Jorge Gonzalez leaned back comfortably in a mauve, medical exam chair that resembles, somewhat appropriately, a living room recliner as he quietly absorbed the diagnosis: At 29, the Santa Rosa landscaper had a stomach ulcer.
A few hours earlier, Gonzalez was one floor above, in Santa Rosa Memorial Hospital's emergency department, literally crying before the pain-killers kicked in. Once stabilized, he was moved to Memorial's new "clinical decision unit," a quiet, eight-bed observation unit that removes patients with non-life threatening conditions from the fast-paced emergency care for severely injured or ill patients.
"This thing is the bomb," Gonzalez said. "Every hospital should have this facility. The nurses and doctors are so nice."
Located on Memorial's basement level directly under the catheterization labs, the unit is where medical staff can calmly monitor such things as gastrointestinal bleeding, severe back pain and headaches, kidney stones or asthma attacks. The goal is to improve patient flow through the emergency department.
It's also an example of new medical services that Sonoma County hospitals have added, or are planning to add, to lure patients in a market that is increasingly competitive.
As the federal health-care law takes effect, such innovations as Memorial's clinical decision unit are intended to help hospitals redefine themselves as places where patients get better and stay that way.
The efforts range from emergency department expansions to a medical fitness center to greater collaboration with medical groups and community clinics.
By 2014, the provisions of President Barack Obama's Affordable Care Act are to take effect, including an expansion of Medicaid, a requirement that almost everyone pay for health insurance and creation of a health insurance exchange system.
While the future of the law remains under political pressure from Republicans, the forces that provoked the overhaul — rising health-care costs, insufficient Medicare reimbursements and the high cost of treating the uninsured — will continue to influence health care delivery.
Sutter Medical Center is expected to open its doors in 2014, an "ideal time to open a new hospital," said Mike Purvis, chief administrative officer.
The new hospital will feature a 24-station "universal care unit" that provides greater care flexibility as well as cost savings. All rooms will be private, reducing the number of times patients have to be moved, as well as the rate of hospital-acquired infections.
The new hospital takes into account trends toward fewer hospital admissions, shorter hospital stays and the growth of outpatient treatments. Nonetheless, possible future expansions to add beds are built into the design.
Mike Cohill, a senior vice president of Sutter Health and interim CEO of Sutter Pacific Medical Foundation, said one way Sutter Health is trying to improve patient care and reduce hospital admissions is a demonstration project called Advanced Illness Management, or AIM.
The pilot program, currently being tried at Sutter-owned Alta Bates Summit Medical Center in Berkeley, provides a full-range of home health services, including nursing, therapy, dieticians and social workers. Sutter officials said the program could be brought to Sonoma County in the future.
And St. Joseph Health System-Sonoma County, which operates both Memorial and Petaluma Valley Hospital, has big plans.
Among them is a two-story, 80,000-square-foot medical fitness center that would integrate health, fitness, and clinical programs, such as physical therapy. The facility, with a projected opening date of 2013, would be similar to one at Queen of the Valley Medical Center in Napa, which is serving as a prototype within the St. Joseph health-care system.
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