As a result of budget cuts due to falling and uncertain reimbursement, Memorial Hospital in Jamestown closed its OB and pediatrics units. Over the past three years, a steady decline in bed occupancy rates in both of these areas was falling.

As a result of budget cuts due to falling and uncertain reimbursement, Memorial Hospital in Jamestown closed its OB and pediatrics units. Over the past three years, a steady decline in bed occupancy rates in both of these areas was falling.

There had been rumors, some of which were picked up by the local media that these services were not going to be available and OB and pediatric patients would need to go about 10 miles to Gladling Hospital instead, should they need OB or pediatrics services.  That also meant the OB’s and the pediatricians in the immediate area would need to apply for privileges at Gladling Hospital and would have to make the trip to see any of their patients admitted there.  Memorial and Gladling are not connected in any way; both are not for profit community hospitals.

Many of the OB and peds staff were very worried about the stability of their positions, and though their concerns were communicated to the director of nursing and the hospital administration as a whole, they really did not get an answer other than the “numbers” showed a decrease in utilization that had not rebounded, and a reduction in the revenue for those areas. The physicians also expressed their concerns in a more direct and adversarial way, but they were told that a decision had not been made, and that the matter was still “under consideration” by the hospital board of directors.

On May 1, an article was printed in the local newspaper that due to lack of funding, the OB and pediatrics inpatient services at Memorial Hospital would cease effective July 1. The article went on to read that staff on those units would be given first consideration for other openings within the facility, and that positions would open at Gladling Hospital since they would be adding to their OB and peds beds.  Some of the staff had as many as 25 years experience with Memorial, and three of the nursing staff are less than five years away from retirement.

How might this entire matter have been handled differently to minimize negative reactions among the staff as well as the physicians?