Nov. 28—When the aging UM Harford Memorial Hospital in Havre de Grace closes on Feb. 6, a new pavilion at UM Upper Chesapeake Medical Center in Bel Air will open on the same day — with the same number of inpatient beds, 72, as the old hospital.
Even so, Harford County residents are concerned that the main health system that serves the county may be overburdened.
Those concerns were expressed by Harford County Council members during a presentation from UM Upper Chesapeake Health leadership at the Nov. 14 council meeting.
Residents have complained in recent years about long wait times in the emergency rooms at both hospitals, and ambulances being diverted to hospitals outside Harford County because local emergency rooms are full.
Yet, UMUCH CEO Elizabeth Wise said the health system will not be adding more beds in the near future.
"One of the things that I have been asked since I got here [in January 2022] is, 'Do we need more beds in Harford County? Do we need more hospital beds?' And as of today, I'm going to say 'No,'" Wise said.
District A Council member Dion Guthrie disagreed.
"It's hard for me to believe," said Guthrie. "I've had numerous people, including some nurses from the hospital, who told me that the normal waiting time in the emergency room is 10 to 12 hours. That's half a day. That's a contradiction to call it an emergency room."
"I just have to respectfully disagree," said Dr. Fermin Barreuto, chief medical officer of UMUCH.
Dr. Colin Ward, chief operating officer of UMUCH, said Maryland ranks 50th out of 50 states for certain metrics that measure emergency department efficiency, with only the District of Columbia performing worse.
"Patient efficiency of movement through the system is an issue that is a challenge across the state," said Ward, "and some of that activity actually happens up in the patient units. But the symptom presents itself in terms of bogging down the emergency department only."
Ward said that the University of Maryland Medical System, which Upper Chesapeake Health is part of, is among the many hospital systems statewide working with the Maryland Hospital Association to improve hospital efficiency.
Interestingly, Harford Memorial is in the top third among hospitals in the state for shortest wait time in the emergency room from arrival to discharge, said Barreuto. Upper Chesapeake Medical Center is around average, he said, at 278 minutes.
A chart from the Maryland Hospital Association shows the average emergency room wait time, from arrival to discharge, in the state is 238 minutes.
Barreuto said Harford Memorial is in the top quartile with 467 minutes on average from a person's arrival to the emergency department to the inpatient bed, and Upper Chesapeake is about average for the state at 665 minutes.
"Harford Memorial is actually performing quite well compared to others within the state," Barreuto said.
But Barreuto said that several factors are involved in the time it takes for a patient to move from the emergency department to an inpatient bed, including transfers and readmissions, and that the hospitals take a daily census to account for those fluctuations.
Barreuto said he and Ward work closely with Harford County Emergency Medical Services to offload patients from ambulances efficiently and return to service, with Harford Memorial's emergency department averaging about 20 minutes and Upper Chesapeake Medical Center around 40 minutes.
"That's amazing compared to what we've had in the past," said County Council President Pat Vincenti.
Guthrie shared that on a recent Monday, his 97-year-old mother-in-law who lives with him had to be taken by ambulance for emergency treatment after having a stroke at home and ended up at Johns Hopkins Bayview Hospital in Baltimore because the county's hospitals didn't have room.
"We called 911, paramedics came right away," he said. "They worked on her, and they sent for the ambulance and the ambulance came. That's the good news. The bad news is ... they call the hospital here and they said they cannot take her; they have no beds. Six o'clock and no beds available. ... I would say you need a lot more beds."
Wise said that the health system is meeting the needs of a growing county with an aging population. She pointed to the new UM Upper Chesapeake Health at Aberdeen, which will include a medical center and a Behaviorial Health Pavilion that will also open on Feb. 6, and a Health and Wellness Center that is already open.
"This is one of the reasons why the medical staff is looking forward to this change in both regionalizing care and making us more efficient," she said. "When you're able to centralize the limited resources that everyone deals with, with regards to physicians and staff, and when they don't have to split as much time between the two facilities, they will get more efficient."
The Aberdeen campus will include a 130,000-square-foot emergency department and 17 short-term beds for observation.
However, with Harford Memorial closing, UM Upper Chesapeake Medical Center will become the only full-service hospital in the county.
"February 6, I think, is a scary day for a lot of people in my community," said District F Council member Jacob Bennett, who lives in Havre de Grace.
Bennett said residents in the northern part of the county are concerned about longer wait times for ambulances once Harford Memorial closes.
"The other concern that I've heard from many people is the worry of the change in the gravitational pull for ambulances now being more centralized to Bel Air," Bennett said. "I know some ambulances will go to Aberdeen, but for intensive care and some of those more severe situations, you're gonna need to get to Bel Air and as ambulances are focused in the Bel Air area, it'll be harder to pull them towards our part of the county."
Ward said his team will be meeting soon with local emergency medical services agencies to discuss keeping a balance between the Aberdeen and Bel Air medical centers.
Vincenti addressed Bennett's concern by saying that the county has two medic units in Havre de Grace, and that the volunteer-based Havre de Grace Ambulance Corps has two or three ambulances also designated for that area. Vincenti added that the Aberdeen campus has room to grow "as the need comes."
State of the county's health care
As part of their presentation, which lasted nearly an hour, hospital officials gave an update on the overall state of health care in Harford County.
Wise said that UMUCH performs a community health needs assessment every three years and then creates an implementation plan, working with the county health department and other community partners. The assessment, she said, is required in order to receive federal funds, particularly from Medicaid and Medicare.
Its most recent assessment showed that Harford County has higher incidences of smoking, hypertension and diabetes compared to other counties in the state. To combat that, UMUCH is focusing on smoking cessation classes, hypertensive screenings, prediabetes care, and educating residents on the signs and symptoms of a stroke, Wise said.
Lung and breast cancer diagnoses are also on the rise in the county, Wise said. "Colorectal [cancer] is another one that we're keeping an eye on," she said.
She said that UMUCH is continuing to invest in its Kaufman Cancer Center at the Bel Air campus.
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Stroke care has become a priority, too. UMUCH was recently designated a "Smart Stroke" center. To earn the "Stroke Smart" designation, hospitals must meet certain standards of care outlined by the American Stroke Association and Maryland Institute for Emergency Medical Services Systems that demonstrates the organization's ability to provide life-saving treatment to patients who may have suffered a stroke, according to a University of Maryland Medical System website.
UMUCH is focused on educating people about the signs and symptoms of a stroke, and what to do if you or someone around you is exhibiting those signs and symptoms. Calling 911 is the first crucial step, Wise said.
"We measure our door-to-needle times, so the faster you get to us, the sooner we can give you the clot-busting drug," Wise said.
UMUCH has drug treatment plans for up to the first 24 hours after a stroke and other treatment options, such as catheterization, she said.
The Aberdeen Medical Center will be Maryland's first acute-stroke ready facility with the capability to evaluate, stabilize and treat individuals with stroke symptoms.
UMUCH also has a patient and family advisory council made up of community members that meets on a monthly basis that provides input and gives feedback on "what we're doing well and what we could do better," Wise said.
Originally Published: Nov 23, 2023 at 6:00 am
