FALL 2023 DEVOTED TO HEALTHFUL LIVING 2 We’ve raised more than $3 million! 6 Why 25 inpatient beds fit Inside Hospital expansion: Designing for the future
2 HEALTH COMPASS FALL 2023 Capital campaign surpasses $3 million raised By Mark Kujala, CMH Foundation Director The BuildCMH capital campaign is off and running. Local patients John Crawford and Jody Stahancyk recently announced a $250,000 donation. In September, Chris Laman, our vice president of strategy, completed a 100‑mile ultramarathon fundraiser, with all the proceeds going toward purchasing healing art for the new facility. And with two successful Diamond Derby events behind us, this brings our capital campaign total to roughly $3.3 million, or nearly one-third of the campaign’s goal. All of this began with having an amazing project to promote. Thanks to the project team and Randy McClelland, project director, I can show off detailed plans of the exterior and interior, 3D models and life-size cardboard mock-ups of patient rooms and other spaces that will be constructed in the new expansion. People always come away inspired and impressed with our plans. They then understand even more how their contribution will improve the patient experience and the overall quality of health care in our community. If you are interested in being a part of this exciting campaign, please reach out to me at 503-338-7505 or mkujala@columbiamemorial.org, and I’d be happy to share more. You can join us in making our vision for health care in the Columbia coast region a reality. By Erik Thorsen, CEO Columbia Memorial Hospital opened its doors at the presentday location in 1977. In that same year, Elvis Presley died, Star Wars (later called Episode IV – A New Hope) opened in theaters, the first Apple II computers were sold and the Concorde supersonic jet flew its first commercial flight. At the time, the hospital employed less than 100 caregivers and offered a handful of services, such as labor and delivery, an inpatient unit and laboratory testing. Over the last 46 years, the facility has undergone several renovations and additions, stretching, growing and using every available nook and cranny to provide needed, advanced health care services here in Astoria. CMH now employs more than 800 caregivers. Despite the tremendous expansion of both our services and team, the footprint of our hospital building has remained largely the same since its opening. When asked why we are embarking on the BuildCMH Expansion Project, an ambitious development that may be one of the largest construction projects in Clatsop County history, it is not hard to explain. We are simply out of room. Room sizes that worked for patients and providers nearly 50 years ago no longer work today. Patients value privacy and dignity (and they should), yet the hospital was not built with those in mind. The infrastructure needed to support certain large equipment is not available, and updating what we have is not feasible within federal and state regulations. Our hospital, though it has cared for many and saved countless lives, has nearly reached the end of its own sustainable life. As we prepare to build a state-of-the-art expansion, one thing I think we’re all excited about is the space it will provide. Continue reading this edition of the Health Compass to learn more about how our new facility will help us grow and serve future generations in our area. Expanding into needed space
COLUMBIAMEMORIAL.ORG FALL 2023 3 Cale Ash, PE, SE, is the principal and group director at Degenkolb Engineers in Seattle. Ash is a structural engineer, project manager, and earthquake and tsunami safety advocate. He is one of the BuildCMH Expansion Project leaders. Ash joined Degenkolb Engineers in 2003. His work focuses on seismic evaluation and rehabilitating existing buildings. Some of his notable projects include the Seattle campus of the U.S. Department of Veterans Affairs; Ocosta Elementary School in Westport, Washington; many other K – 12 seismic retrofits; and the evacuation tower in Tokeland, Washington. Q What excites or interests you most about the CMH project? A “Something that really resonates with me is the hospital providing a resilient facility for the community and the patients. “We see this as a great opportunity to bring forward the work we’ve done with other coastal communities. Plus, we have experience navigating FEMA grants. Grant funding will help offset the cost premium to make the hospital tsunami-resilient. We’ve been working with CMH to pursue FEMA grants since we started working together in 2021.” Q What are some other notable projects