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After COVID, Midland Health looks to the future

This article was originally published by the Midland Reporter-Telegram on July 6, 2021.

With dramatically lower numbers of acute and convalescing COVID-19 patients in the hospital, and large-scale testing and vaccination efforts behind us, Midland Health can focus on the future of health care in Midland for the first time in more than a year. While we have a wide variety of projects underway, three major initiatives will do the most to shape our future.

Master Facilities Plan

Development of the Scharbauer Tower was intended to provide a long-term solution to the obsolete and deteriorating inpatient facilities at Midland Memorial Hospital. The tremendous generosity of our community, combined with favorable construction costs, allowed us to build extra capacity in the new tower. After securing additional philanthropic support, we were able to turn these shelled spaces into a beautiful, state of the art neonatal intensive care unit (NICU) and an additional floor with 48 beds of inpatient capacity. The ability to add the ninth floor nursing unit was a particular blessing, as we were able to build it with enhanced negative air flow capabilities that made it an ideal environment for the care of the huge influx of COVID inpatients we received last fall and winter.

The Scharbauer Tower has proven to be everything we hoped it would be, but that project was only the first step in the planned transformation of the main campus, leaving most outpatient functions for future redevelopment. As our outpatient demand grows, and our 70-year-old buildings continue to deteriorate, the time has come to address the remainder of our master facilities plan.

The first step in advancing the master facilities plan is the emptying and demolition of the old buildings on the main campus. Our guiding philosophy in relocating staff and services has been to maximize the use of the properties we already own, including the Abell-Hanger Pavilion and the former west campus, recently rededicated as the F. Marie Hall Outpatient Center. Our outstanding Wound Management Center moved to the Hall Center on June 7, and we plan to relocate the Sleep Lab there later this year. Coming soon will be the relocation of our Day Surgery and Outpatient Treatment Center functions from their old building locations onto the sixth floor of the Scharbauer Tower, leaving only administrative functions remaining in the spaces to be demolished. Over the next several months, these non-patient care functions will move to either temporary or permanent new locations, to allow demolition to begin in early 2022.

While we expect to significantly reduce operating and capital costs by removing the old buildings, the principal purpose of the project is to build modern, accessible spaces to care for our outpatients. Highlights of the plan for new space include a dedicated outpatient access point on the south (Illinois) side of the campus; new, easily accessible spaces for preoperative evaluations and day surgery; a dedicated parking garage; a new endoscopy suite; a conference center; and a variety of administrative functions dislocated from the old buildings. Further expansion could include space for additional surgical capacity; expanded women’s and children’s services; and reconfiguration of the emergency department to add dedicated space for pediatric patients.

As we move past the conceptual stage and into more detailed design, we must also establish the funding sources for this substantial project. Improvements in Midland Health’s balance sheet will make it possible for us to combine available cash with low-cost new debt, hopefully supplemented by the support of Midland’s philanthropic community, to provide funding to complete the master facilities plan. Over the next several months, we will refine the design, establish the amount of funding available and proceed accordingly.

Comprehensive Behavioral Health Center

Five years ago, the community mental health assessment performed by the Meadows Mental Health Policy Institute outlined for us the tremendous need for additional behavioral health care resources in Midland. Since the report was published, Healthy Minds has done great work in raising awareness and helping to remove the social stigma associated with behavioral health concerns. Texas Tech’s establishment of a Midland-based psychiatric training program, supported by the Midland Development Corp. and local foundations, gives us a base on which to build a new behavioral health workforce for the region.

As we have learned more about the behavioral health crisis in the Permian Basin, it has become clear that we must provide a wider range of services and make them more readily accessible to everyone in our community. Working with Oceans Healthcare and a diverse group of local stakeholders, we have begun to develop a vision for a truly comprehensive behavioral health treatment center for the region. The new facility would include expanded inpatient capacity for adults and adolescents; longer-term residential and intensive outpatient programs; ample capacity for all types of outpatient counseling services, accessible to people with a wide range of abilities to pay for services; testing and treatment services for children; and creative options to assist local criminal justice officials in redirecting appropriate individuals away from detention and into treatment programs.

We hope to secure funding for this comprehensive behavioral health effort from the sources noted above, as well as potentially available state and federal money specifically dedicated to mental health services advancement. Details on this major effort are expected to come together this fall.

Population Health Management

Among the most powerful lessons of the pandemic was acknowledgement of the disparities in access to care that exist throughout the country. While COVID touched everyone in one way or another, those with limited access to quality health care seemed to fare the worst. Individuals without a primary care provider, or faced with social issues that prevent them from understanding and addressing their own fundamental health needs, are at a tremendous disadvantage when faced with a challenging disease.

Prior to the pandemic, Midland Health had begun a program of specific outreach to low-income patients suffering from a variety of chronic ailments, through a vehicle we call the Equitable Care Alliance (ECA). Mining data from the emergency department, we were able to identify people suffering with chronic diseases like congestive heart failure and specifically target those who seemed to be struggling to manage their conditions. With ongoing care management efforts, we have seen some early success in reducing ED utilization and improving quality of life. We are now developing a renewed initiative to more broadly address the management of severe chronic disease across the entire community, including the offering of palliative care services to patients with conditions that standard medical and surgical treatments are unlikely to resolve.

One of our strategic objectives is to improve our community’s health to the extent that Midland County reaches the top 25 (top 10 percent) of Texas counties in the annual Robert Wood Johnson Foundation County Health Rankings report. In support of that goal, we have developed the Lifestyle Medicine Center; supported the concept of “food as medicine” by sponsoring educational events and development of community gardens; partnered with the city of Midland, Greenwood ISD and Midland ISD in employee wellness programs, and supported Midland Fire/EMS’ Community Paramedic program to improve care for regular emergency department visitors. These and many other initiatives have helped move our “Health Outcomes” ranking from No. 42 to No. 27 over the last four years. For the same period, Midland County’s “Health Factors” ranking moved from No. 63 to No. 15. When combined, these results place Midland among the 2021 “Healthiest Counties in Texas.”

Management of the health of an entire population is a daunting task, but it will be increasingly essential as health care funding gets tighter in the future. At Midland Health, our efforts will focus first on those for whom the greatest benefit is available. Improvements in health literacy, enhanced outreach to those who are struggling with debilitating and costly chronic diseases, and tailoring care to the unique needs of each individual have the potential to make our community even healthier. We recognize that it is less expensive and improves the quality of life when we keep people well, instead of trying to manage chronic diseases after they develop.

This is a new day for Midland Health. We are proud to serve the people of our great community, and appreciative of the resources entrusted to us to do so.

The full article is available online here.