Pillar 1.

Our current space is too small to meet our community’s health care needs. We are bursting at the seams!

THE NEED FOR SPACE

In 1972 when our current community hospital was built, our valley’s population was 6,500 residents. Today, we number over 10,000 and our community is slated to reach 12,000 residents by 2030.

This growth is acutely felt within our current 42,000 square foot hospital. Operations are literally bursting at the seams. Closets have been converted to offices, administrative activities have been moved to temporary trailers, and modern medical technology barely fits in small, outdated rooms.

These cramped quarters regularly result in the loss of valuable business. Patients are transferred to Confluence Health in Wenatchee due to lack of hospital capacity. And the hospital’s orthopedic surgeon, Dr. Schkrohowsky, is unable to perform joint replacements because of size constraints in the operating rooms.

Even with these limitations, the hospital’s volumes continue to increase, as evidenced by robust departmental growth over the last 5 years:

  • Emergency Department: +26%
  • Radiology Exams: +58%
  • Laboratory Tests: +100%
  • Surgeries: +65%
  • Physical and Occupational Therapy: +29%

Based upon these trends, studies have identified that a new facility with 77,000 square feet will adequately address space-related issues. Additional studies have shown that creating a facility of this size is done most efficiently by building a new hospital at the hospital’s vacant land in Apple Blossom Center versus remodeling the current facility.

THE NEED FOR PATIENT-CENTERED ENVIRONMENTS

In addition to more space, we need a hospital designed to deliver quality care in today’s health care environment.

Nationwide, care quality is increasingly being defined by the patient experience. Hospitals are judged on their ability to efficiently resolve patient ailments, but they are also rated by the degree to which they create a comfortable and supportive environment for both patients and their families.

Our current hospital fails to create such an environment. Access is steep and can be dangerous in winter months. Parking is limited. Privacy is lacking throughout the building due to space constraints. And the existing cafeteria and small outdoor fountain offer minimal refuge to anxious family members.

A new hospital at Apple Blossom Center will address these issues by providing:

  • Easy vehicle access via Hwy 97a and expansive parking outside main entrances.
  • Greater privacy in the Emergency department and within single patient rooms.
  • Larger and more comfortable birthing facilities for delivering moms and their families.
  • Comfortable common spaces for family members and an inviting outdoor garden.
  • A heliport located just outside the ER department for quick transport to bigger facilities if required.

A 2016 American Hospital Association survey (2) reinforced the need to integrate patient privacy and comfort into a hospital’s design. The reimbursements a hospital receives from Medicare are tied to patient satisfaction and patients are increasingly selective in an age of high deductibles about where they choose to receive their health care.

In this environment, our current facility is lacking. Recent statistics showing a 6% drop in overall in-patient market share from 2010 to 2014 reinforce the need to address patient privacy and comfort.

Patient satisfaction scores continued to be on par with hospitals of our size during this period (3).  Demand in general for health care services did not decrease (4).  In fact, volume of in-patient stays from 2010 to 2014 remained steady5, even while market share dropped, suggesting the hospital has ample business to capture.

As care experiences have improved in neighboring Wenatchee, the experiences offered by our own hospital has lagged farther behind based upon its outdated architecture. Patients are drawn to comfortable and nurturing environments and our present hospital, by its very design, cannot create such environments.

A new facility will rectify this issue and restore our hospital’s competitiveness in our healthcare market.

THE NEED FOR MODERNIZATION

Finally, in addition to needing more space and an architecture that creates patient-centered environments, we need a hospital that can operate efficiently under present and future health care conditions.

In the coming decades, health care will be optimized so that in-patient hospital services (overnight stays) are used less and out-patient services and surgeries are utilized more. Additionally, more collaboration is expected between hospitals in our region to improve patient care.

The new hospital is designed with these trends in mind. The number of in-patient rooms will remain the same even as our district’s population grows. But expanded day-surgery procedure rooms will accommodate higher flows of out-patient activity. The hospital’s current out-patient services already account for 70% of hospital revenue, so expanded out-patient capacity will prepare the hospital to capitalize even more on this growing sector of the health care market. Along these same lines, the new hospital will allow specialists from Confluence Medical Center in Wenatchee to see and treat patients here in Chelan.

