Kona Community Hospital staff and ohana wave signs Thursday on Queen Kaahumanu Highway. Courtesy Photo/Special to West Hawaii Today
Dozens of people recently rallied for Kona Community
Hospital on Queen Ka`ahumanu Highway adjacent to the LDS Church. Waving signs and shakas, hospital
leadership, board members, doctors, staff, and family came together to thank the community and Big
Island legislators for their support while the hospital seeks funding for crucial infrastructure upgrades.
“I am overwhelmed by the support our community is giving us,” said Clayton McGhan, Kona Community
Hospital Chief Executive Officer. “We love this community we call home, and it’s clear the people here
care about their hospital. They are the reason this funding is important. We’re also very grateful to our
government leaders, including Senator Kanuha and Representatives Lowen and Kahaloa for their
support. They have listened to and championed our needs during this legislative session.”
Kona Community Hospital is seeking almost $19 million from the state legislature to upgrade its nearly 50-year-old facility on Haukapila Street in Kealakekua. The funds would cover improvements to areas like its central utility lines, HVAC system, and the hospital’s pharmacy drug compounding facility.
Without the full appropriation to fix these items, the hospital might lose its ability to perform surgeries
and provide some emergency care. Patients and their relatives know that it could be the difference between life and death.
The sign-waving event provided an opportunity for hospital personnel to show their appreciation. “The overwhelmingly positive reaction of cars passing by filled our hearts,” said chief nurse executive, DianeHale. “We truly are grateful for our community’s support.”
Kona Community Hospital achieved the international Baby-Friendly designation for adhering to the highest standards of care for breastfeeding mothers and their babies. (Kona Community Hospital)
Kona Community Hospital has achieved the highly prestigious international Baby-Friendly designation after a rigorous review process conducted by Baby-Friendly USA, the organization responsible for bestowing this certification in the United States, according to a press release from Kona Community Hospital.
To receive this distinguished honor, a hospital must adhere to the highest standards of care for breastfeeding mothers and their babies. These standards are built on the Ten Steps to Successful Breastfeeding, a set of evidence-based practices recommended by the World Health Organization and the United Nations Children’s Fund for optimal infant feeding support in the precious first days of a newborn’s life.
The positive health effects of breastfeeding are well-documented and widely recognized by health authorities throughout the world. For example, the Surgeon General’s 2011 Call to Action to Support Breastfeeding stated that “Breast milk is uniquely suited to the human infant’s nutritional needs and is a live substance with unparalleled immunological and anti-inflammatory properties that protect against a host of illnesses and diseases for both mothers and children.”
Kona Community Hospital joins a growing list of more than 20,000 Baby-Friendly hospitals and birth centers throughout the world, 600 of which are in the United States. These facilities provide an environment that supports breastfeeding while respecting every woman’s right to make the best decision for herself and her family.
“This designation is the culmination of a lot of hard work and determination across our organization, all with a goal of helping families get off to a good start,” said Heidi Fromm, the hospital’s obstetrics nurse manager. “We are proud to offer an environment that supports best practices shown to increase breastfeeding exclusivity and duration and are committed to give moms who choose to breastfeed the best chance for success.”
Kona Community Hospital personnel held at beach cleanup at Old Airport on Jan. 28. Photo Courtesy: Kona Community Hospital
Kona Community Hospital Employee Engagement Committee members conducted a beach cleanup at Old Airport last weekend, on Saturday, Jan. 28.
The committee, hospital employees, and family members spent several hours picking up rubbish on the shores of the beach park and in the picnic areas. Over a hundred pounds of trash were collected.
“We wanted to give back to our community outside of our facility as a healthcare community,” said Michelle Gray, current chairman of the employee engagement committee.
CEO Clayton McGhan said, “Kona Community Hospital staff are amazing … It was great to see the staff and their families come out for a singular purpose, to preserve the life and beauty of our beaches.”
Registered Dietitian, Sue Little and Dietetic Intern, Tessa Zhang review malnutrition diagnostics.
