Hochrhein Clinic
| Hochrhein Clinic | |
|---|---|
 |
|
| Sponsorship | Waldshut district |
| place | Waldshut |
| management | Hans-Peter Schlaudt |
| beds | 303 |
| Employee | 750 |
| including doctors | 110 |
| areas of expertise | 13 |
| Annual budget | 55 million euros |
| founding | 2018 , as a hospital 1411 |
| Website | www.klinikum-hochrhein.de |
The non-profit Klinikum Hochrhein GmbH , formerly Spital Waldshut GmbH (from 2005) and Spitäler Hochrhein GmbH with two houses (from 2011), has been the sole sponsor of the hospital of the same name in Waldshut since November 2018 .
In 2004, the district of Waldshut, together with a hospital fund , transferred the hospitals in Bad Säckingen and Stühlingen, which were then still belonging to the Hegau-Bodensee-Hochrhein (HBH) hospital association , to the Hegau-Bodensee-Hochrhein-Kliniken GmbH (HBK) as of 31 December 2010, however, the Bad Säckingen hospital took responsibility again. The district got out again as a shareholder in HBK. The clinics in Waldshut and Bad Säckingen merged to form Spitäler Hochrhein GmbH .
At the end of 2017, the hospital in Bad Säckingen was closed due to an excessive financial burden - the construction of a central clinic in Albbruck is currently being planned and prepared in the district.
Until the opening of the central clinic, the Waldshut hospital took over the basic, regular and acute inpatient care for the Waldshut district on the Upper Rhine and the Swiss border .
Current developments
In July 2020, the Supervisory Board of Klinikum Hochrhein GmbH appointed Hans-Peter Schlaudt as managing director for a further three years. He brought the deficit clinic “on track” and “further merits are the recruitment of new chief physicians, the establishment of new departments and the introduction of new processes,” said the chairman of the supervisory board, District Administrator Martin Kistler , in a press release.
- Expansion of the departments
A new chief physician has been hired for intensive care medicine , the chief physician of the central emergency department and most recently (from September 2020) a chief physician for trauma surgery in the center of orthopedics , spine and trauma surgery . In terms of corona infection, "June went very quietly, in July the number of new infections increased and in the current month [August] the trend [...] continued with an upward trend". The 7-day quota in the Waldshut district is one of the lowest in the southern Black Forest-Baar-Bodensee region (as of August 18, 2020).
In operation since March, but due to the corona pandemic, the new cardiac catheter laboratory in the Center for Internal Medicine and Cardiology was only presented in August 2020 . The aim is “a 24-hour presence [...] Currently there are two doctors specializing in cardiac catheters, two employees for nursing activities and four other employees. [...] Uncomplicated cases could go home on the same day. "
- Extension building (north building)
At the beginning of September, construction of the three-story, interim building on stilts, which will be erected in modular construction in front of the entrance area of the hospital, will begin. Completion is scheduled for spring 2021. In addition to an intensive care unit with 14 beds on the first floor, two wards with 24 beds each are being built above - the rooms in the existing building that are freed up as a result can be converted. “Although the clinic is to move to the planned central clinic in Albbruck by 2028, the extension is essential as an interim solution.” According to Hans-Peter Schlaudt, “15 years of renovation backlogs” can also be tackled, and District Administrator Martin Kistler pointed out that the clinic will be able to "participate in developments in the medical field over the next six to eight years". “The extension costs a total of 15.5 million euros. There are three million euros in funding from the state. The remainder is borne by the district and the city of Waldshut-Tiengen. "
Location and importance
The Hochrhein Clinic is a basic and standard care hospital and is located on the western periphery of the city of Waldshut. Within a radius of over 50 km, the Hochrhein Clinic is the largest hospital in the region. The structure of thirteen specialist disciplines enables the treatment of patients who are admitted from the Waldshut district, from the surrounding districts and from Switzerland. The clinic currently operates 303 beds and treats 12,500 inpatients per year. The Waldshut Hospital has been an academic teaching hospital of the Albert Ludwig University in Freiburg since 2014 . After the opening of the district's central clinic in Albbruck, the Hochrhein Clinic in Waldshut is to be closed after the hospital in Bad Säckingen has been closed at the end of 2017.
