New clinic to ease UI hospital demand -- but not for long

Even with Coralville, UI health chief expects more satellite clinics will be needed

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CORALVILLE — The Iowa River Landing outpatient clinic is on track to open in October with expectations of reducing visits to University of Iowa Hospitals and Clinics’ main campus by at least 200,000 annually, but officials say the hospital’s patient numbers could climb back to pre-River Landing levels in three years.

Growth of inpatient programs like surgery and transplants at the hospital will continue to fuel a rise in numbers even after River Landing opens, those officials said.

"If we come back to the same level we have to look elsewhere," UI Vice President for Medical Affairs Jean Robillard said. "We want to see what happens with River Landing first and how that impacts the volume here."

Volume growth nearly across the board at the hospital led UI officials to form a long-range plan to move many outpatient, ambulatory services off site, away from the crowded main campus on Melrose Avenue and Hawkins Drive. Opening the $73 million Iowa River Landing clinic next fall just south of Interstate 80 in Coralville will be the first major step in that direction.

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"One of the exciting things is how much our programs are growing, which is why it’s so critical we have River Landing going to handle the growth," Ken Kates, UI Hospitals and Clinics chief executive officer, said.

Outpatient visits to the main hospital campus this fiscal year are projected to top 813,000. That’s growth of almost 31 percent in the past 10 years, and more than 53 percent in the past 15 years.

Not only are inpatient and outpatient numbers climbing, but construction begins soon on a new Children’s Hospital slated to open in 2015 and all patient rooms eventually will be converted to single occupancy. Those plans mean space is at a premium at the hospital campus.

Leaders envision a future where the on-campus hospital is used mostly for inpatient programs, such as surgeries and critical care, with outpatient functions moved when feasible to off-site clinics where parking and access is easier for patients, Robillard said.

The new Children’s Hospital and two additional new towers included in the hospitals' long-range plan will be added to the 3.5 million-square-foot main facility in an east-to-west configuration, differing from the current north-to-south layout, Robillard said. It’s also possible parking ramp 2 will come down and be replaced with underground parking. An updated long-range plan through 2020 — which at last report had an estimated price tag of $1.1 billion — will go to the state Board of Regents in February.

This planning  for the hospital is similar to what was done in the 1970s and 1980s, when several of the existing pavilions and parking ramps were built, said state Regent Bob Downer, an Iowa City lawyer. The state’s Board of Regents oversees the hospital and university. Congestion, access and the visitor experience are all part of what officials want to address, he said.

"We’re going through another major reconfiguration of the hospital complex," he said. "Our overall mission is to deliver the best quality health care as effectively and efficiently as we can, and it seems to me that the rest of what we do has to fit within that."

Three QuickCare clinics operated by UI Hospitals and Clinics in the Iowa City-Coralville area are a key part of shifting traffic from the hospital, officials said. A fourth clinic is to open on Mormon Trek Boulevard. Those clinics are meant for walk-in medical visits for things such as strep throat, flu and earaches, to help take the pressure off the hospital emergency room.

Kates said 30,000 patient visits are expected at QuickCare clinics this fiscal year.

A new Family Medicine Clinic also is to be built on Melrose Avenue, across from West High School. Hospital officials may take that estimated $13.8 million project to the regents in February for budget and design approval. That clinic, opening in fall 2014, would move family medicine away from the hospital.

The UI also bought in the past year 40 acres at Highway 965 and Forevergreen Road in North Liberty to eventually replace a clinic in that area and possibly house more ambulatory clinic functions.

The nurses and staff at off-site clinics, like the one at River Landing, will be based at those sites full time. Doctors may travel back and forth between off-site clinics and the hospital, but an electronic records system will help with efficiency, Kates said.

River Landing also will have labs and testing capabilities on site, providing a one-stop shop for patients.

"In general I think it will be smoother, easier for the people," Robillard said. UI officials expect that to have an impact on patients and the hospital system. "I think demand will increase," Robillard said.


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