140 year of Shriners

140 year of Shriners

Wednesday, April 24, 2013

One year after Erie Shriners closes inpatient unit

BY DAVID BRUCE, Erie Times-News david.bruce@timesnews.com  PUBLISHED: APRIL 24, 2013 12:01 AM EST
The former Erie Shriners Hospital for Children looks the same from the outside.

A statue of a fez-wearing Shriner holding a child still stands guard outside the two-story, redbrick building. Parents still drive hours to bring their children -- some wearing plastic leg braces or protective helmets -- for therapy, outpatient surgeries and clinic visits.

But there have been a host of changes inside the facility since it converted April 24, 2012, from a hospital to a same-day surgery and outpatient center.

"We have completed what we intended to do to ensure our sustainability," said Charles Walczak, administrator of the Erie Shriners Ambulatory Surgery Center and Outpatient Specialty Care Center, 1645 W. Eighth St. "Now we're looking at growth."

What Erie Shriners did was close its inpatient surgery unit. All patients who require at least an overnight stay are now sent to either UPMC Hamot, Children's Hospital of Pittsburgh of UPMC, or Philadelphia Shriners Hospital for Children.

Concentrating on same-day surgeries, therapy and clinic visits enabled Erie Shriners to slash its 2013 operating budget to $7.8 million, down from $9.25 million in 2012 and $11.08 million in 2009 -- the year in which Shriners International delegates proposed closing six hospitals, including Erie's.

"I don't know if we would have closed had we not made these changes," Walczak said. "But this was our best alternative. We are now being used as an example for other (Shriners hospitals) to follow."

But the changes have come at a cost to some patients and employees.

After all, 86 of Erie Shriners' 134 inpatient surgeries in 2012 were actually done in Pittsburgh, while 36 were performed in Philadelphia, said Mary Jane Antoon, R.N., Erie Shriners' director of patient care services.

Only 12 were done at UPMC Hamot, though the Erie hospital also saw some of Shriners' same-day surgeries that were scheduled late in the day.

As a result, northwestern Pennsylvania families, who used to stay at home during their child's inpatient visits to Erie Shriners, now must travel in most cases to Pittsburgh or Philadelphia, and stay for up to several days.

"Shriners International provides transportation and assists patient families with other needs in these cases," Antoon said. "It could be the cost of meals or lodging."

Erie Shriners orthopedic surgeon and former chief of staff John Lubahn, M.D., said the facility works to reduce the travel time for its patients.

"What is happening is that anyone who lives north of Interstate 80 goes to Erie, or even Pittsburgh," Lubahn said. "The kids who end up going to Philly are those who live more toward Harrisburg."

Lubahn said he hopes to increase the number of Shriners surgeries performed at Hamot, where he works. It depends on recruiting at least one more surgeon to Shriners, he said.

"We're working to recruit another hand surgeon to our office," Lubahn said.

Closing its inpatient unit has allowed Erie Shriners to reduce its staff. It currently employs the equivalent of 86 full-time people, down from 97 in 2012 and 124 in 2009.

Walczak said there have not been any layoffs in the past year.

"We have reduced by attrition," Walczak said. "There have been unfilled positions that we have elected not to fill."

Erie Shriners saw a 9 percent increase in its number of clinic and therapy visits in 2012, but a 10 percent decrease in same-day surgeries.

Part of the problem is the difference between outpatient surgeries -- which Erie Shriners performed when it was a hospital -- and the ambulatory surgeries now done there, Walczak said.

"Outpatient surgery patients in Pennsylvania can have a longer recovery stay than ambulatory patients," Walczak said. "That restricts the number of surgeries we can do here at Shriners. We have to err on the side of safety."

Erie Shriners also became a landlord in August 2012, when the Children's Hospital Specialty Care Center Erie opened in the Shriners' former inpatient unit on the second floor. The center is not affiliated with Shriners.

A medical clinic featuring pediatric specialists from the Pittsburgh hospital, the center allows area families to make preoperative, postoperative and diagnostic visits for their children without traveling to Pittsburgh.

"Having the clinic does help us because we can refer our patients upstairs for services we can't provide instead of sending them to Pittsburgh," Antoon said.

Danielle Winkler (at left), 16, of Erie has her reflexes checked by orthopedic resident Dr. Purab Viswanath (at right) at the Shriners Hospitals for Children in Erie on April 23. In the background, Sue Margraf, R.N. records Winkler's vital signs. JARID A. BARRINGER//ERIE TIMES-NEWS

DAVID BRUCE can be reached at 870-1736 or by e-mail. Follow him on Twitter at twitter.com/ETNbruce.
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