September 19-23, 2022, Is Malnutrition Awareness Week: Do You Know the Signs of Malnutrition?
From September 19-23, 2022, Kona Community Hospital is taking part in Malnutrition Awareness WeekTM, an international effort to increase the awareness, diagnosis, and treatment of malnutrition in patients.
Malnutrition Awareness Week is an annual, multi-organizational campaign created by the American Society for Parenteral and Enteral Nutrition (ASPEN) to focus on nutrition as a patient right and nutrition’s vital role in health and recovery.
Kona Community Hospital’s Registered Dietitian Nutritionists (RDN) will be participating in events throughout the week to reinforce the significance of nutrition in medical treatment and educate patients and community members on the importance of discussing their nutrition status with their healthcare professionals.
Malnutrition, when unrecognized and untreated, results in longer hospital stays for patients, twice the need for rehab or long-term care, and a 3.4 times higher rate of hospital deaths. In addition to its human toll, malnutrition raises hospital costs by 73% and can cost an additional $10,000 in hospital readmission stays.1
While older adults are particularly susceptible to malnutrition, others at risk include people with infections; those with long-term health conditions including kidney disease, diabetes, and lung disease; and people with cancer, dementia, and other chronic conditions.2
It is important to know the signs and symptoms of malnutrition. If you or your loved one is experiencing any of these, talk to your healthcare provider:
Unplanned weight loss
Loss of appetite
Not able to eat or only able to eat small amounts
Feeling weak or tired
Swelling or fluid accumulation
Our staff will also be taking part in additional educational programs offered by ASPEN to increase their understanding of how to recognize and treat malnutrition.
Guenter P, Abdelhadi R, Anthony P, et al. Malnutrition diagnoses and associated outcomes in hospitalized patients: United States, 2018. Nutr Clin Pract. 2021 Oct;36(5):957-969.
Tappenden KA, Quatrara B, Parkhurst ML, et al. Critical role of nutrition in improving quality of care: an interdisciplinary call to action to address adult hospital malnutrition. JPEN J Parenter Enteral Nutr. 2013;37(4):482-497.
About Malnutrition Awareness Week
Now in its 10th year, Malnutrition Awareness Week is an annual, multi-organizational campaign created by the American Society for Parenteral and Enteral Nutrition (ASPEN) to spotlight nutrition’s vital role in health and recovery, reinforce for healthcare professionals the impact nutrition has in medical treatment, and educate the public on the importance of discussing their nutrition status with their healthcare providers. For more information, visit www.nutritioncare.org/MAW.
About ASPEN
The American Society for Parenteral and Enteral Nutrition (ASPEN) is dedicated to improving patient care by advancing the science and practice of nutrition support therapy and metabolism. Founded in 1976, ASPEN is an interdisciplinary organization whose members are involved in the provision of clinical nutrition therapies, including parenteral and enteral nutrition. With members from around the world, ASPEN is a community of dietitians, nurses, nurse practitioners, pharmacists, physicians, scientists, students, and other health professionals from every facet of nutrition support clinical practice, research, and education. For more information about ASPEN, please visit www.nutritioncare.org.
Laura Ruminski/West Hawaii Today file photo Kona Community Hospital.
A bill aimed at providing funding for site selection for a new hospital in Kona faces one more hurdle this legislation.
House Bill 1638 was passed 4-0 by the Senate Committee on Health, Human Services and Homelessness following a hearing Friday afternoon.
The measure would appropriate a currently unspecified amount to the Hawaii Health Systems Corporation (HHSC) to conduct a site assessment to identify and evaluate viable locations for a new hospital site in North Kona.
Discussion about the need for a new hospital to serve residences in North and South Kona has been ongoing for nearly two decades. The area is currently served by the 94-bed Kona Community Hospital constructed in 1974 in Kealakekua.
Jim Lee, HHSC West Hawaii Region CEO, submitted testimony to the Legislature backing the bill.
