Northern Arizona Healthcare talks patient care at packed forum ahead of 480 vote in Flagstaff

Throughout the two-hour event, Northern Arizona Healthcare (NAH) officials answered questions on everything from the quality of care at the Flagstaff Medical Center to the financing and reasoning behind the relocation, which voters will weigh in on this November in a special election.

The forum came as the fight over the hospital relocation has begun to heat up in recent weeks.

After the rezoning that would allow the hospital development was approved by Flagstaff City Council in June, a group of Flagstaff residents and a political action committee called Flagstaff Community First were successful in getting the topic on the November ballot, letting Flagstaff voters make the final call.

Those opposed to the plan have pointed to later phases of the project set to include commercial and residential uses, and have raised questions as to how much Flagstaff taxpayers may have to pay for the public infrastructure associated with the relocation. 

Only time will tell what decision Flagstaff voters will make, but NAH CEO David Cheney said one way or another he is committed to providing Flagstaff and the region with a new medical center. 

“What we’re in, currently, is a wonderful 1972-model hospital. It’s awesome, if we were in 1972,” Cheney said. “My commitment as the CEO is to make sure you all have access to a modern hospital. If this does not go through, I’m not just going to go back and go, ‘I guess we’re just in this 1972 model until 2050.’ It’s not going to happen. So we have to look at what our options are. We’ve already said we can’t remodel the [current] hospital.”

Throughout the forum, many of the questions from the public surrounded the issue of what is preventing NAH from simply expanding its current campus on Hospital Hill.

The hospital owns about 21 acres of property just to the east of the current Flagstaff Medical Center, across San Francisco Street. A portion of the property already holds the Summit Center, although NAH has put that building up for sale.

So several members of the public wondered: Why not simply use that property to expand the hospital in place?

NAH Vice President of Construction and Real Estate Development Steve Eiss said the problem they saw with that option is that it would compound the issues they already have with the hospital building. Because of how the hospital has evolved and been built on and added to over the years, Eiss said, it is a very inefficient and difficult building to operate within.

“Our hospital now is so inefficient, from a layout perspective, because we have so many double-occupancy rooms, because we have odd-sized rooms with odd-sized units that lead to staffing ratios,” Eiss said.

Various departments are spread out throughout the hospital structures, meaning it is difficult to transport patients who may need a specific test done, or to see a specific specialist, from one area to another.

And NAH Chief Nursing Officer Tyffany Laurano said that also creates challenges from a patient care and comfort perspective.

“If you’re in the emergency department, and you’re admitted to one of our inpatient units, you have to travel close to three quarters of a mile through other departments, through main hallways, through the skybridge. And you’re really exposed; it’s a very vulnerable feeling. And it’s not a private feeling,” Laurano told the crowd. “One of the things that will be really nice about our new facility is the ability to be able to transport patients in a private setting, so that we’re not rolling them close to a mile through the community in which they live as patients.”

Eiss said the way the hospital is set up also artificially reduces the number of beds they can use.

At the moment, many of their patient rooms are built to house multiple patients at a time. But they often cannot actually keep multiple patients in those rooms, be it for reasons of privacy, patient comfort or any other number of factors. According to Eiss, that often means that while on paper they have a certain number of beds, the number is far fewer in reality.

Eiss said that means while the newly built hospital will have 36 more beds than the current hospital on paper, they will actually be getting many more beds than they have at the moment.

“So while we might have 240 beds, we don’t ever really get to use 240 beds,” Eiss said. “So when we’re increasing by 36 beds, we’re not just increasing by 36 beds. We’re increasing the utilization of our beds, because they’re single-occupancy private rooms in a very well thought out ratio. So overall, it’s going to be a much more highly efficient building.”

But those improvements would simply not be possible if they continued to build up at the current facility, Eiss said, adding that doing so would compound the problems they already face with departments being so spread out from one another.

With the hospital already spanning Beaver Street, building another facility across San Francisco Street would put them in the situation of now spanning two streets and nearly three city blocks.

“And you heard colleagues earlier talked about [patients] getting pushed three-quarters of a mile from your patient room to imaging or whatever. Well, [expanding across San Francisco] would only make that worse, if we continue to go in that east-west direction,” Eiss said.

Those 21 acres to the east also come with other issues — namely, it is significantly lower than the rest of the hospital complex and the topography would be difficult and expensive to develop on, Eiss said.

The hospital had in 2019 announced its intention to expand in place as it developed a new strategic plan. But Eiss and Cheney said there was no actual plan to do so.

“That was a mistake, we never should have said that, we never should have put that out there — because there was no plan behind it,” Cheney said.

Eiss said the discussions hospital officials were having at the time led them to conclude that more expansion was not feasible and a new hospital would need to be built.

“So there are no drawings that show a new hospital on the existing facility, because we had a team of medical designers that we hired and worked with that said, ‘This isn’t going to work here, so we need to start looking at alternate options,’” Eiss said. “Quite frankly, [it’s] the genesis of what got us here tonight.”