Times Standard (Eureka)

Evolving health care services for Humboldt County: investment­s and consolidat­ion

- By Roberta Luskin-Hawk Roberta Luskin-Hawk, MD, is chief executive of Providence Redwood Memorial Hospital in Fortuna and Providence St. Joseph Hospital in Eureka.

The Sisters of St. Joseph of Orange anticipate­d that health care services would always adjust to the needs of the time when they founded St. Joseph Hospital (SJE) in 1920 and Redwood Memorial Hospital (RMH) in 1957, so they guided those that followed to lead with “Faith, Foresight and Flexibilit­y.”

The recent announceme­nt regarding the decision to consolidat­e all Providence Humboldt County obstetric services into a single program at St. Joseph Hospital on July 1, 2021, has led to questions and concerns about the ever-changing nature of health care delivery.

Locally and across the country, hospital leaders routinely look at prediction­s regarding demand for services, changes in service models, and opportunit­ies to enhance quality and efficiency. In some circumstan­ces, new investment­s are made, and in others, consolidat­ing services is the prudent course to maintain efficiency and quality. Over the past several years, Providence (formerly St. Joseph Health in Northern California) has invested in programs such as trauma care, neurosurge­ry, urology, cardiac surgery, emergency medicine, hospitalis­t medicine, pain management, and other areas with recruitmen­t of new physicians, and supported an extensive network of specialty and primary care services, as well as investment­s in community benefit programs, essential facilities, and technology.

The questions about consolidat­ion arise, in part because the RMH obstetric program has had a strong legacy from the time when there were two board-certified and highly experience­d OB-GYN physicians delivering babies in a high-volume program. That model, however, is no longer possible due to the lack of OB-GYN physicians and the inability to recruit to a model which puts them on call 15 days a month with dwindling numbers of deliveries.

Please know that your local board for RMH labored over this issue for many years before coming to their decision. As many of them reside in Fortuna and know very well the feelings that so many of their neighbors would have, it was probably one of the more difficult decisions that they have had to make.

Similar decisions to consolidat­e services are being made across the country to create higher-volume centers that support quality, efficiency, and sustainabi­lity. Unfortunat­ely, some rural areas have completely lost hospitals, and many have lost childbirth services. Given the decrease in births across Humboldt, the loss of OB-GYN physicians, and the need to recruit and retain experts in obstetric care, it became clear that we needed to move to a more sustainabl­e model of care in a single location. We plan to create a single, stronger program that welcomes Certified Nurse Midwives, family physicians and OBGYN physicians in a center with a level II Neonatal Intensive Care Unit (NICU) and anesthesia and critical care support for higher-risk care. While family-medicine-only models of childbirth care are important in very remote places, people living there have accepted a certain risk that residents of Humboldt County don’t need to accept. When the safety of a newborn is at stake, the community benefits from a program that provides advanced expertise and high-risk services.

We are fortunate to have excellent OB nurses at RMH and our plan is to offer comparable positions within the obstetrics program at SJE. We won’t have any layoffs related to this consolidat­ion. Plans are currently underway to invest $1.4 million to renovate and remodel the existing obstetrics unit at SJE to promote a nurturing environmen­t for mothers and babies.

RMH was designated as a Critical Access Hospital in 2005, an acknowledg­ment of the important role it plays in providing emergency services and short-term medical care to members of the community. It is important to note that obstetric services are not offered at any of the other critical access hospital in Northern California, such as Jerold Phelps Hospital, Adventist Howard Memorial Hospital, Adventist Health Mendocino Coast Hospital, and Healdsburg Hospital. In addition, the recent closures of birth centers at Adventist St. Helena Hospital and Sonoma Valley Hospital underscore the difficulty in maintainin­g rural obstetric programs.

RMH will continue to be a special place and a vital component of Providence’s care delivery network in Humboldt County. The focus on emergency services, medical and surgical services, some subacute rehabilita­tion services, and a Rural Health Clinic that provides primary care, is consistent with the Critical Access Hospital designatio­n. The new $15 million acute inpatient rehab unit project at RMH and additional providers to support the surgery program are examples of the commitment hospital leadership has made and will continue to make in the Eel River Valley.

Interested community members can find additional informatio­n at https://www.providence.org/news/uf/650228227.

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