The transition of three state-run Maui medical facilities to Kaiser Permanente has hit another snag. The move will now be delayed until next summer. The decision has left hospital officials worried about further cuts to services and staff.
I meet Doctor Ron Boyd in the hallway at Maui Memorial Medical Center. He’s pacing the halls on his cell phone, advising a staff member on care for a patient in his ward. The interventional cardiologist has worked here for more than a dozen years and is currently the chief of medical staff at the hospital. He says the delay of Kaiser taking over Maui Memorial has left him and other staff members in a gray area.
"The biggest concern now is that the hospital has been in limbo," Boyd said. "We're now working without about a quarter of our staff."
That’s 401 vacancies for hospital employees. Some are filled by traveling nurses or temporary workers. Because of the uncertainty in timing of the ownership change, Maui Memorial is essentially on a hiring freeze.
"It's the frustration of not knowing," he said. "We're completely in limbo. You can't start any project because you have no idea if the project would have any meaning starting when there may be a transition to Kaiser. So the whole place has been put on stop, and that's no way to run a hospital."
Boyd says he’s seen problems arise in his department that make him concerned that patient care and safety could be at risk.
"You turn around and ask for something, or some instrument, tool, or catheter, and they have this blank look on their face," said Boyd. "I think particularly in the O.R., that leads to some tentatively dangerous situations"
"We can't safely operate this way for a long period of time," said Wesley Lo, the Maui region chief executive officer for Hawai‘i Health Systems Corporation. "We're going to have to start looking at reducing our capacity to safely take care of patients."
Last year, the legislature authorized the privatization of Maui Memorial Medical Center, Kula Hospital and Clinic and Lāna‘i Community Hospital. Kaiser Permanente was scheduled to take control back in June. But opposition from the state’s union workers have delayed the transition, which now won’t begin until July of next year.
"I'm just trying to get this thing to transition, but the transition keeps on changing," said Lo. "What do you do? It's very much of a quandary. I am aware of other people that are talking about leaving. So we are at a tipping point I'm afraid."
After a recent meeting with the board, Lo says in order to keep the hospital afloat, they’ll have to reduce capacity. That would mean cutting critical care beds by a third and eliminating 12 medical surgical beds. Something that would have been a problem on the day we talked.
"Today, I had 17 critical care patients out of 24 beds, with 7 beds available," said Lo, as he looked at his chart of the day. "So if I closed 8, I'd have to do something with that patient, either hold them in emergency room or choose to ship them to Honolulu if there was an accepting physician."
Lo expects the availability of medical care will only become more stressed as we near the winter months, a busy season for hospitals, when they have a spike in tourism from colder regions. Lo said the proposed cuts will be the topic of a series of public meetings on Maui next month.