Boston Medical Center is preparing to break ground soon on a $270 million construction and renovation project that it says will consolidate the hospital’s two South End campuses and eliminate 60 beds while maintaining the same level of services.
The project, expected to be completed in 2017, is a belated culmination of the 1996 merger of Boston City Hospital and University Hospital, which created Boston Medical. While the hospitals have integrated departments over the past 18 years, and closed one of the two emergency rooms in 2010, they have continued to offer medical care at both campuses, often shuttling patients admitted at one to specialists at the other — a two-block ambulance ride.
That would end under the consolidation
plan. It has been approved by Boston Medical’s directors and the Boston Redevelopment Authority but awaits a “determination of need” certificate from the state Department of Public Health.
“We’re positioning ourselves for the next phase of health care,” said Dr. Ravin Davidoff, chief medical officer at Boston Medical. “We’re creating a patient-centered clinical campus.”
The plan calls for eight additional operating rooms and about 70 single rooms on the former Boston City Hospital site, expanding outpatient facilities and the gastroenterology department, and creating an updated, consistent feel throughout a sprawling campus dotted with aging buildings. It would also expand by a third Boston Medical’s congested emergency department, the busiest in Massachusetts with nearly 130,000 patient visits last year.
But it will also mean closing the Newton Pavilion on the former University Hospital campus. Those two adjoining buildings will be sold.
Proceeds from the sale, along with money raised through philanthropy and bond financing, will bankroll construction and renovations at the Menino, Yawkey, and Moakley buildings on the remaining campus, plus a transport bridge that will ferry patients from a helipad over Albany Street to the medical center.
Overall, the hospital’s footprint will shrink by about 329,000 square feet to just under 2.1 million square feet.
The consolidation is expected to save at least $25 million a year through energy efficiencies and the elimination of “workarounds,” such as the short ambulance trips to bring patients admitted in the emergency department to neurosurgery and cardiac specialists at Newton Pavilion.
Beyond the savings, there will also be larger and more efficient space for mothers and babies, for intensive care, and for doctors to collaborate.
“It’s caring for the patients in the right setting, in the most efficient manner,” said Bob Biggio, vice president for facilities and support services.
Some of Boston Medical’s competitors acknowledge privately that its redevelopment plan is a bold response to a changing health care environment in which hospitals face cuts in government payments for Medicaid and Medicare — the top sources of revenue for Boston Medical, the state’s largest safety net hospital.
Despite those reductions and a national decline in the number of inpatient procedures, most hospitals have been reluctant to eliminate beds.
That may be changing in such cities as Boston, however, where academic medical centers also are grappling with reduced funding for research and must adapt to new insurance contracts that reward them for positive health outcomes and for keeping patients out of the hospital.
“Hospitals are going to have to work more efficiently, like other industries,” said Harry Glorikian, managing partner at the Cambridge consulting firm Scientia Advisors. “If that means they don’t need as many beds, they can apply the savings to optimizing their plants and improving their services.
“They will have to manage care more efficiently outside hospitals to reduce admissions, and they will have to do what they do internally more efficiently, as well,’’ he said.
Leaders of the Massachusetts Nurses Association have protested the decision to close the former University Hospital campus, where more than 450 of its members work as registered nurses. Boston Medical officials say they anticipate their staffing needs will remain constant, so the nurses will be able to move to the consolidated campus. But to do so, they may have to switch their affiliation to the Service Employees International Union, which represents nurses there.
“While management has stated publicly that there will be positions for everyone following the consolidation, they have refused to put that guarantee in writing for the East Newton Campus nurses,” said association spokesman David Schildmeier. “These nurses have years of experience providing care to the patient population served by the hospital and they and their patients deserve that the new consolidation will ensure the same level of care.”
The issue is under negotiation but is not expected to delay the hospital’s consolidation.
During the three-year redevelopment project, Boston Medical would operate on both campuses.