Case Study: Consolidating Two Acute Care Hospitals

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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.

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Rethinking the Intensive Care Unit

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Many hospitals feel that they never have enough intensive care beds and are constantly pressured to expand existing units or create new units. Historically, intensive care units (ICUs) have provided intensive observation and treatment of patients in unstable condition. Because of the high-tech requirements and highly skilled staff, these units are expensive to build and operate. Insufficient intensive care beds also affects the ED, as high-acuity patients waiting to be admitted backup in the ED when the ICUs are full.

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Vascular Centers Are Addressing an Unmet Demand

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Historically, hospitals have focused on growing their cardiology programs and services that treat atherosclerosis, or hardening of the arteries, and other heart conditions. However, it is becoming increasingly evident that programs to address systemic vascular disease ― cerebrovascular, carotid, aortic, and peripheral vascular are needed to address a growing and unmet need. The National Institutes of Health (NIH) reports that non-coronary vascular stenosis and arterial breakdown is a prevalent disease in the United States. Up to 12 million people are estimated to have peripheral arterial disease (PAD) compared to the same number (12 to 13 million) with coronary artery disease (CAD). With the emphases on CAD as a serious health problem in the U.S., vascular disease is more often under-diagnosed and as a result is frequently under-treated.

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TUG Robot Is Working Harder Than Ever

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TUG RobotThe autonomous mobile TUG robots, developed by Aethon, work 24/7 to deliver drugs, laboratory specimens, supplies, linens and meals and cart away medical waste, soiled linens and trash at a variety of medical centers throughout the U.S.

The TUG robot has a map of the hospital stored in its memory and uses a scanning laser and 27 infrared and ultrasonic sensors to detect and model the environment in real time to maintain accurate position and avoid obstacles. It stands back from elevators and summons them through the hospital’s wireless network, using radio waves to open doors. It even audibly speaks while performing its tasks and automatically returns to its charging dock after completing a delivery. The UCSF Medical Center is deploying a fleet of about two dozen TUG robots at its new state-of-the-art hospital at Mission Bay in San Francisco and TUG robots are installed at 35 VA hospitals.

This article is an update of a previous post.

See the TUG robot in action.

What 19th Century Technology is Still Thriving Today?

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Pneumatic TubesEvery day, all around the world, hospital staff turn to a transport network that the Internet and the latest Silicon Valley wizardry cannot match — the pneumatic tube system. Designed primarily to move paper, this cutting edge technology in the 19th century drove commercial businesses — such as postal services and department stores — whose physical size demanded something faster than standard human pace. With the arrival of the Internet, pneumatic tube systems lost their value for many industries. But this technology not only endures — but thrives — in hospitals, particularly with the introduction of wider diameter containers and use of air flow to slow down the containers for a soft landing at their destination stations so to avoid damaging sensitive lab samples.

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Centers of Excellence: A Hub and Spoke Approach

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Center of ExcellenceFor several decades, healthcare organizations have been developing Centers of Excellence to better compete for market share, research dollars, philanthropy, and scarce subspecialists. Promoting a specific program within the healthcare organization’s broader portfolio of services helps to attract the critical mass and resources required to make it successful. Centers of Excellence are commonly developed for cardiac care, cancer treatment, neurosciences, orthopedics, pediatrics, and women’s health, although various other clinical programs and specialties may also be candidates. Historically, these centers were envisioned as freestanding facilities with the name prominently displayed on the building’s facade. Before high-speed internet and intranet connections, this concept was promoted to improve collaboration and communication among the healthcare providers as well as to provide one-stop-shopping for the customer.

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