Swedish plans changes in Ballard

Citing weakening financial performance at its Ballard hospital, Swedish Medical Center has again proposed closing most services for seriously ill patients, turning the 163-bed hospital into a "comprehensive ambulatory center" focusing on outpatient procedures.

And like last time Swedish pitched major changes two years ago, the idea is being panned by Ballard leaders, who say it would hurt the neighborhood, particularly its poor and elderly.

"For [Swedish] to insist that people who need hospital care go far away is really counterproductive," said Jody Grage Haug of the Ballard District Council.

Under the proposal, which Swedish management presented to staff last week, Swedish would keep Ballard's emergency room open. But most inpatient services, including the intensive-care unit, which Swedish says has declining numbers of patients, would be closed, as would the transitional-care unit, which offers rehabilitation services.

Instead, the Ballard facility would offer outpatient services, such as diagnostic imaging, physical and occupational therapy and outpatient surgery. Swedish also is considering adding alternative and complementary medicine, chronic-disease-management services and a more robust obstetric service, said Kevin Brown, Swedish vice president for strategic planning.

The Ballard campus would have limited short-stay, low-intensity inpatient beds, such as for ambulatory surgery patients who needed to stay overnight, Brown said.

The plan will go before the full Swedish board of directors when it meets later this month and in June. A final plan is expected to be approved by late June, Brown said.

Swedish proposed similar changes during merger discussions two years ago with Northwest Hospital & Medical Center. Northwest backed out of that deal in late 2004. But Swedish has continued to consider a "different mix of services on the Ballard campus," said spokesman Ed Boyle.

Swedish says the Ballard hospital would need "significant resources" to be rebuilt as an "inpatient hospital of choice."

Ballard has 163 beds and is about five miles from the main campus on First Hill. Founded in 1928 and built as a 100-bed hospital in 1954, Ballard Community Hospital became part of the Swedish system in 1992 and has the equivalent of 440 full-time employees.

A "question-and-answer" memo from Swedish leaders circulated to the staff last week said inpatient admissions at Ballard have been steadily declining as competition has increased, not only from other Swedish campuses but also from other hospitals.

But Haug, who chairs the Ballard District Council's planning committee, said the move would ignore planning principles that encourage "urban centers," where people can work, shop and use services near their homes. And difficulties in traveling outside the community for care hit older and poor people hardest, she said.

Rob Mattson, district coordinator for the Seattle Department of Neighborhoods, said Ballard citizens have a proprietary interest in the hospital because of a communitywide, grass-roots effort to raise money for the hospital.

"The closures of community hospitals are sort of an emotional issue as much as a practical one," he said. "Most of the locals still call it 'Ballard Hospital.' They rebel against any mention of Swedish."

So far, Swedish has not planned meetings with Ballard residents, but focus groups last year helped Swedish decide what services to include in the plan, Brown said.

"This is still early on in the process," Boyle added. "We still don't know the answers to a lot of questions."

According to the Swedish memo, changes are needed because the population of Ballard is becoming younger, more diverse and more mobile, and the population is not expected to grow a lot in the next five to 10 years.

Haug said that's "a bunch of nonsense."

"There are 1,100 new housing units going in within a couple blocks of my house."

Carol M. Ostrom: 206-464-2249 or costrom@seattletimes.com