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Queen of the Valley Hospital: Sanctuary at a Crossroads
Queen of the Valley Hospital is almost always full. That's not good. Not only are our beds full, we are almost out of room for our outpatient services. That's not good, either.
The 1997 Budget Act gave birth to a series of Medicare funding cutbacks both here and across the country. Plus, new California seismic regulations for hospitals require us to move all our patient care services from our original Trancas Street building. Furthermore, U.S. Homeland Security Director Tom Ridge has threatened to withhold state and local bioterrorism grants if local hospitals don't enhance the "surge capacity" of their emergency rooms.
Amid all this, we at Queen of the Valley Hospital cannot lose sight of our moral obligation to keep this hospital a sanctuary when any community crisis strikes-whether it's a natural disaster or man-made.
To respond to these potential crises, the hospital will expand the number of inpatient room beds and emergency room holding beds at its own expense.
Additionally, with the support of our community, we plan to make four much-needed improvements to the Queen. Our goal is to raise our level of surgical, diagnostic, treatment, rehabilitation, and long-term health care approaches to address the unique and demanding health care problems we face here in Napa.
Our four projects are:
1) Purchasing and installing a computer-controlled robotic surgery system which will provide our patients with minimally invasive surgery, meaning quicker recovery, less pain, and less trauma. (Fundraising need: $2 million)
2) Replacing our Magnetic Resonance Imaging (MRI) machine, which is out of date and cannot be upgraded. (Fundraising need: $2.2 million)
3) Replacing the older of our two linear accelerators in our radiation oncology department. The older accelerator is 20 years old, its technology is obsolete, and it cannot be upgraded. A replacement will reduce the frequency and length of radiation treatments, is expected to bring higher cure rates to our patients, and can be upgraded. (Fundraising need: $2.2 million)
4) Building the Queen of the Valley Health Institute/Queen of the Valley Hospital Center for Health Improvement on our campus. (Fundraising need: $8 million)
This new 57,500 square- foot clinically integrated outpatient center will allow us to make improvements in inpatient and outpatient services.
• We will relocate inpatient care areas from our Trancas Street site due to California’s seismic safety regulations for hospitals. This will allow us to:
a) Expand our laboratory facilities inside the main hospital building due to the creation of more space from the vacated patient rooms,, and
b) Return staff members and services to our main hospital building after overcrowding had forced us to rent office space throughout Napa.
• We will centralize, reorganize and introduce new outpatient services. We plan to:
a) Centrally locate and expand cardiac rehabilitation, The Breast Center, and outpatient physical therapy programs;
b) Offer a new medically supervised cancer patient rehabilitation program;
c) Expand diabetic patient exercise and nutrition counseling, and
d) Create a public health information and treatment program designed to lead our community out of its current high risk health situation by introducing programs in preventive health care and alternative medicine.
Here, as in our main hospital, we will care for everyone, no matter what their creed, ethnicity, or economic status may be.
All of us who love and support The Queen are now turning to the people and the public institutions they lead in the Napa Valley-our nation's center of the food and wine culture-to help us move ahead with our plans. Our four-part plan gives priority to people's long-term health; the well-being of families; and the future health of the ever-growing numbers of people who have chosen the beautiful Napa Valley as their new home.
Queen of the Valley Hospital is a sanctuary at a crossroads.
Your opportunity to help us reach our $14.4 million goal is now.
No coward soul is mine,
No trembler in the world’s storm-troubled sphere:
I see Heaven’s glories shine,
And faith shines equal, arming me from fear.
Remembrance
Emily Bronte
An earthquake grips us all with fear. So, do bioterrorism, "dirty" bombs, compromised water supplies, and other homeland disasters. When a catastrophe strikes, Queen of the Valley Hospital must remain a sanctuary for the injured and sick as it has for the last 44 years.
In any of these calamitous scenarios, our emergency room staff and facilities would be under overwhelming pressure. And even when patients are moved out of the emergency room, many will need continued hospitalization. Queen of the Valley Hospital is already planning to use its strategic capital over the next several years to:
• Add more inpatient beds-three in critical care and three on our telemetry floor, and
• Remodel our emergency room adding four additional holding beds, so we can speed up emergency care.
Today, with The Queen as overcrowded as she is, we must move patients to other hospitals. We don't like doing this, and neither do our patients or their families. But it's our only solution right now.
The commitment of an estimated $3 million in hospital funds to pay for additional beds plus our emergency room expansion by 2004 requires us to turn to our community for help with the rest of our long-range plan.
