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Imminent Hospital Closure Roils Clinicians, Spurs Admins into Action

Analysis  |  By Lena J. Weiner  
   May 09, 2016

Hospital workers may understand why their hospital has been slated to shut down, but that does not negate their concerns about their job prospects or the health of their community.

Few situations more are more divisive than a hospital closure. Interactions among leadership, clinical staff, and other workers are loaded with emotion, tinged with suspicion, and can easily turn negative.

As representatives of senior leadership's more human side, HR leaders can feel stuck between a rock and a hard place—HR workers might understand the administration's reasons for their decision, but that does not negate worries about employees and their future.

This drama plays out every time a physicians practice, hospital, or health system enters into a partnership agreement, agrees to be acquired, makes a bid for another organization, or has to announce that a facility is closing.  

HR leaders have found themselves on both sides of the divide, sometimes playing the part of community organizer to keep hospitals open, and sometimes having to explain why a closure was necessary to enraged workers.

A closure is playing out right now in southern California.

Saddleback Memorial Medical Center - San Clemente, a 73-bed hospital which employs about 200 people within the non-profit MemorialCare Health System, is slated to close its doors permanently on May 31. The hospital's administration says it is averaging 2.75 admissions daily and two surgeries per week.

The MemorialCare Health System, which is headquartered in suburban Fountain Valley and had revenues of $2.2 billion in 2015, operates two other medical centers in Orange County and three in neighboring Long Beach, in addition to medical groups and convenient care services that are scattered throughout the region.

Approximately 45 physicians practice out of the San Clemente campus; about 20 of them have volunteered or provided financial support to the fight to keep the hospital open, says Gialamas.

He organized the group with the support of two other San Clemente campus physicians.

Below, two healthcare leaders with very different roles in the closure share best practices they were able implement. Tony Struthers is the administrator of Saddleback Memorial, San Clemente. Gus Gialamas, MD, is an orthopedic surgeon who has spearheaded a fight to keep the hospital open. The transcript below has been lightly edited.

HLM: What arrangements have you made for healthcare workers who will be displaced through this closure?

Struthers: We are grateful to the dedicated employees at the San Clemente campus. We are working with our employees to identify job opportunities within the healthcare system at our hospitals and numerous healthcare facilities, holding job fairs and providing one-on-one assistance.

Our job fairs feature representatives from our sister hospitals and outpatient centers, and our recruiter is expediting interview opportunities with our sister programs, facilities, and services.

We expanded our human resource hours, our question-and-answer sessions, and recruitment assistance. We are also offering a number of classes, including those on resumes, interviewing and networking; employee development department informational sessions and benefit sessions.

Of our 122 full- and part-time employees on the San Clemente campus, about 60 will have been placed within MemorialCare hospitals, outpatient facilities, and affiliated organizations in Orange and Los Angeles counties, thus far.

Many others have indicated that they have secured positions elsewhere and we continue to work to help our employees with the transition.

HLM: How has the HR department been involved in this closure?

Since August 2014, we have reached out to thousands of employees, physicians, community organizations, elected officials, and other stakeholders throughout the region regarding our vision to convert the campus into a state-of-the-art ambulatory campus.

We have held regularly scheduled town hall meetings and other gatherings for employees. We have maintained an "update" column on the intranet to keep employees aware of key dates, timelines and other information.

[And] we have conducted outreach visits to physicians most active at the campus and sent written communication at key junctures during the process.

HLM: How did you involve local political leaders in your fight to keep the San Clemente campus open?

Gialamas: Over the last few years, we have formed a group called Save San Clemente Hospital and tried to educate our community, legislators, and city leaders as to the effects of a closure. Over the course of the last two years we've done a lot of outreach, and we have a website.

We've had two bills in the legislature and Senate in California, SB 787, both of which failed in Sacramento, for various reasons. But we just met with the healthcare agency, and had a public hearing on April 29.

Forty of our residents here in San Clemente gave public testimony about the negative impacts of closure. We're waiting now for the impact study from the Healthcare Agency of Orange County, which will be delivered to the California Department of Public Health.

HLM: What have you learned about organizing healthcare professionals to advocate for their hospitals?

Gialamas: Don't make it a political issue.

Listen, I've been a lifelong Republican, and this is Orange County. It seems like everything has been politicized. But I've learned that some things in life shouldn't be political. I've found myself looking for like-minded people who are advocating for [the community's] health, particularly those with unmet needs and underserved populations, such as seniors and the homeless.

I've also learned a lot about the challenge of organizing physicians. Many in our area have been reluctant to get involved. I think it's [exacerbated] by the burnout rate, which is another ethical crisis in America. But there are plenty of physicians in our corner who have been supporting us.

HLM: How can you find allies in the community to help get the word out?

Gialamas: I live in an area that has a homeowner's association, and I talked to our HOA president and asked him to send out a notice that our local hospital was in danger of closing.

The CEO of a local PR firm saw that note, and I hired his PR firm to communicate our message to the city. The first thing we did was to send out a message to 14,000 homes here in San Clemente and neighboring Dana Point and San Juan Capistrano advising people that the hospital would close and that this would have a negative impact on emergencies they may face down the line.

We then went to the press, issued press releases, spoke directly to the city council, and attended city council meetings almost every other week for the next year and a half, and finally, we got everyone's attention.

Once the community started talking about the possibility of losing a 911-service, they became engaged.

Our group spoke to the Rotary Club, Exchange club, HOAs, and other groups. I think we got our message across in a reasonable fashion. We want people to know that losing emergency care access and a hospital is not good for our community.

Despite Gialamas's efforts, the hospital is still slated for closure on Tuesday, May 31, a fact that makes him worry about the future of San Clemente. "Market forces should not dictate a community's ability to access emergency and acute care. It's the health and safety of our communities that is at stake here."

Lena J. Weiner is an associate editor at HealthLeaders Media.

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