KEY FINDINGS/OBSERVATIONS

SITE VISIT TO REVIEW PHYSICAL PLANT

ADJACENCIES, EFFICENCIES AND ISSUES

 

September 19, 2002

 

 

 

 

As part of Garfield County Public Hospital District #1’s (Garfield)  current State planning grant, Health Facilities Planning and Development (HFPD) conducted an on-site review of acute, outpatient and long-term care operations in order to evaluate opportunities to improve operating efficiencies.

 

The following observations are a result of that review.  These observations are not listed in any order of priority:

 

 

ü      PT is currently located in “prime space” adjacent to the nursing home, but can be relocated as the space is not required to be co-located or adjacent.  In other words, no concerns were identified by staff in physically separating the PT space from the nursing home.

 

ü      The nursing home’s nursing station is undersized.  There is inadequate counter/work space for charting and other paperwork.

 

ü      Philosophically, the nursing home would like to transition to a more resident and family centered model (i.e.:  Mt St. Vincent, Seattle).  Ways to accommodate this transition should be explored.

 

ü      Improved visual and electronic monitoring/observation  of acute care patients, when the acute care nurses are triaged to the emergency room should be provided.  However, because of the relatively low acute care census, non-capital options should be explored.  Specifically, the current proposal to the State to allow a portion of the nursing home  beds to convert to swing bed status would directly address this concern.

 

ü      Creating separate and distinct areas of the hospital for inpatients and outpatients would be beneficial.  Currently, most patients, families and guests enter through the main hospital doors. Creating distinct areas for outpatient registration and waiting will reduce noise and patient traffic in the hallway, and provide compliance with federal patient privacy requirements.

 

ü      None of the inpatient areas have piped in suction or oxygen.  In addition, the HVAC system is inadequate, at best. 

 

ü      Central supply and equipment storage are somewhat remote from the acute nurses station.  Opportunities to consolidate (or relocate some) CS closer to the acute nursing station should be explored.

 

ü      The building is lacking in conference, storage, education  and  office and workspaces for staff.

 

ü      The efficiencies (cost reductions) associated with relocating the Clinic to the hospital proper will be explored.  The clinicians did express reservations about being “on-campus”.  These reservations related to becoming “inefficient” during clinic times, if hospital staff become too demanding and request multiple interruptions.  The concerns of the clinicians should be explored prior to any decisions being rendered. 

 

ü      If Garfield opts to convert it 25 nursing home beds to “swing bed” status—this will simply be a paperwork change; a change made to maximize current reimbursement.  From a staff and community perspective, it should be viewed as “business as usual”.

 

 

Next Steps:

 

1.      Finalize options for future service delivery.  Understand and finalize licensing and reimbursement implications/options.

 

2.      Conduct analysis of operating cost savings.

 

3.      Present to Board