The University Hospital is prepared with specialists and equipment to treat seriously ill or injured patients from across the commonwealth, or even across state lines. New patients frequently arrive, seeking valuable spaces still occupied by others who have been diagnosed and treated but are too sick to be discharged. The Transitional Care Hospital is situated to accept these treated patients, effectively expanding the capacity of the hospital.
The TCH — a 35-bed facility located on Ivy Road five miles away from Grounds — is estimated to free up to 23 beds at the Medical Center per day and save the medical system millions of dollars in costs.
“We provide acute long term care,” Director of Clinical Operations Tara Beuscher said. “The patients are at a state where immediate risk is gone, but they still need much more treatment before they can be discharged. They may also need specialist attention, sometimes on a daily basis. We are a hospital for people who need a month stay.”
Such a facility may be referred to as a Long Term Acute Care facility, and it is distinct from both rehabilitation facilities and nursing homes or hospices. Patients are often too sick to endure more than two or three hours of rehabilitation per week — much less than the three hours daily required by acute rehab hospitals. At the same time, the facility solely provides long-term acute care, which typically only lasts a month or so compared to the indefinite care provided by hospices or nursing homes. The narrowness of this niche explains the TCH’s relatively small capacity.
Patients who receive treatment at TCH often are not recovering from a single problem.
Dr. Sarah Brumfield, who works as a TCH physician, said that she sees a wide range of patients in terms of background and history leading to hospitalization, many of whom suffer from multisystem failure. For example a younger patient may need to recover from severe traffic injuries including stroke while also suffering from Cystic Fibrosis and COPD. She estimates that up to half of the patients treated could be under 65 years old.
To care for these serious conditions, the TCH is staffed with 120 members, many of whom are healthcare providers on 12-hour rotating shifts.
“Most [TCH physicians] have critical care experience, such as ICU experience,” Brumfield said.
This is especially important as patient conditions can quickly change, resulting in 14 percent of patients requiring readmission to the specialist care at the Medical Center.
Both Beuscher and Brumfield said there is no common cause for such readmission, except “worsening condition.”
“A lot of times they are very sick, we try to treat them while their condition is stable, but sometimes they need more surgery,” Brumfield said. “They need to be on norepinephrine, they need IC level of care, that’s why they go back. They need a higher level of care.”
The TCH was created at the University six years ago as one of only four LTAC facilities in Virginia, and one of 400 in the entire nation. Of these many are operated for profit, with only 20 percent of them being publicly funded.
“We are unique in that we are state funded, Beuscher said. “So we can provide the best care possible.”
There are many opportunities for nursing students, medical students and Madison House program volunteers within the day-to-day operations, Beuscher said.
“I think that everyone has something they can bring and something they can find, not just science people,” Beuscher said. “We are a hidden gem among the health system … The students value their time here.”
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