Hospital Follows Trends in Expansion

Harvard-affiliated Mt. Auburn Hospital, hampered in the past by chronically outdated facilities. Is following a recent trend in medicine with its proposed $45 million renovation project to modernize the institution and increase its capacity for high turnover procedures and outpatient services.

The main changes that would come from the proposed expansion, which has been criticized by neighborhood residents for its effect on other area hospitals and is currently pending state approval, would be a renovation of the hospital's crowded patient rooms and an expansion of its obstetric and psychiatric services.

The hospital also intends to build a new ambulatory care facility which is not part of the plans submitted to the state, according to Mt. Auburn President Francis P. Lynch.

In recent years many hospitals have significantly increased their ambulatory facilities, and the practice has been widely acclaimed as being more economical and providing better patient care than previous methods.

Last year two of the other 13 Harvard-affiliated hospitals opened new ambulatory care facilities.

"Ambulatory care is the wave of the future," Francis H. Burr '35, chairman of the board of one of them, Massachusetts General Hospital, said yesterday.

Lynch said recently the expansion of such outpatient services is inescapable. "It will be forced and required from the system," he said, adding, "Ambulatory care makes good sense."

"It isn't necessary that if you [check into] the hospital it's an expensive place to be. We can do [a simple operation] much better if you can come in at 7 in the morning and be out by 3.30 or 4 in the evening," he explained.

Childbirths to Increase

The service which would be most expanded by the proposed renovations would be obstetrics. The hospital is seeking permission from the state to add four maternity beds to its existing 20, which would allow it to increase the number of deliveries it performs from about 1100 to 2000 per year.

Lynch said he sees potential for growth in the area because "over the past 10.15 years many hospitals have closed their obstetrics units" for economic reasons or shifted emphasis to more complicated procedures.

In the expansion, Mt. Auburn intends to shift from the more traditional sterile method of childbirth to a more relaxed procedure involving the whole family. Their application to the state says, "Many women are looking for a childbirth experience that regards birth as a normal process rather than as an illness...Mt. Auburn Hospital is building a reg-

ional family maternity program with an emphasis on birthing rooms and nurse-midwife care."

The proposed obstetric expansion has worried Cambridge residents and the board of the Cambridge City Hospitals. Who fear that if Mt. Auburn does increase its services by 800 births each year, the municipal facility may be forced to close its maternity department.

This would hurt the community, they contend, because the Cambridge Hospitals provides most of the free care in the city, and closing the department might weaken other parts of that hospital. The Cambridge Hospitals is also Harvard-affiliated, and with Mt. Auburn has run an obstetrics training program for the Medical school.

"An expansion of obstetrics services at Mt. Auburn from 1200 to 2000 would lead to a closing of those facilities at Cambridge. I don't see how that can't happen," Dr. Robert M. Neer Jr.'57, chairman of the municipal the board which oversees the city hospital, said at the board's meeting this week.

Lynch disagreed, saying, "That's simply not an accurate claim." "Our plan does not assume that they are going to their obstetrics services," he added.

The Cambridge Hospital's obstetric facilities have been operating recently at only 40 percent of capacity, and that hospital's board resolved this week to work to double that figure within two years. Members have said they feel this would be difficult in the face of the Mt. Auburn expansions.

But Lynch said his hospital was aiming at a different market, the suburbs to the west of Cambridge, and that it would be possible for both hospitals to expand. He explained, "The babies are out there.