ABOUT US      
     

I worked with Jim Foster to start AIHM in early May, 2007, in order to bring all of the different people and organizations of Maui County together.  We need to pose a united front to the legislature to get improved healthcare for Maui County.        More About Jan

One in eight Maui patients is transported to Oahu.

Unstable Patients are difficult to transport. These patients are more likely to have adverse outcomes including death with transport. The transport can be agonizing to a patient with multiple fractures. A patient who has suffered a heart attack and needs surgery is suffering damage to their heart while this time consuming transport occurs.

Many of these patients experience delayed transport for up to days. If it is raining, they can’t transport. If the team is on its way, and there is a more serious case on the one of the other islands, the team is diverted to that transport. This means extended delays for the Maui patient.

The transport is very difficult for the patient. After a long wait while they are in serious condition, they go by ambulance to Kahului airport. There are occasional delays at the airport while the ambulance waits for construction equipment ahead of them at the gate they use, or staff to open the gate.

Then the patient is loaded into a fixed wing plane and goes to Honolulu International Airport. After that, they are loaded onto another ambulance and go to the appropriate hospital on Oahu. There are often traffic delays in Honolulu.

The patient’s family is left wondering how the patient is doing. They are not able to go with the patient. They must make travel arrangements. This means that if the patient dies en route, they die alone without their families by their side.

The family then must have money to pay for hotel rooms which are often difficult to find. They need money for their meals and transportation. Frequently, close family members cannot go because of this situation. Of those who go, many sleep in waiting rooms of the hospitals or in their rental cars on the street. If it is a neonate, the family may be there for days to months.

These families are away from their own support systems. They frequently are away from other children while they are on Oahu with a sick or critical child. They may not have family to watch the children left behind on Maui. They lose their jobs from extended leave of absence. Families can be in financial ruin from one illness. There is a Ronald McDonald house and it is frequently full.

Maui is the only major Hawaiian island without at least two acute care hospitals.

Maui is the only major island with acute inpatient services provided solely by the Hawaii Health Services Corporation (HHSC). Maui has the lowest acute care bed to population ratio of any major Hawaiian island. Bed shortages at Maui’s acute care hospital occur on a regular basis, potentially endangering the well being of critically ill patients. The result is that Maui County residents must go to Oahu to receive medical care that should be provided on Maui. This increases costs and creates unnecessary burdens on Maui County residents (especially low income and indigent).

The most recent data (2004) shows Maui Memorial Medical Center (MMMC) medical/surgical unit occupancy at 92.9% - MMMC physicians indicate current occupancy often exceeds 100%.

An island community with only one acute care hospital is at a great disadvantage should a natural or man-made disaster or an epidemic occur. Maui Memorial is already at overcapacity and these crises could result in the closure of the only acute care hospital for the Maui County community. For example, one case of SARS resulted in the closure of a 500 bed hospital in Toronto for several weeks and Hurricane Katrina severely damaged the medical facilities in the Gulf Coast area. The medical world is afraid of a serious worldwide flu epidemic. All of these scenarios are not “what if”, but rather “when”.

Maui currently faces a critical acute care bed shortage. By 2009, this shortage will be severe – negatively impacting access and quality of care for Maui County residents and visitors.

Services Not Offered on Maui:

Many non-ER patients must go to Oahu at their own personal expense for treatments and appointments with specialists not offered on Maui

Specialty services not offered on Maui:

NICU (There are no neonatal intensive care beds on Maui.) Often much of the most critical 12 hours of a premature or sick infants life is spent waiting to be transferred to Oahu – contributes to poor long-term outcomes or death. Many infants are not stable for days and transport places the infant’s life at risk – risk factors are time and the actual transport. Specially trained staff is not available to care access to specialized products and equipment. Mothers are forced to leave a critical infant on Oahu without a mother or travel to Oahu, risking loss of income, job and support systems (left behind in Maui). Lower income families are generally unable to absorb all of these burdens

