Guest blog from Ken Hinck
Eden’s Director of Physical Medicine and Rehabilitation
and Disaster Preparedness Coordinator
We’re all aware of the devastating events happening in Japan. News updates are available around the clock, and we can’t help but focus on the dramatic images of destruction, heroics, despair and hope. The events in Japan remind us again of the immense power of our planet. And we’re witnesses to the ability of the people of Japan, arguably the most earthquake-prepared people in the world, to cope in the earthquake’s aftermath.
Our focus rapidly shifted as events unfolded. Initially, we focused on the news of one of the world’s largest recorded earthquakes and, soon after, the destruction caused by the tsunami. As the tsunami raced across the Pacific, we awaited the arrival of the tsunami surge upon our shores, amazed by the strength of a surge generated 5,000 miles away. And now our focus shifts to Japan’s nuclear disaster and to the presence, no mater how unlikely, of any increased radiation here at home.
Chile, New Zealand, Indonesia, China, and now Japan, I’ve heard it said that the faults of North America are the only “Ring of Fire” faults not to have ruptured in the past decade. Although there is some small comfort in knowing that the type of faults we live on won’t generate an earthquake of Japan’s magnitude, given Bay Area soil, a significant earthquake can cause violent shaking in some areas. Depending on the location of an Alaskan earthquake, a tsunami could affect our coast and could raise concerns about California’s nuclear power plants located on or near active faults and the coastline.
So what do we do?
We take this as a wake up call and prepare! Our focus should shift from current events to our own preparation. It is not a mater of if, but when, a major earthquake will hit the Bay Area. Ben Franklin said it best, “By failing to prepare you are preparing to fail.” If we fail ourselves, we fail our family, and we can not help our community. And as we have seen, a strong community will be needed to respond and be resilient.
Our ability to provide assistance begins with individual preparedness. Studies indicate that responders first need to know that their families are safe so they may fully respond to an event. At Eden, we offer our staff classes in individual and family preparedness so they are confident in their family’s safety and are better able to focus on serving our community. I believe we need to increase the number of prepared families in our communities so that we are all able to take care of ourselves in times of disaster. When we are confident in our own family’s safety and well being, we are better able to reach out and assist others.
Make sure you have a “Family Disaster Plan,” that you have disaster supplies at home to provide for your family and pets for at least 3-5 days, that you have a disaster kit in your workplace and in your cars and never allow your gas tank to fall below half a tank. Find out your employer’s disaster plans for evacuation and shelter-in-place and how you will be contacted after an event. Contact your local fire service and inquire about Neighborhood Emergency Response Teams (NERT) in your area. If they do not exist, ask about training and how you can form one. You can also visit the American Red Cross web page and enroll in their emergency preparedness classes.
Eden Medical Center and Sutter Health continuously prepare to respond to disasters, and we work closely with Alameda County Public Health and other health care and emergency services partners. Our coordinated efforts greatly improve our ability to provide for the healthcare needs of our community. I’ll write more about how we prepare for disasters at Eden and within the community to ensure we are here when you need us most.
“It takes a lot of unspectacular preparation to produce spectacular results.” – Roger Staubach, Hall of Fame Football Player
by Jeffrey W. Wright, Heliplanners, Aviation Planning Consultants
Heliplanners is proud to have been involved with the replacement hospital project at Sutter Medical Center Castro Valley. One of the first items in this major project was to relocate the existing at-grade helistop (helicopter landing area) to make room for construction of the new hospital building. Heliplanners was brought on board to assist the overall project team with the site selection, planning, design and permitting for the new helistop.
The selected site provides ready access to the Emergency Department while meeting all aviation design criteria including the all-important airspace obstruction-clearance criteria. The site presented some challenges to build in an area that will be used throughout construction, and then link to the new hospital once it opens in 2013. We had to take into consideration the airspace clearance, existing structures, ongoing construction and most direct access to the Trauma Center. The first step was for the construction crews to prepare the site, which was to grade a small hill just 150 feet from the existing location.
