Hospital transitions emergency staff

COEUR d’ALENE — Kootenai Health, one of the few remaining community-owned hospitals in the U.S., isn’t having an emergency with its front-facing department. But there is definitely change going on, CEO Jon Ness said Wednesday.

Ness and Communications and Marketing Director Kim Anderson said a broad staffing change in its emergency department was planned well before its contract with Western Medical Associates expired Jan. 1. A key reason for the change is a familiar issue throughout North Idaho.

“This is all about growth,” Ness said. “The front door of Kootenai Health is the Emergency Department. It needs to be outstanding.”

Recent full-page ads in The Press from Western Medical Associates emergency physicians note that the organization had been providing emergency medical care at the hospital for 30 years.

“Kootenai Health leadership has decided to take over ongoing provider staffing of the Emergency Department effective January 1, 2022,” the ad says. “We are very saddened to no longer be able to provide our excellent emergency medical care after this transition. As a result, 24 of 27 WMA physicians/APPs (representing over 400 years of KH EM experience) will be relocating their services. This will take place during the COVID pandemic, ongoing hospital capacity/staffing issues, hospital construction and expansion, and rapid growth in our region.”

Ness declined to respond directly to the ad or rumors circulating about alleged walkouts or takeovers.

“We can’t and won’t talk about contractual negotiations,” he said. “This is about the future — forward-looking to really build capabilities for emergency medicine for a far bigger community and far more complex patients than we’ve had in the past.”

Anderson said the hospital recently had a 900-respondent survey done — a practice the hospital hires a company to do about every three years — and as expected, growth was a central issue.

“In Kootenai County, 86% of those surveyed agree the area is growing quickly and 57% view that pace of growth in a negative light,” she said. “However, when asked about important institutions such as hospitals, 81% of Kootenai County residents surveyed agreed that Kootenai Health needs to grow in order to meet the needs of the area’s population.”

Moving past the contracted services of an outside organization was necessary to meet modern challenges, Ness said, adding that changing staffing models at KH isn’t new. Within the last decade, Kootenai Health has transitioned away from hospitalists and oncologists coming from private practice and instead fills those critical positions with highly qualified hospital employees.

“With larger hospitals, that is the norm in the U.S.,” Ness said. Kootenai Health has more than 3,700 employees.

According to Anderson, Kootenai Health’s emergency department now sees about 50,000 patients annually, and that number is expected to reach 75,000 by 2025. But it’s not just the number of patients, she said; it’s the complexity of those cases and the urgency with which they’re treated.

Kootenai Health is North Idaho’s regional referral center for traumas and ‘time sensitive’ emergencies such as stroke and cardiac arrest, Anderson said. The hospital serves emergency patients from Grangeville to the Canadian border — a challenge that was likely not foreseen years ago.

Ness said many previous WMA physicians were board certified in family medicine, not emergency medicine. Having the ability to recruit more doctors board certified in emergency medicine is essential, he said.

According to Anderson, more than 90 physicians have applied for the 23 positions in the emergency department.

“We have signed commitments from 17 providers set to arrive over the next six months,” she said. “All are residency trained in emergency medicine and board certified/board eligible in the specialty. We also have a verbal commitment from a physician medical director who has significant ED practice leadership in a busy emergency department. We have not had this many physician applications for a service line before, which speaks to the quality of this opportunity.”

Anderson said that when the WMA staff’s last shift ended, the temporary replacement staff took over without disruption.

“There was no lapse,” she said.