April 16, 2004 – Although Roy L. Schneider Hospital and Myrah Keating Smith Community Health Center continue to face challenges, Rodney E. Miller Sr. told St. John Rotarians on Friday, both facilities have seen vast improvements since he came on board two years ago.
Miller, who is chief executive officer at the hospital, said its building, the staff and the community were crying out for help when he arrived.
"It was not a clean and friendly environment. The hospital was sick," he told the more than two dozen Rotary Club of St. John members gathered for their weekly meeting at the Westin Resort's Beach Terrace Restaurant.
Miller said morale is now at an all-time high, the infrastructure has improved, the hospital has new equipment, new doctors have signed on, and the facilities now rival those of any community hospital on the mainland.
Additionally, he noted, going up next door is the Charlotte Kimelman Cancer Center, which will provide local treatment so that patients will no longer have to go off island. "There's nothing that will rival our cancer center, not even in Puerto Rico," he said.
And, he pointed out, the hospital won accreditation from the Joint Commission on Accreditation of Health Care Organizations last December — on its first try after about 20 years in operation. For a hospital, "that's the Good Housekeeping Seal of Approval," he said.
However, there are still what Miller termed opportunities to face. The hospital, like many health-care facilities on the mainland, has a chronic shortage of nurses. To meet needs, it has been forced to spend more than $6 million a year on contract nurses.
To relieve the situation, he said, the territory's young people must be encouraged to pursue careers in health care. He said the hospital gained six new nurses through providing intensive remedial training for University of the Virgin Islands nursing graduates who failed their licensing exam the first time.
Miller also said the Schneider emergency room is a sore spot. Patient flow needs improvement, he said, and the facility can be overwhelmed when gunshot victims arrive, forcing people with less-threatening medical concerns to wait. He said a task force is working on the flow problem.
The hospital also faces the challenge of changing the perception carried over from the 1990s and earlier that it was not up to snuff. "We have people go away for physicals," Miller said, a bit incredulous that people are taking their health-care dollars off island for that purpose.
If that money stayed on island, he said, the facilities could improve even further. However, he acknowledged that there will still be some conditions that can't be treated on island.
Erica McDonald, Myra Keating Smith administrator, joined Miller in responding to the oft-asked question of why St. John women can't deliver their babies at the community health center. For decades, women did so using the services of a midwife; but in more modern times, they have made the boat trip to Schneider Hospital for delivery after having had their prenatal care on St. John.
McDonald cited liability: "The first time it doesn't occur the way parents expect it will, they will sue," she said.
There are no obstetricians on the health center staff. McDonald said the pregnancy rate on St. John — typically seven or eight women a year — isn't high enough to justify paying one $300,000 a year and setting up delivery facilities at the center.
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