With a nod toward overall community disaster preparedness, the new helistop is designed to accommodate aircraft as large as the Sikorsky Blackhawk, which is used by most military branches including the Coast Guard and National Guard. This allows the Medical Center to accommodate that helicopter for disaster relief in event of a major earthquake, wildfire, terrorist attack, airline or train accident, etc. Of course, the typical patient transports would be provided with much smaller helicopters locally by REACH, CALSTAR, Stanford LifeFlight and CHP.
Heliplanners assisted Sutter Health‘s project team by providing liaison and permitting assistance with the Federal Aviation Administration, Caltrans Division of Aeronautics and the Alameda County Airport Land Use Commission. We also assisted the project team with countless details related to construction of the helistop to ensure that, when completed, it would qualify for the Heliport Permit issued by Caltrans Division of Aeronautics during its final inspection. Caltrans inspected the helistop and issued the permit on October 27, 2009.
Heliplanners, based in Temecula, California, has assisted hospital, law enforcement, fire department and corporate clients with heliport development throughout the United States since 1987. In that time, we have been involved with well over 125 heliport projects in over 20 states. We congratulate Sutter Medical Center Castro Valley on the excellence of its approach to the entire hospital reconstruction project, providing a state-of-the-art medical center for Castro Valley residents.
Photo of the collapsed Cypress Overpass, courtesy of U.S. Geological Society.
by Cassandra Clark, Project Communications Director
This week we are commemorating the 20th anniversary of the Loma Prieta earthquake. The media will cover the remembrances, the progress we have made since then, the victims, the heroes.
Those of us who were around then have memories of this momentous event. My memories are perhaps much more vivid than most. That single event changed my life, changed my career, and ignited in me a passion for health care and the important work we do.
I had worked at Eden Hospital only 2 months when the earthquake hit. My boss was on vacation, camping in the desert far away from news of the quake, and I was a newbie just learning the ropes. I left work that day just before 5 to get home to meet some friends to watch the World Series. I was driving my VW convertible down Castro Valley Blvd. when the ground started shaking and the road before me started moving like a snake. I thought my tires were falling off and that the street lights above would fall on me! I drove the few minutes to get home, only to find the power out and the phones dead. So I headed back to the hospital to check in, as per our protocol
I didn’t leave the hospital for two days.
We had 42 patients from earthquake-related injuries that night in Emergency and Trauma. The worst were from the Cypress structure collapse in Oakland, brought to our Trauma Center. Not knowing the details, I went first to the Emergency Room, where I sat and listened to one young man talk about leaving his car on the collapsed upper portion of the freeway, climbing down the side of the concrete rubble, and then calling his mom to pick him up. He had an injury to his mouth and was shaken, but he told us the details of what happened. I still remember his face, his name, the shocking details of his story. The TV in the corner of the waiting room was showing news coverage from Oakland and San Francisco, and I got word out to the hospital staff so they would know what was happening.
We set up the Command Center sometime later. Soon, the reporters started showing up and the media calls poured in from all over the country, all over the world. Gloria, my co-worker, and I gathered information from every department, and talked to patients and families. As the spokesperson for the hospital, I conducted interviews for the next two days and, as it turned out, for many months that followed. I was so tired at 4 a.m. when Harry Smith from CBS New York called that I could hardly get the words out. It wasn’t my best interview, but I was new at this! We tried our hardest to keep all the information straight: how many patients, where they were from, what their injuries were. We had calls from families trying to find loved ones. We had calls from local residents wanting to know how to help. Reporters from other parts of the country were under the impression that the entire SF Bay Area was reduced to rubble, and they wondered how we could even take care of patients.
Over the next several days, I got to know so many of the patients and their stories. Some did interviews, some just wanted to talk privately. Some couldn’t talk, their injuries were so severe the nurses didn’t think they would survive. Two patients from one van on the Cypress freeway were the most severely injured, but they survived, and I remember them and their stories as if it were yesterday. I met their families and got to know them over the next six months or so. And I saw the incredible care that Eden Medical Center’s staff provided. The doctors, the nurses, the respiratory therapists, physical therapists, social workers: all of them played such an important role in their medical and emotional care.
