As part of cutbacks at University of Maryland Medical System, the vaunted Maryland Shock Trauma Center is closing one 20-bed unit.
John W. Ashworth III, director of the Shock Trauma Center, said the closing was a response to empty beds, as patients are discharged more quickly. The closing will mean a staff reduction in Shock Trauma of 66. Of those, half are nurses, aides and technicians, a reduction of 10 percent in direct patient care staff. The other half are in administration and support such as billing and information systems, a cut of 18.5 percent.
While Shock Trauma had 94 patients on a typical day as recently as three years ago, it now averages 75, a drop of 25 percent, according to Joel G. Lee, vice president for market development and communications of the medical system.
Quicker discharges, Ashworth said, result in part from insurance pressure to keep costs down, but also are made possible by technological changes and by development of "alternate sites where the patients can be cared for in other ways, such as rehabilitation facilities and home health services."
Just 10 years ago, he added, the average patient stayed in Shock Trauma 17 days. Now that's down to five days, although a Shock Trauma stay might be followed by care in another facility.
The Shock Trauma cuts are designed to save $3.5 million a year, part of $17 million in system-wide savings from a total budget of half a billion dollars, Lee said.
In addition to the Shock Trauma unit, the hospital closed a 16-bed surgical-oncology unit, merging it with other units, and is consolidating its cancer intensive care unit with its bone marrow transplant unit. Overall, the system is eliminating 255 jobs.
Although it is increasingly profitable -- from $3.9 million five years ago (1.3 percent of revenue) to $17.5 million in fiscal 1996 (4.1 percent of revenue) -- the system needs surpluses to meet capital requirements for construction, renovation and new technology, according to Robert A. Chrencik, senior vice president for finance.
Dick Johnson, president of The Golden Hour Coalition, a group ** concerned about Shock Trauma issues, said he believes care in the famed center has declined over the years, although he said he was unsure what impact the closing of the unit would have.
Ashworth said the closing, and the shorter hospital stays that led it, have "absolutely" not hurt patient care. "Our mortality rates are superb, and remain that way," he said. "Our patient satisfaction numbers are as good as they have been or better. The quality indicators are there."