“Kona Community Hospital’s current facility is nearly 50 years old. The hospital’s aging infrastructure has major deficiencies, with many critical systems in urgent need of repair and renovation. We struggle almost daily with the very real potential that one system failure or another could shut down hospital operations,” he said in written testimony.
Mayor Mitch Roth also weighed in on the bill.
“Enhancing the health and well being of out entire community is a priority of my administration and facilitating access to quality medical services is central to that commitment” his testimony said. “Presently the only available acute care in the area is provided through an aging hospital located 20-30 minutes away from where the population growth has been in Kona over the past three decades.”
Katelyn Shirai is a medical student at John A. Burns School of Medicine and a Hilo native. She provided written testimony from the perspective of a future physician.
“With the growing population in West Hawaii, it is imperative that medical facilities are modernized and expanded to provide much needed health care services to meet the demand of its surrounding community. This measure may also help to recruit and retain health care professionals, helping to close the critical physician shortage on the island of Hawaii,” she wrote. “Born and raised in Hilo, I have experienced first-hand, the effects of the state-wide physician shortage, as well as the lack of services and specialties in health care. As a student at JABSOM, we have learned so much about the health care disparities that so many people in our community face. This measure is a significant first step in addressing health care disparities and promoting health equity.”
The Senate Committee on Health, Human Services and Homelessness Friday opted to leave setting a dollar amount to the Senate Committee Ways and Means, the bill’s last committee stop. A hearing date there had not yet been set as of press-time Tuesday.
“We’re pleased that HB 1638 is moving forward with our amendment request to also include a hospital needs assessment. We’re very grateful to Representative Lowen for introducing this measure for the benefit of our West Hawaii community,” Lee said Tuesday.
In other hospital-related news, the HHSC West Hawaii Regional Board of Directors recently elected new leadership. The board now includes Daniel Rick, PT, as chairperson, Sarah Hathaway, MD, as vice chairperson, and members Frank Sayre, DDS, Dave Hiranaka, MD, Laura Bowman, APRN, Jane Clement, Charles Greenfield, ESC, Tracy Yost and JoAnn Sarubbi, MD.
Sayre, the former-chairperson, previously told West Hawaii Today that a new hospital facility would carry a price tag around $300 million.
Kona Community Hospital. (Laura Ruminski/West Hawaii Today file photo)
A bill in the state House to provide funding for a site assessment to find a viable location for a new hospital site in North Kona passed its first committee hearing Thursday.
House Bill 1638, introduced by Rep. Nicole Lowen (D-North Kona) seeks $1 million to identify and evaluate viable locations for a new hospital, a recurring endeavor brought up yearly in the Legislature.
Lowen said the site assessment is needed to lay the groundwork for building a new hospital in North Kona.
“We have to put one foot in front of the other,” she said. “If we don’t start talking about this now, how long will it take?”
Discussion about the need for a new hospital to serve residences in North and South Kona has been ongoing for nearly two decades. The area is currently served by the 94-bed Kona Community Hospital in Kealakekua, a Hawaii Health Systems Corp. facility constructed in 1974.
“The population in the Kona area has grown and migrated north since the hospital was built almost fifty years ago, so the hospital is no longer located in the area with the highest residential density and need for services. While the highway in North Kona has been expanded, the hospital in South Kona sits on a single-lane highway that is vulnerable to traffic congestion, making it difficult for emergency vehicles and others to reach the hospital quickly,” the proposed bill reads.
The bill further states a new, more modern facility can provide additional services, better access to Kona International Airport, which is nearly 20 miles from the current facility, for medical airlifts, and a more convenient location for the area’s residents. The new hospital would also serve as an attractive workplace and help the state recruit doctors and health care workers to fill the state’s critical need.
According to a November 2021 report submitted to the 2022 state Legislature, there are currently 10,592 physicians licensed to practice in Hawaii, but just 3,290 are actively providing patient care and provide 2,857 full-time equivalents of direct patient care. The number of full-time equivalents was up 45 over 2020.
