Martha’s Vineyard Hospital outlines plans for use of old building

Yellow tape blocks the door that until one month ago was the entrance to the Martha’s Vineyard Hospital emergency room. The hallways, nurse stations and patient rooms, stripped of equipment, are quiet.

With the opening of a new, modern hospital in June, the one-story wood frame building, prone to leaks in heavy rain, that was the Island’s hospital since 1972 is about to get a new service life.

The vacant spaces will be used for physician offices, an expanded area for the cardiac rehabilitation and physical therapy units, office space for hospice, storage for medical records now kept off-site, and a consolidation of administrative functions now spread between the 1972- and 1929-era structures on the hospital campus.

In a telephone conversation Monday, Tim Walsh, hospital chief executive officer, described the plan that he presented at a meeting of the hospital trustees Friday.

Mr. Walsh said the doctors’ offices would remain in the same wing. The hospital will create three new physician offices to meet future needs.

The hospital is anxious to bolster primary care and wants to hire two new doctors. The search has been difficult. “There is a huge demand all over the country for primary care doctors,” Mr. Walsh said.

The Island’s high cost of living is also a factor. The cost to move to the Island and purchase a house can be daunting on a primary care doctor’s salary, which relative to other specialties is on the low end of the scale.

“We have to help with a lot of different pieces to make it all come together,” Mr. Walsh said.

As an example, he noted that the hospital spent $2.1 million the last time it set out to recruit, hire, and establish new primary care doctors. That effort resulted in five new practices. In that instance, the state Department of Public Health allowed the hospital to use $925,000 it set aside for community benefits to underwrite the effort.

Although in poor shape, what remains of the 1929 building now provides office space for the people who add the codes needed to process insurance claims. The billing department is housed in a nearby house. Medical records now stored at some cost offsite would be stored nearby. The plan is to consolidate intertwined functions in one area.

“Having it all in the same area will help a lot and increase efficiency,” Mr. Walsh said.

Hospice is now housed in a trailer set in a courtyard. That organization would receive long-promised office space in the main building.

The physical therapy department is so cramped that the hallways are sometimes used for exercise space. That department would move to the area that once housed the lab and radiology. Patients would be able to park in the former emergency room lot for easy access.

The receiving department would be moved from the old building to the back of the wing. That would allow easy access for trucks.

Mr. Walsh said the plans are in the early stages. He said the location of all the departments has not been finalized and discussions would continue with the staff. “We’re in the early stages of trying to piece it all together,” he said.

Mr. Walsh said the notion that there might be surplus space that could be devoted to other Island uses — for example a senior daycare facility — does not take into account the hospital’s needs.

He said the 1929 building is in terrible shape. “We really need to get people out of there,” he said.

Tim Sweet, chairman of the hospital trustees, said that the initial hospital plan included building a new medical office building in place of the 1972 building.

When the board looked at the costs, it decided to scale back, to move forward with a new hospital, and to renovate the existing building into a medical office building.

“That is what you are going to see that building become over time,” Mr. Sweet said.

Mr. Sweet said the added space would allow the hospital to support more visiting specialists.

Perception and practice

In other business Friday, the board discussed hospital operations and patient complaints over waits for treatment in the emergency room.

“Obviously, we are one month in, so we are going through a little bit of a shakedown cruise,” Mr. Sweet said.

The new hospital opened for business on June 15. Mr. Sweet said the transition was a complicated and well executed ballet of many moving parts.

“At the same time,” he said, “you are breaking in a new building, new equipment, new procedures, new processes, and there have been a few missteps, but we are working on them all.”

Mr. Sweet said the board sees two issues. One is how to manage each department as efficiently as possible, and the other is perception tied in part to the transition from the old building with one main entrance and curtain dividers to the new building featuring separate entrances for ambulance arrivals and walk-ins and private treatment rooms.

“What we realized is that part of the problem is perception,” Mr. Sweet said of the board discussion. “In the old hospital when you went into the emergency room, you not only knew how busy it was, you almost knew what was wrong with everybody.”

Mr. Sweet said a patient sitting in the waiting room would be unaware that all 16 treatment rooms may be full. He said the ER has been very busy from the day the new hospital opened, but the private layout creates a disconnect between the people in the waiting room and the treatment rooms.

“We have to do a better job of communicating what’s going on, how long it is taking, and how many people are being treated and why,” he said.

Mr. Sweet said the hospital is analyzing staffing and processes to see where improvements can be made. “I think we are much better already, 30 days later, than we were 30 days ago,” he said.

Mr. Sweet said the hospital wants to hear from patients and members of the community.

“We need to hear back from anybody who thinks that we can do a better because we can and we know we can,” he said. “Dedie Wieler [chief quality control office] in quality control will follow through on anything that is brought up. She’s been terrific about it.”