High Risk Obstetrics

Obstetric anesthesia

Lactation services

PICU

CICU

CVICU

MICU

Cardiac services – open heart surgery, coronary Artery Angioplasty and stenting

Advanced diagnostics

State of the art cancer treatment

Alternative medicine

Recompression chamber

Burn unit

24 hour pharmacy services at hospital

Food services around the clock for both patients, visitors & staff

Positron Emission Tomography / CT

MMMC’s CT is a 2 slice machine = diagnostic errors

Acute dental and oral surgery treatments relating to trauma

West Maui – The Only Hawaiian Island Without a Hospital:

West Maui has only a limited urgent care center. Medical emergencies on West Maui can take up to hours to get to MMMC which often doesn’t offer what they need anyway. Then they face additional delays in transport to Oahu. This causes West Maui patients to have the poorest outcomes including death.

Medical experts agree that survival rates of critical stroke and heart attack victims increase dramatically when patients reach a full service hospital with one hour: the so-called "Golden Hour." West Maui does not have an acute emergency care hospital to serve 50,000 residents and visitors and 5,000 people who work here. No immediate acute care is available to take care of stoke and heart attack victims or those who suffer life-threatening injuries or other medical emergencies.

Maui County and Maui Memorial Medical Center Deficiencies:

MCare is operating a 16 bed ER at MMMC. This causes long waits. Emergency visits are estimated to increase 60% from 36,300 in 2005 to 58,000 in 2015. This would be 10 patients per day per bed. That is if we can get them to arrive in the ER in a timely manner. Each one could have about 2 hours per bed. Of course, if we are still transporting them to Oahu and it takes up to 12 hours (sometimes much more) they are going to have to share beds with incoming patients. We will not be able to have a flu epidemic and we can’t have any more cruise ship mass illnesses. We can also not have any large victim trauma incidents including tsunamis, hurricanes or earthquakes. A disaster where the airport is closed as in a plane crash is in particular out of the question.

ICU is only 16 beds. This causes a back up of ICU patients in the ER. These ICU patients must then be taken care of by the ER staff. These ICU patients have a very high acuity and require more staff hours of care. This causes further back ups in the ER.

The ER has no cardiac specialty triage unit like other hospitals do. This means that cardiac patients including heart attack victims must wait their turn with other patients. This can lead to permanent heart damage and death.

Other Reasons We Need Two More Hospitals on Maui:

· Creation of new jobs, educational opportunities, and industry—especially in the growing field of healthcare

· Attraction of medical personnel with valuable experience and personal resources

• Healthcare professionals
• Biotechnology researchers
• Medical devices/software designers
• Students (nursing and medical)

· Maui patients will finally have a choice of hospital facilities

· “Medical Tourism” will develop with visitors arriving from the Mainland and Asia for
       medical treatments and evaluations.

· Complementary care approach can attract those who currently shun traditional medicine
       and enrich treatment options for all.

· Creation and promotion of healthy lifestyles, with the community health center providing
       examples and resources and setting community standards.

· Maui’s population is estimated to grow from 140,500 in 2005 to
        167,100 in 2015.

· An aging population will drive intense demand for hospital services.

• Residents 45-64 years-old will increase 34%
• Residents 65+ will increase 55%

· Outpatient diagnostic and therapeutic services will significantly outpace population
         growth  – CT-6.8%, MRI-6.4%, PET-16.9%.

· Research indicates a need for 95 additional beds in 2010 and 140 in 2015.

Number of Hospital Beds in Hawaii; Comparison by Island:

In 2003, the State Health Planning and Development Agency (SHPDA) recognized 23 civilian acute care hospitals and Tripler Army Medical Center, which supplies integrated services to all three military branches. Eleven of these 23 hospitals, each with 75 beds or more, are considered major community hospitals. Nine major community hospitals are currently located on O'ahu.

Hawaii ranks 34th in the nation in hospital beds per 1,000 people, at 3.4 per 1,000.

Long-Term Care Beds per 1,000 Population:

Hawaii's bed rate of 25 beds per 1,000 residents aged 65 and older, is one-half that of the U.S. rate of 50 beds per 1,000 population aged 65 and older.

Maui has .9 hospital beds per 1,000 people

Oahu has 2.2 hospital beds per 1,000 people

Molokai has 1.5 beds per 1,000 people