It was because of this experience that I knew that I was in the right place, that the mission and purpose of our organization was alive and carried out in the most complex, and the simplest, ways. We all made a difference, and we were all here for one reason: to take care of the people who need us in the most critical times. It didn’t matter what our role was, we all had a responsibility to take care of them and their families. I didn’t check vitals or change dressings, but i could spend time with each of them, help them process what had happened, help them tell their stories if they wanted. I could help their families and our staff with simple things to make their lives there easier.
A year later, we held a press conference with a couple of the patients who survived, along with their doctors and nurses. It was an emotionally charged event, before and after the conference, for one patient in particular. The memories were so vivid and frightening, but she wanted, or perhaps needed, to talk about it, to see the trauma surgeon and staff, to process what had happened. Years later I saw her and her colleague on a PBS special, talking about their lives since the earthquake. My heart ached, and still does, for the pain they endured. Their lives were never the same. I don’t know where they are now, but I still think of them, pray for them, and wonder if they were able to persevere.
Five years after the earthquake, I met a woman who came into the hospital to give birth to twin boys. She, too, was severely injured in the earthquake and came to our trauma center that night. She had such severe abdominal injuries that she was told later by her doctor that she would not be able to have children. But life had other plans for her. On this day, October 17, 1994 — the 5th anniversary of the quake — she gave birth to her “miracle” boys. The trauma surgeon who saved her life 5 years earlier assisted in the delivery. They are 15 now, and I wonder if they know how incredible their story is.
These stories, and many others, are on my mind as we approach the 20th anniversary of the quake. It amazes me how much our lives are intertwined by such an event. And how each person I met has their own memories, and their own scars.
I am also grateful for the experience, for all that I learned as a result, and for finding my passion in my career. Today, as I work with the Project Team to build a new hospital, I am reminded why this project is so important. I am proud of the tradition of care at Eden, and proud to be working toward construction of a new hospital so that the tradition can continue for many years to come.
By George Bischalaney, President & CEO, Eden Medical Center
Health care reform is on the agenda, again. The stakes are high, but our President is determined to make some significant changes. As the discussion moves from general to specifics, special interests are staking out their positions. None of the stakeholders—hospitals included—wants to feel the impact or be at a disadvantage.
Amidst the demand for cost reduction and health care coverage for all, there is and must be continued investment in care. Physicians demand it. They expect to be able to practice with state-of-the-art equipment and facilities to produce outcomes that meet national, state and local quality standards. Patients demand it. They want to know that their local hospital has the right number of well-trained staff as well as the latest diagnostic and treatment equipment, and contemporary facilities.
With this backdrop of conflicting needs, Eden Medical Center is about to begin a three-year project that will result in the replacement of the Castro Valley hospital. The project cost is estimated to be $320 million. The current 55-year-old building is anything but contemporary. With few private rooms, small operating rooms and inadequate support space for clinical services, a new hospital is very much needed.
Eden Medical Center has served the community well, but it was not designed for patient comfort and needs, more for staff needs and functionality. While our project may seem ill timed given the uncertainty of hospital reimbursement, we are required to meet California legislated standards for seismic safety in hospitals. And it truly is needed.
We’ll celebrate our long sought goal with a ground-breaking ceremony on July 1st. Then we’ll spend the next three years continuing the investment in the new buildings and equipment, while observing and hoping that decision makers do not enact legislation that essentially penalizes us for the commitment we are making. When we celebrate the grand opening and our new beginning early in 2013, it should be with the same hope and dreams as those who celebrated the first ceremony in 1954.
By Jack Alotto, President & CEO of Eden Medical Center Foundation
My name is Jack Alotto. I am the President & CEO of Eden Medical Center Foundation. I’ve been raising money for non-profit organizations for more than 20 years in health care as well as the arts and social services. At Seton Medical Center Foundation in Daly City, we raised more than $1 million and increased Seton’s employee giving campaign by 600% in my first year.
I also started the first planned giving program for the City Library of Santa Clara, California. We even created a used bookstore and café called Friends of the Library—we made great cappuccinos!
For the past two years now, I’ve been steering the ship at Eden Foundation, and we are fortunate to have a very active board with 17 members, including Lawrence Dickinson, M.D., one of the top neurosurgeons in the East Bay and our board chairman.