New earthquake protection standards resulting from the California Seismic Safety Act requires all medical facilities to either retrofit or remove patient care areas from buildings built before 1974. This means we have to move all patient-care services out of our main hospital building on the Trancas Street campus. The law still allows us to use that 1958-vintage building to accommodate other expansion needs such as offices and laboratory services. That's what we intend to do until the building is eventually removed.
Regrettably, the seismic mandate is unfunded, so we have to pay for the project ourselves. We have until 2013 to meet the state's deadline, but because our outpatient services are already at capacity, we need to develop solutions now. We do not believe a staged or piecemeal approach is economically sensible, nor is it in the community's long-term best interests.
Capital Project #1: The da Vinci (TM) surgical system
Purpose: Introduction of this innovative remote surgery system will be a boon to our patients, reducing trauma, pain, recovery time, and their length of stay in the hospital
Fundraising need: $2 million
The robot-assisted operating room of tomorrow is just around the corner for many patients.
MIT Technology Review, November/December 2000
Massachusetts Institute of Technology
Our highest priority of the three advanced technology capital projects we need for The Queen is the purchase and installation of a da Vinci (TM) system for minimally invasive surgery. This robotic system is the greatest boon to patient care, pain control and recovery that we've seen in decades. It is the surgical process of the future.
A da Vinci (TM) system allows the surgeon to operate on patients remotely, while significantly enhancing the surgeon's ability to execute highly complex surgical procedures. The robotic system uses three-dimensional visuals through high-resolution television monitors that allow the surgeon to zoom in and out of the area under treatment.
The $2 million system for The Queen will have three components: 1) purchasing the robotic system, 2) remodeling an existing surgical suite to accommodate the new equipment, and 3) training our surgeons and operating room support staff.
A da Vinci (TM) system is known as minimally invasive surgery because this robotic technique involves only very small incisions. Such surgery will improve our patients' care and treatment by reducing trauma, blood loss, post-operative pain, infection risk, and scarring. Combined, this will lead to faster recovery, which will reduce the length of patients' hospital stays.
The U.S. Food and Drug Administration, which must approve each robotic system's surgical procedure separately, has OK'd the sale of the da Vinci (TM) system for many procedures. The Queen will use its system for heart/thoracic, urological, gynecological, and general surgery. Use of the system for heart surgery is still undergoing FDA trials. It is expected to be approved soon.
This will revolutionize heart care in the U.S., and having our own robotic system and trained staff in place will allow The Queen to offer robotic heart surgery as soon as it's approved by the FDA.
This will be important to us because The Queen's Regional Heart Center attracts patients from throughout Napa, Solano, Lake, and Sonoma counties; Kaiser, military, and California correctional hospitals; the state of Oregon, and from as far away as Canada. We do some 200 open-heart surgeries annually, and we're extremely proud of our team of exceptional surgeons.
Capital Project #2: Magnetic Resonance Imaging (MRI)
Benefit: Replacing our 10-year-old MRI will offer patients more comfort, earlier detection of problems, shorter diagnostic appointments, and the new machine can be upgraded in the future
Fundraising need: $2.2 million
Technology is very important. We felt that Queen of the Valley is the center for this area and should be top-notch.
Iva and Vaclav Mostecky
Donors of peripheral vascular equipment
Our second important capital project for The Queen consists of replacing our old magnetic resonance imaging (MRI) machine with one that is more powerful and patient-friendly.
The Queen was the first institution in Napa County to offer MRI diagnostics. This process allows physicians to "look" into people's bodies without using X-rays. Instead, an MRI uses a magnetic field and radio waves. Our original machine is 10 years old and cannot be upgraded.
The new machine would be either "open field" meaning it is open on both sides, or "open bore" meaning the platform on which the patient lies is much larger. Many patients have very low tolerance for the old, more confining machines.
The new machine would also provide clearer and higher quality images. This improved quality will give our physicians and technicians the ability to detect problems much earlier. It would especially benefit patients requiring MRI diagnostics for stroke, brain and cervical spine trauma.
Furthermore, diagnostic periods with a new machine would decrease from an average of 45 minutes to 20 or 30 minutes. A new MRI would also reduce The Queen's dependency on distant referral centers for data analysis.
We plan to install the new machine in our existing MRI room.
Surgical robotics and MRI's are the two biggest ticket capital equipment purchases for hospitals these days.
