assured a 10-year expansion binge for Oklahoma City's medical establishment during the 1980s. But there were signs that the cost of steady growth was showing up in renewed strains against a smaller manpower pool and, quite possibly, a more vigorous pursuit of fewer dollars in the years ahead.
The most obvious change, in the view of Baptist Medical Center's chief operating officer, Stan Tatum, was a revised hospital and medical care reimbursement system decreeing flat rate payments. Gone is the ability of hospitals to bill for all the services demanded by their patients.
Putting it bluntly, it means stricter limits on the amounts hospitals can actually collect from patients or third parties. And, for many, it has meant fewer admissions, which translates into lost revenues.
"We are moving into an area of limited resources, requiring a more serious look at the operating dollars we have," said Tatum. "It brings manpower into play." What he and other administrators are facing, he suggests, is an urgent need to pare down the number of available jobs.
Along those lines, Tatum and Baptist are reviewing the role of the professional nurse and the nurse's specific duties. They will try to define the jobs requiring less expertise and, at the same time, extend the study to other professional categories.
During the next decade, hospitals will tend to concentrate on areas of strength, or centers of excellence, as some describe them. Baptist, says Tatum, has identified several. At the top of the list: cancer and heart.
Two others apparently rank high on the priority list:
The ospital's burn center and the cochlear implant program launched by Dr. Jack Hough.
During the 1980s, the center has invested at least $55 million in new facilities and expansion.
According to Tatum, Baptist put $11 million into an expansion of its east tower, adding four floors and more private rooms. It is still licensed, however, for 577 beds.
One of the new floors is to be opened in December, the others at three-month intervals.
Baptist Medical Plaza North, along with a connecting tunnel and a parking garage, was constucted during the 1980s at a cost of $17.5 million. About $9 million went into a new outpatient facility and laboratory. A conference center was added in 1986 at a cost of $2.5 million. Emergency room renovations and two new trauma rooms cost about $800,000.
By early summer, a Women's Center may be completed at an estimated cost of $8 million. And, by June 1990 a new heart catherterization facility is scheduled for completion at a cost of roughly $4 million.
Tatum said a significant expansion of obstetrics and neonatal care is about a year and a half away.
At Mercy Health Center, capital expenditures during the last 10 years were said to have exceeded $50 million. The figure includes equipment and construction of new or expanded facilties.
The hospital's Family Birthplace, the "one-stop" labor, delivery, and neonatal services center, was opened last year at a cost of $2.5 million.
One of the decade's major projects, the McAuley Medical Plaza, a four-story outpatient facility with two floors reserved for physicians' offices, was completed in 1983.
The acquisition of updated equipment required large outlays for Mercy. Example: a new CAT scanner at $1.1 million.
New radiographic equipment, including a radiology computer system …