Additionally, our new hospital will cultivate increased revenues through:

  • An expanded and more efficient emergency department that increases the number of patients who can receive care, especially in high-demand summer months.
  • Expanded physical therapy, occupational therapy, and orthopedic departments with services designed specifically for our expanding population of 65+ aged patients.
  • Enlarged operating rooms that allow surgeons to offer more diverse surgical services.

CONSIDERING AN ALTERNATIVE

Pillar #1 is based upon the assumption that as a valley we want our hospital to continue to provide the same ongoing level of health care service. But some suggest that a downsized business model like Cascade Medical Center in Leavenworth would be a preferred future. Cascade operates an ER, has seven med/surgery beds, and offers out-patient services, but does not offer OB or surgical services.

Unfortunately, this model provides less to the community and costs about the same to the taxpayer. Cascade Medical Center receives a comparable level of tax support from its constituents as LCCH, and performs on par financially6. Fewer services. No reduction in price.

Furthermore, should the hospital adopt such a model, it would involve the layoff of roughly 1/3 of its workforce. This would have significant economic impacts within the valley and a loss of valuable living-wage jobs. Finally, expectant mothers and others needing regular health care would be required to make regular trips to Wenatchee. Such travel would be especially hard on families with limited time and economic resources.

For these reasons, our community is better served by a hospital that remains committed to providing OB, surgical, and other in- and out-patient services.

CONCLUSION

In conclusion, our current hospital is lacking in size and lacking a design compatible with current trends in health care. Its architecture does not create patient-centered environments. Its layout prevents staff and administrators achieving maximum efficiencies in operation. We need improved layouts and more space to rectify these issues and to capitalize on the outpatient opportunities of the future.

NEXT UP: PILLAR 2 – The Cost to Remodel is $12 Million more than Building New

Our next discussion will center around Pillar 2 – The Cost to Remodel vs. Build New.  The Hospital Board of Commissioners spent nearly six months probing the pros and cons of building new vs. remodeling.  We will review the Board’s study and why the signs unequivocally point towards building a new hospital.

REFERENCES

  1. http://lakechelancommunityhospital.com/wp-content/uploads/2016/09/Comparative-Analysis-of-Facility-Costs.pdf
  2. http://www.hfmmagazine.com/articles/1878-2016-hospital-construction-survey
  3. Latest WSHA Hospital Quality Report – 2014/2015 data
  4. http://www.lakechelancommunityhospital.com/wp-content/uploads/2016/08/Master-Planning-June-2.pdf
  5. Total Patient Days: 5,846 – 2010; 5,859 – 2014; LCCH
  6. 2015 Audit Reports – LCCH & CMC

The evidence

A make-shift storage closet, carved out of the medical/surgical floor to house equipment in between uses.

Medical equipment needs proper storage to ensure it’s not damaged, can be housed in a clean environment and can be located when needed.

This old bathroom has been converted to a computer closet for the PIXIS station – or the “brains” of the system that controls all the medications needed by patients staying on the medical/surgical floor of the hospital.

A lack of physical space in the laboratory creates “log-jams” of people trying to move about their work space to complete their tasks. This can result in slower result times on lab tests that cause delays in care throughout the hospital.

A utility sink and dirty linens closet now houses extra equipment for the ED, such as bedside commode – which are utilized by patients who can not walk to the 1 ED bathroom shared by all patients.

As it’s not a “clean” room, equipment must be sanitized every time it goes in and out of storage, adding to wait times and general inefficiency.

This old patient bathroom has been re-purposed to house our pulmonary function testing equipment.

There is literally no bathroom, closet, nook or cranny of the hospital not being utilized for some purpose. We are bursting at the seems and need more space.

Imagine being only several feet away from someone in the hospital for end of life care, an infectious disease or a loving, supportive family who wants to be at the hospital all day long.

Double occupancy rooms are outdated and don’t put patients’ needs first. Why are single rooms better? Lower infection rates, patient privacy and dignity and better sleep.

When was the last time you shared a hotel room with a complete stranger?

Laboratory needs have cannibalized rooms never meant for that equipment, leading to cobbled together solutions. There is no more space to take over. The facility cannot update laboratory diagnostics without new space.

Medical Records have no space to organize files prior to transporting to offsite storage. Every department of the hospital needs more space.

Pillar 1 Video - Larry McFadden

Pillar 1: The Lake Chelan Valley is growing. We need a larger, modern hospital to meet our health care needs.#WeCantAffordToWait

Posted by Citizens for a New Hospital Now - Lake Chelan on Thursday, March 2, 2017