The sudden closure of Astria Regional Medical Center in Yakima raises serious concerns for patient care in the Yakima Valley, particularly emergency, neurosurgery and cardiothoracic care, doctors and nurses said.
A U.S. Bankruptcy Court order Wednesday allowed Astria Health to immediately start winding down inpatient services at the hospital at 110 S. Ninth Ave. Astria said it had run out of other options to keep the hospital running. The emergency department is scheduled to close at 12:01 a.m. Monday.
Patient numbers at Regional, which were ranging from the 20s to low 50s in the 214-bed hospital, have dropped over the past few days as patients are discharged and transferred to other facilities.
Dr. John Zambito, medical director for Regional’s emergency department, said closing Regional will affect the community’s ability to respond to trauma cases.
“I use the term catastrophic,” he said. “This is potentially catastrophic for health care in the Yakima Valley.”
Flu cases peaked in Yakima in December, and Yakima’s other hospital — Virginia Mason Memorial — saw a record number of patients visiting the ER that month. In one day alone, there were 330 patients in the emergency department at Memorial.
Astria Regional’s emergency room has been seeing an average of 100 patients a day over the past couple of months, said Dr. Mark Silverstein, chief of staff. The physicians expressed concern about increasing the patient load and demand on the ER at Memorial, and its ongoing impact on staff there.
Dr. Rachel Monick, who has worked in Astria’s emergency room for more than five years and was at Memorial for five years before that, said trauma is one of the areas in which losing Regional will be harmful.
“The community doesn’t understand how potentially dangerous the immediate closure of the hospital is without a set backup plan,” she said, especially the immediate loss of Regional’s cardiothoracic and neurosurgery services in Yakima, which will take time to re-establish.
“Those are things that are so important in the initial golden hour of trauma — the first hour after the traumatic injury,” she said. “That’s what determines a successful outcome. That’s why it’s so important to have those things here instead of transferring (patients).”
Transferring patients also can be difficult for families who need to travel, and for people with fewer resources, she said.
Regional’s ER cared for many of Yakima’s gunshot victims because of its location. It also had a number of patients walk into its facility because of its location near downtown, the physicians said.
The Washington State Nurses Association filed an emergency motion in court Friday asking the bankruptcy judge to reconsider the closure. A hearing is planned Tuesday morning.
In its motion, the nurses group said Regional is one of two hospitals in Yakima County designated as a Level 3 trauma center, which provides 24-hour immediate coverage by emergency room physicians, and quick access to general surgeons and anesthesiologists.
“The reduction of Level 3 trauma center coverage in Yakima County (population 251,446) from two to one hospital will have a significant impact on the community’s access to timely urgent and emergency care,” the filing said. “In comparison, Benton County (population of 201,877) has two Level 3 trauma centers.”
Regional is the only hospital within 100 miles with an open-heart surgery program, and the percutaneous coronary intervention program at Memorial relies on the open heart surgery capacity at Regional to care for patients whose conditions require a level of service that Memorial can’t meet, the court document said.
Astria has three catherization labs, which are examination rooms in a hospital with diagnostic imaging equipment used to look at the heart and provide treatment. Memorial has two, and is working to add a third. The Regional physicians noted there are days when those labs are in high demand, and upgrades are planned on Memorial’s labs, which will affect service.
Last month, Memorial received a Certificate of Need from the state Department of Health to do a percutaneous coronary intervention, a heart procedure, on an elective basis. To get the certificate, Memorial made a transfer arrangement with Kadlec Regional Medical Center in Richland. According to Google Maps, it takes about 1 hour and 16 minutes to drive the 78 miles between the two hospitals.
Diane Patterson, senior vice president and chief operating officer at Memorial, said the hospital can also set up a mobile catherization lab to provide additional cardiac care.
“We’re evaluating all the possibilities to ensure our community has the care they need for cardiac care,” she said.
She notes that the health care industry has been moving toward cardiac procedures, such as the elective PCI that Memorial is now able to do, that have reduced the need for open heart surgery. “There is more and more that can be done in cardiac intervention,” she said.
Patterson said good cardiac care doesn’t necessarily mean doing everything in one location. “For us, it’s partnering with Virginia Mason, it’s partnering with Kadlec, if a patient needs open heart surgery.”
Monick said while the staff at Regional have been concerned with decisions made by Astria’s administrators, they have remained committed to the organization because they care about the patients they serve and appreciate working with one another.
“We stay because we care about the patient population,” she said. “And we know it’s important for it be open.”