you’ve worked on? A “The first half of my career, I worked very closely on many projects for the Department of Veterans Affairs. I completed a seismic evaluation of four buildings at the Seattle campus. I also redesigned the retrofit of those buildings, including their main hospital building, two patient towers and their community living center. “Similar to CMH, those buildings were built in the 1980s, so the buildings were vulnerable to earthquake damage. We were able to identify the weaknesses and improve them so they could work through an earthquake.” Q What does your role entail? A “For the expansion hospital, I’m working to understand project goals, specifically resiliency goals, and working with ZGF [project architect] on how we achieve those for the size of the building, for the existing hospital and the future uses for the hospital. “We looked at the hospital’s current design to see how the building would work for future needs. The current hospital was built in the 1970s, before engineers and seismologists knew about the Cascadia Subduction Zone. They didn’t consider there could be a big hazard close to the project site. “There are engineering standards that help us guide the process of the existing building. That entails reviewing the building design and almost reverse engineering to understand how strong it is. [We’re looking to see] if there are areas that could be damaged if there was an earthquake. “We combine that with future plans for the expansion. We look at the floor plan and where we can provide additional structure to the building so it can resist shaking in case of an earthquake. We are enhancing structural bones to resist earthquake forces.” Get to know the structural engineer
4 HEALTH COMPASS FALL 2023 As the summer came to a close, CMH reached a major milestone with the BuildCMH Expansion Project by completing the design development phase. Many departments and hundreds of caregivers worked with our architect team from ZGF to outline the details of their spaces in the expanded hospital, breaking ground in late 2024. The design development phase included the last major design work before moving into a more finalized budgeting and construction documentation phase, which is a quieter period as far as caregiver involvement goes. At the start of the year, we anticipate fully moving into construction documentation. The new hospital facility will grow from about 56,000 to 182,000 square feet, with significant space improvements for the Emergency Department (ED), Surgery, Imaging and caregiver respite areas, in addition to other zones. Learn more about how we’ll grow into the additional square footage: Emergency Department The ED will gain nearly 10,000 square feet, more than doubling the number of treatment rooms. It will include Safer Rooms, allowing caregivers to accommodate a broader spectrum of patient types and acuity levels. In addition, the ED will have its own imaging equipment, including a CT and x-ray unit, which will help patient flow immensely. Previously, the ED shared imaging equipment with our main hospital Imaging Services, so emergent cases would throw off a day’s schedule. With dedicated machines, there will be less disruption for all patients. Imaging The number of mammography machines will double, allowing more patient access and shorter wait times for appointments. Advanced imaging technology, such as new CT, MRI and PET CT machines, will be purchased. A dedicated Interventional Radiology suite will also be constructed, allowing CMH radiologists to perform imageguided, minimally invasive procedures without open surgery. Inpatient units (Critical Care, Medical/Surgical and Observation) Inpatient room sizes will drastically increase, providing more space for patients and their visitors. All rooms will house only one patient, and they will be located on the third floor with views of the Columbia River or green spaces outside. Every room will also have a private bathroom and shower. An Observation Unit, including four rooms (in addition to the hospital’s Building a state-of-the-art
