Opinion

Cause of hospital’s deficit has nothing to do with patient count | Guest commentary

I have been privileged to serve as the chief nurse for Whidbey General Hospital for the past 18 months. With an exceptional team of administrators and staff, I have worked to build a patient-centered, technologically sophisticated and fully integrated care delivery system.

I came to Whidbey after 40 years of executive leadership in some of the most respected hospitals in the world, as an advanced practice nurse, retired Army Lt. Colonel, university professor, consultant and with a PhD in Health Policy and Management.

From this perspective, I would like to respond to some badly misinformed opinions expressed in recent letters to the editor.

First, like 72 percent of all community hospitals in the nation, Whidbey General has run a deficit for the past year because we implemented the federally mandated Electronic Health Record (EHR).

An audit last month states that without that one-time investment, WGH would have had a positive bottom line. In addition, sequestration has resulted in a 2 percent reduction in reimbursement.

As a result, the hospital is paid 99 percent of costs, not charges, from government payers, resulting in payments lower than costs to operate this year. We provided several million in charity care last year, much more than we received in tax support. No private hospital would serve this important mission.

Some believe WGH should be sold to a private hospital group. If that occurred, the “wallet biopsy” is the first procedure patients would undergo in the ER. Patients without financial means would receive minimal screening and be sent elsewhere.

Decisions about healthcare on Whidbey would be made at far off corporate headquarters. Unprofitable but essential services like infusion therapy, provided through our award winning cancer program, would be cut. Staffing would be slashed to maximize shareholder returns — not to the meet community needs.

Contrary to Dr. Richard Wagner’s assertions in his Sept. 25 letter to the editor, the deficit has not been caused by caring for fewer patients. The hospital’s surgical volumes are the highest they have been in five years, allowing us to serve more than 3,000 patients in our operating rooms over the past year. Inpatient volumes are the highest they have been since 2004. We frequently reach maximum inpatient capacity.

More than 18,000 patients annually are served in the emergency department by board certified emergency medicine physicians and nurses. Contrary to the notion that we are a “first aid station,” hundreds of our neighbors owe their lives to highly skilled professionals in our Level III trauma center. Our 80 slice CT supports an innovative Telestroke program that provides rapid evaluation by stroke specialists at Swedish Medical Center.

Our level I cardiac center can optimally treat 90 percent of cardiac patients and provide follow-up care for the rest in our clinics.

Some allege that not providing highly specialized interventional procedures like open heart surgery render the hospital unnecessary.

In reality, if a hospital does not perform large volumes of these procedures, it is not in the best interest of patients to offer them.

Evidence shows that hospitals performing few complex procedures have much poorer outcomes.

Such procedures should be regionalized. Whidbey’s population does not support the minimum numbers to perform these procedures.

Our patients are best served by long-standing partnerships with the best tertiary providers of these procedures.

Single patient rooms are a necessity and have been the standard since 2005. New construction would not be approved otherwise. Medicare coverage is the same whether a patient is in a single or double room. Medicare pays based on allowable costs for a diagnosis and there is no additional cost for patients.

Every day I have to move patients from room to room to accommodate clinical conditions that require a single room for medical necessity.

This week, 30 percent of double rooms were occupied by patients whose condition prohibited them from sharing a room. Five of those patients had an infectious disease and three had serious mental health conditions, making them a threat to others.

This effectively took 16 beds out of service.

Our patients want and expect privacy, protection from infection, the ability to speak in confidence with their health care team and to have family present.

Patients do not want to share their most intimate personal moments with complete strangers only a few feet away or walk down the hall with tubes to take a shower.

Nurses should not have to spend precious time moving furniture and being injured in cramped, inefficient rooms.

Our doctors should not have to whisper to patients to assure privacy.

I am proud of the service we provide, the skill of our staff, the technology we use and the many quality awards we have earned. I urge anyone with questions or concerns to contact the hospital and learn the facts about the bond proposal.

 

 

Linda Gipson is chief nurse for Whidbey General Hospital.

 

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