A Message from Patrick Muldoon, Medical Center President

Good morning,

Since late October, I have been writing to you about our organization’s very serious financial situation. I described how we would get back on track to achieve our goal of reducing our operating loss in fiscal year 2014, through a plan called Phase 1.

This plan called for making tough decisions about programs and services we offer, resulting in an impact on the size of our workforce. I made a commitment to you that we would do the things that ensured the Medical Center is here and strong for our patients, our employees, our system and our community.

In this message, I update you on our decisions to date and describe changes effective today. We put everything on the table to assess impacts on our patients, employees, the organization and community. Although we have made significant headway in reducing costs, patient volume and revenue continue their decline at the Medical Center, so managing and reducing our expenses at a quicker pace remains essential to our decision making.

Thank you to my executive team, our clinical chairs and chiefs, administrators, staff and physicians for all you have done to help carry out our Phase 1 plan to date and will do in the weeks and months to come as we continue to make changes. This is an important foundation for Phase 2, the vision that system president and CEO Eric Dickson, MD, has set forth for our health care system to become more effective, efficient and affordable for our patients.

Through your continued support and extraordinary efforts, we will get through this difficult period and become an even better Medical Center as a result.

Our Workforce at the Worcester-based Operations

What we have done since October

From October through February, reductions at the Medical Center total 285 full-time equivalents (FTEs), including 31 management positions to establish a structure that significantly improves the alignment and accountability for clinical services at the Medical Center and a more direct connection between managers and their front-line teams to leadership.

What we are doing today

As a result of service changes described below, and including actions in March, an additional 103 FTEs are impacted. Please keep in mind, the term FTEs does not directly relate to the number of people that will ultimately leave our organization because a reduction in overtime hours, position vacancies and an overall reduction in hours are included in the calculation of an FTE.

Today, we are informing our employees and labor unions about the current changes. As always, employees in affected positions will be treated with respect and dignity, and we will provide the resources they need to help them through this transition.

This is absolutely the hardest part of our decision making. It is incredibly difficult for all of us to consider the impact that losing a job has on individuals and families. The reality is that so much of what we do every day involves people who perform our nonclinical work and those who deliver clinical care.

In addition to actions at the Medical Center, reductions have occurred and will continue in the other Worcester-based operations – the Medical Group and the corporate (Division 40) areas of Finance, Information Services, Marketing and Communications, Human Resources, Legal and Compliance Departments.

Service Changes

What we are doing today

With quality and patient safety our number one consideration, we made decisions after evaluating patient volumes, demand for services and duplicative services.

Effective immediately, we will begin to wind down the following services:

  • IV Therapy – Services will be provided by bedside nurses.
  • Three operating rooms on the Memorial Campus; one operating room on the Hahnemann Campus – With the development of more efficient block schedules for surgeons, we can reduce three of 17 ORs at Memorial and one of nine ORs at Hahnemann. We will adjust staffing to meet the needs of the OR schedule and our surgical volume can be managed in the remaining ORs with no disruption of patient care.
  • Memorial Campus West 1 – The average yearly census of our med/surg units on this campus is lower, an example of declining patient volume. We determined this unit, one of our oldest facilities, can close with patients safely cared for in other Memorial Campus units.

We are consolidating or downsizing the following:

  • University Campus Emergency Department Adult “Fast Track” – Because the ED’s overall census is down, adult Fast Track patients are now effectively cared for in the main ED.  Adult Fast Track staff now work within the main ED, and Pediatric Fast Track (PediPlace) will be consolidated into the pediatric ED and flex to meet volume levels.
  • All remaining Memorial Campus infusion services will move to the University Campus, joining gynecologic oncology infusion and other infusion services present there.
  • Memorial Campus Endoscopy services are being downsized to match volume.
  • Revenue Cycle Department – With our new billing system, we are streamlining the revenue cycle process, including placing resources at the front-end of the process where the collection of important patient information is most critical and alleviating rework in other functions.

The number of beds in the following Children’s Medical Center units will be reduced to allow us to more efficiently care for our youngest patients:

  • University Campus Pediatrics 5 East
  • Pediatric Intensive Care Unit (PICU)

The following location is for sale as part of our effort to use our physical space more efficiently:

  • 11 Shattuck Street. When the building is sold, employees working there will relocate to new offices in space already available.

I am confident these changes will allow us to continue to provide the high-quality, safe care our patients expect, as we have carefully considered this in our decision making. We will communicate with the small number of patients that will experience a change in the location of their care.

* * * * *

We remain steadfast in our mission – that of a safety net hospital for the underserved in our communities. That will never change.

But our Medical Center has become “all things to all people.” We are a four-campus organization first established decades ago and we must face the realities of health care in Central Massachusetts today, including the fact that the level of patient volume that supported an organization of our current size and scope is gone, and not coming back. A move toward patient wellness and prevention is a good thing, but it also has resulted in reduced demand for our services, many of which have not changed with the times.

Providing “the right care at the right time and at the right place” can no longer mean that we provide all of that care at the Medical Center.  In fact, we will continue to review less-acute care services and programs that we currently provide at our higher-cost, high-acuity Medical Center campuses.  We will inform you about the decisions we make to provide these services in lower-cost settings or through lower-cost providers that ensure the delivery of high-quality care.  And, I will continue to let you know of additional changes this fiscal year to create a solid financial foundation as we enter fiscal year 2015 and Phase 2.

What I am asking of you
Today’s announcements represent change that is transformational, and because it is, I know you have many reactions. As we move forward with this hard and challenging work, let’s all stand together as one to support each other and to always put our patients first. It’s natural to feel many emotions, but please remember, our patients and their families are counting on us to care for them when they are at their most vulnerable. They need us, and through our focus on providing them the best care, we are all strengthened.

We’ve already made significant progress: Today’s changes, and others made since October, represent an annual expense run rate reduction of an estimated $32 million. This is incredible work and I thank you! There is more to do, and I am confident we will get through this, together.

I want to hear from you; please write a comment on this post. I hope to also see you as I round in our units and departments with our senior leaders in the coming days and at upcoming employee forums; watch for the forum schedule.  Please talk with your managers and supervisors and if you need it, our Employee Assistance Program is always available, at 1-800-322-5327 or 508-856-2737.

Thank you.

Muldoon, Patrick signature