- For the current situation, see: Situation and Outlook 2019/20
history
Historical background
The hospitals in the Middle Ages were above all places of care for the poor and needy, for the elderly, for orphans and foundlings, for pilgrims and strangers. In addition, they were used to provide health care, although this was only possible to a very limited extent; so the presence of doctors in the early hospitals was rather rare. A city doctor (Physikus) who also took care of the hospital was only available in the big cities. Initially founded as spiritual institutions in monasteries and churches, in the 12th and 13th centuries the hospitals were increasingly transferred to religious lay fraternities who, in addition to the charitable service, also took on the administration. Thanks to donations and foundations, the hospitals became important businesses, some of which had considerable assets. Above all, the beneficiaries contributed to this, who “bought” their way into the hospitals for their old-age security and pension provision.
Founding of the Heilig-Geist-Spital
“On the Monday before St. Martini in 1411, the town of Waldshut bought the Ze Stunzingen farm from Mrs. Catarina von Thayningen, located above the town of Waldeshueth for 140 Marks Lötigen silver Zurich weight to build a hospital for the Holy Spirit with all the goods that were there are located in the vicinity of Eschpach, Waldkirch, Schmitzing, and Indligkoffen ”.
This sentence from the founding document marks the beginning of the more than 600-year history of the Waldshut Hospital. The aforementioned court formed the economic basis for the hospital; it was to be built and maintained from the proceeds of the farm. This foundation was a purely urban welfare institution.
The hospital was built on the banks of the Rhine at Unteren Tor (today Rheinstrasse 55). Originally, it was a multi-storey stone building with various ancillary buildings, vaulted cellars and a garden. The central room was the so-called “arm's room”, in which the sick beds were set up. In addition, a four-story hospital building was built for the hospital master and the beneficiaries. The hospital was mainly a poor and elderly care station. The hospital soon developed into a beneficiary house for the elderly and infirm and acquired land, forests, goods, extensive real estate and considerable financial resources through mortgages and donations, and thus became a wealthy and wealthy foundation ( hospital fund ).
As in many other places in Waldshut, before the hospital was founded, the special leprosy house on the Steig, a leprosy house to accommodate the infectiously ill (the "lepers"), was built outside the city as early as 1321 . This foundation probably goes back to the Johanniter . This facility existed for several centuries. A continuing "Leprosenfonds" was only combined with the Spitalfonds in 1827.
In 1422 the city council donated an altar in the armory and a chapel within the hospital property. From 1436 there was a priestly position for pastoral care of the hospital inmates. In 1557 a bather is mentioned, to whom the bathing room at Waldshut Hospital was transferred.
Originally built in the Gothic style , the chapel was rebuilt until 1660 with a donation from the governor Straubhaar and received a Marian altar in high baroque cartilage style attributed to Johann Christoph Feinlein . Services were held in the hospital chapel until 1884. From 1890 it was used as a warehouse.
The special status of the four forest cities and their joint administration meant that in early modern times either the Physici in Ensisheim , including Georgius Pictorius from 1540 to 1573 , or the Physici von Rheinfelden were also responsible for Waldshut.
The hospital in modern times
In the early modern period, passing doctors also practiced on site. The best-known among them Paracelsus came repeatedly through Waldshut on his wanderings. In 1595 Count von Sulz had the alchemist and miracle healer Leonhard Thurneysser arrested in Tiengen on the pretext of collecting debts and arrested him at the Küssaburg.
In 1611, the two physicians of the forest cities in Rheinfelden fell victim to the last great plague outbreak on the Upper Rhine. In 1641, at the time of the French-Swedish occupation, a Waldshut city physician is mentioned for the first time on the occasion of acceptance into a rosary fraternity. At that time, city doctors were generally charged with advising hospitals on a part-time basis in addition to their varied work . It is possible that this doctor occasionally also cared for sick people in Waldshut.
