A South Bay physician has asked the California Department of Public Health to conduct an "impact assessment" of Scripps Health's recent decision to close the labor and delivery unit at Scripps Mercy Chula Vista (Calif.) Hospital and transfer obstetrics services 12 miles north to its Scripps Mercy Hospital San Diego campus.
In a letter to the state's health department, Kofi Sefa-Boakye, MD, requested an investigation be conducted, writing that the San Diego-based health system has a moral obligation to keep the labor and delivery unit at the Chula Vista facility open since it predominantly services low-income mothers, according to a March 18 report from The San Diego Union-Tribune.
Dr. Sefa-Boakye, who has delivered babies in the region for more than three decades, expressed concerns about the care for patients who may arrive at the hospital with severe pregnancy complications, such as placental abruption, seizures and septic shock.
"We're just concerned about the women possibly arriving there after the unit is closed and not being able to be cared for appropriately and increasing the maternal morbidity and mortality and the neonatal morbidity and mortality in the South Bay," Latisa Carson, MD, another obstetrician and gynecologist who has years of experience delivering babies at Scripps Mercy Chula Vista, told the news outlet.
The health system has said consolidating obstetrics care with Scripps Mercy San Diego is necessary to open up capacity for patients in need of a medical-surgical bed at Mercy Chula Vista.
"Scripps Mercy Chula Vista's emergency room visits average 170 patients per day, and frequently top 200 or more per day," a March 7 Scripps Health memorandum shared with employees and previously obtained by Becker's said. "We have been exceeding our licensed med/surg capacity every day over the past 12 months, resulting in long waits for many of our Emergency Department (ED) patients to be placed in an available med/surg bed."
The memorandum announcing the change to staff also stated that only about half of beds in the OB unit at Mercy Chula Vista are in use on average, and that the change is expected to bring in 28 additional medical-surgical and observation beds.
The full transition is expected to take three to four months, officials previously said. According to The San Diego Union-Tribune's report, the health system has said it will continue to contract with obstetricians to be available for emergency cases at Mercy Chula Vista, though staff have raised concerns about not having a sufficient team to handle emergencies.
"The people who would be 'stabilizing' and delivering would be the emergency room staff," a nurse who has worked at the hospital for more than a decade and asked to remain anonymous told the news outlet. "Obstetrics and gynecology is not their forte; it's not what they are trained to do."
Meanwhile, health system officials have reiterated that an "organized approach" is being taken to ensure a smooth transition.
"We will make sure that we can make safe handoffs, safe transfers, maintain a safe continuity of care," Tom Gammiere, Scripps' senior vice president and regional chief executive in south San Diego County, told the news outlet.
The change in services will affect around 135 employees at Scripps Mercy Chula Vista, and Scripps has said it is working to identify other opportunities for affected employees within the system. Severance paperwork has reportedly been provided to 136 workers, and they have been made aware of a notice for 51 full-time equivalent positions in the labor and delivery and postpartum departments at Mercy Hospital San Diego, a Scripps spokesperson told Becker's. Additionally, there are 11 full-time and part-time positions posted at other Scripps sites in OB services.
"Scripps is committed to maintaining safe, high-quality emergency obstetrics services at Scripps Mercy Hospital Chula Vista, both now and after the consolidation with Scripps Mercy San Diego is complete," the health system said in a statement March 19. "We are continuing to work on the specific operational details of our OB services plan at Chula Vista as we move through the early stages of the 90-day regulatory notice period. We will ensure safe labor and delivery services with appropriate staffing, as well as safe handoffs and transfers after delivery, including neonatal transfers requiring intensive care with our partners at Rady Children’s Hospital. In addition, Scripps is providing full transparency to the California Department of Public Health and is completing all regulatory requirements related to this transition."