Sutter Health, Eden Medical Center
Straight Talk with the CEO

Straight Talk from the CEO
By George Bischalaney, President & CEO, Eden Medical Center

hello-eden

Since the early stages of planning to replace Eden Medical Center, there’s been a lingering question on people’s minds: what name will the new hospital carry? All of the initial planning and building documents have used the name Sutter Medical Center Castro Valley, and the reference has stayed with us through construction and even on this blog site.

We were well aware that many people in the community, and certainly within the Eden family itself, were disappointed at the prospect of losing the original name

The name Eden has been connected with the hospital since it opened in 1954 has come to mean so much for the thousands of people who have been treated here for illness and injury, who delighted at the birth of a child or participated in our events and classes. For the thousands of employees, physicians and volunteers here, the name Eden is as familiar as family..

So, today I am pleased to tell you that the name will continue. Eden Medical Center will be the name of the new hospital when it opens.

I share in the excitement of this conclusion, because of what it has meant and continues to mean to our community. There is a history here that cannot and will not be erased, and a legacy will be passed on to future generations to continue the excellent and compassionate care that you have come to expect.

by George Bischalaney, President & CEO, Eden Medical Center

patient-room

A recent article about the new hospital construction asked readers the question, “Is the hospital too lavish, or is the new hospital just a reflection of modern times?” The reason the question was raised, from what I can gather, is because the new hospital will have all private rooms. This is a marked difference from our 1950s-era hospital that has mostly two-bed and some four-bed wards, shared bathrooms and a curtain for privacy.

When we began designing the new hospital, one of the first questions we asked ourselves was whether or not there would be all private rooms. It wasn’t a long discussion, and the answer was quickly determined to be yes.

The existing hospital, with its multi-bed rooms, is how hospitals were designed in the late 1940’s and early 1950s when Eden Hospital first opened. Sixty years later, the thinking regarding rooming of patients has evolved, just as every other aspect of hospital medical care has evolved.

There are compelling clinical reasons why hospitals across the country are converting to private rooms. Highest among these reasons is infection control. One can pick up any magazine or medical journal and read about the growth of bacterial adaptation to antibiotics over the past decade. In hospitals, there is an ever-increasing need to isolate infectious conditions that create a risk for other patients. Any such high risk patient requires a private room for better management of their illness and also for the safety of other patients and protection of hospital staff. This happens daily in our hospital, and it means that a two-bed ward then becomes a private room, decreasing the number of actual beds available for use. (See previous articles about the effects on comfort, efficiency and increased capacity.)

There are equally significant social needs for private rooms. Patients who are critically ill, injured or at the end of life often have many family and friends who want and need to visit for extended times. It is appropriate that these patients have privacy for the comfort of the family as well as for other patients and visitors.

Privacy and comfort are also compelling reasons for private rooms. Federal regulations to protect a patient’s privacy have changed how we design interiors and how we communicate with patients and other caregivers. But aside from being a regulatory requirement, privacy is a practical consideration every patient should have. This is very challenging to maintain in a room with two or more patients who are separated by nothing more than a thin curtain. In fact, across the country, the demand for private rooms isn’t driven by the perception of “luxury,” but by the need for privacy, dignity and respect.

There seems to be an outdated and misguided view that a private room is only for VIPs, those who can pay more, or those looking for luxury accommodations. There was a time when this may have been the case, but it is no longer true. At Eden, there is no added cost burden to a patient in a private room. And when the new hospital opens, there will be no fee or increased cost to any patient to be in a private room.

I can fairly assume that those who raise a concern about all private rooms have not been hospitalized themselves, or have never experienced a loved one at end of life in a patient room with one or more other patients. In talking with patients and families in the hospital, I have never been told that the single room was not preferred. It’s clear that people prefer privacy (see Washington Post article).

Our patients will benefit, and I believe they will be much happier as a result of the new hospital having all private rooms.