All the money we raise helps ensure that patients and the community we care for have the most technologically advanced, highest quality care available. We pay for medical equipment, clinical training and continuing education for our staff, plus health education seminars for our community, and health care for our uninsured residents.
I’m proud to say that in the last two years we’ve raised more than $4,000,000, while keeping our costs surprisingly low. We owe our highest admiration and heartfelt gratitude to you, our patients and members of the community for your generous donations and participation in our special events. And a special thank you to our physicians and employees who give the Foundation tremendous support.
Take a look at the prolific list of equipment and community service programs your donations paid for last year. Donor Gifts Have Gone a Long Way in 2008…
With contributions from individuals, physicians and staff, corporations and foundations, Eden Medical Center Foundation has made the following gifts to Eden Medical Center:
Tools to Enhance Patient Care
• A new CT Scanner for San Leandro Hospital provides improved diagnostic services to inpatients and outpatients
• Laerdal Airway Management Training equipment for trauma nurses to sharpen their airway management skills through realistic practice
• Two blood pressure/pulse ox/temperature monitors keep triage equipment up-to-date
• Four new trauma monitors providing state-of-the-art monitoring of trauma patients to enable health care providers to have immediate and ongoing assessment of trauma patients
• An exercise bicycle at Laurel Grove Hospital helps rehabilitation patients recover more quickly
• A golf cart for Food and Nutritional Services provides prompt service to patients and reduce the risk of injury to employees
• New IV poles and wheelchairs help nurses and department staff to provide better patient care
• A new LCD/DVD supports ongoing training for Emergency Room and trauma staff
• Bladder scanners allow the neurology/medical/surgical unit and 5th floor surgery department to perform noninvasive monitoring for postoperative patients
• A JUZO Perometer in Rehabilitation Services enhances the level of patient care provided to lymphedema patients
• X-ray imaging is performed during vascular and orthopedic surgical procedures through the use of a radiolucent surgical table
• A pediatric bronchoscope is life-saving equipment trauma surgeons use to address breathing problems of children in the trauma center, thus saving a trip to the operating room.
• Radiology techs underwent training on the best use of the Toshiba Fluoroscopy and Multi-Purpose room to facilitate better patient care.
• Free senior flu clinics were held at San Leandro Hospital and Eden Medical Center
• A Women’s Health Symposium at Eden Medical Center provided an evening of free education on the health risks women face
• Eden Medical Center hosts five cancer support groups for patients and families facing cancer, caregivers and for people mourning a loss.
• Continuing education for nurses keeps Eden’s nurses up-to-date on the latest in health care
• Students at Skyline High School, San Leandro High School and Castro Valley High School go through the anti-alcohol and drug program, Every 15 Minutes
• Social Work Services provides shelter for transients recovering from a wound
• Support for Spiritual Care volunteers working in Social Work Services department
• GE Medical Systems Bone Densitometry Screening equipment allows Eden provide free screening at health fairs and community events
• Community members and Eden employees can take part in smoking cessation programs
• Emergency First Aid Guidelines assist local school staff members in responding to emergencies until medical staff can arrive.
Besides funding projects for our two hospitals in Castro Valley and San Leandro, we have taken on raising money for Sutter Medical Center Castro Valley, the hospital that will replace Eden Medical Center.
My vision is that once the doors open, our Foundation will pay for anything the new medical center needs! We have already started our fundraising efforts; last year’s Golf Tournament, which netted more than $60,000, was the first fundraiser on behalf of the new buildings.
So here is our wish list for Sutter Medical Center Castro Valley:
The Need: $25 million
Your generous contribution could provide technological and equipment updates so doctors and nurses can provide patients at the new Sutter Medical Center Castro Valley with the best in medical care. Advancements in technology for medical tools and equipment mean patients can experience less pain and discomfort, and doctors can perform less invasive procedures. This can translate into shorter recovery times and decreased hospital stays so patients can go home sooner. We constantly strive to improve a patient’s health care experience and state-of-the-art equipment and technology helps us to meet this goal.
