Will also Undermine the Quality and Safety of Patient Care

This morning we learned that UMass Memorial Medical Center has announced yet another round of layoffs and service cuts at its Memorial and University campuses in Worcester.  More than 80 registered nurses and as many as 90 other employees will be impacted by the layoff announced today, which includes the closing or reduction in a number of services, including the closing of three OR suites, the closing of an entire medical floor and the elimination of the IV therapy team on the Memorial campus.  On the University campus, UMass wants to consolidate and reduce the size of the pediatric unit, pediatric ICU and pediatric float pool, and as with the Memorial campus, to eliminate its IV therapy team.

The nurses believe this plan is pennywise and pound foolish.  In making these cuts, they will impact the quality of patient care, which is only going to cost them more in the long run.

UMass Memorial already has among the worst records on preventable readmissions in the state and the system is among the most highly penalized in the state for readmissions; and these cuts will only increase the risk for preventable readmissions in the future. 

The reduction in the pediatric service is a concern as UMMC is the primary provider of critical care for children in central Mass, which means more parents with seriously ill children from the region are going to be forced to travel to Boston or Springfield for care they used to get close to home. 

The loss of the medical floor is of concern because of what it means for the system’s ability to deal with an increase in patient volume, particularly during flu season.  UMMC has closed a floor like this in the past, only to have it reopened because the system could not cope with a surge in patient demand.

The loss of the IV team is a major concern as these nurses are experts in administering and monitoring intravenous lines that provide medication, fluids and nutrition for patients; and these nurses  are key to patient safety and patient satisfaction.  This will make the hospital’s problem with readmissions even greater, because these experts are crucial to preventing infections and other complications related to IV therapy, especially given the complex patients cared for by this system.

All the cuts, especially the IV therapy cuts, place an added burden on staff who have been struggling to maintain patient safety under a barrage of layoffs and reductions.  The nurses, who fought so hard for safer patient limits in their union contract last year that enabled them to spend more time with patients, will see those improvements undermined as they are forced to absorb the duties previously performed by other nurses or support staff. 

The bottom line is you can’t cut your way to safety.  This plan will mean a further erosion in the quality of care, less care for patients, and higher penalties for poor care.

As this hospital bemoans its financial position as the justification for these service cuts, the public and policymakers need to hold this system and all health care providers accountable for making patient safety their highest priority.  Unfortunately, there is a lack of transparency when it comes to hospital finances and investment practices, both in what is reported to the public and for the timeliness of that reporting.  

While addressing the crisis at UMMC, the MNA/NNU is also looking to improve the transparency of hospital financing across the Commonwealth through its efforts to pass the Hospital Profit Transparency and Fairness Act, a ballot measure that would require comprehensive and timely reporting  of hospital finances and investments (including money stashed in off shore accounts).