Employees enjoy the Groundbreaking Ceremony

By George Bischalaney, President & CEO, Eden Medical Center

It’s finally begun! Twelve years of planning, ten years of actively working, and finally, ground was broken on Wednesday July 1, 2009, for the new hospital on the Eden Medical Center campus. It has been an extraordinary effort by so many to get us here. Persistence, patience and untiring efforts have paid off.

The first phase of work involves relocation of the helipad, a necessary step to clear the way for development of the hospital and medical office building. It will be challenging throughout and very difficult at times.

The immediate impact is loss of on-campus parking. Not a lot, but unfortunately in a place where it is needed. This work is occurring adjacent to the Emergency and Trauma Services entry points. Ambulance bays remain accessible and the existing helicopter landing site remains functional throughout this phase. Parking for patients and visitors is affected and will be relocated a couple of times as work progresses.

Already there is activity in other areas of the broader construction zone. An apartment building facing Stanton Avenue was reduced to rubble in a matter of two days. The neighborhood is experiencing the onset of three years of traffic associated with the project, as debris is removed and equipment and supplies arrive.

Work was temporarily interrupted and the worksite cleaned up for a brief but well received ceremonial groundbreaking event on July 1. Employees, physicians, the project team and Eden Medical Center as well as Sutter Health leadership officially christened the site with the photo-op tossing of dirt. It was an exciting moment for those who have waited to so long for this day.

As the work progresses, our official site for tracking the work will keep those who check in up to date. And coming July 20, there will even be a webcam for viewing the work as it proceeds.

Let us know if you have any questions or comments.

George Bischalaney, President and CEO, Eden Medical Center

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.

George Bischalaney, President and CEO, Eden Medical Center

By George Bischalaney, President & CEO, Eden Medical Center

On May 12, 2009, the Alameda County Board of Supervisors deferred action on the Environmental Impact Report (EIR) and related actions needed to begin the redevelopment of the Eden Medical Center campus.

The delays were for the most part caused by the late submission of information from a group opposing the approval.  Their opposition stems from a misguided effort to link the future of the San Leandro Hospital to the future of the new Eden campus hospital.  Opponents contend there is a nexus in the decision making as well as an unaddressed impact to the new Eden hospital.

Our initial assessment is twofold.  First, the future of each hospital is distinct from the other.  The Board of Supervisors’ actions regarding the Eden redevelopment will not affect the decision process to determine how the San Leandro campus will be used in the future.  Secondly, there was very little or nothing new in the comments that actually addressed the EIR itself.  Hopefully, the Board will draw the same conclusion and move forward with the needed approvals on June 9th.

Eden Medical Center
has been the designated trauma center for Southern Alameda County for more than 20 years.  It has served thousands of patients over that time, including victims of the 1989 Loma Prieta earthquake that shut down the Bay Bridge and collapsed the Nimitz Freeway in Oakland.  It is absolutely critical that Eden is replaced as soon as possible.  Earthquakes, like all natural disasters, are unpredictable. People will rightfully ask why we weren’t prepared if avoidable delays in preparing for the inevitable are not overcome.  We have a need to rise above politics and special interests to meet a greater obligation of the health and well being of the community of being served.  People of good will and with good intentions can do so.  Let’s hope we see this kind of sentiment on June 9th.

You can take action and sign a petition to the Board of Supervisors and urge them to stop delays and vote yes on the EIR.  Please take a moment to sign the petition at the link below.

http://www.thepetitionsite.com/1/rebuild-eden-medical-center

Thank you for your continued support of the new hospital.

George Bischalaney, President and CEO, Eden Medical Center

 

By George Bischalaney, President & CEO, Eden Medical Center

Last week, the Obama Administration kicked off its efforts to address one the President’s stated priorities, health care reform.  What does that mean, and what will be the result? I wish I really knew.

According to the President’s advisers—and Obama himself during the campaign—there is a need to extend health care coverage to millions of uninsured people across the country, while reducing cost and improving quality. Truly admirable goals with which very few could disagree.

Early discussion of President Obama’s plan calls for creating a savings of $634 billion over the next ten years to help fund reform. A recent article referred to this as a “down payment” on the overall expected costs. About half of this amount is targeted to come from reduced payments to Medicare and Medicaid (known as Medi-Cal in California) providers. On the surface, this is a disquieting concept.

