Growing pains | AspenTimes.com

Growing pains

John Colson

Jeff Vichick, director of Valley Views new 16,000-square-foot radiology department, shows off the CT scan unit with faux skylight above. (Kelley Cox/Glenwood Springs Post Independent)

When Glenwood Springs celebrated the opening of a $29 million addition to its aging Valley View Hospital, the question naturally arose: What about Aspen Valley Hospital?The short answer is, AVH has its own plans to update the facility; some improvements have already happened. But major facility improvements will take “perhaps as long as 10 years,” said hospital CEO David Ressler.

AVH was headed for a dramatic series of improvements and expansions at one point, at an estimated coast of as much as $40 million. But when the hospital ran into serious financial trouble, pushing it millions of dollars into the red and resulting in the firing of its two top administrators, only the most urgent upgrades were completed.AVH is now on stable financial footing, officials say. And the hospital did recently spend about $6 million on upgrades to surgical services, the operating room, the cardiology clinic and pharmacy facilities.But for now, further plans for renovating, updating, improving or otherwise modifying AVH are on hold while the hospital’s board of directors and administration decide exactly what is needed.

Valley View Hospital’s $29 million, four-story addition is virtually a new hospital. Essentially only office space remains in the old facility, built in 1955.On the outside, the expansion is highlighted by a new entrance, a 92-foot clock tower, a covered emergency room entrance and additional parking under a covered main entrance.Inside, there is a new 7,900-square-foot emergency department with a decontamination room just off the entrance, two trauma rooms, a nurse’s station, two cardiac rooms and 14 patient beds.Plus, all departments in the new hospital will have private patient rooms, and plenty of space for staff including men’s and women’s locker rooms and staff lounges.Adjacent to the ER is a new 16,000-square-foot radiology department, three times the size of the old one, with new imaging equipment and a large waiting room. It also includes a separate area for women awaiting mammograms and ultrasounds – a room one hospital official described as being like a cozy den with wood finishes and comfortable chairs.”Outpatient radiology is about three-quarters of what we do,” Valley View CEO Gary Brewer said earlier this year.

The hospital also offers free valet parking to patients.Aspen’s plans still evolvingIn August, the AVH board of directors hired a Denver-based architectural firm to get the planning process going, at a cost of $80,000.Hospital CEO David Ressler said HLM Architects was to initially base its work on a 2001 master plan created with a $34 million expansion in mind. The goal, he said, was “to see if that $34 million is still a good number. It could be $42 million. It’s difficult to say.”

Since then, however, the consultant has been working closely with administrators and doctors to refine what is called the “needs assessment.” And this, according to Ressler, will ultimately become the basis for a new hospital expansion master plan.Whatever the final outcome, it is unlikely that the remodeling and upgrading will take place all at once.”One fell swoop may not be the final answer because we’re going to have to live in this hospital as we work on it,” Ressler remarked, adding that HLM has worked with Aspen Valley Hospital in the past, and that “they have a lot of experience, they’ve done a lot of hospitals.”At this point, the general goal is “really to put a new face on the hospital … improving the flow, the efficiency” of the different departments in a way “that takes the hospital to being much more outpatient-oriented,” Ressler said.The number of patient beds is not expected to be reduced, but outpatient services will be increased as a percentage of the hospital’s overall services. According to Ressler, the hospital’s outpatient load has been growing steadily, while inpatient demands have remained relatively constant.

“We’re building on our strengths,” Ressler said this week, noting that AVH is “a small hospital, extremely personalized. We want our facilities to be state-of-the-art but still reflect our community.”Though the assessment process is being overseen by John Schied, director of operations for AVH, the consultants have been meeting with various departments to assess their needs.Also being examined is how AVH staffers feel about the standards of care they give now and how that might improve in the future.For example, hospital standards once called for large wards with multiple beds; current practice calls for private rooms. Or, technology employed in the nursing station might need to be upgraded.”They look at the way we want to deliver care … 10 years down the road,” Ressler said, commenting on everything from the size of the operating rooms to the privacy afforded patients as they go through the check-in process at the front desk.All of this, he said, will translate into square footage numbers, efficiency calculations and flow charts to make the best use of the space available at the hospital’s present site.

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AVH’s service area stretches from the Basalt/El Jebel area up to Aspen and even, during summer months, over Independence Pass to Leadville. Though Ressler did not know the exact size of the hospital’s service population, he said it comprises local residents, part-time residents and visitors – groups that share some health-care requirements, but often have divergent needs.Thus, AVH aims to “provide what we can do very well” and not try to be all things to all people in terms of health care.

For example, people come to AVH from near and far for such services as plastic surgery and orthopedic care. But the needs assessment might show that for other services, patients are better off at Valley View.Ressler said there currently is no formal, recognized patient-sharing cooperative arrangement between AVH and VVH, but that is another thing that might come out of the needs assessment process.”We really feel like we’re part of a larger system of hospitals,” he said, explaining that AVH has affiliations with hospitals around Colorado and the United States for referrals of patients, provision of privileges for visiting doctors, or training programs for nurses and doctors.As the assessment process continues, probably into early 2006, there will come a time when the hospital board gets the results of the consultants’ study and begins working with Pitkin County and the community to shape the hospital’s future.Ressler indicated that, while it is impossible to predict with any certainty, it is likely that the ultimate goal will be to expand the hospital on its existing site, over a period of years, using “a combination of funding sources” ranging from taxes to donations and grants.

This will be complicated by the fact that the hospital district is carrying about $27 million in debt from earlier tax-supported bond sales, which need to be paid down before the district can safely borrow more money for an expansion project.”We’re looking at the expansion as an ongoing process that we’re in right now,” he said, noting that there is still money to be used to accomplish smaller upgrades to specific departments.In the meantime, Ressler said the current facility is “functional, but John Colson’s e-mail address is jcolson@aspentimes.com