Dive Brief:
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DeGraff Memorial Hospital in North Tonawanda, N.Y., plans to break ground on a $7.8 million emergency department (ED) renovation in August that will more than double the ED space. The ED expansion will include 17 new treatment bays, a trauma room, a bariatric room and an airborne isolation room.
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The project will also reduce the hospital’s medical/surgical facility from 66 beds to 10 beds for lower acuity patients. The Buffalo News reported that 104 jobs will be affected.
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DeGraff Memorial will stop performing surgeries and close its intensive care until on Oct. 1. Patients for those services will need to go to Millard Fillmore Suburban Hospital in Amherst, N.Y. DeGraff will instead focus on ED, infusion services, wound care and its geriatric clinic and outpatient services, such as imaging, lab and rehabilitation services.
Dive Insight:
DeGraff’s parent company, Kaleida Health, is calling the plan “DeGraff 2020.” Darcy Craven, president of DeGraff Memorial and Millard Fillmore Suburban Hospitals, said the change will “put our resources into the services” that make sense for the patient population.
This is part of a trend of hospitals seeing sagging inpatient numbers. Hospital utilization and hospital beds are declining, while expenses are rising. Community hospitals have struggled to find their footing in the current healthcare environment of lower inpatient reimbursement rates and risk-based delivery.
Providers have instead focused more on outpatient services, which cost less to operate and are often more convenient for patients. Some hospitals are even viewing former retail spaces as places to open outpatient services. Another community hospital, Hallmark Health in Massachusetts, recently announced it's cutting medical/surgical beds and intensive care unit (ICU) beds at Lawrence Memorial Hospital in Medford.
DeGraff Memorial will go from a once 169-bed full-service hospital that featured labor and delivery, pediatric care, intensive care and heart services to a 10-bed hospital. The hospital’s bed count dropped to 66 beds after it merged with Kaleida Health and began its focus on outpatient services and ED.
The hospital said the average daily census was 46 in 2006, and the number has since dropped to between 12 and 15.
Kaleida Health said it has tried to expand DeGraff over the years, but has seen “little success.” Since 2012, the hospital has seen a 33% decline in inpatient admissions, 54% decline in outpatient surgery and 63% decline in inpatient surgery. However, the hospital’s ED volumes have increased from more than 14,000 in 2013 to nearly 15,500 in 2015.
A recent survey of hospital C-suite executives found 57% said their primary concern was improving access to ambulatory and outpatient settings, which was the same percentage as those looking to reduce expenses. Also, 55% said boosting outpatient procedural market share is on their priority list. To show how outpatient services have grown for hospital leaders, just a year ago Advisory Board Company found that the top concerns were minimizing unwanted variation in care cost and quality.