Continuing aftershocks from the violent earthquake that devastated Southern California on Jan. 17 are forcing providers whose facilities have been damaged to reconsider plans to rebuild and accelerating plans to integrate services with other providers.
Janice Ploeger, a spokeswoman for the state's Office of Statewide Health Planning and Development, said continuing strong aftershocks have forced the state to send structural engineering teams back to re-evaluate structures at 18 healthcare facilities that previously were declared unsafe but repairable. The inspectors must determine whether buildings have sustained further damage, causing them to become unsalvageable.
At hospitals that have been closed or at which some services have been shut down by damage from the initial 6.6 temblor, executives have been pushed to make quick decisions about the future.
Last week, Los Angeles County-USC Medical Center was forced to close its pediatric pavilion and evacuate 76 patients after inspectors from the Office of Statewide Health Planning and Development determined that the 39-year-old structure wasn't safe for treating patients.
The pediatric pavilion is part of Los Angeles County's 2,045-bed medical complex, considered one of the nation's largest teaching hospitals.
LAC-USC executives said damage probably caused by a series of strong aftershocks in the early morning of Jan. 29 was the prime reason behind the structure's voluntary shutdown, because medical personnel feared continuing aftershocks would weaken the building further. As of last week, there had been 3,100 aftershocks after the initial quake.
Some 60 pediatric patients were transferred to Women's Hospital on the LAC-USC campus, and 16 adult patients were sent to a county facility in Downey, Calif.
Unlike newer medical center structures, the pediatric pavilion doesn't have the heavier steel I-beams and concrete construction now required to comply with standards set after the 1971 Sylmar, Calif., quake that leveled the county's Olive View Medical Center.
County officials now must decide whether to rebuild the pediatric hospital or postpone reconstruction until the year 2002. That's the scheduled opening for a $1 billion replacement facility that would consolidate the medical center's operations on land near the existing medical campus, northeast of downtown.
Several LAC-USC structures, including its 166-bed psychiatric hospital, still are closed after sustaining damage from the initial earthquake. Preliminary estimates of the damages to county medical buildings have been set at $389 million.
At Saint John's Hospital and Health Center in Santa Monica, hospital executives weighed the tasks of reopening in the short term against rebuilding and planning for the long term.
Hospital executives said they will demolish one severely damaged structure and rebuild inside a portion of the hospital that state inspectors have ruled to be repairable.
State inspectors closed Saint John's main patient buildings Jan. 19 after finding severe damage to support columns.
Acknowledging that a full replacement facility isn't necessary to meet community needs, Saint John's executives said they will opt to reconstruct a smaller facility with fewer beds (Jan. 31, p. 6). Details of the plan haven't been disclosed. However, according to information learned by MODERN HEALTHCARE, as part of Saint John's comeback plan, it's studying a possible joint relationship with nearby Santa Monica Hospital Medical Center, a UniHealth America-operated facility.
A high-ranking executive at Santa Monica Hospital, requesting anonymity, confirmed last week that representatives of both organizations conducted initial informal discussions late last year about "working together and possibly sharing services." They signed an agreement to negotiate a "more formal relationship" in the coming months, the source said.