The number of doctors, however, does not meet the state’s demand, according to the Hawaii Physician Workforce Assessment Project. Hawaii, according to a demand model based on U.S. average physician use, needs 3,395 full-time equivalents of practicing physicians.
“This indicates a shortage of 537 FTE of physician services. However, when island geography and unmet specialty specific needs by county are examined, the estimated unmet need for physicians (accounting for geographic distance and air travel) increases to 732 FTEs,” the report reads. “The demand model predicts our demand will increase by 38 FTE a year. If we only increase our workforce by 50 a year, we will not meet our demand in the foreseeable future.”
According to the report, Hawaii County needed to increase its number of physicians by 40% or 187 doctors to meet demand in 2021. An additional 16 primary care providers were needed to meet demand in that field alone.
All of the written testimony submitted to the House Committee on Health, Human Services and Homeless supported the measure.
Hawaii County Mayor Mitch Roth in his testimony wrote: “Enhancing the health and well being of our entire community is a priority for my administration and facilitating access to quality medical sen/ices is central to that commitment. Presently, the only available acute care in the area is provided through an aging hospital located 20-30 minutes away from where the population growth has been in Kona over the past three decades.”
Jim Lee, who is the Regional CEO for the HHSC and oversees Kona Community Hospital, noted West Hawaii’s population is currently growing faster than both North and East Hawaii. In 2018, prior to the pandemic and influx of residents amid remote work and other opportunities, population growth in West Hawaii was projected to increase by 6.1% by 2023. Reflecting this growth, inpatient and emergency department visits among West Hawaii residents have been increasing.
Last year, Kona Community Hospital recorded 22,000 emergency room visits.
Though able to meet the community’s needs, the hospital’s aging infrastructure has major deficiencies, with many critical systems in urgent need of repair and renovation.
Judy Donovan, regional marketing and strategic planning director, said the West Hawaii Region Board recently approved a six-year, phased in master facility plan to address the repairs and expansion needed, estimated to cost $80 million.
“The infrastructure is crumbling. It needs a new roof and a new wastewater treatment system, among other improvements,” said outgoing Board Chairperson Dr. Frank Sayre.
With an estimated price tag of $300 million for a new facility, Sayre said the money for repairs to the current hospital are critical given the length of time it will take to secure funding and finalize construction of a new one.
Donovan said the top three priorities include $22.5 million for the design, construction and equipment for a new oncology building, $2.5 million to repair the roof, and $3.5 million for the renovation of the Emergency Department.
“In addition, we need $20 million for a new electronic medical records (EMR) system, which is not in the master facilities plan,” said Donovan.
The existing EMR system expires in June 2023.
Sen. Dru Kanuha (D-Kona, Ka‘u) has included funding requests for the hospital in his request via Senate Bill 3383. In addition to the three projects Donovan listed, Kanuha is asking for $2 million to upgrade wastewater treatment and money to replace the EMR with an EPIC system.
“We struggle almost daily with the very real potential that one system failure or another could shut down hospital operations,” said Lee.
“It’s more than time that something happens. It’s the first step in a very long journey,” said Sayre
Hospital is looking at long-term solutions to expand and bolster its workforce.
As the last of the federally-funded health care workers leave the island this week, KCH has begun efforts in building out staff, from starting recently graduated nurses in specialty units to offering a nine-month surgical tech program.
Stephanie Irwin, KCH Director of Education, said the hospital is looking at hiring in more specialty areas, including the emergency room. For the first time in KCH’s recent history, the hospital hired a newly graduated nursing student from Hawaiʻi Community College at Palamanui in 2020 into the behavioral health unit, which is considered a specialty.
“There’s a nursing shortage and being able to start someone in a specialty area is exciting,” Irwin told Big Island Now.
KCH hires about three nurses a year from the nursing program at Palamnui. Officials say these new hires typically work six months in the Med Surge Acute unit before moving into a specialty.