COLUMBIAMEMORIAL.ORG FALL 2023 5 25 inpatient rooms), will increase access for same-day surgery patients and those who will be in the hospital for procedures for less than 48 hours. These rooms will free up other inpatient rooms for patients requiring longer stays. Family Birth Center Expectant mothers can anticipate a spa-like, holistic experience, with larger patient rooms; private bathrooms, including a tub and shower; and sweeping views of the Columbia River or green spaces outside. Privacy If you’ve been a patient at CMH, you may have experienced being wheeled through a public hallway to the surgical suite or procedure space. When the hospital was first built, patient privacy regulations and expectations were not what they are today. In the Built-in resiliency measures Because the hospital is located in a tsunami inundation zone, the expansion will be built with resiliency in mind. A deep pile foundation and steel structure will anchor the building to the ground, and the third and fourth floors will be able to accommodate up to 1,900 people as a refuge in case of a natural disaster. In addition, critical infrastructure, generators and the helipad will be located on the roof, away from any potential hazards near the ground. This will allow the hospital to continue to function even in an emergency. expanded facility, private corridors will provide more dignity and privacy for all patients. Private rooms with their own bathrooms and showers will also augment patient confidentiality. Surgery CMH added a Stryker Mako SmartRobotics system in 2023 for total joint replacements. Plans for the expansion include additional operating rooms (ORs), with a separate OR dedicated solely for C-sections in the Family Birth Center. Surgical spaces will grow from about 12,000 square feet to nearly 28,000 square feet, and pre- and post-operative rooms will increase from seven to 19, providing ample space for patients needing surgical services. Caregiver amenities Over the past few decades, caregiver spaces were reduced to make room for more patient services. In the expanded hospital, nearly 6,000 square feet will be dedicated for caregiver use only. There will be private lounges, locker rooms and lactation rooms, with a respite area included on every floor. Caregivers may also access outdoor terraces that are exclusively for their use. facility
6 HEALTH COMPASS FALL 2023 By Robert Holland, MD, PhD CMH Board of Trustees President The announcement of a major remodel of CMH has generated considerable local interest. The effort will be one of the largest single construction projects for Clatsop County and will propel CMH into being one of the most modern small hospitals in the country. Many questions have been received as to why the Board of Trustees decided to retain the 25 inpatient bed size, rather than increasing that number. With the cost of hospital construction now exceeding $1,000 per square foot, every inch of space must be scrutinized. A shift to outpatient care As a clinician with nearly 40 years of experience, I have witnessed a revolution in how medicine has developed and seen a giant shift away from inpatient care to extensive application of outpatient treatment and surgeries. When I trained, patients undergoing gallbladder surgery or a hysterectomy could anticipate spending three to five days in the hospital recovering. Now, those having gallbladder removal, hysterectomies, knee and hip replacements, and many other procedures go home the same day and recover quickly. Change in surgery procedures alone removes much of the need for inpatient beds. Powerful antibiotics that can be administered to outpatients, infusion centers, endoscopy clinics and increased office procedures have irreversibly changed the needs for inpatient admission. Patients are admitted now only with more serious conditions that are not yet amenable to outpatient therapy. Medicare requirements CMH is considered a Critical Access Hospital by Medicare, a designation which provides cost-based reimbursement allowing smaller hospitals in rural areas to afford providing lower-volume care in essential geographic areas. Requirements for this designation include limiting bed count. is at a premium Space A practical, creative solution With this background, the board employed due diligence to evaluate countywide demographic and market share for inpatient bed needs. We took into account that the current average daily inpatient census is 12 patients and the average length of stay is three days. We found that between CMH and the capacity of Providence Seaside Hospital, the county would have access to 50 beds. Rather than increase the number of beds, the board decided to add four dedicated observation beds, which allow stays of up to 48 hours; add more Emergency Department and outpatient surgery pre- and post-operative rooms; and expand our telemedicine and virtual care options. With these plans, CMH can modernize and serve community needs without necessitating any change in Medicare designation. We can add high-tech, state-of-the-art medicine in a Planetree atmosphere within appropriate fiscal limits.
