ER Physician Says Hospital Plans Not in Best Interest of this Region's Kids

Must-Read: Comments from a doctor working on the growing Eastside who sends many young patients to Children's Hospital (highlighting added):

"...As an emergency medicine physician practicing in Kirkland, I have witnessed firsthand the growth on the Eastside and in Snohomish County of the need for inpatient pediatric care. Young families with young children are not, in general, settling in Seattle, but in outlying communities where the median home price is more affordable. The vast majority of these children who need admission to a hospital do not need highly specialized care, but rather ongoing care of relatively simple disease processes such as asthma and dehydration.

As it stands, these children often require transfer to CHRMC because of the paucity of inpatient pediatric beds in this service area. This adds further stress to families who are already faced with the emotional and financial burden of hospitalization. Adding inpatient pediatric beds to the Eastside, or South Snohomish County would be a vastly better approach to the need for inpatient resources.

Statistics provided by CHRMC show that the majority of their admissions do not require specialty care and that the majority of patients admitted do not resided in Seattle. These facts argue against the logic of expanding at the Laurelhurst campus. While cost has been sited as a reason not to expand elsewhere, CHRMC's original plan to erect massive towers above the existing campus would have cost more than construction at an alternative site. Creating a partnership with an Eastside hospital with land and space, where zoning is appropriate for a hospital expansion and nearer to where the growing pediatric population actually lives, is a far more logical means of addressing the region's needs for expanded inpatient pediatric care. For example, the land and buildings recently vacated by Eastside Group Health would provide more land (with an onsite healthcare facility already established) for less money than the deal to acquire the Laurelon property.

Any operating costs secondary to 'redundancy' would quickly be offset by the income generated by admission at an Eastside facility. I believe more Eastside doctors would admit children if they didn't have to worry about the inconvenience to families of doing so in Seattle. Why else would Swedish have submitted a certificate of need to establish an inpatient pediatric presence on the Eastside?

Not only would establishing a separate campus provide more comprehensive care for the children and families of the region, it would serve more practically in the event of a mass casualty incident [(MCI)]. At the most recent meeting of the Central Region Trauma Council, of which I am a member, the Triage and Critical Care Task Force announced [the results of] a study to optimize care to the region's pediatric population in the event of an MCI. They found 'the current centralized system for care of hospitalized children in King County' to be an obstacle to this goal. Maintaining inpatient pediatric care only at the existing CHRMC campus could have dire implications if the hospital itself, or transportation routes to it were damaged by a natural disaster, or terrorist attack.

As the medical director of [a large Eastside city]'s Medic One, I also worry about the implications for transport of critically ill children from the Eastside. With Highway 520 becoming increasingly congested, the creation of worse traffic congestion on Montlake and along the arterial roads serving CHRMC has potential lethal implications when timely transport is essential. While CHRMC has suggested that they can mitigate traffic concerns by expanding use of alternative modes of transportation, it is impractical to believe that staff that need to arrive during off hours will use bikes and public transportation and ludicrous to believe that families with sick children will be able to use any transportation other than their own vehicles.

...CHRMC has yet to provide an explanation for its desire to add ten times what the State's formula for need has determined to be the necessary number of beds. It has also failed to mount an effective argument against creating inpatient beds at an alternate site (one that would better serve the needs of the region's children). Without these essentials, the City and the CAC cannot, in good conscience, approve any of the existing alternatives. At least three new alternatives must be created: 1) no build (until CHRMC can explain its need to expand inpatient services despite falling use of such services since 2004); 2) limited expansion to meet bed necessity set by a certificate of need issued before creation of another draft master plan; 3) creation of an additional campus in a location better suited to serve the region's growing pediatric population."