Answering a critical need

Over the last two decades I have had the great pleasure of serving as an attending physician in all five of our emergency departments. These emergency departments, as well as many others throughout our region, serve as safety nets for the communities we live in.  One of them, the emergency department at the University Campus, is different than all the others. The University Campus emergency department serves both as a local safety net and the clinical backup for smaller, less comprehensive emergency departments in the region. Today, this important community resource is being severely challenged in its ability to fulfill its mission to those who depend on it.

IMG_5522

The Emergency Department at the University Campus of UMass Memorial Medical Center is the backup for hospitals throughout Central Massachusetts.

The University Campus emergency department is the region’s only Level 1 Trauma Center.  It also serves as the region’s tertiary referral center for pediatrics, stroke patients and cardiovascular emergencies. Every day the sickest patients from around the region are transferred to the University Campus emergency department and, working in cooperation with the transferring hospitals, our caregivers labor to provide the best care possible to them. It is critical that we have the necessary capacity at the University Campus to accept transfers from other hospitals and right now we are frequently challenged to do so.

The University Campus faces an almost daily challenge of too few beds for large numbers of critically ill people waiting to be transferred. This creates potential patient safety issues not only on the University Campus but also across Central Massachusetts. We believe the best way to address this issue is to add more medical-surgical beds at the University Campus.

For the reasons noted above, Patrick Muldoon, the Medical Center president, and I have made the difficult decision to close 13 beds on 8 East – our University Campus inpatient psychiatry unit – to make room for 18 new medical-surgical beds. Strengthening our resolve in making this decision is the availability of new resources for patients requiring inpatient psychiatric services. Specifically, 16 new beds have recently opened in Webster through Harrington HealthCare and a new 102-bed facility named TaraVista recently opened in Ayer. In addition, there is a new 150-bed inpatient psychiatry facility opening soon in Westborough.

To assure that we continue to appropriately serve the needs of our medically complicated psychiatric patients, which after careful study averages a daily census of 6-8 patients, we will maintain 14 medical-psychiatric beds on 8 East and invest in the renovation of that space to make it more appropriate for the needs of these patients and their caregivers.

Deciding to close psychiatric beds was not an easy decision and we hope you understand that we did so only after a careful and thoughtful process with the best interests of our community at heart.

You can find additional information here.

Thanks for taking great care of our patients and one another,

Eric

2 thoughts on “Answering a critical need

  1. Lets play this out … you Eric have a mentality ill family member who is a brittle diabetic with some cardiac issues.. so they need immediate psychiatric assistance.. so they don’t qualify for the psychiatric beds you speak of … they can’t mange the medical issues of said patients …where does your family member go .. 8 east a place that’s capable of caring for your family member’s psychiatric issues as well as managing their medical problems that would block their admission to the free standing for profit facilities you speak of, actually the Westboro site doesn’t even exist to care for said family member in need .. let’s play it out further, let’s pretend your not a person of means , you have no money and public transportation is your only way to visit your mentality ill family member whose recovery depends on contact with family and support systems.. well you don’t get to visit them in the great new psychiatric venues that don’t exist.. and the ones that do exist as so far away you are only able to call or write to the one you love who needs you !! I’m an emergency department nurse that has proudly worked in the trenches of this emergency department with you .. you know me , what I’m about.. safe and appropriate care for patients. I of all people recognize the need for more medical beds to ease the overcrowding of our emergency department..I see and work it every day .. but not at the sacrifice of our mentality ill of Worcester, I ask you to to imagine your the one waiting for an appropriate medical/psychiatric bed only to be denied or transferred far away from the ones you love ; there must be a better way !!

    • Lyn,

      Thank you very much for your comments on the latest Everyday Innovators blog regarding changes at the University Campus emergency department. You raised several good points and I can assure you they are issues we have grappled with in trying to reach a responsible, medical solution to the challenges facing our caregivers and patients there: too few beds for many critically ill patients..

      Our analysis shows that at any given time, 70 percent of the patients on 8 East have no medical issues that cannot be met at a free-standing psychiatric unit. Only 30 percent of the patients on 8 East at any given time meet medical necessity that only 8 East can deliver. That means most of the time, 8 East is functioning the same as a free standing psychiatric unit, rather than a psychiatric unit that is capable of caring for medical issues that cannot be addressed elsewhere in the system.

      In terms of transportation, TaraVista is investigating adding a shuttle service to address distance issues to assist in family involvement in the psychiatric care of our patients, but that is still to be determined. While Signature Health Care, located in Westborough, is currently not opened, it is expected to open the first week of June (May 2017—checking on date), far ahead of the projected downsizing of 8 East. Although all 152 beds will not be immediately available, more than 13 beds (the downsizing of 8 East) will most certainly be available at that time. That site is less than 20 minutes away, and provides public transportation for family and loved ones.

      Harrington Hospital, also about 20 minutes away, has recently expanded its psychiatric bed capacity by 16 more beds. Their facility is currently not filled to capacity and we will work with them to refer appropriate patients as well.

      On average we have 10 med/surg boarders without psychiatric disease for every patient that has a medical and psychiatric problem. The 14 beds that will be left on 8 East will be used for medically complex patients – which averages 6-8 on any given day.

      With a combined 275 new, licensed inpatient psychiatric beds opened or expected to open in central Massachusetts in 2017, there will most certainly be adequate capacity to handle the reduction of 13 beds on 8 East, providing quality care for psychiatric patients in the region. And, importantly, the additional medical-surgical beds will ensure we can care for the sickest patients in the region.

      Thank you once again for your feedback and continued support of patient-centered care at UMass Memorial!

      Eric

Leave a comment

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s