COLUMBIAMEMORIAL.ORG FALL 2023 7 FEMA advances CMH’s $20 million grant request One of five applications selected in Oregon for the program In August, CMH was notified that its application for the Federal Emergency Management Agency’s (FEMA) Building Resilient Infrastructure and Communities (BRIC) grant was selected to advance after a rigorous national competition. It was one of five BRIC applications selected in Oregon. CMH announced its BuildCMH Expansion Project earlier this year, with the goal of building a resilient hospital facility that can withstand a natural disaster, such as a tsunami or earthquake. The $20 million grant will help achieve resiliency goals outlined in project plans, including constructing a deep pile foundation and tsunami vertical evacuation structure able to accommodate 1,900 people, as well as locating critical infrastructure, generators and the helipad on the roof. “We could not be more thrilled for our project and community,” says Erik Thorsen, CEO. “We want to say thank you to the many elected officials who wrote letters of support for our application. This is confirmation that our plans to construct a resilient hospital for our community are in line with FEMA’s goals to help communities build resilience to extreme weather events.” According to the FEMA press release, 124 projects in 115 communities were selected for BRIC grants totaling $1.8 billion. The selections are critical mitigation projects and activities to reduce natural hazard risks for states, local communities, tribes and territories. “Columbia Memorial Hospital serves communities on Oregon’s North Coast, and it must be able to withstand a natural disaster,” says Congresswoman Suzanne Bonamici, who represents the First Congressional District of Oregon. “It is an honor to have helped secure federal funds that will help CMH build new disasterresilient facilities. I look forward to seeing how the project develops and will continue advocating for the investments and resources coastal communities need.” Internal steel structure: The steel in the expansion will be hardened against an earthquake or tsunami event, and connections are repairable, if needed, to help CMH come back online more quickly in the aftermath. Learn more about BRIC grants at FEMA.gov.
COLUMBIA MEMORIAL HOSPITAL 2111 Exchange St. Astoria, OR 97103 Nonprofit Org. U.S. Postage PAID Salem, OR Permit No. 86 Find us on social media! @cmhcommunity @cmhcommunity linkedin.com/company/ columbia-memorial-hospital @cmhcommunity In mid-August, CMH hosted its fourth Regatta Square Block Party as part of the 129th Astoria Regatta Festival. At the event, there was a live DJ; a free kids’ zone featuring inflatables, a rock wall and face painting; a family-friendly barbecue lunch; the OHSU Knight Cancer Institute mobile outreach van; and a health fair with CMH medical experts and community organizations. In addition, the team for the BuildCMH Expansion Project was on hand to answer questions and introduce the community to CMH’s vision for an expanded hospital, breaking ground in late 2024. Team members present included those from CMH, ZGF (design and architecture), Skanska USA (general contractor) and Degenkolb Engineers (structural engineer). They brought a 3D model of the expansion to the event and shared updated renderings with attendees. “The Regatta Square Block Party was a great place to start presenting to the public what we envision as the future of health care in Clatsop County,” says Randy McClelland, BuildCMH Expansion Project director. “We received a lot of positive feedback and are excited to keep sharing more as our plans progress.” Cover photo is a rendering of the hospital following the BuildCMH Expansion Project. CMH HEALTH COMPASS is published as a community service by COLUMBIA MEMORIAL HOSPITAL, a Planetree Gold-Certified Person-Centered Care Facility. 2111 Exchange St., Astoria, OR 97103, telephone 503-325-4321, website: columbiamemorial.org For information about CMH HEALTH COMPASS: Sarah Bello, MBA, Marketing Manager Robert Holland, MD, PhD President, Board of Trustees Erik Thorsen, MBA, CPA, FACHE Chief Executive Officer Nicole Williams, MPA, FACHE Chief Operating Officer Christopher Strear, MD, FACEP Chief Medical Officer Information in CMH HEALTH COMPASS comes from a wide range of medical experts. If you have any concerns or questions about specific content that may affect your health, please contact your health care provider. Models may be used in photos and illustrations. 2023 © Coffey Communications, Inc. All rights reserved. Jarrod Karnofski, DPT, ATC, MSHCA Vice President, Ancillary and Support Services Judy Geiger, RN, MBA Vice President, Patient Care Services Christopher Laman, PharmD, MBA Vice President, Strategy Brandon Parker, MBA, CPA Vice President, Finance Nicole Perez, BSHA, MSITM Vice President, Health Information Services Introducing the community to our plans Visit columbiamemorial.org/events to find other public events you can attend to learn more about the expansion. You can also stay up-to-date on project news at columbiamemorial.org/buildcmh.
RkJQdWJsaXNoZXIy ODQ1MTY=