Mass. hospital considering converting ED to urgent care clinic
In 2009, due to decreasing volume, the department was converted to a satellite facility, limiting the number of beds
Wicked Local Metro, Needham, Mass.
SOMERVILLE, Mass. — "It's not about our jobs, it's about our patients."
On May 1, Somerville Hospital management met with nurses and staff to present their proposal for converting the emergency department to an urgent care clinic by spring 2020.
Care providers are worried about how this change will limit what care the facility is able to provide, particularly among the vulnerable communities they serve, such as the homeless and immigrant population.
"To take away services, especially for people where this is their only means of care, especially non-English speaking people, not only is it disrespectful, this is such total disregard for people that already find it hard to navigate a health care system," said Somerville Hospital ED nurse and Massachusetts Nurses Association (MNA) member Lisa Valley-Shah. "To now disregard them and basically tell them they can no longer come here for things they get from us is dangerous for their health and welfare. It's such a burden for these people."
No decision has been made at this time, but the hospital is continually evaluating "the needs of the communities [it] serves." In March and April of 2018, Cambridge Health Alliance (which owns Somerville Hospital) partnered with the city to create a Somerville/CHA Health Care Advisory Group to "prioritize health needs and offer programming and service recommendations." They held six listening sessions in the community and conducted a survey.
"We are currently working on a detailed proposal based on those sessions and some of the key findings," said David Cecere, CHA's Senior Director of Corporate Communications. "[These include] increasing access to convenient and affordable urgent services, addressing the changing demographics (Somerville is now one of the youngest communities in the state), [and] maintaining access to the underserved populations who are core to our mission."
In 2009, due to decreasing volume, the department was converted to a satellite facility, limiting the number of beds. According to MNA's Director of Strategic Campaigns Roland Goff, volume has been fairly consistent since then, with the department on budget, not bleeding money.
Valley-Shah noted, however, that they've been working in total disrepair though they've asked for upgrades numerous times.
"It seems the plan all along was to convert," she said. "They've just been investing in the Cambridge Hospital ED."
Converting to an urgent care clinic would include many changes, such as reducing the number of beds from 16 to 6, reducing the hours open from 24-hour coverage to 9 a.m. to 9 p.m., and more limited services (for example, if a patient appears with an acute issue, staff will dial 911 for an ambulance to take to an ED as determined by the ambulance co/EMTs).
"I'm deeply concerned about the unintended impacts that the loss of this important service will have for the community and especially for our more vulnerable residents who rely on access to this local Emergency Department," said Mayor Joseph Curtatone. "At this time, I have not been convinced that this is the right decision for Somerville, and I strongly urge CHA to discuss this more thoroughly with the community before taking action."
An urgent care clinic cannot treat the same level of injury and symptoms that an ED is equipped to treat. Valley-Shah and Dianne Roberto, an ED nurse in Somerville, reported having many patients sent to them from urgent care clinics across Somerville.
"People who use this, it's going to be really hard for them to go somewhere else, a lot of people walk in, they live in the neighborhood, so now they'll lose those services," said Goff. "It sounds like, 'oh, they're converting to an urgent care center, but there are a lot of things lost. There won't be any MRI, ultrasound, CAT scans, or any respiratory treatment."
Hospital assistant Luciara Santos said these patients don't feel well-treated at the other campuses. They come from Dracut, Tewksbury, Haverhill, and the South Shore for care at Somerville Hospital.
"They're taking many services away our patients that we – over 35-40 years – have raised families in this emergency department," said Valley-Shah. "And our homeless population, our psych patients that come in: we clothe them, we feed them, we care for them, and we nurture them. These are people who are going to be totally disregarded in Somerville and these communities – there will nowhere for these people to go."
Though management said Cambridge Hospital is prepared through their renovation to accept these people, Valley-Shah is skeptical, noting the overcrowding she's observed on numerous occasions.
In March 2019, Lawrence Memorial Hospital in Medford officially closed its emergency department and extended urgent care hours.
The Medford Transcript reported back in January about residents concerns about this change. Melrose-Wakefield Healthcare, who owns the hospital, repeatedly cited a decline in use of the emergency room to justify their decision to close the department.
Cecere said CHA is committed to improving health in Somerville – citing expanded primary care services (in addition to opening a new primary care center at Assembly Square) and improved access for mental health and substance use services.
"As more patients receive care in an outpatient setting, our system-wide investments reflect that trend: improvements to our network of primary care centers and expanded primary care and women's health access in the metro-north communities we serve," he said. "At Cambridge Hospital, we completed emergency department renovations and launched a Psychiatry Access Service."
There will be community meetings in June to review the proposals and solicit feedback before finalizing a plan to present to the CHA Board of Trustees.
©2019 Wicked Local Metro, Needham, Mass.
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