Not too long ago, Eden Medical Center was recognized as one of lowest cost hospital providers in California. It should be no surprise that our costs have risen over the past few years. We have invested heavily in new equipment, both in medical technology and information technology, in order to continue to bring state-of-the-art services to our communities, and to provide our physicians and clinical staff the best tools to diagnose and treat our patients.

Last year, our labor settlement with registered nurses resulted in a three-year agreement that will give the nurses a 20% wage increase over the term of the agreement in addition to improved benefits. This kept our wages comparable to other local hospitals.

One of the benefits Eden Medical Center employees enjoy is a fully paid health plan for themselves and their families. Last year, the average cost was approximately $22,000 per year for an employee and family.

Despite these costs, Eden remains one of the lowest cost providers when compared to peer groups throughout the State. But as can be imagined, it is difficult to contain costs in our environment, especially when 60% of our costs are employee-related expenses. We are, after all, a service industry that is people- and technologically-driven.

The early announcements about health care reform create some concern. To expect to realize the savings needed to fund the plan through reduced payments to health care providers is very troubling.

Physicians are increasingly affected by efforts to reduce reimbursement. Many physicians talk of extending their days, working longer hours, much of which is devoted to the increasing amount of paperwork demanded from them. At the same time, we as patients expect them to remain current in the knowledge of new drugs and treatments in order to serve us to the best of their ability. This is resulting in a shrinking primary care base at a time when our population is aging. How does the plan for reform intend to address this?

Government payers of healthcare services for hospitals—the Federal Government for Medicare, and the State for Medi-Cal—are not paying the full cost of care at the present time. For each patient that is covered by Medicare or Medi-Cal, the cost to care for that patient exceeds current reimbursement. Further reductions will increase the gap that is, out of necessity, made up by insured patients—those lucky enough to have coverage through their employers. This is a cycle that needs to be broken if we are to have true health care reform.

The problems with our health care system are very complex. Reducing payments in an attempt to reduce costs will not yield the full reforms that are needed. I can only hope that this is not another piecemeal approach to change. A broader view of the systemic issues is needed. With the President’s staff talking about implementing reforms by the end of this year, it is questionable as to whether or not this will actually occur.

As always, your questions and comments are welcome. We will respond as quickly as possible.

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.

George Bischalaney, President and CEO, Eden Medical Center

By George Bischalaney, President & CEO, Eden Medical Center

This past year was another busy year for our elected representatives, passing another bevy of bills that will impact hospitals and other health care providers. In every case, I have no doubt, each bill was written with some positive motive; to provide better access to health care services, to help control or reduce costs, to protect confidentiality or a patient’s right of choice, or in some cases mandating policies or practices that are costly to implement and monitor and may have a questionable cost benefit to patients.

But will more legislative remedies to the extremely complex and already cumbersome system of health services in California actually improve the patient care experience? One has to wonder.

In most service industries, the consumer helps direct change by withholding use of a service that doesn’t meet his/her needs. This is not as easily done when someone needs medical care. Yet the consumers, our patients, speak to us through direct communication and through their responses to the surveys we send. What we need to do is listen more attentively and respond more appropriately.

At Eden Medical Center we randomly send out surveys to patients who have been hospitalized, patients who use our mental health services, patients who have surgery and leave the same day, and patients who use the Emergency Department. We ask about every aspect of their experience, from the time they are registered through their discharge from the hospital. This includes physician and nursing interactions, quality of food and housekeeping, and the staff that drew blood or took an x-ray. Patients or family members are also invited to write comments, good or bad, and tell us anything else they think we should know about our services.

Hospitals are for the most part, stops of last resort for all. People come here already laden with apprehension, uncertainty and even a certain amount of fear. They have seemingly little or no control over what is about to happen to them or their loved ones. It is our job, our responsibility, to care for them as we would members of our own family.

