Hospital quietly becomes major medical center

June 13, 2008
By


Courtesy Photo Dr. Jim Hu of Brighham and Eomen’s Hospital performs robot-assisted cancer surgery at JP’s Faulkner Hospital in one of many new services there.

JAMAICA HILLS—No babies are born at Faulkner Hospital.

But a decade after the century-old community hospital merged with Brigham and Women’s Hospital, transforming into a satellite of that prestigious medical center, a baby nursery is about the only hospital service Faulkner does not provide. Everything else—from emergency rooms to doctor’s offices to psychiatric services—are there for the community’s needs.

Faulkner, at 1153 Centre St. on the Jamaica Plain/West Roxbury border, has been growing quietly but quickly, with major new services—including robot-assisted surgery—coming by the month.

It has become a local hospital loaded with Longwood Medical Area (LMA) doctors and departments. It’s a non-academic hospital, but also trains students from the medical schools at Harvard and Tufts. It offers complex care, but also holds community health screenings and educational programs.

“In some respects, we’ve got the best of both worlds,” said David Trull, Faulkner’s president and chief executive officer, in a Gazette interview.

Faulkner’s expansion in recent years has not always been obvious. Most of it has taken place inside the existing hospital buildings in a series of renovations and reorganizations.

It’s likely to continue growing that way, said Trull. Only one construction project is on the long-term horizon: a new orthopedic medicine building that would go atop the hospital’s front garage along Whitcomb Avenue. Actual planning for that project might begin in a year or 18 months, Trull said.

Expansion has brought one element that neighbors can’t miss: parking and traffic. The hospital built a new parking garage in 2003, but employee parking on local streets has remained an issue frequently addressed by the Jamaica Hills Association.

Faulkner is addressing parking, too. Next month, its employees will start using a new satellite parking lot on Washington Street near the Forest Hills T Station, Trull said. Employees will be encouraged to use the T and can hop onto a shuttle bus from the lot to the hospital.

Faulkner opened in 1903 as a “fully equipped modern hospital,” as the Boston Globe reported at the time, according to the local history web site “Remember Jamaica Plain?”

In practice, it became a classic community hospital—a place patients could find quality standard care, but that would have to refer them to a bigger hospital for sophisticated surgeries or other procedures.

That has changed in recent years. Large hospitals have begun affiliating with community hospitals and moving various services off-site. That saves valuable real estate in such places as the LMA, provides lower costs and gives the local hospitals many more resources.

That is what began happening at Faulkner in 1998, when it merged with Brigham and Women’s under the Partners HealthCare umbrella organization. The hospitals remain independent, operating under separate licenses, but have a close business and medical relationship. Faulkner even changed its logo a couple of years ago to include Brigham and Women’s symbols.

Today, Trull said, about 80 percent of Faulkner’s facilities are leased to Brigham and Women’s or to Atrius Health, a group of practioners that includes Dedham Medical Group. The rest is devoted to private practioners.

The partnership has meant an influx of Brigham and Women’s doctors and services—and a skyrocketing growth rate.

The sheer numbers speak for themselves. Before the merger, Faulkner was performing about 6,000 surgeries a year. Today, it performs about 11,000.

Pre-merger, Faulkner served about 5,800 patients a year, as counted by hospital discharges. Today, it’s about 8,400.

And in 1998, Faulkner had about 760 full-time-equivalent employees. Today, it has about 1,200.

Of course, healthcare is about quality, not just quantity. Trull said that includes behind-the-scenes infrastructure and technology that improves patient care, even if patients never notice. An electronic prescription-writing system to improve patient safety is one such technology. So is a new, state-of-the-art magnetic resonance imaging (MRI) machine coming in this month.

“They’re things we couldn’t have done as a stand-alone community hospital,” Trull said. “A lot of the technology available downtown is now available here.”

Robotic surgery, which came to the Faulkner last month, is another example. Brigham and Women’s surgeon Dr. Jim Hu uses a robot known as the da Vinci to perform prostate cancer surgery. The robot is connecting to Hu’s fingers by sensors that duplicate his movements while canceling out any tiny hand tremors. The robotic surgery allows for a much smaller incision, reducing complications and allowing patients to leave the hospital much sooner, according to Faulkner.

Faulkner has 153 beds for “inpatient” care—patients who have to stay at the hospital for some time. Trull said there are no plans to increase the number of beds. Instead, the growth is in outpatient care—patients who can leave the same day—especially since modern surgery allows many patients to go home right away.

So, while the bed count isn’t changing, the number of operating rooms went up by four in the last year. Faulkner now has 16 operating rooms, double what it had in 1998.

In the past year, Faulkner has brought in a new plastic surgery center offering a full array of services, including breast reconstruction.

The Mohs Surgery Center for skin cancers also moved recently to Faulkner from the LMA’s Dana-Farber Cancer Center. “Unfortunately, it’s one of the fastest-growing areas in terms of care needed,” Trull said.

Next month, an expanded Brigham and Women’s/Faulkner cardiology unit will open. And in late August or early September, a new hand surgery center will come in as part of an expanded orthopedics practice.

Orthopedics—care for musculoskeletal problems such as bad joints—is a growing area as the US population ages. It is one of Faulkner’s expansion areas of the future, Trull said.

Trull noted that a community hospital can be an especially good location for people with orthopedic problems, which often limit movement. “People can get in here a lot easier than they can get into downtown,” he said.

While Faulkner has its heart set on a new orthopedics building—a few floors of offices built atop the parking garage—that project is “still a dream,” Trull said.

Robots aside, another area Faulkner would like to see expand is the old-fashioned doctor’s office.

“Most [hospitals] would love to be in the position of attracting more primary care physicians,” he said.

Best of JP 2014