Waldshut medicine experienced a high point at the end of the 17th century. Rudolf Elias Camerarius (1682), Johann Jakob Franz Vicarius (from 1688) and Karl Nicolaus Lange (from 1699), who were appointed to the Leopoldina due to their scientific qualifications, practiced Waldshuter Physici . On behalf of the Waldshut Council, Johann Jakob Wepfer examined the precarious working conditions of the millstone breakers who suffered from silicotuberculosis in the millstone pits . In 1710 the Kleggau regional physicist from Tiengen Johann Christoph Gockel had a Kurtzen report printed in Waldshut near Waltpart on how to prevent viruses from both the plague and other contagious diseases . In 1755, the sick President Greiffenegg ordered Johann Georg Zimmermann to come to Waldshut. The Waldshut surgeon Jakob Bürgi achieved a remarkable second career as a landscape watercolor painter in Mainz in the 1770s. The Waldshut city physician and pharmacy owner Sebastian Fahrländer moved to Switzerland in 1798 and took on a leading political role in the newly founded canton of Aargau.
The hospital in the 19th century
With the transition to the Grand Duchy of Baden , Waldshut became the seat of a grand ducal office physician in 1806. The first district doctor to be appointed was Anton Kuichel, who set up an epidemic hospital in the Capuchin monastery in 1814. 160 soldiers and 65 citizens, including the entire secular clergy and the district doctor, fell victim to a typhus outbreak. The first staff surgeon in Baden was Ignaz Straubhaar (1817–1819 also Waldshut mayor). In 1859 a medical officer, a forensic doctor, three surgeons and a pharmacist worked in Waldshut.
Since the end of the 18th century, the change from hospital to hospital began in the big cities, due to increasing medical knowledge and the increasing population. The hospital's predominantly nursing task was replaced by medical diagnostics and treatment in the modern hospital. The new task was aimed at "eliminating defective body conditions". Since then, this change has fundamentally determined hospital development. In Waldshut, too, the old Heilig Geist Hospital no longer met the new requirements. For this reason, various plans were made for a new building, which, however, could not be realized due to the time circumstances.
In 1861 the hospital moved to the former Capuchin monastery, which was more spacious and which was redesigned for the new purpose. The old hospital on Rheinstrasse passed into private hands.
The sisters from the motherhouse of the Vincentian Sisters in Freiburg took care of the sick. The nuns stayed in the Waldshut hospital for 110 years, the last sister left in 1968.
The renovated hospital, the newly equipped sickroom in the Capuchin monastery and the care by trained nurses led to an increased occupancy of the house. To remedy the lack of space, another two-story stand-alone building was built south of the monastery. The next 120 years to this day should be characterized by ever new construction phases and the expansion of the hospital to the west. This fact resulted from the medical necessities, the growing number of patients, the hygienic and organizational requirements and from the endeavor to improve the comfort for the patients.
In 1895, the city council gave full-time medical care to a surgically trained general practitioner for the first time, who also ran a private practice.
Historical case reports from Waldshut (selection)
- Johann Jakob Wepfer: Observatio XXI 1669 and Observatio CIV around 1670. (books.google.de)
- Johann Jakob Vicarius: How the rural people care to heal the epidemic dysentery, 1691. (books.google.de)
- Sebastian Faller: Head injury with a happy ending, 1841. (books.google.de)
The hospital in the 20th century
In 1926, a specialist in surgery, gynecology and radiology was employed as the chief doctor. He was involved in the planning for a new hospital building, a three-story building that was to adjoin the old Capuchin monastery to the west.
On December 15, 1928, the new building was inaugurated, which was connected to the old hospital and which still forms the old core of the hospital today. The sickrooms faced south to the Rhine, while the functional rooms, surgery and X-ray departments were housed in the northern part of the building. The outbuilding to the south of the former monastery, created in 1884, was demolished. In 1938 a nursing school was founded, which, after an interruption in the post-war period, was reopened in 1951 as an independent institution of the hospital fund.
