Thursday, 19 September 2013 00:00
As almost everyone is aware, there are major changes underway in the way health care is delivered and financed. The scope of this transformation is national, regional and local. No entity, hospital or healthcare organization can avoid the impact of these developments, whether we like them or not. Without the need for elaboration, this is the relevant context of our ongoing discussions about the current circumstance and future plans for Glen Cove Hospital. The following is intended to provide further clarity with regard to Glen Cove and builds on our previous discussions. I have divided the following into two components: A). a general contextual overview, and B). a description of how Glen Cove Hospital will continue to serve the needs of the community.
• Glen Cove Hospital has been serving its community with competence, compassion and commitment for over 90 years – a remarkable and proud history.
• The goal and commitment of North Shore-LIJ, wholeheartedly supported by the community, is to build on that history, continue that commitment and preserve Glen Cove Hospital as a robust and essential asset, serving the needs of the Glen Cove community now and into the future.
• There is no plan or intent to close the hospital.It is imperative that this be understood by the community and its leaders.
• However, given all the changes affecting health care and the iron-clad commitment to maintain the facility as a successful enterprise, changes are necessary. Too many hospitals across the New York area (13 in recent years) and the nation have closed because of a failure to anticipate, adapt and evolve. This must not happen to Glen Cove.
• Maintaining the hospital as-is has proven to be unsustainable – despite all best efforts. It is worth noting just a few facts:
• Overall inpatient volume continues to decline and will continue to do so.
• Some of the services common in a “full-service” hospital already have been closed (e.g. obstetrics and pediatrics) because of declining volume.
• More and more care that was once provided in a hospital is now provided outside the hospital – and with better results. This has greatly reduced the need for beds. Current and future state and federal policies penalize hospitals for admitting patients who should not be hospitalized.
• A significant portion of the building is currently under utilized.
• A significant portion of Glen Cove residents do not use Glen Cove Hospital. They go elsewhere for their care, such North Shore University Hospital, St. Francis, etc.
• As we transition to a facility that will meet the community’s future needs, we have committed that all affected employees will be protected and offered jobs elsewhere in the North Shore-LIJ Health System. This, of course, protects family income and the economic base of Glen Cove.
• Glen Cove Hospital will be a model for how a hospital (with its proud history) can adapt and change as we enter a new era of health care delivery. Local residents will be proud of the new facility we develop.
• The “New” Glen Cove Hospital will be a demonstration of how to enhance services to the community by providing or being the catalyst for a broader array of community based services.
B. The Future Plan
While discussions and input on the transition are not complete or final, it is important to outline what the facility will include.
• Emergency Services: The Glen Cove Hospital Emergency Department will continue to provide 24-hour access to board-certified emergency physicians, as well as specialty trained nurses and other staff. Services will be enhanced, not reduced.
• As is the case currently, patients who present at Glen Cove Hospital requiring diagnostic or interventional cardiac catheterization, cardiac bypass surgery, complex neurosurgery, etc. will be evaluated, stabilized and then transferred to another hospital.
• The Emergency Department will continue to serve patients with behavioral health conditions, and connect patients to home care and their primary care physician.
• There will be a special emphasis and focus on the needs of the elderly – a major priority in the Glen Cove area.
• Ambulance transport (as is the case today) will be on 24/7 standby to ensure rapid transport when necessary.
• Inpatient Care: The hospital will continue to maintain a number of inpatient beds to meet the essential needs of the community. Typical conditions that we treat in-house today include such diseases as pneumonia and gastritis. Our ability to treat those conditions will be unchanged.
• For patients requiring a shorter period of treatment or observation, a short-stay clinical decision unit (CDU) will be established. This unit will allow clinicians to monitor their patients longer than a typical emergency room visit, ensuring that their condition is properly evaluated before they are treated and discharged.
• The total number of beds will be dictated by need and may fluctuate over time.
• Ambulatory Surgery: Glen Cove Hospital will continue to perform a small complement of ambulatory surgical procedures. Various subspecialty practices, including podiatry, ear nose and throat, and others, are in discussions with our clinical and administrative leadership to establish an operating room presence. Ambulatory endoscopy services will continue to be provided within the hospital.
• Hospice Care: The hospital currently has a hospice presence, providing care to patients at the end of life (most hospice services are home-based). We are currently working with Hospice Care Network to increase our presence in the Glen Cove community through a combination of increased hospital as well as home based programs. Other palliative care enhancements will be introduced as plans solidify.
• Cancer Services: Outpatient cancer services delivered in the Don Monti Cancer Center will continue as they exist today.
• Chemotherapy infusion is currently performed in a five-chair unit at Glen Cove Hospital – this will continue. Radiation medicine services will continue to be performed in the state-of-the-art linear accelerator at Glen Cove Hospital for radiation oncology patients.
• Community physicians will continue to be available to their patients as they are now.
• Outpatient Therapy: Glen Cove Hospital has a long tradition of providing excellent physical rehabilitation services. Once again, the demographic profile community calls for this to continue.
• Physical and Occupational Therapists who currently treat community residents in the hospital’s Wunch Center will maintain their presence. Treatments for orthopedic injuries and neurological conditions will continue to be available. Home-based therapy services will also be available through the North Shore-LIJ Home Care Network.
• Respiratory therapy services will also be offered on-site and in the community through the geriatric medicine leadership based in the hospital.
• Family Medicine: The North Shore-LIJ Health System has a proud tradition of offering care to all members of the community, regardless of their ability to pay. The Family Medicine practice at Glen Cove Hospital carries on this work every day.
• General primary care services will continue to be offered, including prenatal care, behavioral services, pediatrics, immunizations and sexual health.
• The connection of this program with hospital care will continue through Glen Cove Hospital’s menu of services, in addition to North Shore University and Huntington Hospitals.
• Dental medicine services will continue to be offered.
• The advanced imaging center at 10 Medical Plaza will continue to offer imaging services such as CT scan, MRI and general X-Ray.
• Home-Based Services: Part of our commitment to the residents of Glen Cove includes highlighting our presence in the community through our robust offerings of home care and house-calls program, and solidifying our relationship with the local skilled nursing and assisted- living facilities. Robust planning is currently underway with our local medical and administrative leadership.
• Increased access to home nursing, therapy and health aide services will be provided by emphasizing community based discharge planning in the hospital. Patients will be offered a variety of home care services by North Shore-LIJ or the agency of their choice. Discharge planners, case managers and social workers will be available throughout the continuum of care at Glen Cove Hospital. This includes the inpatient beds, the emergency room, as well as the family medicine practice.
• North Shore-LIJ Home Care also offers a Geriatric Care Manager Service through its Circle of Care Program. Geriatric care managers provide a range of services to patients and their families, including health advocacy and referrals for other hospital treatments, home health needs, transportation, elder law, financial planning and others.
• Increased home-based hospice services will complement our existing in house beds.
• Other Services: As discussed at some of the meetings I have been having with local elected officials, we are reviewing whether there are opportunities to deploy other services and some back-office functions to Glen Cove to take advantage of the large, unused space currently in the hospital. While we have no specific plans currently, the evaluation process is continuing.
We will continue to work with local elected officials, community leaders and local physicians in a collaborative, reasonable manner to meet the current and future health care needs of the Glen Cove community.
Michael J. Dowling
President & CEO