04/28/2007

Making more efficient use of hospital resources

By Brett Harwood

Our first job at Jersey City Medical Center is to provide medical care for the people of Jersey City and Hudson County in the 21st century. To do that, we have to recognize where we have been and where we need to be.

We are the hospital for mothers and babies, even more so with the closing of obstetrics at Bayonne Medical Center. From the beginning in the 1930s, more babies were born in our Margaret Hague Maternity Hospital than at any American hospital. We have a fine tradition to build on.

We will invest even more than we have in the past in childbirth and in infant pediatrics, including both high-risk pregnancy and the treatment of infants who need the most intensive care. Our community and region has shown that it demands these services, just as it demands world-class trauma services.

There is much to do still. But we are getting our financial house under control. Most important, we have taken critical first steps by deciding what we are best at.

But in these challenging times for every hospital, we cannot afford to waste resources or to waste the state taxpayer money that makes up much of our income. All of our current changes are the result of an eight-month evaluation of the needs of our community, as directed by the New Jersey Department of Health and Senior Services, in consultation with our performance improvement consultant, Wellspring Partners.

But hard choices had to be made. You already know of the closing of our pediatric residency program. There simply were not enough patients coming through to properly train young doctors and maintain our accreditation. The same factors influence our in- patient pediatric program.

People did not bring their children here for specialized pediatric services. Changes in medicine have led to ever-shorter hospital stays. Treatments that used to require a hospital stay can now be handled on an outpatient basis. We are now using as low as one third of the beds in our pediatric section. That patient population does not support the program and it would be an ever-greater drain on our resources to try to compete in a region that is over-supplied with similar pediatrics facilities. These children go to other hospitals and we need to recognize that.

We will continue to provide children with the best of care on an outpatient basis, through clinics and our emergency room. We will continue to stabilize seriously injured or seriously ill children, just as we do now, before sending them for more specialized care elsewhere. But we can no longer devote resources to an in-patient program that has limited demand.

The fact is that we are the safety net hospital for the region, the hope of good hard-working people who frequently cannot afford to pay. That requires that we do what we need to do to survive and thrive. Because of our patient mix, we still must rely heavily on government paying the bills of many of our patients. If the state reduces the $34 million we currently receive for providing that care, programs the community needs may have to be further prioritized and evaluated. In this era of limited resources, no hospital can be all things to all people.

Nor can we afford to compete with ourselves. Greenville Hospital is a sister hospital under LibertyHealth. To more efficiently use the resources of these two hospitals less than three miles apart we will concentrate acute care at the newer and better-equipped JCMC and are evaluating moving specialty programs like behavioral health to Greenville. In these competitive times for hospitals, it is likely that the governor's Commission on Rationalizing New Jersey's Health Care Resources will eventually recommend a similar action.

We took these steps proactively, anticipating financial shortfalls and not wanting to have to make serious changes under crisis circumstances forced upon us by others. We wanted to continue to meet our community's need for excellent medical care. Our aim was $32 million in savings. We are already more than two-thirds of the way to this goal with $22.4 million in operational improvements so far.

BRETT HARWOOD is chairman of the LibertyHealth System Board of Trustees.

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