BLUE BLAZERS, WHITE COATS Hopkins outpatient center, opening tomorrow, stresses service as well as surgery


Borrowing a page from the hospitality industry, Johns Hopkins Hospital opens a new $140 million outpatient center Monday as much designed to provide customer satisfaction as medical care.

The new one-stop center aims to woo patients attracted by the Hopkins name but put off by the prospect of parking problems, long waits, a massive complex and red tape.

The eight-story outpatient center at 601 N. Caroline St., one of the largest in the Northeast, is an effort by Hopkins to capture a significant share of what it sees as the main area of growth in medicine over the next decade.

That growth largely results from a cost-driven shift from hospitals to less expensive surgery and medical centers, many of them free-standing and independent of hospitals.

The Hopkins center is designed "to enhance what we call the ideal patient encounter. We want minimal inconvenience and waiting time, and maximum time with the doctor," said Dr. Mark C. Rogers, a member of the committee that oversaw the center's design.

The center, which initially will operate about 11 hours a day, will be able to handle up to 1,200 people a day in 10 specialties ranging from dermatology to surgery.

"Many things done in the hospital previously, including large amounts of surgery, are now done at outpatient facilities," said Dr. Rogers, chair of the department of anesthesiology and critical-care medicine. "We all support that. It is a way for the patient to save money," he said.

Hopkins hopes to attract customers from throughout the region with such features as express check-in and a covered walkway leading from a secured parking garage -- it's surrounded by a high iron fence and a dry moat -- into a hotel-like lobby.

When the first two floors open Monday, staff members outfitted in gray and blue business suits -- uniforms similar to those used by the airline industry -- will be behind the counters. And patients can register by phone the night before their visit.

The center will open in phases through Aug. 1. In addition to eight operating rooms, the building contains 191 examination rooms, 28 radiology imaging rooms and 12 blood-drawing stations. An express testing center allows patients to have a series of often-ordered tests -- blood, chest X-ray, electrocardiogram -- in one location, with results available while they are still in the center.

It offers an expanded general medical evaluation service, an express pharmacy and, in leased space, an optician offering glasses made on the spot.

The building will house some of the 300 doctors expected to use the center every week, whose offices are now scattered throughout the Hopkins complex.

Specialties moving into the building include radiology; neurology; a new program for treating kidney stones; head and neck surgery; gynecology and obstetrics; and pediatrics.

"Except perhaps for the Mayo Clinic, you won't find outpatient centers with this collection of technology and specialties anywhere in the country," said Steven H. Lipstein, executive director of the new center.

The opening of the outpatient center is the culmination of nearly eight years of planning at Hopkins in anticipation of fundamental changes in the health-care delivery system.

Nationally, more than 50 percent of surgery is performed on an outpatient basis, meaning that the patient is not admitted to a hospital and usually goes home the same day, according to a study by the American Hospital Association.

Today at Hopkins, outpatient surgery accounts for 39 percent of all procedures, up from 9 percent a decade ago, and outpatient surgery and other services bring in 20 percent of the hospital's annual revenues, about $90 million. With the new center, revenue from outpatient services is expected to increase 13 percent in each of the first two years. Doctors expect to perform 6,500 operations in the first year, and the long-term goal is 10,000 procedures a year, Mr. Lipstein said.

The move to outpatient centers is being fueled by the federal government's efforts to reduce costs, particularly its decision to reimburse Medicaid patients in outpatient settings, and by pressure from insurers and employers eager to lower costs. In response, individual physicians want more efficient centers.

Last year, overnight hospital admissions dropped more steeply than in any of the previous five years. At the same time, hospitals are experiencing a serious challenge from free-standing surgery units that appeal to doctors on grounds of efficiency.

Hospitals' share of outpatient surgery dropped to 83 percent in 1990, down from 90 percent in 1985, according to the hospital association. Independent surgery centers performed more than 2.3 million operations that year, up from 710,000 five years earlier.

The Hopkins outpatient center is named for the hospital's president, Robert M. Heyssel, who is retiring in June after 20 years at the helm of Hopkins medicine.

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