The Aspen Times
Aspen, CO, Colorado

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April 20, 2013
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Greg Balko: Guest opinion

I believe that Aspen Valley Hospital clearly has made the case for the expansion and that the extensive-needs assessment was done in a thoughtful, factual and logical manner. What we are trying to accomplish here already has been done by our neighbors in the Summit County and Grand River hospital districts.

Like Aspen Valley Hospital, both of those districts have critical-access hospitals with similar patient volumes. Both of those hospitals have updated their facilities, and our proposal is similar to theirs - based on our community's specific needs.

As a practicing emergency physician and former Aspen Valley Hospital board member, I know firsthand that this remodel is far overdue for all phases of the hospital. In 1977, when the hospital was built, outpatient care was virtually unheard-of. If you needed a test or procedure, you were admitted. There was little need for outpatient areas or waiting rooms. CT and MRI scanners didn't exist. In the operating rooms, the large equipment needed to perform arthroscopies, laparoscopies and the like simply didn't exist. Back then, multidrug resistant bacteria didn't exist. It was acceptable then to have double-occupancy rooms, curtains between beds and occasional hand-washing sinks dispersed here and there. What was acceptable then is not an acceptable method of treating patients today.

Some people contend that we should have just built a new emergency department. I served on the hospital board when we began the design process for the master facilities plan, and I can tell you that the entire project is necessary. We needed a new patient-care unit, intensive-care unit, cafeteria, office space and parking garage just as much as we need a new emergency department, operating room and diagnostic imaging area.

The plan for phasing the expansion was developed strategically so that the hospital could remain fully functional 24/7 with minimal disruption to patients. Simply said, because of infrastructure issues and construction logistics, we cannot build a new emergency department without replacing other vital functions first.

In terms of my department, emergency medicine wasn't even recognized as a medical specialty when the hospital was built. In 1977, there was less of an understanding of how the department should be designed to deliver patient care privately, safely and efficiently the way we understand now.

The current emergency department is literally a giant hallway with curtains. As a patient, it is impossible to talk about your medical problems without someone else in the department overhearing you. Additionally, we are grossly lacking sufficient square footage. We do not have enough space to allow for proper work flow or to accommodate our equipment, consultants or family members wishing to visit their loved ones.

Our department also is severely lacking in that we only have one high-efficiency particulate-air-filtered negative-pressure room, which helps isolate people with respiratory infections. We do not have a decontamination area. Our private rooms all are separated from the nursing station and out of their direct observation. Essentially, anyone who is ill has to be brought into our main department where they can be observed but are only separated from other patients by a curtain. Our new design resolves all of these significant deficiencies and more.

When I step back and look at this process, I have to admit that I am dismayed that there is controversy over the completion of the hospital expansion plan. It is my opinion that most of the stated opposition to the project is based on premises that are nonfactual. There has been some constructive criticism, such as the need to mitigate the lighting. The hospital is doing its best to correct situations like that.

I need to refute what has been written and said inaccurately. Our mill levy has not doubled. In fact, it is at the same rate it has always been. The mill levy supports the operational costs for Aspen Valley Hospital and is not used for capital improvements. The physician offices are not subsidized. To do so would violate federal law.

Phase II was supported by the community at large with the passage of a general-obligation bond. Aspen Valley Hospital is not asking taxpayers for any additional money to pay for phases III and IV. They will be funded through philanthropy. If the hospital can't raise the money, it will not proceed forward. It is also my opinion that the community, which voted with its tax dollars to build Phase II, would, in even greater numbers, support the completion of the project. Improving the physical space with a more efficient layout will not raise operational costs. It very well may reduce them.

It is also my opinion that most people would agree that the top two community needs are education and health care. The future health care of this community should be a priority. Aspen is known for its beauty, healthy lifestyle and progressive thinking. We all know how lucky this community is to have such a great hospital. We easily have the finest rural hospital in the country, but the facilities don't match or even reflect the excellent care we provide inside.

One of my partners, Dr. Bud Glismann, put this into perspective for me when he told me that the Ford Pinto was in production during the same time our existing hospital was built. In 1977, the Pinto was built on a carburated 2.3-liter engine and a four-speed manual transmission. It only had 89 horsepower. It did 0 to 60 in 10.8 seconds, and it took more than 175 feet to stop from 60 mph. With regard to safety, it had drum brakes, no air bags or crumple zones and it had lap belts in its rear seat. It also had an issue where in a rear end collision the gas tank could puncture and the vehicle could explode in flames.

Let's fast forward to 2013, using the same automobile manufacturer, Ford, to exemplify my point. The 2013 Ford Focus is available with an even-smaller 2.0-liter fuel-injected twin-turbo engine that makes 252 horsepower, six-speed automatic transmission, four-wheel disc brakes, stability control, and six airbags. It goes 0 to 60 in 6.5 seconds and stops in only 112 feet. It is clearly more nimble and safe, especially in a collision and the gas tank will not explode.

When was the last time you saw a Pinto on the road? Like our current hospital, it can get you from point A to point B, but it won't do it as safely or efficiently as a more modern one will. If you had your choice in automobiles, or in this case hospitals, would you choose to keep driving a Pinto or would you choose one that is more modern, safe, and efficient?

Dr. Greg Balko is a resident of Snowmass Village.


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The Aspen Times Updated Apr 21, 2013 09:18AM Published Apr 20, 2013 10:57PM Copyright 2013 The Aspen Times. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.