Mission Hospital officials presented a strategic plan this week they said will meet state requirements for seismic standards up to 2030 and include services tailored to the needs of the community.
The plan includes retrofitting, the introduction of new and improved services, cosmetic and efficiency renovations within a sustainable budget and without a reduction in the bed count, officials said. It is related to and dependent on revisions to the Mission Viejo strategy, begun before the Laguna Beach campus was acquired about 18 months ago, which changed the game plan.
"Mission Hospital is an organization that is good at planning and it is an organization that is good at executing," said Michael Beck, hospital vice president of operations. "It is not necessarily good at doing it fast."
The commitment to retrofit the Patient Care Building and the South Radiology Building to meet the state's 2030 standards is the top priority. They are the only two of the nine buildings on the campus required to meet state seismic standards.
"Retrofitting must be done by 2015, but if we show we have allocated resources and are working on it, we expect the state will give us more time," Beck said.
After 2030, the hospital will have to be razed to meet state standards, which was considered after the acquisition, along with downsizing, Beck said.
Plan includes new services
A focus group came up with five areas to which the hospital should allocate time, effort and money.
•An orthopedic unit
Because the obstetrics and long-term care units were closed by Adventist and never filled after the acquisition by Mission, space is available for new or expanded services deemed important in Laguna.
An out-patient cancer unit will focus on breast and skin cancers.
"We will be bringing in new technology," Beck said.
The gastro-intestinal lab will be equipped with an endocoptic ultrasound, a diagnostic tool for oncologists, as well as other specialists, that is currently not available anywhere in South Orange County, Beck said.
"Laguna will be the only place in Orange County with the technology for several years," Beck said.
Esophageal and other cancers will be treated in Mission Viejo.
Also, the hospital has been approached by a group of orthopedic surgeons who are interested in bringing services to Laguna.
Patients from all over the country and the world seek out surgeons and they go where the doctors tell them, Beck said. Part of the decision is family accommodations while the patient is hospitalized.
"Would you want to stay in downtown Los Angeles or in Laguna Beach?" Beck asked rhetorically.
Another upside to the Laguna campus is the surgeons will not get bumped from the operating room schedule by a trauma case, as can happen in Mission Viejo, said Lisa Weaver, hospital vice president of development.
"There are six ORs in Laguna, and only two or three are used daily," Beck said.
However, high-risk cardiac cases, for which doctors need to keep their skills sharp, and patients suffering a stroke will go to Mission Viejo where they can be treated without delay, which is essential, Beck said.
"Mission Viejo's stroke center has expertise and equipment that is only available in a couple of places in the United States," Beck said.
"Our hope is that the community doesn't have to worry about where to go — we'll do that," Beck said.
Crisis transportation between the two hospitals is provided by ambulances stationed at both campuses and one half-way between to replace one on call.
Neither campus will have a wellness center.
In response to a question by Katherine Doe, a frequent visitor to City Council meetings, Beck said programs based on stem cell research are not contemplated at the hospital.
Asked by South Laguna resident Richard Picheny if the hospital had thought about developing the area above the hospital, Beck said the issue had not been discussed in a single meeting.
The plan the hospital came up with to deal with the five targets is not set in stone, Beck said. Technology, state requirements and community needs could change, with consequent changes to the hospital's strategy.
"Seven different strategies were considered, priced out and the pros and cons discussed and evaluated on the relationship to the Mission Viejo campus," Beck said.
Finally it came down to reducing the size of the Laguna Beach campus or retrofitting the two buildings and renovations.
Downsizing was estimated to be cheaper, but would not meet Mission's goals or satisfy community needs, Beck said.
All decisions for the hospital are based on what Beck called the three pillars: sacred encounters, perfect care and healthiest communities.
"Everything we do, everything we spend money on needs to be linked to these three things," Beck said.
Six performance standards related to the three pillars include patient experience, which falls under sacred encounters; stewardship, which keeps operations consistent with resources; growth through clinical program leadership, providing needed services; wellness and health improvement, generally programs outside the hospital walls; physician engagement, relationships with hospital; and quality — hard to define, but if you see it you know it, Beck said.
Where the money will go
Once it was decided how best to use the Laguna Beach campus, the big question was how to spend the money.
"When we first moved here, retrofitting was estimated to cost $80 million," Beck said.
After a lot of study by Mission of what is actually needed, conducted under the leadership of Lisa Weaver, vice president of development, the price has declined to about $17 or $18 million for retrofitting, Beck said. The lower costs were attributed to changes in technology, the state's extension of the deadline to retrofit and acceptance of alternative processes to meet the standards.
Renovations will run about another $13 million and some are underway.
The only contracted services at this time are cleaners and the Chemical Dependency unit on the fourth floor.
The exterior has been painted and landscaping is progress. The MRI has been relocated, a major issue because it had never been legal in its previous location, which obscured the entry to the emergency unit.
Estimated costs of $11 million will be spent to upgrade the central plant, which manages utilities, water and air conditioning. The project has begun and could continue through 2013.
The chillers, which help regulate building temperatures, will be needed again this summer, but they have been moved to where the MRI is located, away from the area that distressed neighbors due to the noise.
"We have noise abatement walls in place," Beck said.
Renovations to the in-patient behavioral unit at a cost of $300,000 should be finished this month. Experts were consulted on making the unit safer and more pleasing for patients.
"It took about 12 months to get it through the state and these were pretty simple changes," Beck said.
Four to six rooms were renovated at a time.
"There will be more work done during retrofitting." Beck said.
The renovation of the main lobby and corridors is scheduled to begin at the end of this year.
A portion of the projects will be funded from hospital operations, the rest from loans and fundraising.
Tuesday's presentation included an animated film of what the hospital could look like after renovations are completed and exhibits of color schemes and materials.
Asked about the colors, described as rather Italianate earthy tones, Beck said he was the wrong person to respond.
Arts Commission Pat Kollenda suggested that beachy colors, blue in particular, would be more suitable, as well as relaxing and calming.
Completion of Goals
"Our goal is to create a place where mind, body and spirit can be healed," Beck said.
"The key to our success is approvals by the state and the city. "We are blessed with a good working relationship with the City Council.
"And we must continue to be good stewards of the hospital's [financial] resources."
Resident Picheny urged the hospital to add "community and neighbor support" to the list.