At the beginning of the war in 1939, part of the hospital was declared a reserve hospital , but this was lifted again in August 1940. In 1949 the Hasenhof was acquired to supply the kitchen.
In 1949 the complex was expanded to include a pavilion building, which was expanded to include a second and third floor in 1953, but only existed until 1986. In 1957 the main building was extended. Financed by reserves of the hospital fund and a state grant, the two-story south building was inaugurated in 1964.
Constantly increasing patient numbers, a continuing lack of space, the desire for modernization and improvement of the hygienic conditions as well as new requirements led to a discussion about a possible complete new construction of the hospital "on the greenfield" outside the city area or an extension at the previous location.
The hospital fund had already acquired the land west of the hospital earlier, so that the hospital could expand further to the west. When the hospital was retained at the previous location, it was decided to build an extension, the so-called "West Building", which was designed in 1979. In 1986 the inauguration of the west building took place.
In the same year the obsolete "east building", completed in 1953, was demolished and a landing pad was created for helicopters.
In 2000, the planning of a further new building in the west of the previous hospital began, in 2002 the south building was increased and in early March 2007 the extended west building was inaugurated.
Since 2012 there has been a newly built psychiatric treatment center in the immediate vicinity as a branch of the Center for Psychiatry Reichenau (zfp).
The former hospital in the Tiengen district from 1893 was a senior citizens' residence until 2012 and was acquired in 2013. It is intended as an accommodation and training location for the increasing demand in the care professions .
Contemporary history
In the course of rationalization efforts, the district of Waldshut transferred "in 2004 the deficit Bad Säckingen district hospital together with the Stühlingen district hospital debt-free to the Hegau-Bodensee-Hochrhein (HBH) hospital association", which was then renamed the Hegau-Bodensee-Hochrhein-Kliniken GmbH (HBK) . Since January 1st, 2005 the official name of the Waldshut hospital has been: "Spital Waldshut GmbH". The hospital fund also continued to exist.
The outsourcing of the problematic facilities in Bad Säckingen and Stühlingen to the neighboring clinic network by the district of Waldshut was a measure that also appeared to be an admission of excessive demands by self-administration and which now suggested an improvement through neutral administrative responsibility. But after a few years it became apparent that there were also structural problems behind it. Because the new owner, the Hegau-Bodensee-Hochrhein-Kliniken , reported a threat of bankruptcy in 2010. The danger to the location in the Waldshut district could only be averted by transferring the Bad Säckingen clinic back. The Loreto Hospital in Stühlingen remained in the new association.
Bringing back Spital Bad Säckingen In
2010, "the district of Waldshut intended to remove the Spital Bad Säckingen from the sponsorship of the insolvent HBH and to merge it with Spital Waldshut to form Spitäler Hochrhein GmbH."
Foundation of the Spitäler Hochrhein GmbH
"The GmbH is 60 percent owned by the Waldshut-Tiengen Spitalfonds, 40 percent by the Waldshut district, the start-up capital is ten million euros, and another eight million are available for renovation and modernization measures."
