The Westerly Hospital administrators say ongoing staffing changes are driven by reduced patient volume and the need to prepare for constant changes in the delivery of healthcare. "Part of the shift we're seeing is a decrease in inpatient care. I call it the new normal," said Jeanne LaChance, hospital executive vice president/COO. The hospital announced last month that 29 employees would be laid off and 59 others would have their hours reduced. Twenty open positions have been eliminated. The number of layoffs was reduced to 26 when some employees who were facing layoffs found other positions at the hospital. As painful and disruptive as the layoffs are, LaChance said they are necessary to better position the hospital for an ever-changing health care landscape and to more accurately reflect the hospital's labor needs. In addition to lower patient volumes at the hospital, the 125-bed facility - like hospitals across the country - is increasingly focused on keeping people out of the hospital through wellness programs and outpatient care. Effective wellness programs will soon be reimbursed by the federal government as part of health care reform initiatives, hospital officials said.