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The Hahnemann University Hospital Closure and What Matters: A Department Chair's Perspective
1R.J. Hamilton is professor and chair, Department of Emergency Medicine, Drexel University College of Medicine, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0002-3606-5389.
Insights
The 2019 closure of Hahnemann University Hospital caused unprecedented graduate medical education displacement. Lessons learned emphasize hospital leadership, finance, and the need for academic medicine commitment to prevent future crises.
Area of Science:
- Medical Education
- Healthcare Management
- Hospital Administration
Background:
- Hahnemann University Hospital's closure in 2019 led to the largest graduate medical education (GME) displacement in history.
- Over 550 residents and 2,000 staff were impacted within a month, causing significant disruption.
- The event, though retrospectively predictable, was a cataclysmic shock to all involved.
Purpose of the Study:
- To reflect on the lessons learned from the unprecedented closure of Hahnemann University Hospital.
- To identify critical factors contributing to the hospital's failure and the subsequent GME displacement.
- To propose strategies for regulatory bodies and health systems to mitigate future academic medicine crises.
Main Methods:
- Invited commentary reflecting on personal experiences and observations as a department chair.
- Analysis of corporate structure, leadership, and financial aspects of the hospital's failure.
- Examination of the roles played by the Accreditation Council for Graduate Medical Education (ACGME) and Centers for Medicare and Medicaid Services (CMS).
Main Results:
- Hospital leadership, organizational structure, and financing were critical determinants of failure.
- ACGME and CMS acted as key stabilizers during the displacement event.
- Opportunities exist for ACGME and CMS to play a more proactive role in preserving teaching programs during future crises.
Conclusions:
- Highly competitive health systems must reconsider non-collaborative strategies to prevent the collapse of struggling institutions.
- A commitment to academic medicine requires adequate resources, knowledge, and expertise.
- Academic medicine is a sacred trust that should only be undertaken by well-equipped enterprises.
Abstract:
The closure of Hahnemann University Hospital, which was announced on June 26, 2019, resulted in the most significant graduate medical education displacement in history, sending over 550 residents to new institutions within a month of the announcement. Over 2,000 physicians, nurses, and staff lost their jobs. While seemingly predictable in retrospect, the closure came as a cataclysmic event to all involved. In this Invited Commentary, a department chair reflects on the lessons learned from these unprecedented circumstances. These lessons cover areas that are not a typical concern for faculty who are focused on teaching their trainees, but are worthy of their attention. Corporate and organizational structure, leadership, and financing of the hospital were critical determining characteristics of the failure. The roles that the Accreditation Council for Graduate Medical Education and the Centers for Medicare and Medicaid Services played in this event were key stabilizers. However, examining their roles in this event offers opportunities to play a more active role in future events and alter how the next massive displacement unfolds, possibly preserving teaching programs. Highly competitive health systems should rethink noncollaborative strategies before allowing struggling institutions to succumb to market forces. Finally, a commitment by a hospital to the mission of academic medicine is a sacred trust with the faculty, trainees, and patients that it serves. It should not be undertaken by any enterprise that is not well resourced and equipped with the knowledge and expertise to meet this most serious of commitments.