The last graduating class at Palamanui in May brought in three nurses as RPN II’s. Aside from the specialty unit hire, the remaining two were assigned to Med Surge Acute units.
“The newly graduated nurses are assigned to a senior nurse who will orient them for six months,” said KCH spokesperson Judy Donovan. “Once their six-month orientation is completed, they will be RPN IIIs.”
Kathleen Kotecki, retired associate professor of nursing from Palamanui, said while there is a need for nurses, there is a shortage in positions available for newly graduated nursing students. The idea of moving new nurses directly into specialty units may help with that as KCH is not limited to just those positions offered to new health care workers.
“Looking at the big picture, we’d have to expand the program so we could graduate more students,” Kotecki said. “Getting more admissions to the nursing program is key. We need new, younger nurses.”
Additionally, Donovan said the goal is to hire three graduated nurses every year with the hope to increase the number to five.
“We will continue this practice in an effort to grow workforce from (within) our local community,” Donovan said.
In an effort to grow from within, KCH will begin its newly accredited surgical tech program, which is set to start in August 2022 with three students, who are currently employed at KCH. Upon completion of the program, the health care workers will be certified to be integral members of the surgical team at KCH.
Irwin said this will be the only program of its kind on the Big Island. It will also be the first accredited program launched at KCH.
“This is a specialized employee position that is difficult to fill,” Donovan said. “Currently, we have a full-time surgical technologist who is also an instructor. We recognized the opportunity to develop a program that will fill an existing employee gap.”
Irwin, a Palamanui nursing graduate, has worked at KCH for 12 years. While it can be wonderful to hire nurses outside the state, Irwin said it can also be hit and miss as they come and end up not staying on the island.
“But when we hire within, itʻs amazing how long they stay,” Irwin said.
KCH currently has 10 full-time positions open, including in the ICU, ER, floats and imaging. Additionally, the in-house lab, Clinical Laboratories is struggling with staffing.
Donovan said the hospital started with 42 FEMA-funded clinicians during the spike of the coronavirus cases over the summer, including critical care nurses, respiratory therapists and imaging staff. Nine of those workers remain as a majority of the health care workers left two weeks ago.
With their contract officially ending on Thursday, Nov. 13, Donovan said four of the FEMA-funded workers have expressed interest in converting to a standard agency contract.
UPDATE: A PREVIOUS VERSION OF THIS ARTICLE INCORRECTLY STATED THAT 35 EMERGENCY EMPLOYEES HEADED TO KONA COMMUNITY HOSPITAL WOULD BE PAID FOR BY FEMA. IN FACT, A PRIVATE DONOR IS PAYING FOR THE FIRST WAVE OF HEALTHCARE WORKERS. FEMA WILL PAY FOR EMERGENCY STAFF MOVING FORWARD.
The State and County of Hawai´i are on the edge of a healthcare crisis.
Visitor restrictions and hospital lockdowns are back in effect across the Big Island as healthcare facilities near patient capacities, a situation directly linked to the massive increase in coronavirus cases across the county. More than 5,000 infections have been reported on the Big Island since the pandemic began, with more than 1,300 currently active.
Exacerbating the situation are shortages of medical personnel.
“Critical staffing shortages continue to challenge all units at (Kona Community Hospital),” KCH Marketing and Strategic Planning Director Judy Donovan wrote in a press release Thursday, Aug. 12.
It is a problem Donovan said KCH will soon address.
“We are looking forward to welcoming 35 clinical staff, including critical care nurses and respiratory therapists, on Monday, Aug. 16,” she added.
The additions will be paid for by a donor who asked to keep their name and the amount donated private. Future emergency hires will be funded by the Federal Emergency Management Agency (FEMA).
But even if healthcare centers can staff enough personnel to keep up with case counts that have been on the rise statewide for weeks, facilities themselves can not be enhanced so quickly.
