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New Facilities Set to Open at Alice Peck Day and DHMC

  • Workers with Landshapes in Richmond, Vt., carry bins of gravel on Friday, Oct. 27, 2017, at Dartmoth-Hitchcock's Jack Byrne Center for Palliative and Hospice Care in Lebanon, N.H. (Valley News - Charles Hatcher) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

  • The Alice Peck Day Memorial Hospital Multi-Specialty Clinic photographed on Friday, Oct. 27, 2017, in Lebanon, N.H. (Valley News - Charles Hatcher) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

  • Lowell Messer, left, supervisor of engineering at Dartmoth-Hitchcock Medical Center, helps Tyler Crory, center, and Michael Kinshaw, both mechanics at DHMC, move a large tub into a spa room on Friday, Oct. 27, 2017, at Dartmoth-Hitchcock's Jack Byrne Center for Palliative and Hospice Care in Lebanon, N.H. (Valley News - Charles Hatcher) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

  • Jason Hutchins, of Richmond, Vt., puts gravel into a drainage ditch on Friday, Oct. 27, 2017, at Dartmoth-Hitchcock's Jack Byrne Center for Palliative and Hospice Care in Lebanon, N.H. (Valley News - Charles Hatcher) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.

  • Ignacio Nuñez, left, of Lawrence, Mass., cleans a light fixture as Ken Duchesney, of Bradford, Vt., paints a wall on Friday, Oct. 27, 2017, at Dartmoth-Hitchcock's Jack Byrne Center for Palliative and Hospice Care in Lebanon, N.H. (Valley News - Charles Hatcher) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com.



Valley News Staff Writer
Monday, October 30, 2017

Lebanon — The city’s two hospitals are preparing to begin welcoming patients to new clinical buildings in the coming weeks.

Dartmouth-Hitchcock’s $22 million Jack Byrne Center for Palliative and Hospice Care is scheduled to open in December, offering 12 inpatient beds and advanced pain and symptom management for seriously ill patients.

The Byrne Center aims to fill a gap in health care services available in the Upper Valley by providing patients and their families with a homelike place, not an intensive care unit, in which to receive inpatient care when symptoms become too difficult to manage at home.

Though similar facilities exist elsewhere in New Hampshire and Vermont, patients in “this part of the Upper Valley have not had that piece of serious illness and end of life care,” said Dr. Ruth Thomson, the center’s medical director.

Improving patients’ experiences is also the primary goal of Alice Peck Day Memorial Hospital’s approximately $13 million multi-specialty clinic, which is slated to open in November and will replace four other buildings by combining all of the community hospital’s outpatient services under one roof. In doing so, APD, which is a D-H affiliate, aims to improve the coordination of patient care.

“It’s very, very exciting,” said Dr. Sue Mooney, the hospital’s chief executive.

Melissa Garland, a registered nurse and the director of nursing for the Byrne Center, was similarly enthusiastic about her facility.

A 23-year resident of the area, Garland said she and others on her nursing staff have been waiting for the opportunity to provide this type of care.

They are “really excited to see this added to our community,” she said.

The 30,000-square-foot Byrne Center — located off of Medical Center Drive to the north of Dartmouth-Hitchcock Medical Center in Lebanon — will provide “general inpatient care,” a hospice term used to describe situations in which a patient’s pain or other symptoms become too difficult to manage in another setting, most commonly at home, Thomson said. Providers at the Byrne Center will work to relieve symptoms such as pain, shortness of breath, nausea and vomiting, she said.

Sometimes patients undergoing hospice care — which is synonymous with end-of-life care and used when a patient is expected to live six months or less — may need to be admitted for a few days while clinicians address such symptoms and help to educate family members on how to manage them at home, said Dr. Kathryn Kirkland, D-H’s section chief of palliative medicine.

While some of the new center’s patients are likely to be at the end of their lives, for others the providers’ aim will be to “get you back home so you can continue living,” she said.

In addition to these types of stays, the center will assist caregivers by offering respite care, Thomson said. This would mean that providers at the center would look after a patient who is receiving care at home while the at-home caregiver takes some time for themselves, she said.

In addition to the patient rooms, the Byrne Center also includes gathering spaces for small and large groups, Kirkland said. Conference rooms will be used for educational programs hosted by D-H or by other community groups, with some programs geared for families and others intended for clinicians, she said.

The $22 million price tag was primarily covered through philanthropy, including a $10 million gift from the Jack & Dorothy Byrne Foundation.

Jack Byrne, a major insurance industry executive who lived in Etna, died in 2013.

Providing the hospice and palliative care in the new setting is not expected to be a money-maker for D-H, though it may free up some hospital beds. And helping patients through a terminal illness is also a priority.

“I think our medical center really sees this as part of our mission to provide the best care in the right place at the right time,” Kirkland said.

The center’s staff is preparing to welcome their first patients in December by ensuring they have in place all of the equipment and employees that they need, as well as by collaborating with the region’s three primary home health agencies — Visiting Nurse and Hospice for Vermont and New Hampshire, Bayada Hospice and Lake Sunapee Region VNA & Hospice — to ensure that transitions from home to the center and back again go as smoothly as possible, said Kirkland.

In the meantime, 150 members of APD’s 430-person staff are packing boxes in preparation for their relocation to the new multi-specialty clinic, which will be opening with staggered start dates throughout the month of November, beginning in the coming days.

“Moving is one of the five most stressful events for any human,” said Dr. Dale Vidal, the clinic’s executive director. Staff members are “trying to be supportive of each other. (I’m) confident it’s all going to go well ... proof is in the pudding.”

The new 44,000-square-foot building will house all of the hospital’s primary care services, as well as specialties including orthopedics, pain management; physical, occupational and speech therapies; X-ray, imaging and laboratory services; cardiopulmonary, general surgery, occupational health, plastic surgery, podiatry, urology, sleep health and women’s care.

The idea for the “one stop shop” came out of a 2013 strategic plan, said Mooney.

“The work that we did at that time we really identified that our campus was not very patient friendly,” she said. “We had acquired old homes and we had renovated them and turned them into office space. From a patient standpoint, even though it’s a small campus, it was actually challenging to navigate the system.”

Financing the $13 million building, which is owned by the Monadnock Economic Development Corporation and leased by APD with an option to buy, was the most difficult part of the process, Mooney said. The project was also aided by a loan through the U.S. Department of Agriculture, she said.

In addition to improving patients’ experiences, providing all of these different services in one place will help reduce the cost of care and improve its quality, Mooney said. By having clinicians in the same building, she hopes they will be able to work together more and have more informal interactions in the break room, she said.

“If it’s difficult to obtain the information or talk to the person that saw the patient last, we tend to duplicate things,” Mooney said. “This is a necessary step on the path. There is still additional work to do.”

Next on Mooney’s list in terms of physical improvements at APD includes renovating an older wing of the hospital, she said.

Both hospitals are inviting the public to events this week to celebrate their new buildings.

APD is hosting a ribbon cutting today at 4 p.m. at the Multi-Specialty Clinic at 9 Alice Peck Day Drive in Lebanon.

On Friday, D-H will host a lecture by Dr. Ira Byock, D-H’s former director of palliative medicine and an expert in the field, at 4 p.m. at DHMC. And on Sunday, there will be an open house from 10 a.m. to 3 p.m. at the Byrne Center.

Valley News Staff Writer Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.