Hershey Medical Center President Deborah Berini sent the following email to employees on Thursday:
Dear Faculty and Staff:
“How can they not have a bed for me?” This was my mother’s question after waiting 24 hours in a St. Louis emergency room. At the time, I worked in an academic medical center much like Hershey Medical Center, which was “always full.” I didn’t have a good answer for her. Now, as the leader of such an institution, when I read our patient satisfaction surveys and review our boarding statistics, I am reminded of that call from my mom, and it really hits home.
This “always full” environment presents a critical challenge, and it is important that everyone know about the actions we are taking to ensure timely access to care. Last October we opened 124 new beds (74 pediatric and 50 adult) with the Penn State Health Children’s Hospital expansion. That three-story expansion allows us to now renovate the adult hospital by eliminating the older, shared rooms on the 3rd floor and converting the former Neonatal Intensive Care Unit spaces on the 7th floor. The result will be 54 new private rooms completed between 2022 and 2024.
As the health system expands, we also are growing capacity in our new community medical centers to ensure lower-acuity patients can be served closer to home.
Beds, however, are only part of the solution to our capacity challenges. We must have processes in place to optimize the inpatient stay. To that end, I charged a team of physician and nursing leaders to develop short-term strategies to improve our use of existing capacity. We implemented several of the team’s recommendations, including increasing physical therapy staffing to expedite weekend discharges and creating a new physician leadership role, medical director of patient throughput. This new role will work with stakeholders and partner with the transfer center and care transitions leaders to address bed capacity, patient flow, triaging, staffing and transfers.
In addition, we kicked off a significant care transition review last month. If we eliminate just 10% of excess days, we would add 27 additional beds to our total capacity. Our goal is to improve point of entry and patient-centered early discharge planning, increase physician advisor presence and enhance the transitional care management program.
Internal processes must work efficiently, but we also need strong community partnerships. Monica Cascarino was promoted to vice president of care transitions in December. She is working to build partnerships with home health care agencies to help transition patients back to their homes.
We are exploring new models of care such as “hospital at home,” which allows certain patients to receive care at home using enhanced home health and virtual technology.
Not everyone knows what occurs behind the scenes, hour to hour, to move our patients through the Medical Center or prepare them for discharge. It takes many hands to make the process work each and every time. With ongoing commitment from faculty and staff, we are poised to make improvements so that our patients are not left wondering, like my mom, why there isn’t a bed for them when they need it.
Over the coming months, I look forward to providing you with progress updates and sharing in the successes yet to come.