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Cook County Health to consolidate pediatric, adult ERs

Wednesday, September 09, 2015
Crain's Chicago Business
by Kristen Schorsch

The Cook County Health and Hospitals System plans to consolidate pediatric and adult emergency services at its flagship John H. Stroger Jr. Hospital.

Dr. John Jay Shannon, CEO of the system, revealed a glimpse into his plans during a Cook County Board meeting today for how Stroger might transform. His remarks followed those of several doctors, nurses and union representatives who support saving, not curtailing, inpatient pediatric services at Stroger.

“We believe that doing so would cause a public health catastrophe for the most vulnerable children in the community,” said Betty Boles, vice president of SEIU Local 73.

The union represents about 2,500 employees who work in the health system, the bulk of them at Stroger. They include lab and operating room technicians, respiratory therapists and food service workers, among others.


A group of advocates including physicians, nurses and unions have launched a website to prevent the system from closing inpatient pediatric care at Stroger. A June memo from within the system said it was considering phasing out the Stroger inpatient pediatric unit.

The website encourages people to sign a petition and contact Toni Preckwinkle, president of the Cook County Board.

Several people today said shuttering services would likely decrease referrals from doctors who send their patients to Stroger and reduce outpatient visits. Kids who are hospitalized elsewhere would likely stay with their new doctors, they argued.

Shannon, the system CEO, stressed that Cook County Health hasn't closed or reduced the scope of inpatient pediatric services. He said the system could be criticized “as being irresponsible” if it didn't look at how employees and space are used.

“There's been a public health triumph over the last generation, not a catastrophe . . . that has led an overall nationwide decline in the need for pediatric inpatient beds,” Shannon said.


Under federal health reform, hospitals and doctors are encouraged to keep patients healthy and prevent expensive hospital stays. That's helped fuel a push to treat people in outpatient surgery centers and doctors offices. Overall, there's less need for hospital beds. Many hospitals in the Chicago area have closed their pediatric wings and now treat kids in beds typically reserved for adults.

As volumes for various inpatient services dwindle, the system is working to expand its overall outpatient footprint to be more competitive under federal health reform. Plans include offering more pediatric services at community clinics bulking up outpatient surgery and imaging services, like MRIs and X-rays.

What will happen to the two hospitals in the system—the other is Provident Hospital on the South Side—as outpatient care expands is evolving. Shannon said plans for Stroger include consolidating what are now separate emergency departments for kids and adults. Most hospitals don't have separate ERs for different age groups. Stroger doctors typically treat up to 350 adults and 26 kids a day, system spokeswoman Caryn Stancik said.

Cook County Health is one of the largest public health systems in the country, serving as the safety net for a largely low-income and uninsured population. Its trauma care is legendary and doctors often note their training there.

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