On the front page of today’s Richmond Times-Dispatch is an article about the demise of the collaborative effort between VCU and Bon Secours to build a freestanding children’s hospital. During my three years in Richmond, I have continually shared my perspective that this proposal was not viable including an Op Ed published in the newspaper on June 30, 2013.
HCA looked at this proposal multiple times to assess whether there was a compelling clinical and financial argument to centralize pediatric services in one place. After a comprehensive and systematic review of the data, it became clear that the proposal of collapsing services across the region to build an independent freestanding hospital would not improve the pediatric care in the market. Moreover, it would come at great financial cost. If the new hospital was built, it would require significant subsidies in perpetuity by the Commonwealth of Virginia (in other words, the tax payers), philanthropists, and cost shifting to insurance companies at the expense of insured individuals and companies across the region. The final conclusion was that the greater Richmond area only had the inpatient volume to fill a small, 100-bed hospital (less than half the size of most freestanding children’s hospitals) and, importantly, that the economics of the enterprise would not be viable for on-going operations. A hospital this size would not be able to offer the requisite pediatric sub-specialty services because patient volumes and research funding would not be there to support it. By comparison, Children’s Hospital of Philadelphia, a nationally recognized pediatric hospital, has more than 500 beds and serves a far larger metropolitan area.
The clinical case was also not compelling. Advocates for a new children’s hospital continually suggested that tertiary and quaternary (high-end) services would be available in the market because of the construction of a new facility. The reality is that 95% of pediatric services are available in our community today. HCA is proud to cover all geographic sectors of Central Virginia with 76 level 3 Neonatal Intensive Care beds, 12 Pediatric Intensive Care beds, 32 pediatric beds, and 8 Pediatric-Ready Emergency Rooms. These services are supported by highly skilled pediatricians, pediatric surgeons, pediatric sub-specialists, pediatric intensivists, and pediatric emergency room physicians. I believe these services have a long-standing history of making a difference in our community, including our most recent annual volumes of almost 1,000 Neonates, 45,000 pediatric ER patients, 6,500 newborn deliveries, 2,000+ pediatric admissions, and tens of thousands of outpatient visits. Building a freestanding children’s hospital would not have better served those patients who have unique medical challenges. Clinical evidence shows these patients are most appropriately served by national centers of excellence that have vast experience treating them.
So where does that leave us today? HCA Virginia, which includes Chippenham Hospital, Johnston-Willis Hospital, John Randolph Medical Center, Henrico, Parham, and Retreat Doctors’ Hospitals, and our free-standing ERs at West Creek and in Hanover are stepping up to give parents choices close to home in a coordinated and integrated fashion. Patients who come into our hospitals electively or emergently can trust our doctors, nurses, and other providers to give them the highest level clinical care in a compassionate manner. We will connect those patients to the best resources in the country, should it become necessary, but most often we are able to keep that care close to our patients’ homes and in coordination with those patients’ primary care physicians.
I look forward to moving on from the community discussion of a building a future children’s hospital to a conversation of building on the great success of the services in our community today in both a clinically smart and coordinated manner. I am proud of our care team, proud of our clinical results, and proud to be surrounded by clinicians who make a difference to the health and well-being of children every day.