Intensive Care, Critical Care and Trauma Center Upgrades
The Need: $15 million
Consider making a gift to help patients in intensive care, critical care and trauma comfortably and safely recover from surgery and other medical procedures. New beds, patient monitors, bedside equipment, and state-of –the-art nurse call systems will improve a patient’s stay and help doctors and nurses better attend to the needs of each patient.
Medical and Surgical Floor Enhancements
The Need: $6 million
Philanthropic support will help us purchase beds and other patient room equipment for Labor and Delivery, the Neuroscience Center and Medical and Surgical Units.
Outpatient Surgery Enhancements
The Need: $3 million
Higher image quality and patient comfort are combined in the newest tools used by physicians and nurses. Your generous gift will enable the Outpatient Surgery Department to replace older, outdated equipment with the latest technology at the new hospital.
We have many giving programs and named gift opportunities available to our donors. If you would like more information about our work at the Foundation and how you can support the new hospital, please call me at the Foundation office at 510-889-5033, or email me.
By Todd Peterson, Vice President of Information Technology, Eden Medical Center
My name is Todd Peterson and I’m Vice President of Information Technology at Eden Medical Center. Castro Valley has been my home for the past 26 years, and I’ve worked for Sutter Health for ten years, joining Eden 2 ½ years ago.
My team is responsible for making sure all computer systems are up and fully functioning 24/7; and while computer repair is a significant part of our business, we are responsible for implementing new technologies that are now vital to many aspects of our patients’ care.
One major project underway that will be a cornerstone of the new Sutter Medical Center Castro Valley hospital is Electronic Health Records (EHR), a project conceived when I was still at Sutter. Basically the new hospital is being designed with minimal use of paper. That’s right… no more clipboards and illegible handwriting.
The EHR will facilitate all clinical documentation and reporting; all medical disciplines will be recorded. What does this mean? Our physicians will get a full view of a patient’s care at any given time, from any location, once their patient has been admitted to the hospital. So the patient’s medical history as it relates to diagnostics, drug therapy, procedures, diet, rehabilitation and notes generated by physicians and nurses will all be available online. This also includes previous visits to any Sutter Health-owned facility or physician office.
The EHR will ultimately be integrated with biomedical technology. That means much of the clinical equipment in patient rooms—heart monitors, blood pressure cuffs, IV pumps, and even the beds themselves—will feed information directly into the patient records. With real time monitors of the patient’s vitals, a physician can be alerted if a trend in their medical condition warrants medical attention well before a critical threshold is met. So the EHR will be a documentation system and much more; it will provide clinicians with a wider view of what is happening with a patient at all times so they can quickly take action.
Patient records will also show a correlation of clinical events, a true cause and effect. For example, a physician may order medications in response to laboratory test results. Subsequent laboratory tests can then be correlated to the timing of the medication and will demonstrate the degree of effectiveness. This constant correlation gives the entire care team the information they need to deliver the best care at the right time.
The critical exchange between the doctor who is on call and the nurse on duty will also be enhanced by EHR. Without delay, a physician can access the patient’s record from home, while the nurse views the same information from a workstation in the patient’s room so rather than just rely on a verbal exchange they are both viewing the patient’s record.
One of the key benefits of EHR is patient safety. In the area of medication management, physicians will use computerized order entry to address legibility issues and alert the physician to any contra indications, such as allergies, food or other medications that the patient is on. The process of administering the drug involves the nurse scanning the barcodes on the patient’s wristband and medication bottles. The system will confirm the patient’s name, medication name, correct time, correct dose and proper route (oral, or otherwise).
We will provide full accessibility to patient data. All this information, all images, reports, etc. will be available at the patient’s bedside. Every patient room, alcoves between rooms and nurses’ station will be furnished with a computer workstation so patient records can be accessed throughout the hospital. Physicians will also have wireless devices such as PC tablets to provide the most flexibility and mobility throughout the hospital.
Down the road, our patients who see Sutter Health physicians will be able to see their own clinical results online; they’ll be able to email their doctors and arrange appointments, and more importantly, track their own history and take responsibility for their own health. We may even use EHR to work in concert with our county and state health departments to track health trends in the community.
The prospects for EHR are endless. Our patients and clinicians become real partners in the delivery of care over the long term.
