Noble ICU necessary for local health service says DPH

WESTFIELD- The Massachusetts Department of Public Health (DPH) notified Baystate Noble Hospital of its determination that the intensive care unit (ICU) and pediatric care unit (PCU) are necessary for healthcare access to the hospital’s coverage area.

The DPH sent the notice to Baystate Noble on July 2. Because the DPH ruled this way, Noble will now need to submit a plan that ensures adequate access to emergency and pediatric healthcare for the affected area.

“The hospital is required to submit a plan for assuring access to DPH within 15 days of the finding, by July 17. As of July 11, DPH has yet to receive the plan from the hospital,” said Marybeth McCabe of the DPH Bureau of Health Care Safety and Quality.

The DPH ruling does not prevent Baystate Noble from closing the two units. The DPH will send the hospital written comments within 10 days of receiving the plan if more information is required. Baystate Noble must then submit a response within 10 days of receiving the comments.

“The essential service closure process provides a mechanism for DPH to review a proposed closure or reduction in services and to ensure that measures have been put in place to minimize the impact on the community and address concerns that have been brought to DPH’s attention,” said McCabe, “However, DPH cannot legally require a hospital to keep a service open.”

Baystate Noble Hospital submitted a 90-day notice of intent to discontinue the two units in question on May 30 of this year. On June 19, the DPH hosted a public hearing at Westfield Middle School on the proposed closures. The hearing was used to allow all relevant and interested parties to share their thoughts on the matter. The meeting was attended by residents, city officials, and representatives of Baystate Noble Hospital.

During the hearing, Baystate Noble Hospital President Ron Bryant detailed the hospital’s plan and reasoning for closing the two units. Bryant said that the beds would be designated as medical surgical beds after the closure. He said that those in the Noble coverage area who need the ICU or PCU would instead be transferred to Baystate Medical Center (BMC) in Springfield.

“For the past several years, the most critically ill patients at Baystate Noble have been transferred to Baystate Medical Center, another affiliate of Baystate Health,” said Bryant, “Baystate Medical Center is the system’s tertiary care hospital where there is a team of physicians who specialize in the care of critically ill patients, and where there is a full range of physician specialists to care for those patients.”

Bryant cited a typically low patient count in the Noble ICU with the average occupancy being just one patient per day. He made the argument that any potential Noble ICU patients would receive better care at BMC. Bryant added that the PCU has not seen a patient in years, due to changes in the manner in which pediatric care is delivered.

At the hearing, City Council President Ralph J. Figy said that he is opposed to the idea of closing the ICU at Noble. He conceded that the PCU may be unnecessary due to the lack of patients.

“Baystate Noble does not just serve the city of Westfield. It is the surrounding communities that are a half-hour out of Westfield that I am concerned about as well,” said Figy.

Figy’s sentiment was shared by several others at the hearing, including Registered Nurse and Massachusetts Nurses Association (MNA) member Donna Kelly-Williams, who said that the extra time to drive between Westfield and Springfield will be too long for patients in dire need of medical attention.

The distance between Noble Hospital and BMC is approximately 24 minutes with minimal traffic. The hill towns that are within the Noble coverage area are even further.

Donna Stern, RN at Baystate Franklin’s mental health unit who was also present at the forum to discuss the proposed Fowler Mental Health Unit closure at Noble, urged people to call their legislators and voice their support of the Essential Services Bill. The bill would require more public oversight when a hospital chooses to close a unit that has been deemed an essential service.

Following the July 2 ruling by the DPH, BMC President Nancy Shendell-Falik made this statement:

“In accordance with Massachusetts Department of Public Health (DPH) process, we will be providing Baystate Health’s plan for access to care and commitment to meet patient needs relating to the transition of ICU and pediatric services at Baystate Noble and Baystate Wing Hospitals.

Baystate’s recent decision to transition ICU beds to medical/surgical beds at both Baystate Noble and Baystate Wing Hospitals was the result of a long and thoughtful process on how to best coordinate care across our health system enabling us to deliver the highest level of safety, quality and patient experience. The vast majority of patients assigned to the ICU in these two community hospitals are actually not higher acuity patients and can be well cared for in their local medical/surgical units. Patients requiring ICU level care are transferred to Baystate Medical Center, the region’s only tertiary care academic medical center, where a highly-trained team, including critical care specialists, oversees care for the most critically-ill patients. Additionally, pediatric patients requiring inpatient care are transferred to Baystate Children’s Hospital or to another facility with specialized pediatric services, based on the preference of the family and the child’s condition. The pediatric beds at Baystate Noble Hospital have not been used in many years, and we are seeking to update the license to reflect that.

Any change in service is carefully planned with the utmost consideration for providing access to the highest quality of care.  We will continue to work with DPH in connection with our plans and commitment to meet the public health needs of the people in the communities we serve,” said Shendell-Falik.


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