The commander of Walter Reed Army Medical Center, faced with a critical shortage of nursing and other support staff, announced yesterday that the hospital is temporarily reducing its capacity by 80 beds and will cut back on the number of patient referrals it takes from other military hospitals in the area.
The cutback, which will last at least through October, is expected to have the most affect on retired military personnel and their dependents because active duty personnel are given priority at military medical facilities, hospital officials said.
"We have stretched our people; we have extended ourselves," said Maj. Gen. Lewis Mologne, commander of the 76-year-old hospital. "But in doing so, we have really diminished our safety margin."
Mologne said he wants to close down 80 of the 783 beds currently filled at the hospital through attrition, rather than by discharging any patients who are there now.
The 80-bed reduction, the equivalent of two average-size wards at Walter Reed, would affect the hospital's surgery, gynecology, medicine, neurology and some emergency evacuation services. Coronary and other intensive care services would be exempted from the reductions, as would the hospital's three psychiatric wards, its 38-bed pediatrics service and its organ transplant program.
The hospital also is planning to shut down Ward 72, the executive suite section where it treats military VIPs.
The bed reductions, according to Mologne, will likely curtail the number of patient referrals from Bethesda Naval Hospital, Fort Belvoir, Fort Meade and Andrews Air Force Base.
Mologne, who called a meeting of the hospital's medical staff to announce reductions in several services, said the changes were designed to avoid the kind of patient care problems recently reported at some other military hospitals.
"We haven't had any calamities, and we don't expect to have any," he said.
The quality of military health care has been questioned in recent months following a series of audits by the Army, Navy and Air Force that found that military hospitals were not following many health standards set up by the Defense Department.
There also have been congressional hearings that featured several military care "horror stories," and last month the department said it planned to order the three services to have some of their inpatient records reviewed by independent health organizations.
Mologne said that at Walter Reed's current capacity, the quality of patient care is threatened and the nursing staffs on several wards are overtaxed. Without the reductions, he warned, Walter Reed could fall below the patient/staff ratio required for hospital accreditation.
In addition to bed reductions, the hospital is increasing recruiting efforts for nurses, instituting a 48-hour work week for most medical personnel and limiting temporary duty transfers. Mologne said he also is seeking an exemption from military-imposed pay caps that have hurt in contracting for civilian nursing personnel.