Phase 1 of the dual-campus integration of clinical services began Feb. 1 and will take several months to complete.
"These changes represent the beginning of our focus on creating centers of excellence in acute, comprehensive care for the elderly and comprehensive musculoskeletal care on the Saint Raphael Campus," said Richard D'Aquila, president and COO. "These changes are complex and exciting at the same time, and require great flexibility and commitment from our staff to achieve them successfully."
"We are beginning the process of reallocating our medical and surgical patients both between units and between campuses," said Victor Morris, MD, vice president, Physician/Patient Access Services. "Creating the proper balance of medicine and surgery units will prepare us for the development of two major anchor programs — musculoskeletal services and geriatrics — on the Saint Raphael Campus.
Dr. Morris noted that more than $40 million has already been spent on the Saint Raphael Campus to refurbish and clean patient units and update infrastructure to better and more safely meet patient and staff needs.
On the SRC, high demand means 25-30 medicine patients a day have been boarding on surgical units. To address this, in February, Verdi 5 North — currently a surgical unit — will be converted to a medicine unit. All SRC surgery patients will be consolidated on Verdi 5 West and Sister Louise Anthony 2. The MICU is also part of the right-sizing and the SRC MICU will expand from 18 to 22 beds as the step-down unit goes from 26 to 19 beds.
Consistent with the initial integration plan, the CTICU closed on the Saint Raphael Campus on Feb. 1, and additional surgical intensive care capacity opened on the York Street Campus to accommodate the transferred volume. Dr. Morris noted that the hospital has no plans to change the acuity level of medical and surgical patients on either campus. Both campuses will continue to provide intensive care for acutely ill patients.
In early 2014, the recently renovated Verdi 4 North will open as the Musculoskeletal Center Unit to complement the current orthopedic unit on Verdi 3 South.
Initially, a small number of physicians from YSC will move their elective cases to SRC. By spring, all elective joint replacements, neuro/spine and ortho/spine patients will begin to be admitted to Verdi 4 North or Verdi 3 South reflecting the SRC's role as the center for all of these elective services.
In addition, this spring, the Acute Care for the Elderly (ACE) unit will move to Verdi 4 West on the SRC. The process will start later this month when the Medical Oncology Unit on Verdi 4 West relocates to Sister Louise Anthony 3 and Verdi 4 West closes for renovation. YSC's East Pavilion 4-6 has already opened as a general medicine unit. This will allow the hospital to accommodate the higher winter census of flu-related medical patients. In May, the renovated Verdi 4 West will reopen as the ACE unit, staffed by hospitalists, ACE nurses and staff. At that time, East Pavilion 6-5 will close for a super-cleaning and will re-open for non-elective orthopedic trauma and orthopedic oncology patients at York Street who are currently treated on the Orthopedics Unit (7-7). East Pavilion 7-7 will become a general medicine unit.
"Yale-New Haven is a national leader in services for the elderly and the Acute Care for the Elderly unit is a pioneer in comprehensive, multidisciplinary care for complex illness in the elderly," points out Peter N. Herbert, MD, chief of staff. "This move initiates the relocation and expansion of this center of excellence to the Saint Raphael Campus, which has long focused on geriatric services."
"With the thoughtful input of many clinicians on both campuses, we are beginning to make unit moves that will enhance clinical integration and better serve our patients," said Dr. Morris. "Right-sizing patient care units involves change and flexibility and we are grateful to all our staff for their patience as we work our way through this process."
"The logistics of these moves fall very heavily upon our nurses who must balance the needs for patient safety with the complexities of moving to a new space," said Ena Williams, RN, associate chief nursing officer. "I'm proud of how well our managers, nurses and clinical staff are preparing for their moves. The key is to take the long view and see how much better our environment and services will be as we continue to provide excellent care to our patients."