Closing a hospital and developing something new ?

[gm]

Dear collegues,

Those of you who have experience working with health care systems in
which there are centralising trends, read on ..................


Last month I facilitated an Open Space for all staff of a small Danish
hospital which will be closed down two years from now. There seems to be
a trend to centralise facilties in larger units assuming the same
services can be offered at lower costs.

The problem statement for the Open Space was: “Closing down: How ?” and
as the director, a surgeon
formulated it very powerfully in his opening statement:

        If one of our loved ones gets seriously ill, we face three options:
        - we can pretend nothing is the matter;
        - we can focus all our energy to check and recheck the diagnosis and
treatment options;
        - we can decide to make the best of the time we have left
        It is to talk about the third choice we are together today
...............

In general, there seem to be a number of issues related to closing down
a small hospital some of which are the following:
• how to prevent “slow death”; a major part of staff leaving for jobs
elsewhere, as a result of which
  hospitals need to close down before the planned deadline, sometiems
creating a gap in available care;
• how to keep the hospital a good place to work (as an employee) or be
(as a patient) in spite of the
  approach of closure ?
• how to handle communications ?
• how to focus HRM in such a way that staff feel the best possible care
is being taken of them ?

In this particular case, a few other issues emerged:

1.  What purpose could the buildings serve after closure ? Having been
designed as a hospital,
      parts may of course be converted into housing, offices and so on
at considerable costs, but what
      about using (part of) the hospital to offer services to citizens
of the town which could utilise the
      space already available, such as fysiotherapy, fitness, massage,
individual practioners of say zone
      therapy, acupuncture and so on ............

2.   How to best handle (especially in a small, relatively isolated
community) the fact that those with
        little education will become unemployed ? What could be done ?
      In this case, doctors and nurses will easily find new employment.
However some 20% of staff are
      assistants with little education and lots of experience. There are
no jobs waiting for them out there.
      I observed the town has two options: accepting to pay social
security for the rest of the lives of
                these  employees ( a sizable amount of money in Denmark); or
sponsoring a program in which this
          group will be assisted and offered facilities to start up new
businesses which can take off upon
          closure of  the hospital. This could for example be care for elderly
who prefer to stay at home as
          long as they like, I don’t know, but I am sure something will emerge.

I am interested to get any feedback on experiences elsewhere, and to get
into contact with anyone working with similar cases to see if we could
do something jointly.

Greetings from Denmark,


Gerard Muller

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