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2 hospitals may realign care

Executives are discussing this plan: Bayfront would stop treating children; All Children's would do no adult heart surgeries.

By TOM ZUCCO and LEONORA LAPETER

© St. Petersburg Times, published April 17, 2003


ST. PETERSBURG -- Bayfront Medical Center and All Children's Hospital are discussing a realignment of services that could end all pediatric care at Bayfront and all adult heart surgery at All Children's.

Gary Carnes, who took over as All Children's CEO in January, said he and Bayfront president and CEO Sue Brody "have talked for several months about the fact that we have adult patients over here and she had pediatric cases over there, and how we could end up helping each other care for them."

The talks are still preliminary, and such a move would have to be approved by the state and both hospitals' boards of directors.

Under the current arrangement between the two hospitals, which are next door to each other in downtown St. Petersburg, Bayfront's acute care pediatric cases are sent to All Children's. Less serious cases remain at Bayfront.

As for cardiac surgeries, in an arrangement that began in the mid 1970s, adult patients are admitted to Bayfront and then transferred to All Children's, which performs open heart surgery on children and adults. Adults are then transferred back to Bayfront.

All Children's performs about 600 to 700 pediatric and adult heart surgeries a year.

Under the new plan, adult cardiac surgeries would be performed at Bayfront. Pediatric cardiac operations would stay at All Children's.

Dr. James Quintessenza, a cardiovascular surgeon at Bayfront and All Children's, said he doesn't see the value of two separate programs.

Instead, Quintessenza prefers a centralized cardiac unit that would serve both hospitals.

"If we separate, we could have two mediocre programs," said Quintessenza, vice president of Cardiac Surgical Associates, a group of 13 surgeons who specialize in pediatric and adult heart surgery.

"There's good statistics that the higher volume programs have better outcomes and lower costs," he said. "We're interested in seeing one set of cardiac surgeons, critical care nurses, heart-lung machines, and all the millions of dollars of equipment it takes to run an operating room. And in a building that bridges the two hospitals, so we can take care of children and adults."

Quintessenza said his group welcomes change and supports both hospitals.

"We want to work with them," he said. "But for Bayfront to go out on their own and do open heart surgery, we're very concerned about that. Right now, for instance, we don't have enough critical care nurses to fill the spots here (at All Children's)."

In anticipation of the realignment, All Children's has asked the state for permission to add as many as 22 neonatal intensive care unit beds, raising its total from 67 to 84.

To make room, Carnes said the hospital will move administrative offices and outpatient services to nearby buildings. Late last year, in a trade with the state, All Children's acquired the former Pinellas County health department building on Seventh Avenue S and gave the state the former Franklin Templeton building on Dr. Martin Luther King Jr. Street S. All Children's renamed the health department building after J. Dennis Sexton, the hospital's former president and CEO. The hospital will spend at least $1-million to renovate the building. It will include administrative offices and physical and occupational therapy centers.

All Children's also has purchased the Laurels Nursing and Rehabilitation Center on Ninth Avenue S. Patients will be transferred to another nursing facility.

"We're hoping to begin some remodeling by the end of this year," Carnes said. "But that depends on the final decision from the state, which we hope to have by the fall."

Funding for the All Children's expansion will come from cash on hand, fundraising, and "some sort of debt," Carnes said. "But we haven't approached the bond authority.

"We will have a much better idea by mid to late June as to what we're doing and how the state feels about our ideas."

Brody said Bayfront will remain a major trauma and birthing center.

"We have a physical connection between the two hospitals -- the tunnel -- but one of my big dreams is to physically connect the two hospitals on other levels besides the basement level," she said.

"I foresee in the future we'll have both patients and staff and physicians back and forth between the two organizations. The real strengths of the two organizations are different, but we both want to make health care even better."

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