The Badische Zeitung comments:
“In twelve days a new future will begin for the Säckingen district hospital. Then it trades with the Spital Waldshut in the newly founded Spitäler Hochrhein GmbH. District Administrator Tilman Bollacher , Waldshut-Tiengens Lord Mayor Martin Albers and representatives of both clinics identified a mood of optimism everywhere during a press conference, which particularly affected the Bad Säckingen district hospital. "
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Optimism
"Nearly eleven months after the departure of Bad Säckinger hospital from the then threatened insolvency hospital network Hegau-Bodensee-Hochrhein (HBH) look forward to those responsible in Spital am Meisenhartweg an optimistic future. 'It is the most favorable result imaginable for the people in the western district of Waldshut', Thater commented looking back on the legally completed merger with the Waldshut Hospital to form Spitäler Hochrhein GmbH in June of this year. [...] Hospital site manager Hubert Aberle: 'Since 1980 no noteworthy renovation measures have taken place'. It is now a matter of taking a complete inventory in order to organize the various tasks after creating a 'master plan'. One of the greatest structural challenges is the improvement of fire protection, which the authorities and the city administration have already called for. At 8.15 million euros, Aberle put the costs incurred for the improvement and renovation measures borne by the Waldshut district. "
However, it does not succeed in leading the Bad Säckingen hospital out of the deficit area (2014: 2.4 million). Based on an expert opinion, there are "considerations in the district to merge the Waldshut and Bad Säckingen hospitals and build a central clinic for 125 million euros."
However, there are doubts as to whether the continuation of both houses as a result of the deficit development and the need for renovation at both locations is a realistic concept. The financial constraints and, above all, the balance of power in the Spitäler Hochrhein GmbH seem to favor the preservation of the Waldshut hospital before that of the Bad Säckinger hospital.
Conflict between locations
“In Bad Säckingen, citizens, local politicians and employees are demanding that their own hospital be kept.” In June 2015, the initiative Rettet Unser Bad Säckingen Hospital was founded.
In July, the district presented a second report, which also recommends combining the two locations Bad Säckingen and Waldshut in a central clinic by 2025 at the latest. As early as 2016, restructuring into 'One hospital at two locations' should take place.
"General and trauma surgery, gynecology and obstetrics, the ENT department, urology and gastroenterology should remain in Waldshut, while vascular medicine, cardiology, geriatrics and operations that can only be planned in Bad Säckingen will remain."
The “2 in 1” concept proves to be problematic in many respects - however, acute care and, above all, quick accessibility play the decisive role for the Bad Säckingen population.
In October 2015 hospital employees and resident doctors in Bad Säckingen form the "Pro Spital" initiative. The district council is trying a strategy with (temporary) concessions: In November 2015, a new concept for the Hochrhein hospitals is resolved: “The trauma surgery in Bad Säckingen is to be closed, but, unlike in the July report, the internal department and intensive care medicine are to be retained . "
“In July 2016, it will be announced that the Hochrhein hospitals in Bad Säckingen will close the laboratory and sterilization. In August, 1200 people demonstrated in Bad Säckingen against the closure of the hospital. ”The district council remains tough and is gradually getting down to business:“ At the beginning of September, the Hochrhein hospitals are closing the Bad Säckingen operating theater due to renovation measures. All operations are carried out in Waldshut, where the surgical staff will also be transferred for the duration of the measure. "
This closure with the argument of a renovation and the relocation to Waldshut 'for the duration of the (renovation) measure' appeared in Bad Säckingen as the beginning of the end of a "2 in 1" strategy in the sense of preservation, which was retained until the completion of a central clinic of both houses by 2025. After this worsening of the situation, the management of Spitäler Hochrhein GmbH came under fundamental criticism and most of those responsible on both sides agreed to appoint an external managing director who should have the necessary crisis experience. The new managing director will be named in August 2017. This means that the prehistory has been thoroughly reviewed for the public.
Loss history of the Bad Säckingen district hospital
The new managing director of Spitäler Hochrhein GmbH , Hans-Peter Schlaudt, saw the core problem in the permanent high subsidy operation of the hospital in Bad Säckingen, which had obviously prevented an additional willingness to invest:
“Financial worries have been a burden for the Bad Säckingen district hospital from the start. The owners put off the need for renovation for decades. "
The district council of the district of Waldshut, which was newly formed in 1973 with the districts of Waldshut and Säckingen, had decided on the new building under District Administrator Norbert Nothhelfer . The old building was from the 19th century. The new building was opened in 1980 - it "forced the Waldshut district council to receive annual subsidies from the district treasury right from the start."
