Photos: State DPH Public Hearings
NORTH ADAMS -- Administrators, nurses, advocates and patients on Friday made arguments for and against ending inpatient pediatric and psychiatric services at North Adams Regional Hospital.
In public hearings held at the North Adams American Legion, the state Department of Public Health took testimony as it prepares to weigh in on whether this constitutes a cut of "essential services."
The state's health department can't stop the hospital from restructuring. But DPH can force North Adams Regional to provide further explanation about its plans should it deem the services essential. DPH will submit its findings within the next 15 days.
The hospital's parent company, Northern Berkshire Healthcare, announced in September its plans to close the Greylock Pavilion, which houses inpatient psychiatric services, and the inpatient pediatric program.
Critical care services would also be cut under the new plan, which the hospital plans to institute by early 2014.
The hospital serves between 14 and 18 inpatients on a daily basis and an additional seven for psychiatric inpatient care. There is approximately one pediatric patient a week.
In lieu of the pediatric and psychiatric units, the hospital would create a 16-bed inpatient unit and a three-room psychiatric "pod" within the emergency department.
The hospital, a not-for-profit, argues that the cuts are necessary to keep itself viable.
"There is no doubt that there is enormous pressure to reduce costs, operate efficiently, and create partnerships," said Leesa-Lee Keith, chief nursing officer at North Adams Regional, in a statement.
The hospital is pushing for a regionally based approach for psychiatric services, such as those offered at Berkshire Medical Center in Pittsfield.
"There are always empty beds at Greylock," said Dr. Jeffrey Doshier, medical director of psychiatric services at North Adams Regional. "By consolidating our services with another hospital, we will be able to provide better, safer and more comprehensive care."
Doshier said Berkshire Medical Center was working with North Adams Regional to ensure that patient transfers go smoothly from the emergency department in North Adams to inpatient care in Pittsfield.
The hospital also is working to provide transportation for families from North County to Berkshire Medical Center, Doshier said.
Donna Kelly-Williams, president of the Massachusetts Nurses Association, disagreed with a regionalized approach to care.
"Dumping patients into other overcrowded and stressed facilities is not a legitimate alternative plan of care for these patients," she said.
Former patients also voiced concern over the closure of Greylock Pavilion.
"I haven't been admitted in many years, but that doesn't mean I'm immune," said one woman.
Another questioned the use of psychiatric pods in emergency rooms. She said she was treated in a pod at Berkshire Medical Center.
"They locked me in a unit ... for 36 hours," the woman said.
Doshier said the proposal would improve psychiatric treatment in the emergency department.
"[Treatment] will happen in a setting that is more private, more comfortable, and safer than it is now," he said.
Hospital staff ranging from emergency room doctors to critical care nurses spoke on the closure of inpatient pediatric services.
"The idea that children who were once cared for on a floor in a setting appropriate to their age ... is not only clinically unsound, but is patently dangerous for the child," said Kelly-Williams.
Colleen Hunkler, an North Adams Regional nurse for more than 25 years, worried about the affect cutting pediatric care would have on North Berkshire families, who would be forced to travel to other hospitals.
"They don't want to be shipped to Pittsfield or Springfield for the care they expect and deserve here," Hunkler said.
A large factor in the debate on the reduction of services is the increased volume of patients other parts of the hospital will be forced to handle. An emergency room doctor argued the ER could accommodate the additional patients, but nurses disagreed.
"Our department will be overloaded with patients with varied and complex conditions," said Hunkler.
Hospital administrators say that the hospital will focus on emergency care for children, not long-term care.
"Most pediatric hospitalizations require more serious support than we can offer."
To reach Adam Shanks, email email@example.com.