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Changes are afoot at Saint Francis Hospital. Earlier this spring, AMITA Health, the overall operator of the hospital, closed the open-heart surgery facilities there, and last week the company applied to the Illinois Health Facilities and Services Review Board (HFSRB) for an exemption that would allow it to close the 18-bed obstetrical unit there.
Nonetheless, the hospital at 355 Ridge Ave. that has served primarily south Evanston and north Rogers Park for decades appears set on maintaining its partnerships within the Evanston community. Its current name is AMITA Health Saint Francis Hospital.
Closing Two Units
The primary reason to discontinue its obstetrical unit, according to the hospital’s application to the board, is “low utilization. During calendar year 2018, the hospital’s obstetrics average daily census was 4.05 patients, down from 4.88 patients the previous year.”
Discontinuing obstetrics at the Evanston site and relocating the service to other AMITA hospitals would enhance patient care, according to the application, “because clinical studies have shown that hospitals that perform higher volumes of deliveries have better results and lower complication rates.” Deliveries would be performed at Saint Francis in “emergency situations,” the application stated.
While deliveries would be discontinued, hospital officials said, the obstetric/gynecological (OB/gyn) service is not closing. “Outpatient OB/gyn care, including prenatal care, will continue to be provided, as will subspecialty gynecological programs, including oncology, urogynecology and gynecologic surgery. In addition, the hospital will continue to support an outpatient OB residency program, with residents’ inpatient rotations taking place at AMITA Health Resurrection Medical Center Chicago.
“Inpatient gynecologic services will continue to be provided, with those patients occupying medical/surgical beds.
“A full range of obstetrics services are available at a number of area hospitals, including The Family Birthplace at AMITA Health Saint Joseph Hospital Chicago (with a Level III neonatal intensive care unit) and The Family Birthplace AMITA Health Resurrection Medical Center Chicago.”
The application for the exemption noted that the project of discontinuing the services is “substantive,” because obstetrics is “a HFSRB-designated category of service.”
Should the Health Facilities and Services Review Board approve the application, Saint Francis would discontinue the 18-bed obstetrical unit within 30 days of the approval.
Earlier this year, the hospital discontinued its open-heart surgery, because of the low number of patients in that category. The caseload for open-heart surgeries dropped from 99 in 2013 to 39 in 2017.
According to the State Board staff report on the hospital’s request for exemption from open-heart surgery, “There is no formula for the open-heart category of service.” The utilizations standards for the open-heart category of services are, for adults, a minimum of 200 open-heart procedures performed annually … within three years after the implementation of the services. “Higher caseloads, over 200 per annum, are encouraged.”
Maintaining Community Ties
Erie Evanston/Skokie Health Center, 1285 Hartrey Ave., has an affiliation agreement with Saint Francis Hospital, and the Evanston Fire and Life Safety Services Department partners with Saint Francis for paramedic training.
Kate Birdwell, Marketing and Public Relations Manager for Erie Family Health Centers, told the RoundTable, “Erie Family Health Centers appreciates the affiliation agreement we have had with AMITA Health Saint Francis Hospital Evanston since Erie Evanston/Skokie Health Center opened in 2012. Referrals from Erie to Saint Francis are available for hospital, testing and specialty services and we do not expect this to change. Although Erie does not routinely refer prenatal patients to Saint Francis, we welcome St. Francis’ pregnant patients who may want to establish or continue their prenatal care with us.”
Fire Chief Brian Scott told the RoundTable, “We have a very strong and valued affiliation with Saint Francis. … They have provided paramedic training and continuing education to our department for over 44 years. We also provide instructional ride-alongs to paramedic students at St. Francis.”
In April, the Evanston Fire Department and AMITA Health Saint Francis Hospital launched EHCO, the Evanston Community Health Outreach initiative. The program uses a mobile integrated health-care approach to provide individuals at high risk for hospital readmission with free in-home medical visits, health education, social service referrals, home safety inspections and other resources.
The goal is to improve residents’ overall health and reduce costly and often unnecessary emergency room and hospital visits by addressing health issues before they reach the crisis level, according to information from the City of Evanston.
Both the Evanston Fire Department and AMITA Health made a two-year commitment to offer the program, which is modeled on successful initiatives in other communities such as Colorado Springs and Rockford, which each saw significant reductions in emergency room visits by enrolled participants.
Under the ECHO program, Evanston Fire Department firefighter/paramedics and nurses from AMITA Health Saint Francis Hospital serve as “community paramedics,” providing participants with the following services:
• Personal health education to better understand their medical issues and recognize problems before they become emergencies.
•Health-care-system education to assist with all aspects of the health-care system, such as finding a physician, scheduling appointments, refilling prescriptions and navigating the complex health care insurance landscape.
• Social service referrals for resources that can improve their quality of life.
• Home safety inspections to ensure they are protected by working smoke detectors, and that other household dangers, such as clutter or trip hazards, are minimized.
At the time of the launch Chief Scott said, “This novel approach will better connect individuals experiencing chronic health issues with the care they need to improve their lives, while also ensuring the efficient deployment of Evanston Fire Department and community resources.”
Kenneth Jones, president of AMITA Health Saint Francis Hospital, said then, “This innovative partnership will help bring important health services directly to some of the members of our community who need it most. By placing trained caregivers out in the community, we hope to better address key health concerns and issues before they escalate into something that requires a trip to the emergency room. Many of our patients find it challenging to find transportation for regular visits and checkups, we’re also helping to solve those issues by bringing the care to them.”
“The program is “designed to help the people who are most in need,” Chief Scott told the RoundTable. “Thanks to the outstanding support of the Saint Francis Hospital Foundation, we have implemented one of the few mobile integrated health care programs in the nation.”