Capital Project #3: Linear accelerator
Benefit: Replacing our 20-year-old original linear accelerator with a new one will reduce the frequency and length of radiation treatments for cancer patients
Fundraising need: $2.2 million
The gap between the excellence we want in our community hospital and what the managed-care marketplace will support seems to be getting wider and wider. So if we want the most up-to-date technologies and highest-quality facilities, it’s up to us to keep filling that gap.
James Tidgewell, President, QVH Foundation Board of Trustees
We have two linear accelerators in our radiation oncology department. These powerful machines treat cancer using precisely directed beams of nuclear energy.
Our original nuclear linear accelerator is 20 years old and well past its prime. Its precision is nowhere near current technology, which causes patients to undergo longer treatments. This machine needs to be replaced, because it cannot be upgraded.
A new machine will reduce the frequency and length of radiation treatments for patients. It also would be able to focus radiation more specifically on the treatment site with far fewer side effects to surrounding tissue. It can be focused on multiple areas at one timem too. Ultimately, we expect the new linear accelerator to significantly contribute to higher cancer cure rates for our patients. This new machine will help us fight cancer more accurately and increase the quality of cancer patients' lives.
The new machine, as is the case with all of today's new linear accelerators, can be upgraded by adding new computer software, which will make it last longer, thus delaying the need to buy a new machine in the future.
The Queen's Community Cancer Center is the only center in Napa County that offers this treatment. We treat 96 percent of the cancer patients in Napa County, so when people need cancer care and radiation treatment, the Queen is likely where they'll go, even if they are Kaiser Permanente members.
Capital Project #4: QVH Center for Health Improvement/ Queen of the Valley Health Institute
Benefit: Our new center/institute will house inpatient care and outpatient services including cardiac, breast, outpatient therapy services, cancer rehabilitation, diabetes follow-up, and community health programs focusing on prevention and alternative medicine.
Fundraising need: $8 million
(Total cost: $13 million, with $5 million paid with Queen of the Valley Hospital capital)
The primary reason driving our project is improving our community’s health now and in the future. This means we’ll have to redesign virtually our entire hospital process and has led us to the idea of centralizing all our patient follow-up services. This makes the new state seismic law, which set this planning process in motion, a blessing in disguise.
Donald H. McComber, Campaign Chairperson
Queen of the Valley Hospital Foundation
The Center for Health Improvement/Queen of the Valley Health Institute will be a 57,500 square-foot multi-specialty health care hub designed primarily for earthquake-safe patient care and outpatient services. It will be an important complement to our 179-bed hospital.
This project is important for three reasons:
1) When compared with counties like ours across the United States, the health demographics of Napa County are dramatically worse, according to federal health records.
2) Disease prevention is fast becoming the U.S. health care model in contrast to the old model, which did not give health care a role until disease and injury had happened.
3) State seismic law changes are forcing us to move patient care rooms to a new earthquake-safe structure.
1) Napa County's public health situation
According to the July 2000 Comunity Health Status Report of the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services, Napa County ranks “unfavorably” in several public health categories including stroke, lung and colon cancer.
The same is true when we're compared with the U.S. rate and also with "peer" counties (counties demographically similar to ours).
Another rather shocking statistic from the federal report shows Californians in general have a 75.3 percent risk factor for premature death due to their sedentary lifestyle, and a 72.5 percent risk factor for premature death due to their low intake of fruits and vegetables.
As your community hospital, we're not exactly certain why these statistics are so high, but these numbers certainly argue for not only increased outpatient support, but preventive care, counseling, and physician-approved alternative medicine approaches.
2) Prevention: the new model
The medical world of the 21st Century is heading straight toward preventive care and disease management to keep patients out of the hospital.
Today, we are witnessing growth in the promotion of the value of a healthy lifestyle, the benefits of preventive medicine, and the development of physician-approved alternative medicine services such as massage therapy, acupuncture, aroma therapy, biofeedback, and new approaches to exercise and stress reduction. Our Center for Health Improvement/Health Institute would make us the first hospital in the Napa Valley to offer alternatives to traditional medical care.
That's because we fully expect holistic care for the body, mind and spirit to attain high social acceptance. We owe this opportunity to our community, especially given its alarming health demographics.
3) The new earthquake law
It is more cost-effective to build the new Center for Health Improvement/Health Institute than to retrofit our old Trancas Street building for earthquake safety.
As a result, the Center for Health Improvement/Health Improvement will be dedicated to
1) Inpatient care and
2) Outpatient services:
a. Cardiac rehabilitation,
b. Breast care and other women’s services,
c. Outpatient physical, occupational and speech therapy,
d. Pain management,
e. Cancer rehabilitation,
f. Diabetic patient exercise and nutrition counseling, and
g. Personal health planning and training.
