Change has started to materialize in the Prince George's County health care system, and Laurel Regional Hospital, in many ways, is on the front end of it.
A new hospital president and University of Maryland doctors who manage the emergency department started work in the beginning of July — the first of many changes in store for Laurel Regional as the county moves to revitalize its health care offerings.
The county-owned health care system includes three 24-hour hospitals — Laurel Regional; Prince George's Hospital Center, in Cheverly; and Bowie Health Campus — and two medical centers. For years, the system has been run by Dimensions Health Care System, a small nonprofit formed in 1982 to manage operations at the county facilities.
Dimensions and the county have had their fair share of financial challenges, which led officials back in 2008 to start to look for a buyer for the health care system, one that could operate independently from the county and had the financial resources to enhance the health care services offered to county residents.
Last year, the county, the state and Dimensions signed a memorandum of understanding with the University of Maryland Medical System to address the health challenges facing the county. The agreement called for the partners to determine the feasibility of transforming the system into a network of teaching hospitals, anchored by a new regional medical facility.
A location for the facility, which is to replace Prince George's Hospital Center, has not yet been identified. The buildings in Cheverly are anticipated to be used for other health care offices.
The partners have taken steps toward accomplishing that goals outlined in the memorandum, the most visible of which is the addition of University of Maryland physicians in Laurel Regional Hospital's emergency department.
"The medical staff is excited about this," said Thomas Burguieres, chairman of Laurel Regional's Emergency Medicine Department. "It's going to bring a different level of care."
Burguieres said the county's hospital system has been suffering and the need for it to be affiliated with a major medical system, like the University of Maryland, has been discussed time and time again. Having physicians from the university run the Emergency Department, he said, "is the tip of the spear for what we hope is going to be a long and fruitful transition."
Of the 10 full-time and eight part-time physicians and four physicians assistants working in the Emergency Department, about half of them are fresh faces from the University of Maryland Medical System, according to Burguieres.
"Next month, some more will be coming in," he said.
The staff that are being retained are being trained to work under the University of Maryland system.
"It's their level of training that's the big difference here," John O'Brien, president of Prince George's Hospital Center, said.
University of Maryland physicians are scheduled to begin working at O'Brien's hospital on Aug. 16. More will begin working at Bowie Health Campus in January.
Rahim Ligon, director of quality and risk management for the University of Maryland Medical System, is now working with Laurel Regional as her home hospital. In her second week at Laurel, she noted that the hospital is "doing wonderful things."
The benefits of Laurel partnering with the University of Maryland, Ligon said, are additional resources, such as increased access to sub specialties and tertiary care, and more doctors working in the emergency room at any one time.
Hospital officials anticipate the more robust staffing will reduce wait times for patients in the emergency room.
Laurel Regional Hospital sees about 36,000 patients in the Emergency Department each year, about 30 percent of the total 120,000 emergency patients treated in the county's three hospitals, according to Dimensions Vice President of Emergency Services Mark Arsenault.
"We're really covering a large proportion ofPrince George's Countycitizens," he said, noting the University of Maryland partnership "will strengthen our emergency services" and "continually improve wait times at all three departments."
Public health study
Though it's unclear exactly how deep of a role the University of Maryland Medical System and its doctors will play in the future configuration of the county health care system, their involvement seems to be key to the plans to create "an efficient, effective and financially viable health care delivery system with a regional medical center" — the goal described in the July 2011 memorandum of understanding.
As a part of the agreement, the partners commissioned a study to assess the feasibility of building such a system and to look at the health care needs of the county.
"Transforming Health inPrince George's County, Maryland: A Public Health Impact Study" was conducted by the University of Maryland School of Public Health and released July 25. It found several deficiencies when comparingPrince George's Countyto surrounding jurisdictions.
The county also has a lower ratio of primary care physicians, dentists and mental health care providers to residents when compared with nearby counties.
Three primary recommendations emerged from the study:
• "Establish a high-quality, academically affiliated regional medical center with a strong and collaborative prevention-focused ambulatory care network."
• "Develop a county-led process to improve public health, expand access to high-quality primary care and support systems integration."
• "Develop a clear brand that promotes a high-quality health care system, encourages residents to return to the county for care and contributes to a successful thriving system."
County, state and University of Maryland officials spoke optimistically about the health care system's future during the July 25 presentation of the study.
"Medical care and public health are unusual bedfellows," said Dushanka Kleinman, associate dean at the University of Maryland School of Public Health. "They share a common goal; but they approach (health care) in different ways, and they've operated independent of one another."
Prince George's County, she said, has the opportunity to "bring these two sectors together and allow for a blending that has not been seen in the area before."
Lt. Gov. Anthony Brown, a Prince George's County Democrat, called the study "eye opening."
One of the data points Brown honed in on during his speech is the high number of residents who reported using a hospital outside of the county, many of whom did so because of a physician referral or insurance mandates. He recalled the physician who delivered his daughter 18 years ago refusing to deliver her at any of the three hospitals in the county.
"There is no reason why any family in Prince George's County should have to experience that lack of choice because either their physician or insurance company says you have to go somewhere else," Brown said.
Finding a permanent fix to financial and other challenges the hospital system has faced is one of the reasons County Executive Rushern Baker III, a Democrat, said he ran for his seat.
Health care, along with education and public safety, has been at the top of Baker's priority list. While the county is looking to decrease its involvement in the hospital system, it is planning increases in public health and wellness programs.
"The county's getting out of the business of running a hospital, which we shouldn't have been in the business of in the first place," Baker said.
The county has been looking to do this for years, but it's had trouble finding a buyer for the entire system.
Baker said the University of Maryland was interested in Laurel Regional Hospital and Bowie Health Campus.
However, he said, it became clear the university, or any potential buyer, was going to need reason to believe investing in a new regional medical center was worthwhile. The study outlines a vision showing that a University of Maryland-affiliated medical system, combined with county-led initiatives to improve public health, can be successful.
Not only will it be successful, Baker said, but "it's going to elevate health care in the region."
On what the changes mean for Laurel, Baker said, "This is a great opportunity to make sure the facility up there is top notch."
Laurel Regional Hospital's new president, John Spearman, agreed — noting that Laurel stands to benefit from enhanced services and additional resources.
"With the enhancements, Laurel will be able to handle a higher level of patients than we currently do," he said.
Spearman said he will incorporate recommendations from the public health study as he develops a strategy for Laurel Regional Hospital's future.