Wright-Patterson under pressure to fill more hospital beds
By BARRIE BARBER | Dayton (Ohio) Daily News | Published: July 30, 2014
Wright-Patterson Medical Center is under pressure to boost the use of its 62 in-patient hospital beds as the Department of Defense looks to make better use of resources in the wake of shrinking military budgets and declining numbers of service members in uniform.
The Defense Health Agency is evaluating health services throughout the DOD. Closure of the base hospital is not expected, but the hospital could be in for some major changes if sufficient progress isn’t made on benchmarks set for the facility.
DOD placed the medical center at Wright-Patt and seven other military treatment facilities on a deferred-status list for re-evaluation in fiscal year 2015, Maj. James Brindle, a Pentagon spokesman, said in an email Monday.
“At this point there are no plans to close Wright-Patterson Medical Center,” Brindle said. “The study is looking at maximizing efficiencies at certain facilities in 2014, and others, like Wright-Patterson Medical Center, in 2015.”
The hospital, which historically has had a 45 percent in-patient bed occupancy rate, has set an average of 70 percent as a benchmark. The hospital also targeted higher clinical productivity in some specialties and is reducing patient referrals to private medical care, according to Air Force authorities.
“What we want to do is make sure that our medical centers are maximizing their resources in terms of money and manpower,” said John Lake, chief of resources at the Air Force Medical Operations Agency at Joint Base San Antonio, Texas.
Wright-Patterson spokeswoman Marie Vanover said in an email: “This study is part of right-sizing Military Treatment Facilities across the Department of Defense. At this time we cannot speculate on what may happen in October 2015.”
Second largest in the AF
The medical center is the second largest in the Air Force and won top in-patient satisfaction scores in 2012 and 2013 in the service branch, and the highest marks for outpatient treatment in three of four quarters last year, based on patient surveys.
In the midst of a $115 million, multi-year renovation, the center has about a $140 million budget, 2,100 employees and treats tens of thousands of patients every year.
Although no immediate decision is due on the status of the in-patient beds at Wright-Patterson, if a closing happened it would have a major impact on jobs, according to an Air Force Medical Operations Agency report released to the Dayton Daily News through the Freedom of Information Act. About 250 staff members would be reassigned and another 250 medical students trained annually at the base hospital would be impacted, the report stated.
The report, based on a site visit in January, noted the various missions supported by the hospital and its training pipeline, while finding the hospital’s emergency medicine was “under-performing” based on military health system modernization standards.
In a video message to Wright-Patterson Medical Center employees in January, then 88th Medical Group commander Col. Stephen W. Higgins, the hospital’s CEO, described the results of the review as “a no-kidding, all-hands-on deck scenario that we are facing.”
Higgins departed Wright-Patterson this month after his tour ended for a new assignment as surgeon general of Air Force Global Strike Command at Barksdale Air Force Base, Louisiana.
“Proving our value to the military health care system and securing the future of Wright-Patt Medical Center is now squarely in our hands,” Higgins said in the message. “…All military treatment facilities across the military health care system will be expected to achieve these targets, or at least demonstrate significant progress toward achieving the targets over the coming year.”
The result could mean closing in-patient functions, fewer specialty services and reassigning staff, he said in the video.
“Team, this is real,” Higgins said in the video. “A new era of corporate accountability is here and the future of this facility rides on the backs of each and every one of us.”
Fluctuating occupancy rates
Occupancy rates have fluctuated, and were above 90 percent for at least two months this year, according to the medical center. The hospital hopes to expand the scope of medical services and build on a growing partnership with regional Department of Veterans Affairs medical centers to push the use of the in-patient beds higher.
It’s also set a goal of a 40 percent productivity rate for some clinical specialties based on the median productivity standards of the Medical Group Management Association; and a 30 percent reduction in patients seeking private sector care, according to authorities.
By mid-June, the medical center reduced private sector care referrals 57 percent since October 2013, according to base officials.
Wright-Patterson and the Dayton VA medical center have referred a small but growing number of patients between the two medical treatment facilities, Higgins said in an interview.
While Wright-Patterson has received accolades in recent patient surveys, it was beset by one highly publicized mishap: A prescription drug mix-up at the satellite Kitty Hawk Pharmacy with eight reported instances of Tylenol mixed with a muscle relaxant because of an automated machine filling error in April, according to medical authorities.
ER visits drop
The emergency department had about a 20 percent drop in visits in the past five years. In 2009, the medical center had 25,128 patient visits compared to 20,099 last year, figures show.
The medical center attributed the drop to a health care model focused on more patients receiving preventive health care to drive down the need for urgent care.
“If we’re doing a better job of taking care of their chronic health needs and keeping them from needing to go to an ER, that’s a success story,” Higgins said in an interview before leaving Wright-Patterson.
The Air Force Medical Operations Agency report recommended better access to VA patients in the emergency department as part of its recommendations.
In response to questions from this newspaper, the medical center suspected the under performance noted in the report was partly because of a backlog of emergency department charts “that had not been coded or had been under-coded at the time of the study.”
Vacancies among contractors handling the work “contributed significantly to this backlog.” The positions were filled and the recording of data was brought up to date, officials said.