Our cardiac rehabilitation program and the Breast Center must move due to the seismic safety law. Outpatient physical, occupational and speech therapy programs and diabetic patient counseling will be moved here from other parts of the hospital. Pain management, cancer rehabilitation, as well as personal health planning and training are new.
A closer look at the Queen of the Valley Center for Health Improvement/Queen of the Valley Health Institute
The Center for Health Improvement/Health Institute would be built on vacant property at the corner of Trancas and Villa Lane on the southeast corner of the hospital campus.
Although the Center for Health Improvement/Health Institute is expected to cost $13 million, The Queen is limiting its community appeal for this portion of its project to $8 million. That’s because our hospital Board of Trustees decided the hospital itself ought to partner with the community in funding this community-focused center.
Not only that, The Queen will fund the Center for Health Improvement’s/Health Institute’s startup expenses during the first year (this is not part of the $13 million). By the end of its second year, we expect the Center for Health Improvement/Health Institute will be self-sustaining, making it a great community program for a long time.
And this center will be for the entire community, no matter what people’s socioeconomic strata. To guarantee that, we are prepared to provide $100,000 annually so uninsured, underinsured, and indigent community members can use our facility.
Our Center for Health Improvement/Health Institute will be divided into four areas:
1) Support facilities. This will include a reception area, staff offices, child care space, rest rooms, lockers, showers, family changing rooms, classrooms, and meeting space.
2) Health improvement. Here we will centrally locate our counselors, therapists, exercise experts, and nutrition specialists. This area includes a shallow indoor lap pool, therapy and exercise pool, cardiovascular equipment, aerobics studio, and health foods lounge.
3) Diagnostic services. This will include The Breast Center, mammography, and bone density testing.
4) Physician office space.
This new 57,500 square- foot clinically integrated outpatient center will allow us to focus on two primary areas:
1) Inpatient care, and
2) Outpatient services.
Inpatient care in our new center/institute
California seismic safety law for medical institutions requires us to move inpatient care from our Trancas Street building to a new earthquake-safe building. Vacating these rooms will give us space to expand our laboratory facilities and enable us to bring staff members and services back to our main hospital building after overcrowding had forced us to rent offices off our campus.
Outpatient services
With the construction of the new earthquake-safe building for our patients, we’ll be able to centralize, reorganize, and introduce new outpatient services. We plan to:
a) Centrally locate and expand cardiac rehabilitation, The Breast Center, and outpatient physical therapy programs;
b) Offer a new medically supervised cancer patient rehabilitation program;
c) Expand diabetic patient exercise and nutrition counseling, and
d) Create a public health information and treatment program designed to lead our community out of its current high-risk health situation by introducing programs in preventive health care and alternative medicine.
Cardiac rehabilitation: Comprehensive follow-up cardiac care, which permits patients to continue building and maintaining their health long after their surgery or heart attack, is seriously lacking in our region, and our current program is overburdened.
Cardiac rehabilitation connects patients with their physicians after surgery. Every day, some 45 men and women visit The Queen’s cardiac rehabilitation area for guided exercise, nutrition education, stress counseling and friendly support. That new area will be at the Center for Health Improvement/Health Institute. Our "old" program is at 115 percent of capacity, and we know we could add another 20 patients per day, if we had more room.
Furthermore, the demand for cardiac care is expected to increase. In the next 10 years, the largest segment of our population will be 45 years of age or older. Heart disease and related problems are the primary cause of death for people in this group. The Queen wants to help them live.
After heart patients "graduate" from physician-monitored rehabilitation services covered by insurance, we offer an elective program at the patient's expense. Despite it being a personal expense, we have had patients in elective cardiac rehabilitation for as long as 10 years! They know it works, and so do we. This represents a stable, ready audience for Center for Health Improvement/Health Institute care. Plus, we need to encourage more people to get engaged in their long-term health.
The Breast Center: Up to 35 women per day come to The Queen for mammography, education, and counseling. Our Breast Center and stereotactic breast biopsy services must be relocated from our Trancas Street building.
Our current Breast Center is far too small. It was originally designed for two mammography machines. We now have four. Overcrowding has encroached on patients' privacy, and we fear this may discourage some women from using our early detection services. If this happens, we all have great cause for alarm.
