Brunswick hospital closes ICU, moves critical patients into medical-surgical unit

By Beth Brogan, BDN Staff
Posted July 04, 2013, at 7:36 a.m.

BRUNSWICK, Maine — Parkview Adventist Medical Center quietly closed its five-bed intensive care unit in June and dedicated four beds in its medical/surgical unit to critical care patients.

The change took effect only four days after Parkview announced it would eliminate 5.4 percent of its workforce — the equivalent of 16 full-time positions.

Nurses who provide care in the medical/surgical unit at the small hospital are now being cross-trained to provide support to ICU nurses, according to Sharon Bagalio, chief nursing officer and vice president of clinical services at Parkview.

Parkview spokeswoman Tori Ryden said, “It’s a great opportunity for our nurses and CNAs [certified nursing assistants] to learn more and make them more marketable down the road, if need be.”

Ryden said both moves are part of an overall strategy designed to reduce costs by $2.5 million. Parkview was directed to make cuts by Central Maine Healthcare, which in August 2012 announced it would seek to acquire Parkview.

In February, the Department of Health and Human Services — which must approve such a merger — informed CMHC that it would not approve the merger without additional information, and CMHC asked the state to suspend its review pending a feasibility study.

On June 3, Parkview President and CEO Randee Reynolds announced that decreased revenues resulting from fewer patients, more free care and unpaid MaineCare debt had prompted hospital managers to eliminate the equivalent of 16 full-time positions, or 5.4 percent of the overall staff. Reynolds said the cuts would be achieved by “reducing management costs and realigning hospital staffing to match current volumes.”

Four days later, the hospital moved four beds from its former ICU to the now 27-bed medical/surgical unit, Ryden said.

“We were told we needed to find a way of cutting a certain amount of money, because when you look at the bottom line, you see we are down this much and we had to make that up,” Ryden said. “Central Maine worked with us on coming up with a plan so we could come up with the money.”

Parkview estimates that it will save more than $400,000 annually by combining the medical/surgical and ICU units, Parkview controller Scott Heatley said in an email Friday. Of that, salaries and benefits make up more than $325,000.

Cokie Giles, president of the Maine State Nurses Association, said Saturday that her chief concerns about such a change were that the nurses caring for ICU patients be properly trained and that the lower nurse/patient ratio in an ICU not be affected.

Bagalio said Monday that the nurse/patient ratio remains unchanged and “the care there has not changed. It’s just where the beds are located and the ability for other nurses to step in and assist the ICU nurses with any needs.”

The hospital’s census wasn’t high enough to justify 28 beds on its medical/surgical unit and a separate intensive care unit, she said, so the two units were combined — as they were at Bridgton Hospital and Rumford Hospital, both also part of Central Maine Healthcare.

Hospitals are not required by license to maintain an ICU, according to John Martins, spokesman for the Maine Department of Health and Human Services, but a hospital must notify DHHS in writing if it no longer will operate an ICU, because it would change the hospital’s license.

In an email Friday, Martins said the state had not been notified by Parkview of any decision to close its ICU.

Chuck Gill, spokesman for Central Maine Healthcare, said the changes at Parkview have not altered CMHC’s goal of acquiring Parkview.

Gill said the hospital plans to move ahead with acquiring Parkview and that the recent changes are a realignment indicated by the feasibility study.

http://bangordailynews.com/2013/07/04/health/parkview-adventist-medical-center-consolidates-icu-and-medicalsurgical-units/ printed on December 19, 2014