On Jan. 15, 2014, The Queen’s Health Systems finalized a historic affiliation agreement with North Hawaii Community Hospital (NHCH).
In the agreement, NHCH became a corporate entity under Queen’s, similar to The Queen’s Medical Center in Honolulu and Molokai General Hospital.
Queen’s immediately worked with NHCH staff and physicians to assess and address the most urgent needs, including keeping the doors to the hospital open.
When Queen’s took on NHCH, there was not enough cash in the bank to make payroll. Our first action was to provide over $800,000 in cash to make payroll and pay bills. Three years later, we have not missed a payroll and infused over $30 million to support the hospital. This is a major commitment of Queen’s to the residents of North Hawaii, and NHCH is an important part of the Queen’s mission.
Today, there are many good things being done at NHCH. Our efforts are all about delivering the best health care possible for the Waimea region and the residents of Hawaii Island.
But there are significant challenges in North Hawaii.
Like many hospitals across the country, NHCH has been operating at a financial loss this year. It is being called upon to achieve better outcomes, enhance patient safety and improve the quality of the patient experience – and to do all of this with declining reimbursements, particularly from government payers, Medicare and Medicaid.
These unprecedented financial risks and challenges due to changes in the health care environment are causing our expenses to grow faster than revenues.
This cannot continue if we are going to meet our mission of providing, in perpetuity, quality health care services to the residents of North Hawaii.
We have undergone a number of initiatives to help assure that NHCH becomes more efficient.
Despite rumors, there have been no mass layoffs at NHCH. Our employees are our greatest asset at NHCH. Earlier this year, we eliminated a handful of positions in an effort to become more efficient. We adjusted staffing based on volume and need based on skill set. Some employees retired and others moved. In some cases, these positions were not filled. NHCH has 315 full-time employees, and this adjustment represents less than 1 percent of the total workforce.
We have also undergone changes in our cancer center. We know that choosing a provider for cancer care is one of the most important decisions anyone can make. Our cancer center staff remains committed to providing quality care and supporting our cancer patients during this transition with compassion and aloha.
Queen’s remains committed to maintaining and developing other important health care services to the North Hawaii community, such as our women’s center. We have invested heavily in physician recruitment as well, and as a result, we have added numerous providers to primary care and specialties including orthopedics, general surgery, OB-GYN, and cardiology.
We are also planning a major $25 million expansion of the emergency room four times the current size. This is an essential community service. Too often patients have to be treated in our ER hallway because the exam rooms are fully occupied. We will be asking the community to support this expansion philanthropically.
We have also created a telemedicine intensive care unit at NHCH, connecting them with critical care specialists at The Queen’s Medical Center on Oahu to provide timely access and immediate critical care support to our NHCH physicians and staff.
Moving forward, we need to contain costs and improve revenues as we strive to provide safe and high quality health care services.
Although we face many challenges, Queen’s financial balance sheet remains strong but we cannot allow marginal financial performance to undermine our financial capacity and jeopardize the sustainability of our mission. Physicians, leadership and staff across our enterprise must work together to improve the quality of the patient experience at NHCH to assure the perpetuation of the mission of our Founders, King Kamehameha IV and Queen Emma.
Art Ushijim is chair of North Hawaii Community Hospital Board of Trustees, president and CEO of The Queen’s Health Systems. Cindy Kamikawa, R.N., is president of North Hawaii Community Hospital.