In only three years, from 1998 to 2001, visits to the Breast Center grew from 533 to 831. As increasing numbers of women seek out diagnosis and treatment, this area of care demands our immediate attention.
Outpatient physical, occupational and speech therapy: Today, we do not have outpatient capacity to offer rehabilitative therapy to stroke and trauma victims beyond their acute inpatient care. These are people who desperately need help. By centrally locating all our therapists, counselors and other specialty professionals in our Center for Health Improvement/Health Institute, we will be much better able to continue rehabilitation for our stroke and trauma patients after their discharge.
Medically supervised cancer patient rehabilitation: This new program is being designed for patients undergoing chemotherapy and radiation. Medical science has proven a fitness regime helps these patients keep up their energy levels, which is a tremendous stimulant to their autoimmune systems. This helps them feel better and get better, which is good news to all of us and is a new approach to fighting cancer.
Cancer is fast becoming a chronic illness, not a terminal diagnosis. So, the importance of medically managed diet and exercise cannot be stressed enough. This truly is a medical growth area and promises to be an important service of our Center for Health Improvement/Health Institute for years to come.
Diabetic patient exercise and nutrition counseling: Our diabetic patients need strictly supervised nutrition and exercise counseling, and The Queen has offered this care for years. We know when patients closely watch their diet and engage in exercise programs, they have far fewer complications such as loss of eyesight and poor circulation, which may lead to loss of limbs-two tragic but common side effects of diabetes. Our Center for Health Improvement/Health Institute would be their venue for counseling and medically managed exercise.
Public health information and treatment: Here in Napa County, we're facing several unique health care challenges, evidenced by our high incidence of cancer, stroke and diabetes. Because The Queen's mission is and always will be to care for all members of our community while operating a progressive, forward-looking medical facility, it is obvious to us we must help our community learn more about preventive health care and alternative medicine.
That's why we are committed to dedicating part of our Center for Health Improvement/Health Institute to providing people with the opportunity to learn how they can take care of themselves through proper diet, exercise, and health maintenance. But even more, we're looking at upcoming trends in the newly developing field of alternative medicine, which incorporates new therapies using massage and aroma; acupuncture; biofeedback, and other ideas, into its holistic approach to health-incorporating the body, mind and spirit into a full circle of health practices. We want to lead the Napa community into the next generation of not just health care, but self-help health care.
Our mission: Continually improving health
To extend the Catholic health care ministry of the Sisters of St. Joseph of Orange by continually improving the health and quality of life of the people in the communities we serve.
Mission Statement
Queen of the Valley Hospital/St. Joseph Health System
A Ministry of the Sisters of St. Joseph of Orange
Continually improving health. That's been the driving ideal of Queen of the Valley Hospital since we opened in 1953. Our sponsors, the Sisters of St. Joseph of Orange, our Board of Trustees, staff, and donors are all dedicated to continual health improvement.
This mission pushes our moral responsibility well beyond healing the sick. Our dedication also focuses on the people around us: those who are fit and healthy. We want to be instrumental in keeping them that way.
Who but The Queen is better capable of bringing that message of health and nutrition to our community through our four-part capital project for our robotic surgery system, new MRI, linear accelerator, and our Center for Health Improvement/Health Institute?
In the 21st Century, we will see ever-increasing promotion of the value of healthy lifestyles, preventive care, and alternative medicine. We need to work within our community to reduce the high local incidences of stroke, cancer, heart disease, and diabetes.
But we recognize our community expects good financial management, too. We're proud to say our market research shows we can expect our proposed Center for Health Improvement/Health Institute to be self-sustaining by the end of its second year.
Managing our fund-raising campaign will be the Queen of the Valley Hospital Foundation and its wonderful leadership donors, including generous annual help from the Vintners' Association Wine Auction. Over the last three decades this collaboration has provided more than $15 million for programs at The Queen. This proposed $14.4 million project will, undoubtedly, be everyone's biggest challenge.
Looking ahead, The Queen must first remain a sanctuary for the injured and sick on a daily basis and certainly when disaster strikes. Second, we must look to the future well-being of our community.
All of us who love and support The Queen now turn to the people and the public institutions they lead in the Napa Valley-our nation's center of the food and wine culture-to help us move ahead with our plans. Our four-part plan gives priority to people's long-term health; the well-being of families; and the future health of the ever-growing numbers of people who have chosen the beautiful Napa Valley as their new home.
Queen of the Valley Hospital is a sanctuary at a crossroads.
Your opportunity to help us reach our $14.4 million goal is now.