Ken Garcia: Saint Francis bucks hospital trend by giving more care 

One century-old San Francisco organization is bucking a state and national trend, and in the coming years it should bring considerable comfort to tens of thousands of city residents.

That would be venerable Saint Francis Memorial Hospital, which last week opened its new emergency department, a state-of-the-art facility in the middle of the most densely populated area of The City. The department is nearly double the size of the former emergency treatment center, which hospital officials are predicting will allow them to serve more patients in less time.

They were throwing a party at the new facility when I visited last week. The cause for celebration is that the second-busiest emergency room in San Francisco is expanding at a time most hospitals are downsizing or threatening closure because of spiraling costs.

"It’s a way to show our commitment to serving the underserved,’’ said Abbie Yant, senior director of community health services at Saint Francis. "Most emergency departments are overcrowded and the patients face long wait times for treatment. We’re trying to change that here.’’

Saint Francis provides a critical link to The City’s public health network since it serves one of the most diverse populations and demographics in San Francisco. Located in the area knownas the "TenderNob’’ — the area between the Tenderloin and Nob Hill — the hospital also provides medical services to people in Chinatown, Civic Center, Union Square and the Financial District.

Only San Francisco General Hospital gets more ambulance traffic, and officials at Saint Francis say they expect to see up to 29,000 patients in their emergency room. The hospital is also the first in The City to complete the first phase of construction under a state mandate to retrofit buildings to new earthquake standards by 2013.

Saint Francis is an affiliate member of Catholic Healthcare West, and its nonprofit status is one of the reasons it decided to invest in an area in which many hospitals are leaving. So its $12.6 million emergency facility, with 19 beds, two isolation units, a decontamination room and all of medicine’s most technologically advanced equipment, is something of a marvel and a civic miracle.

According to the California Medical Association, more than 65 emergency departments closed in California between 1990 and 2000, a troubling statistic that shows the increasing inability of hospitals to keep up with the escalating costs of health care. Emergency rooms are particularly hard-hit because the care they provide is among the most expensive — and disproportionately given to patients who do not have health care insurance.

A report issued by the CMA two years ago found that emergency room losses reached $461 million in fiscal year 2001-02 alone, with physician losses accounting for an additional $175 million. Emergency rooms feel the fiscal pain more than most departments because they are open 24 hours and third-party payers such as Medi-Cal don’t cover the actual costs of emergency care.

Add to that the fact that one in five Californians don’t have health insurance and most indigent patients use emergency rooms as their de facto health care providers. That will explain why the number of emergency roomvisits in the state is expected to hit 12 million this year — a record that continues to soar.

"The staff and management at Saint Francis understand the need for more emergency care even if it’s not profitable,’’ said Dr. Jack Lewin, the California Medical Association’s chief executive officer. "It’s a decision that definitely goes against the grain, but it’s heartening that one facility has decided to step up. We have to tip our hat to Saint Francis for taking this important step.’’

That will explain a lot about the hospital on the hill, which is showing its community spirit at a time other Bay Area medical centers are laying off staff, cutting services and sliding perilously close to being put on life support.

Last week, Saint Francis opened two new entrances to the emergency room — which is one of the reasons Theresa Edison, the ER’s nurse manager, decided to come back early from maternity leave.

"This facility will make our lives so much easier,’’ she said. "I couldn’t wait to come here and get back to work.’’

It just happens that this is Emergency Nurses Week, an annual tribute to all skilled caregivers in the U.S. It’s mostly ceremonial, but somehow it means a little more to those working in their sparkling new quarters on Bush Street between Leavenworth and Hyde.

Ken Garcia’s column appears Tuesdays, Thursdays and weekends in The Examiner. E-mail him at kgarcia@examiner.com or call him at (415) 359-2663.

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