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Gijanto/My Turn: Keeping pace with the times

S ometimes a building is not just a building. Sometimes it’s the difference between growing services and standing still. The operating rooms at Baystate Franklin Medical Center are a prime example. In 1975, they were state-of-the-art. They matched the way surgeries were being performed at that time — when most patients stayed overnight beforehand and afterward, when technology was simpler and when procedures took longer to complete.

A lot has changed in 40 years. We need to change our space to match today’s practices — so that it will be appealing to the surgeons we are working hard to recruit, and will reflect the quality of care our surgeons and nurses, techs and assistants provide to the patients we serve.

For the past several months, in partnership with our colleagues at Baystate Health, we have been developing various options for the construction of new operating rooms at Baystate Franklin. We have now narrowed the field from six options to two. And working with the architectural firm of Steffian Bradley & Associates, we have a preliminary budget projection of somewhere between $22 million and $24 million. This would be one of the largest projects ever undertaken at our hospital and next steps include finalizing a business plan to demonstrate that we can pay for this over time and outlining a community capital campaign to help fund it (we already have a large anonymous contribution to kick off that campaign when the time comes). We will be reaching a final decision on this project by the end of this year.

One of the questions that always comes up when hospitals start talking about building projects is whether or not the money we plan to spend on “bricks and mortar” will take away from the money we spend on staff. This question is especially timely since Baystate Franklin recently laid off nine medical-surgical nurses due to a continuing downward trend in the average length of patient stays — from 3.4 days in 2012 to our current average stay of 2.4 days. The total number of medical-surgical patients has remained pretty much the same; they are just staying for less time. Shorter stays translate into fewer patients in the hospital on any given day with more nurses scheduled to work than are needed for the patients who are here. When that happens, nurses’ shifts may be cancelled so that instead of working their usual 36 or 32 hours a week, they may only work for 24. This is acceptable during an unusual lull that then picks back up again. But for us, the lull had continued for nine solid months in a row, which was clearly a trend we needed to address.

Here’s how this recent difficult staffing decision and the building of new operating rooms comes together. Shorter patient stays are actually a good thing, in that patients are leaving the hospital sooner to return home or to receive their follow-up care elsewhere in the community. There is much evidence to show that the longer patients remain in the hospital, the longer their healing process will be. So it’s important that we keep working to bring that number down, and to keep developing the outpatient services people need after they are discharged. The care is still being provided, it’s just shifting to other locations; and thanks to developments in medicine and technology, the quality of that care keeps improving. Surgery is a case in point, as 90 percent of our surgeries at Baystate Franklin are now done on an outpatient basis. Incisions are smaller so patients are up and around faster, and they heal sooner.

Our challenge as a hospital and medical community is to keep pace with these changes while providing the best patient experience we possibly can. Recruiting more physicians to this community is essential — bringing more services close to home so that people do not need to travel farther away for care that can and should be available in a community hospital. Right now, we are actively recruiting for one or more urologists, for an additional gastroenterologist and an additional orthopedic surgeon to join the rest of our surgical team — from general surgeons to obstetrician-gynecologists, ophthalmologists and vascular surgeons. To recruit these doctors, we need office space for them to move into; and thanks to the Greenfield Town Council’s recent approval of a zoning change, we will now be able to purchase and build on the Catholic school property on North Street. As these doctors’ practices grow, other staff will be hired as well.

In these ways, the new buildings — from offices to ORs — will lead to new jobs and to more of the services our community needs and deserves. Working together, we will make it happen.

Chuck Gijanto is president of Baystate Regional Markets, which includes Baystate Franklin Medical Center .

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