If more legislation is needed to encourage us or force us to care for patients as we would our own family members, then we deserve what is given us. However, if we truly listen to our patients, our customers, and respond as a service industry that needs to be attentive to the needs of its customers, the industry would be vastly improved in terms of quality care and the patient’s experience. What more is really needed?

As always, we want to hear what you have to say. Please feel free to comment or ask questions in the comment box beneath each post, including this one. We will respond as quickly as possible.

George Bischalaney, President and CEO, Eden Medical Center

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.

By George Bischalaney, President & CEO, Eden Medical Center


The Next Generation Hospital. The new Sutter Medical Center, Castro Valley.

Hello, and welcome to our new Sutter Medical Center Castro Valley blog. As CEO, I want to introduce our new blog site and invite you to participate in conversations with us as about the new hospital and medical office building that will replace Eden Medical Center in Castro Valley. I’m very excited to be able to share information and engage with you as we create a state-of-the-art medical complex from design, through the regulatory approval process and finally through each phase of construction, up to the opening in early 2013. It is a long, exciting journey and I look forward to taking you along.

It is clear to us that we need to hear from you, our extended community—patients, neighbors, employees, physicians and business partners—in order to help us meet our goals. We know that many of you who are reading this blog will have strong opinions you would like to share with us. We too feel that communication should not be only one-way. We believe that all of us are more effective when we work together and collaborate to solve problems, address questions openly and discuss issues of importance to the entire community. After all, this is your community hospital and medical center, and we are here to serve your health needs as well as we possibly can. This is our primary goal.

To fulfill that mission and our pledge to include the community in building a medical center that will serve everyone’s needs, we have launched a Social Media outreach program using the Web to not only keep you informed, but to give you a chance to interact with us so we can address your questions and concerns. Our blog will serve as your Internet “headquarters,” where you can find updated information and links to our main Eden Medical Center web site, plus links to other popular online social networks where we have started groups and online communities for further discussion about the new medical center.

Through a variety of social media tools, including our blog, Internet video clips, podcasts, popular social networks such as Facebook, LinkedIn, MySpace, Twitter, YouTube, Flickr, FriendFeed and others, you will get regular updates on our progress, plus you’ll have the opportunity to comment back, ask questions, and give us your opinions and perspectives. You’ll be able to converse with hospital administrators, the architects, our Social Media project team, clinical staff and other key people from Sutter Medical Center Castro Valley. We’ll feature posts from guest bloggers, as well as podcast and Web video interviews.

By the way, we did a survey about the community’s use of social media and social networks, but if you did not know about it before, your input is still very valuable to us. You can still take the short, fun Social Media Survey.

We would love to know if you are aware of other social or online neighborhood networks that we may not have covered, such as a Yahoo, Google, AOL or Ning groups. If so, please let us know. We would be glad to participate on already existing online neighborhood, business or other networks to provide information and discuss relevant matters with your communities.

To date, much of the work in bringing our vision to reality has been behind the scenes. Our design team has worked closely with physicians, employees and medical center trustees to help envision our future campus. In the very near future, we will have more detailed exterior images that highlight the buildings and the campus changes. Much of this is still subject to refinement to meet local and State approvals.

We invite you to subscribe to our blog by email or RSS feed…please note the box above, where you can enter your email address, or you can click on the orange RSS symbol above it to subscribe in an online reader (such as Google Reader). Your email address will remain private and will not be shared with other organizations for commercial purposes. If you subscribe, you’ll be alerted by email or in your reader whenever there is a new post to read on our blog.

If you want more information about Sutter Medical Center Castro Valley, you can find basic information on our About page.

For healthcare information, please visit our main web site.

Thank you for visiting, and please feel free to leave a comment or question in the space below. We’ll be glad to respond within a day or two.

George Bischalaney
President & CEO
Eden Medical Center


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  • Welcome To Our Blog

    We have launched a Social Media outreach program, using the Web to keep you informed about our progress in building the new Sutter Medical Center Castro Valley, a Sutter Health affiliate, which will eventually replace Eden Medical Center. We want to provide you with a forum to interact with us so we can address your questions and concerns.

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