Facilities look to expand services with weekend hours

Experts say the changes benefit patients and the hospitals.
PHILADELPHIA (AP) -- Starting this fall, elective Caesarean sections will be scheduled on weekends at Lankenau Hospital, where 2,300 babies are born every year.
Other surgical departments at the acute-care teaching hospital in suburban Philadelphia are also considering expanding hours, including the cardiology, orthopedic surgery, plastic surgery and urology departments.
Many hospitals nationwide have added evening and weekend hours for outpatient services such as mammography, MRI, ultrasound and lab tests. Hospitals are not yet jumping on the weekend surgery bandwagon -- but a hospital consultant predicts it is only a matter of time before other facilities follow in Lankenau's footsteps.
"Hospitals struggling to get control of costs can't afford to have a huge portion of the physical plant lying idle for two days out of seven," said Robert V. Reece, senior vice president of Cambridge Research Institute, a health care consulting firm in Massachusetts.
What they're trying to do
Hospitals and medical centers are looking for ways to ease overcrowded facilities, meet demand caused by closures of neighboring hospitals and departments, deal with an aging population and accommodate more demanding patients who want more control over when they get tests and treatment -- and refuse to take time off from work to do so.
The change can benefit hospitals, too -- especially those that are packed to the gills during the traditional weekday hours.
"It's a matter of meeting consumer demand and of operating in the most efficient way we can," said Gail A. Egan, Lankenau Hospital's president. "On lots of levels, it simply doesn't makes sense for us to operate only during the traditional bankers' hours."
In a survey Lankenau distributed to doctors, roughly a third said they would be willing to work nontraditional hours such as weekend surgical shifts. The next step is seeing whether support staff, from anesthesiologists to case managers, would be willing to do the same, Egan said.
"Surgeons don't work in a vacuum; we need to have the whole team on board," she said.
Added services
Among hospitals that haven't taken the weekend surgery step but have added services elsewhere is City of Hope National Medical Center outside Los Angeles, which has extended mammography hours at its women's health center until 8 p.m., on alternating days of the week to accommodate different work schedules.
"A lot of women work the same hours as we were open," said Marti Verfurth, director of the women's health center. "Making it less of a challenge to get a mammogram is beneficial for the patient and it's beneficial for us, because we can catch problems faster if we make it easier for women to come in."
Rick Wade, senior vice president of the American Hospital Association, noted that 15 years ago, hospitals filled with empty beds didn't foresee the change that was coming, and the crowds along with it.
As smaller community hospitals closed or eliminated departments amid spiraling health care costs, dwindling reimbursement rates and rising medical malpractice insurance premiums, the facilities left standing -- often larger teaching hospitals -- are getting the overflow.
Since managed-care organizations in recent years began loosening cost-cutting policies that shortened or eliminated hospital stays, the beds filled up. But because the change was unexpected, it left many hospitals without money or plans for expanding.
"Managed care has relented from some of the more restrictive things they were imposing on people ... the delays and the things they wouldn't pay for," he said. "And patients now pay a bigger out-of-pocket cost, so they want more of a say in [determining] when they get that wrist replacement or that knee replacement."
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