To Reduce Risky Patient Transfers, California System Must First Change the Law

by Lola Butcher

Preparing to deliver healthcare services in a new way sometimes means you need to fight current laws or licensing requirements. That’s what staff at Palomar Pomerado Health discovered after they came up with a way to reduce the risks associated with transferring patients from one unit to another.

New Hospitals; Modern Beds
Steel erection for the new Palomar Medical Center West, a 450-bed hospital in Escondido, Calif., was completed this summer, and the 750,000-square-foot campus is expected to open in 2011.

Designed to fulfill Palomar Pomerado Health’s vision of becoming the “healthcare system of the future,” the new hospital will include 168 acuity-adaptable beds that could be used for either medical-surgical patients or intensive care unit (ICU) patients.

Avoiding Transfer Risks
The idea is to build in flexibility. Those rooms might be used for medical-surgical patients initially but, as inpatient acuity levels rise as expected, the rooms would be already equipped to deliver ICU care.

Another option: a room could be converted from ICU to medical-surgical when the patient’s condition improves, allowing the patient to remain in the same room throughout the hospital stay.

“You would avoid all the risks of transfer—continuity of care, miscommunication during handoffs, losing the patient’s belongings, work-related injuries for the staff—if the patient stayed in the same room,” says Bob Hemker, CFO of Palomar Pomerado Health, a two-hospital system in suburban San Diego.

Fighting the Law
There is just one problem: California’s licensure law does not recognize acuity-adaptable beds.

“We are building this unique way to deliver care that makes a lot more clinical sense, business sense, patient-centric sense, and safety sense in an environment where the state licensure system does not recognize those benefits,” says Hemker.

That is why Palomar Pomerado’s chief nursing officer is working with state legislators to pass a bill that would change the 30-year-old hospital license regulations. How and when the issue will be resolved is not yet clear, but Hemker refuses to worry about it.

His rule: Do not be restricted by current limitations—regulatory, political or financial—as a barrier to out-of-the-box thinking about healthcare delivery in the future.

“Allow yourself to go out there and create a sense of urgency for resolving a problem,” he says. “Otherwise, you are putting yourself in a constrained environment by viewing a situation as today’s status quo rather than what could be tomorrow’s reality.”

Interviewed for this article: Bob Hemker, CFO, Palomar Pomerado Health, San Diego.

Lola Butcher is a freelance writer from Missouri.