Your input is very important to us. I invite you to ask me any questions about the EHR system by either commenting beneath this post (click on the title of the post, if you are on the blog’s front page, and you’ll see the comment box below), or by emailing me.
Sidney Wanetick, M.D.
My name is Sidney Wanetick. For 26 years, I was in practice as an OB-GYN in Castro Valley, and I delivered more than 3,000 babies at Eden Medical Center.
In 2008, I retired from practice to accept the position of Vice President of Medical Affairs at Eden Medical Center. Today, I serve as the administrative liaison between the medical staff and administration, helping to support our physicians as they provide high quality care to our patients now and as we look to the future of Eden.
In addition to other duties, I am actively involved in assisting our physicians in recruiting new physicians to the community.
I’m very excited about the new Sutter Health hospital that is replacing Eden. Several major benefits stand out. In particular, having all private rooms for patients will make a huge difference, bringing more services to their bedsides and giving them more quality time with their doctors.
From the physician’s standpoint, this is a much better way to take care of patients and have important conversations with family members in private, as well as offer patients the privacy and rest needed for recuperation. The nurses’ stations will have a view of every patient’s room for faster response to patient needs.
The whole atmosphere of the new hospital will feel less institutional and more supportive, soothing and restful.
Today, even though Eden has 176 beds, we are unable to utilize all of these beds. Most rooms are semi-private, with very few private rooms and even a few four-bed wards. Yet, we can’t put men and women together, and we can’t mix patients with infections in with the general patient population. So even though Eden is larger, the Sutter replacement hospital will end up with a much better capacity for utilization of services.
Moreover, we are seeing a steady decline in the number of patients admitted to the hospital for more extended periods of time. When I first started my practice we admitted twice as many patients for surgery as we do today. My patients stayed in the hospital for five days or more! Also, if patients were scheduled for surgery, they would be admitted the night before. Today patients often have surgery and are discharged the same day, or, if they are admitted, the average length of stay is much shorter.
In addition to the 130 acute care beds, we’ll have a 34-bed, multi-purpose Universal Care Unit (UCU), which also supports the shorter hospital stay. Let’s say an Emergency Room patient has been treated and needs to stay for observation, but not necessarily be admitted. He or she can rest comfortably in the UCU. Or, if a patient is recovering from same-day surgery, we could have him assigned to a UCU bed where he’ll get the attention he needs.
There will also be vast improvements in our information technology systems that just aren’t possible at Eden; our current system has reached capacity. With the new electronic medical records system, our clinical staff will have access to lab reports, x-rays, medication, etc., right at their fingertips. Recent studies have demonstrated improved outcomes and fewer errors in centers that have electronic records, and the new hospital will have innovative, secure electronic records and data systems.
I welcome your comments and questions. Please feel free to leave a comment by clicking on the title of this post (if you are on the front page of the blog), and a comment box will appear below.
By George Bischalaney, President & CEO, Eden Medical Center
Yesterday, one of Eden Medical Center’s neurosurgeons, Dr. Dickinson blogged about what’s in store for neuroscience at the new Sutter Castro Valley hospital. Coincidentally, Eden was also mentioned in an article in the AARP Bulletin on February 2, which it picked up from the Contra Costa Times.
The article basically said that the State of California through its Office of Statewide Health Planning and Development (OSHPD) had released statewide data on “hospital death rates.” This data has been collected for some time and the most recent release includes data for 2007.
Eden was identified as having a “Better-Than-Average” rating for patients who undergo craniotomies, which is a procedure for removing brain tumors. The statewide average was 6.7%, while the rate at Eden was measured at 0.7%. We were one of 25 hospitals, among 400 hospitals statewide, with better than average results, and one of only three in the Bay Area. These results do not come about by accident or good fortune.
Eden has been a designated trauma center in Alameda County for over 20 years. The experience and training of our trauma center staff has helped strengthen the services we offer in surgery, critical care, diagnostics, rehabilitation and general medical care. The methods used by the trauma center surgical team have carried over to every patient treated at Eden.