Hilo Medical Center (HMC) reported earlier this week that it is already nearing capacity, and just 24 patients are currently hospitalized for COVID-19 island-wide, not all of them at HMC. The number is almost certain to rise, as only 58% of the county is fully vaccinated and the Big Island’s seven-day average is 94 new infections every 24 hours. To make matters worse, most of those cases are connected to the now-dominant Delta variant, which is both highly transmissible and results in more severe symptoms than did earlier strains.
HMC has opened a COVID unit, which can accommodate 16 patients, not including those requiring care in the hospital’s intensive care unit (ICU). But the number of COVID patients is not the only problem.
More people have sought inpatient care for standard ailments, as more patients have become vaccinated and the pandemic has settled in as an element of everyday life. That has resulted in less aversion to seeking in-person medical treatment than was seen last year when the pandemic was still new, medical professionals say. This development has crowded hospitals further and stretched resources thinner, also putting at higher risk patients in need of critical care unrelated to COVID-19.
The situation would not be solved, but can be significantly alleviated, with higher vaccination rates. According to Department of Health statistics, 61.1% of all Hawai´i residents are fully vaccinated and 68.7% have received at least one dose.
Hilton Raethel, president and CEO of the Hawai´i Healthcare Association, told Hawaii News Now (HNN) that as of Thursday, there were 282 individuals hospitalized with COVID-19 statewide. Of that group, 91% are unvaccinated.
“This is really stressing out hospitals across the entire state. COVID patients take a lot of work,” Raethel told HNN’s “This Is Now” program. “Fortunately, not as many are in the ICUs (or) are on ventilators as they were last year, at least proportionately. But the sheer volume of cases and the fact that they are infectious creates a drain on our healthcare system.”
KCH said Thursday that it is currently caring for nine COVID patients, none of whom are vaccinated. Four are residing in the ICU.
“Since we began measuring vaccine status of admitted patients, only one COVID positive patient was vaccinated,” Donovan said. “We strongly encourage anyone who has been postponing receiving the COVID vaccine to do so now.”
No visitors are being allowed into KCH, save for a few “compassionate exceptions” in the cases of laboring obstetrics patients and those facing end-of-life circumstances, Donovan continued.
As of Thursday, Kohala Hospital has reinstated a lockdown of its facilities, meaning visitors will not be allowed.
Governor David Ige on Tuesday, Aug. 10 announced an executive order that immediately reinstated several coronavirus-related restrictions throughout Hawai´i.
The order reset social gathering limits in all settings to 10 individuals indoors and 25 outdoors. For high-risk settings, such as restaurants, bars, gyms and other social establishments, maximum capacity was reduced to 50%. All patrons of such settings are mandated to maintain six feet of social distancing, are not allowed to mingle between tables, and must wear face coverings at all times, even when seated, if not actively eating or drinking.
Furthermore, professional events planned to accommodate more than 50 individuals, such as weddings, conventions, concerts, etc., must submit virus-mitigation protocol to the relevant county agencies for a sign-off in order to host those events legally.
“We are seeing widespread community transmission,” Ige said. “We need to take action, and we need to take action now. We need to minimize person-to-person contact in order to reduce transmission.”
The governor added he believes mandates will need to be in place for four to six weeks before Hawai´i might track any statistically significant benefit from them.
Throughout the month of June, HFS Federal Credit Union staff and members helped to raise funds for two local foundations during their Annual Fundraiser: the Hilo Medical Center Foundation and the Kona Hospital Foundation.
The Hilo Medical Center Foundation has supported East Hawaii for over 25 years, while the Kona Hospital Foundation has provided care to the West Hawaii communities for over 35 years. Both have diligently supported the Big Island around the clock throughout the pandemic. Each organization will be receiving $5,000, consisting of donations from generous credit union members and staff.
“Hilo Medical Center Foundation and our Board of Trustees are so grateful to the staff and members of HFS Federal Credit Union for their generosity and support to keep access to high quality health care close to home,” said Lisa Rantz, executive director of the Hilo Medical Center Foundation.
