Rosa Saca, RN, MHA, spent more than two years coordinating nursing with support services to start the heartbeat of the new Los Angeles County+USC Medical Center, which sprang to life on a sunny, up-tempo moving day.
It took only 10.3 hours for 800 nurses, along with physicians, staff, and two Air Force Reserve squadrons, to safely transfer 387 patients around the block from the old General Hospital of TV drama fame to a state-of-the-art replacement complex a half-mile away.
Saca orchestrated the Nov. 7 move from the Depression-era hilltop hospital into a fully functional and efficient but more compact $1 billion modern facility. There are fewer beds — 600 compared to 824 — and an expanded 120,000-square-foot ED featuring 131 patient bays, touted as the largest in the nation, to handle 200,000 emergency visits a year.
Settling InA patient is moved through the first floor of General Hospital.
The shakedown stage of settling in finds many nurses working for new managers or with different colleagues, and some RNs cross-trained in advance to practice in a higher-acuity setting. An example is upgrading skills to move from step-down critical-care units, which no longer exist, to practitioners in fully functional CCUs.
This is a wonderful opportunity for consolidation of services, but it also requires many nurses to learn new skills in a different environment, Saca says. Some nurses have difficulties leaving a familiar and comfortable routine, while others are happy for the chance to upgrade to a higher practice level in a modern setting, she says.
Careful PlanningA patient is loaded onto an ambulance.
Chief Nursing Officer Irene Recendez, RN, credits Saca’s liaison work and advanced training with making the staff transition to the new hospital less bumpy.
Saca’s pre-move activities included five preparatory patient transfer drills, using mock-ups of clinical units to acquaint nurses with their new stations, and guiding RNs through workflow redesigns to streamline efficiencies. Saca, a specialist in hematology and oncology with 15 years of management experience in ambulatory care settings, put aside clinical duties to become a key member of the Replacement Facility Move Project. Among other things, she held workshops on how supplies will flow to nursing units on any given day, or how the new facility’s kitchen serves patient meals.
A New Home
She isn’t sure if nurses will take fewer steps on a shift, but notes the consolidated facility has all acute-care services in one structure instead of two massive buildings that included the Women’s and Children’s Hospital. The Clinic Tower, Diagnostic and Treatment Tower, Inpatient Tower, and Subterranean Central Plant are all under one roof.
Michael Wilson, a spokesman for the county Department of Health Services, says the iconic structure built in 1933 that served as a long-running frontispiece for the soap opera General Hospital from 1975-2004 is now used for overflow office space.
The nearby new hospital now gives the region’s poorest patients private rooms with flat-screen TVs instead of old ward-style accommodations with five or six beds, Wilson says. There is also far more natural light, better air conditioning, fewer floors, faster elevators, and much more effective airflow systems.
It’s a vastly different overall patient experience, Wilson says.
Saca says she still has fond memories of spending her first years of training at the hilltop hospital that overlooks east Los Angeles. She arrived there in 1987 with a nursing degree from Walla Walla Community College in Washington.
I personally feel a little nostalgic, she admits. General Hospital will always have a place in my heart, no matter how nice the new home is.