Building upon the trauma center’s effectiveness and with the support of Sutter Health, Eden established the Sutter East Bay Neuroscience Center several years ago. One of the mainstays of these programs is neurosurgery (brain surgery). Eden is blessed with a core of very highly regarded and skilled neurosurgeons as part of its medical community. It is because of their expertise and our joint commitment to excellence in neurosciences that we have been able to have such outstanding results with this critically ill patient population.
OSHPD has a website with a link to all of the recently released data (go to www.oshpd.ca.gov and click on AHRQ). OSHPD points out that this data is risk adjusted, to ensure that all hospitals are treated fairly and that evidence suggests that high mortality may be associated with deficiencies in the quality of hospital care provided.
Public reporting of hospital data will become more common, and its use by consumers greater over time so that they can be better armed when making important decisions about where to seek their health care services.
By Bryan Daylor, Vice President of Ancillary and Support Services at Eden Medical Center
Technology is critical to convenience & efficiency…
As I mentioned in my previous post, our collaborative team has been very focused on how we would use technology, innovation and design to improve work flow and increase efficiency. You may also want to read the previous post by Andrew Flanigan, Senior Planner/Designer with Devenney Group, the architecture firm for Sutter Medical Center Castro Valley.
For example, in our clinical lab today, we have clinical space that is not fully utilized. The lab was originally designed when equipment was much larger and therefore required more space. The current lab was designed as a “decentralized” service, meaning that different sections of the lab, i.e., blood bank, hematology, chemistry, microbiology, pathology were divided into separate areas. We have learned over the years that this concept is outdated, as well as inefficient to operate and impractical to rebuild.
The new “best practice” is to create a centralized service where the work flow is organized and instruments are closely aligned. In this type of design the work flow is much more efficient, and staff has fewer steps between tasks and can be much more expedient in processing specimens. Ultimately this increases turnaround times of critical test results for physicians and patients, and results in a better work environment for the staff. With the advances in technology, one person can do multiple tasks in one area using state-of-the-art instrumentation.
Another mechanism to provide efficiency and convenience for the patient is the new Control Center, located on the first floor close to high activity areas. The Control Center functions similar to an “air traffic control” room. It is staffed with a variety of people representing key functions within the hospital. The area is designed for maximum communication and collaboration among the teams.
There will be multiple computer screens that will provide large visual displays of the various activities and flow of resources—patients, staff and key equipment. Bottlenecks in processing and movement of patients through the care continuum will be readily apparent and the Control Center staff will be able to quickly resolve issues. This will allow us to be much more efficient as we’ll see problems before they occur. The computer monitors will show us bed status: full, vacant, ready for cleaning; patients scheduled and waiting for discharge; expected completion times for surgical procedures; ER patient flow status, etc.
What does this mean for patients? It means less waiting time, more convenience and more time for personal care. For example, the Control Center can monitor patient wait status to ensure no one waits too long for testing. The necessary alerts will be displayed to the staff so they can provide efficient service. If surgical cases are running late, staff will be able to more effectively plan so resources of the OR and other support areas will be efficiently utilized, including communication to other affected physicians, patients and families. We’ll know on a real-time basis if we’re not performing at optimum levels and what the barriers might be. This knowledge will allow us to take the necessary action—e.g., deploy additional resources such as staff or equipment, and return the hospital to optimum performance levels.
Patient-focused clinical flow…
We also looked at clinical flow, from the patient’s perspective. One of our major goals from the beginning has been patient-focused care, creating convenience and comfort for our patients. We have effectively eliminated unnecessary trips within the new hospital for both patients and staff, starting with pre-op registration and diagnostic testing before surgery.
In the new hospital once the patient is registered and accompanied to their suite, clinical staff will come to the room for laboratory and other portable diagnostic testing. The goal is to minimize the amount of travel and disruption for the patient. We are also putting more services at the bedside. Due to the new hospital design of all private inpatient rooms, which are larger than our current rooms, we will be able to deliver more therapies at the bedside. This is an improvement for both patients and staff.
Please email me if you have any questions about the internal layout of the new medical center, or feel free to leave a comment here. We welcome your input!
