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Case Study:Consolidating Two Acute Care Hospitals
Continued
PROPOSED FACILITY CONSOLIDATION PLAN A new 210-bed hospital is planned with a community hospital focus and “centers ofexcellence” in obstetrics, cardiology, and cancer care. Valley Hospital will maintaininpatient and outpatient sub-acute, rehabilitation, and psychiatric services with theolder wings demolished to reduce the overall space to be maintained at this site.Rural Hospital will be maintained with a community hospital and short-stay focusand Coast Hospital will be demolished and the land sold off to a local developer foran alternate use.
80
Beds
65
Beds
210
Beds
Rural
HospitalCommunity
hospital/
short-stayfocus
8 m i l e s
Coast
Hospital
Other CountyHospital
2 m i les
360
Beds
New HospitalCommunity hospital
focus with OB, cardiac,
and cancer care
Maintain IP/OP
sub-acute,
rehab, and
psych services
Valley
Hospital
5 m i l e
s
80
Beds
65
Beds
210
Beds
Rural
HospitalCommunity
hospital/
short-stayfocus
8 m i l e s
Coast
Hospital
Other CountyHospital
2 m i les
360
Beds
New HospitalCommunity hospital
focus with OB, cardiac,
and cancer care
Maintain IP/OP
sub-acute,
rehab, and
psych services
Valley
Hospital
5 m i l e
s
80
Beds
65
Beds
65
Beds
210
Beds
Rural
HospitalCommunity
hospital/
short-stayfocus
8 m i l e s
Coast
Hospital
Other CountyHospital
2 m i les
360
Beds
New HospitalCommunity hospital
focus with OB, cardiac,
and cancer care
Maintain IP/OP
sub-acute,
rehab, and
psych services
Valley
Hospital
5 m i l e
s
210
Beds
210
Beds
Rural
HospitalCommunity
hospital/
short-stayfocus
Rural
HospitalCommunity
hospital/
short-stayfocus
8 m i l e s
Coast
Hospital
Other CountyHospital
2 m i les
360
Beds
360
Beds
New HospitalCommunity hospital
focus wit h OB, cardiac,
and cancer care
Maintain IP/OP
sub-acute,
rehab, and
psych services
Valley
HospitalMaintain IP/OP
sub-acute,
rehab, and
psych services
Valley
Hospital
5 m i l e
s
The table below displays the proposed clinical service realignment plan which as-
sumes that the Valley Hospital site will continue to be used for inpatient sub-acute,rehabilitation, and psychiatric services, along with outpatient dialysis, physi-cal/occupational therapy, and psychiatry.
Clinical Service
Coast
Hospital
Site
Valley
Hospital
Site
New
Hospital
Site
Rural
Hospital
Site
Inpatient Acute Medical/Surgical Closed No Yes Yes
Servi ces Sub-Acute Closed Yes No No
Rehabilitation Closed Yes No No
Psychiatry Closed Yes No No
Obstetrics Closed No Yes No
Outpat ient Emergency Closed No Yes Yes
Servi ces Su rgery Closed No Yes Yes
Imaging/Special Procedures Closed No Yes YesCardiac Rehabiliation Closed No Yes Yes
Dialysis Closed Yes No Yes
Physical/Occupational Therapy Closed Yes No Yes
Psychiatry Closed Yes No No
Radiation Therapy Closed No Yes No
As shown on the following page, a reduction in the need for expensive procedure
rooms or treatment spaces and corresponding equipment and staffing is an-ticipated with the consolidation of the Valley and Coast Hospital acute care servicesinto a single new, efficient facility.
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Case Study:Consolidating Two Acute Care Hospitals
Continued
Modality
Coast
Hospital
Valley
Hospital Total
Combined
Need Variance
Emergency Treatment 10 14 24 18 -6
Diagnostic Imaging 4 4 8 5 -3
CT 1 1 2 1 -1
Nuclear Medicine 1 2 3 2 -1
Surgery 4 5 9 7 -2
Current Procedure Rooms/Bays
The elimination of six emergency treatment bays, three diagnostic radiology rooms,
one CT scanner, one nuclear medicine camera, and two operating rooms to ac-
commodate the same or greater number of procedures has significant cost im-plications both on the initial capital cost of new construction and on long-term oper-ational costs.
COMPARISON OF EXISTING AND NEW SPACEThe construction of a new, efficient facility results in significant space reduction asshown in the graph below.
-
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
Inpatient
Nursing Units
Diagnostic/Treatment
Services
Adm in istr ati ve
Services
Building Support
Services
Customer
Am en it ie s
Existing Valley Hospital
Exisitng Coast Hospital
New Hospital
Prior to construction of the new facility, Coast Hospital and Valley Hospital togetherutilize 532,000 building gross square feet (BGSF). The new facility will require only340,000 BGSF with 80,000 remaining at the existing Valley Hospital site to ac-commodate post-acute, rehabilitation, and psychiatric services. With Coast Hospitalclosed, a total of 420,000 BGSF will be needed to accommodate the same or high-er workloads compared to the existing 532,000 BGSF. This results in a savings of112,000 BGSF (21percent reduction).
Cynthia Hayward, AIA, is founder and principal of Hayward & Associates LLC.
