Growth in Sussex County has exploded. Farm fields are now full of houses, many second homes to those who live upstate or out of state. But when part-time residents retire and move to the area, they put more stress on the healthcare system.
“Most of the growth is people who’ve moved here from some other area and retired,” said Fried, Beebe’s president and CEO. “They’re older, so they tend to use healthcare at a higher rate. It really exacerbates the growth in terms of the demand for healthcare service.”
While the national growth rate over the next five years is expected to be 3.8 percent, Sussex County’s population is growing faster. In the next half decade, Sussex County is projected to grow 7.4 percent, with an estimated 9.2 percent growth in the Lewes-Rehoboth area.
Continued growth is reflected in Beebe’s daily census numbers. At a recent American Hospital Association meeting, Fried said he learned hospitals generally average about 65 percent capacity daily. On average, Beebe’s Savannah Road campus reaches 85 percent capacity each day.
Richard Schaffner, executive vice president and chief operating officer, said the average daily census was 136 when he returned to Beebe two-and-a-half years ago – he previously worked at Beebe for three years in the mid-2000s. Since returning, he said, the census has jumped to 155, as of last month.
“We continue to see that steady growth month-over-month in terms of patients who are coming in,” he said, noting the upward trend is expected to continue for at least the next five years. “We have done a fair amount of work around what we think our capacity needs to be as we move forward.”
In November 2015, Beebe officials unveiled a plan to expand the Savannah Road campus. Officials have met with neighbors in the months since and continue to tinker with the plan. A revised plan is expected to be released in June, Fried said.
But expansion to the Lewes campus is only one way Beebe is changing for the future.
Beebe’s service area encompasses about 150,000 people from within Route 16 to the north, Route 113 to the west and the Maryland-Delaware line to the south.
A challenge Beebe often encounters, he said, is when patients use the Emergency Department as their primary-care physician.
To prevent that, Beebe has opened and expanded hours at walk-in clinics in Millville, Millsboro, Georgetown and Rehoboth Beach. They are also working to add 14 primary-care physicians to the medical group.
“A lot of the the cases we see come into our Emergency Department are truly those patients,” Schaffner said. “We’ve done a pretty good job between ourselves and the folks from Sussex Emergency Associates to get the public better educated in terms of what you can use a walk-in center for and what you can use the Emergency Department for.”
Beebe does a community needs analysis every two to three years, leading to initiatives such as new walk-in centers in specific areas.
“The summer is the [busy] time around here,” Schaffner said. “We’ve heard over the years from the folks in our South Coastal areas about the challenges they have coming up from Bethany and Millville. It’s a lengthy trip for those patients, so we try to take that into consideration when we’re looking to expand.”
The number of people seeking walk-in care has increased 164 percent in just the last three years.
For Emergency Department patients who do require longer stays, Schaffner said, the hospital has adopted lean management principles. Pioneered by the Toyota Motor Company, the philosophy is designed to speed up the process. In healthcare, that means lowering the time it takes for patients who arrive at the Emergency Department to be admitted to the hospital.
Expansion of staff is also an important tool to stay ahead of the projected growth. When Fried joined Beebe in 1995, there were about 70 doctors. Today, Beebe’s medical staff is close to 400, including nurse practitioners and physician assistants.
“We recognize to serve a growing community, we need to have good doctors here,” Fried said. “And not only primary-care doctors, but also specialists.”
Including all staff, Beebe employs about 2,300 people across its medical group and the hospital.
“We wouldn’t be able to do what we do without our talented team members,” Schaffner said. “They’ve all stepped up to manage growth in patient volume. People are working extra shifts when necessary. They’re all committed and truly professional all across every department within our organization.”
That includes Beebe’s Home Care Services. Like many of its other efforts, Schaffner said, home care helps relieve stress on Beebe’s facilities. The number of people seeking home care services has grown 170 percent over the last five years, Schaffner said.
Beebe is also focusing on expanding the Margaret H. Rollins School of Nursing. Starting this fall, the school will increase its enrollment from 30 to 45 students.
“That’s really a great win because those are folks who understand our system, work within our system, get clinical experiences here, so when they graduate, it’s a natural transition for them to come to work for Beebe,” Schaffner said.
Q: How would Beebe be impacted if the Affordable Care Act is repealed?
Fried: It could affect us quite a bit because of the Medicare population and the Medicaid population, the exchanges. We just heard last week that Aetna is pulling out of the state, so certainly what happens in Washington and Dover has a big impact on whether or not people have coverage and how they use the healthcare system.
It matters a lot to us, and we’re very involved from a local and a national level to try to help ensure whatever does get passed is focused on trying to do what’s best for the patient and making sure they have access to care.
Q: How did the Affordable Care Act impact Beebe?
Fried: I don’t think we saw the exchanges grow as fast as people thought, but certainly there were people who didn’t have coverage before that had it. Before ACA, there were a lot of people who ended up having to declare bankruptcy because of significant medical bills, which we certainly don’t want to see happen. I think the hospital industry as a whole has always felt the ACA was important to provide care for everybody to make sure everybody got covered. There were a lot of things in the act that we didn’t necessarily agree with, but we continue to hope that over time instead of throwing it out and exposing people to not having coverage, that there are things that can be done to tweak it and improve it.
Q: How does the expansion of other medical groups affect Beebe?
Fried: It certainly impacts us. We hear people all the time talk about what’s going on at Bayhealth. We have our own plans for expansion. We are trying to develop a plan that not only addresses in-patient needs, but out-patient needs as well, and not just one location, but multiple locations.
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PROJECT UPDATE [JUNE 15, 2018]: Due to anticipated changes in our community’s use of healthcare facilities and services, we have re-evaluated the scope of our expansion and decided to enhance and expand access to advanced medical technologies and outpatient services rather than proceeding with the construction of additional inpatient rooms on the Lewes Campus. To learn more about these changes, and how we’re continuing to make the next generation of care a reality in Sussex County, click here: https://www.nextgenerationofcare.org/2018/06/15/healthcare-is-changing-and-so-is-beebe