Q & A with George Bischalaney, President & CEO, Eden Medical Center
We recently had an opportunity to talk with George Bischalaney, President and CEO of Eden Medical Center, about some questions that have been raised in the local community about the number of beds that will be available for patients in the new Sutter Medical Center Castro Valley. This is part of a series of Straight Talk with the CEO blog posts we plan to publish, that began with Mr. Bischalaney’s first post.
The questions from the community are in bold, with George Bischalaney’s responses below:
Why will the new Eden Hospital have fewer beds than the current hospital?
The current hospital was built in the early 1950s, more than 50 years ago. At that time, rooms housing more than one patient were the then current design. Since then, we’ve learned that it’s much more efficient to have private rooms for everyone. It’s better for patients, since they are not exposed to the illnesses of others, and it’s better for families, allowing more space and time with their loved ones, and better for hospital staff in caring for patients effectively.
The new hospital will have 130 private rooms, each designed in way that brings as much care to the bedside as possible. The hospital overall will be more patient-centric, and the patient rooms will reflect this philosophy in their design and in the future delivery of nursing care.
Will 130 beds be enough for our future needs?
We believe 130 beds are sufficient to care for patients as we envision hospital services in the near future. Concerns I have heard generally compare the current bed count to the proposed bed count in the new hospital. The fact is that there is not the significant change that most people perceive.
The current Eden Hospital building has 178 licensed beds. However, many of these beds are apportioned into specialty services. There are patient rooms, or beds, dedicated to obstetric patients, psychiatric services and three distinct critical care units.
The new hospital will continue to have a dedicated obstetrics service, but will not have beds dedicated to inpatient psychiatric services. There is a greater demand for outpatient service, which we also provide and will continue to provide in the future. We will dedicate one complete floor to critical care in the new hospital. This change will allow us to concentrate our critical care clinical providers more effectively and they will work more efficiently as a result. This will not only help reduce cost but will also improve the quality of care for our sickest patients.
We will have 90 general medical/surgical beds, all in private rooms in the new hospital, compared to 111 beds in the existing building, of which the vast majority are in two bed and four bed patient rooms. Multi-patient rooms are much less flexible, in that we cannot mix genders, patients with infections, nor do we want to put patients in end of life situations with other patients due to the greater needs of these patients and their families. None of these factors come into play with private rooms, making them much more efficiently used and reducing the overall need.
Today, patients spend less time in the hospital than they did even a few years ago. Patients now have surgery and go home the same day. Patients have babies and go home in two days. In both these examples, it was not unusual for patients to spend five or more days in the hospital in the past. Our single patient rooms will be utilized much more efficiently and therefore, fewer are needed.
What if there is a natural disaster—will you be able to take care of the community?
Any natural disaster could overwhelm our ability to meet the community needs. This is true of any public service, be it fire, police or hospitals. However, we feel that we are still positioned to respond appropriately if needed. One reason we believe this is the addition of something entirely new to our community, a 34 bed Universal Care Unit. While these are not licensed hospital beds, and therefore, are not included in the count of 130 beds, they are single patient accommodations that can be used to care for injured patients in a disaster situation. For every day use, they are meant to care for patients who stay less than 24 hours in the hospital, or who need a period of observation following treatment in the Emergency or Trauma Services. Therefore in a disaster response, we would have 174 patient stations available, in addition to the standard capacity in the Emergency and Trauma Services.
But wouldn’t it be better to have more than we need, knowing this area is overdue for a major earthquake along the Hayward Fault line?
No, that would be wasteful. Consider this—it will cost $2.5 million in total project costs for each new bed built in the new hospital. We also know that an unused bed, or room, has ongoing costs in maintenance and upkeep. It is estimated by industry experts that unused beds in hospitals have an average annual cost of $322,000. This is expensive space to have, “just in case.” Let’s not forget that ultimately, it is you and I who pay for this. Whether it’s through direct charges from the hospital when we use it, or in health insurance premiums, the costs are passed through to the buyers of health care services. We have an obligation to the community to build what the community needs, but in an efficient and cost effective manner for today and tomorrow. Remember, you don’t build a church just for Easter Sunday.
Additional questions and comments are welcome, in line with our comment policy. We will make every effort to respond within a few days.