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 services. Both of these facilities share essentially the same market along with a competitor 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.
KEY PLANNING ISSUES
Ocean Health contracted with a facility planning consultant to help its leadership to develop a clinical service realignment plan based on an evaluation of key 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, computer tomography (CT), nuclear medicine, and non-invasive cardiac diagnostics.
PROPOSED FACILITY CONSOLIDATION PLAN
As illustrated in the figure below, a new 210-bed hospital is planned with a community hospital focus and “centers of excellence” in obstetrics, cardiology, and cancer care. Valley Hospital will maintain inpatient, subacute, rehabilitation, psychiatry, and outpatient services with the older 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 focus and Coast Hospital will be demolished and the land sold off to a local developer for an alternate use.
A reduction in the need for expensive procedure rooms and treatment spaces — and corresponding equipment and staffing — is anticipated with the consolidation of the Valley and Coast Hospital acute care services into a single new, efficient facility. The elimination of six emergency treatment bays, three diagnostic radiology rooms, one CT scanner, one nuclear medicine camera, and two operating rooms — to accommodate the same or greater number of procedures — has significant cost implications both on the initial capital cost of new construction and on long-term operational costs.
COMPARISON OF EXISTING AND NEW SPACE
The construction of a new, efficient facility results in significant space reduction. Prior to construction of the new facility, Coast Hospital and Valley Hospital together utilize 532,000 building gross square feet (BGSF). The new facility will require only 340,000 BGSF with 80,000 remaining at the existing Valley Hospital site to accommodate post-acute, rehabilitation, and psychiatric services. With Coast Hospital closed, a total of 420,000 BGSF will be needed to accommodate the same or higher workloads compared to the existing 532,000 BGSF. This results in a savings of 112,000 BGSF (21 percent reduction).
[This Case Study was included in Healthcare Facility Planning: Thinking Strategically (second edition) by Cynthia Hayward where you can find the proposed clinical service realignment plan and details on the space impact of consolidation.]