“'A problem we have to live with', the then District Administrator Bernhard Wütz saw in the regular red numbers of the district hospital in Bad Säckingen 23 years ago [1994] when the district council dealt with the annual finances. [... 1994] demanded the Greens in the district council for "unacceptable deficits" for an external auditor. In 2000, SPD parliamentary group spokesman Rolf Rüttnauer called for the district hospitals to cooperate with the municipal hospital in Waldshut. “However, the city was unwilling to do this.
Finding a solution without a private carrier option
The lack of investment in renovations in Bad Säckingen resulted in personnel problems and a shortage of doctors, but there was little sympathy for privatization. "In 2003, the Green District Councilor Ruth Cremer-Ricken called for the hospital to be preserved" by all means. "
- In 2003 - the minus hit just 2.8 million euros - negotiations with the public Hegau-Bodensee-Klinikum became concrete.
- Closing the hospital in Bad Säckingen or the “Central Clinic Concept” was not an option at the time.
- The way out seemed to be given by a change of responsibility to a new agency:
Failure with the neighboring group
“The handover of the two houses in Bad Säckingen and Stühlingen in January 2004 was not in vain. For three years, the Waldshut district had to share in the deficits and transfer 5.8 million euros for fire protection measures. In 2009, District Administrator Tilman Bollacher had to promise a further 3.7 million euros; for "securing the future", but also as a signal to the creditor banks, because meanwhile the HBH company was on the verge of bankruptcy. […] For the Bad Säckinger Klinik, the beginning of the divorce from the Singener Verbund. In 2011 the hospital went back to the Waldshut district, the clinic group had not brought the expected savings. Of ten million euros that were transferred to Singen in seven years, two million come back - but also a high need for renovation. "
The Waldshut Spitalstiftung had offered the district “the merger in a joint GmbH” prior to the retrieval, although this involved major financial requirements: the district must bring in 10.4 million euros by 2015. But the optimism of the then district administrator to be in the black after three years was not confirmed. In 2013 the obstetrics department in Bad Säckingen came to an end. Between 2012 and 2015, there were deficits of almost five million euros. Only 60 out of 100 beds were occupied in 2012, the national average was 79. "
In 2016, the first 'relocations' in Bad Säckingen were carried out by the Hochrhein hospitals - laboratory, sterilization and, in September, the surgical area to Waldshut “due to renovation measures”. It is said to be relocated with staff “for the duration of the measure”, but the assumption arises that this can hardly be reversed.
Dissolution of the Spitäler Hochrhein GmbH
At the end of 2017 accounted for Südkurier in the chronicle of a decline : the "development of the hospital in recent months shows how managers have driven the establishment systematically against the wall. […] In the end there is still hope for the health campus. […] No other topic has moved and mobilized the population in the region as much in the past year as the decline of the Bad Säckingen hospital. Hundreds of letters to the editor as well as overcrowded discussion groups and district council meetings give eloquent testimony to this. The fight to keep the hospital was ultimately in vain ”.
2017 kicked off - according to the newspaper - in January was a letter from Minister of Social Affairs Manfred Lucha (Greens) to District Administrator Martin Kistler. “Lucha demands that the holding on to two hospital locations be given up in favor of a central hospital.” However, the Bad Säckingen hospital should be renovated and remain in place until the central clinic opens. "Displeasure also triggers the demand made by the chairman of the CDU district parliamentary group, Martin Albers. He wants to specify the district council resolutions made 14 months earlier so that Bad Säckingen should no longer be a house of basic and standard care. [...] At the same time, the Pro Spital development association is launching an information campaign in the communities in the western district. "
The fact is that due to the location of the two hospitals, the medical care of the population in the eastern part (the former old district of Waldshut) seems to be improved and in the western part (the former district of Säckingen) it would be disadvantaged - through longer journeys for patients, especially in emergencies , also of the staff and also consequences for the infrastructure.
In February there is a reflex on these factors:
"The shareholders of Spitäler Hochrhein GmbH [...] publicly admit bottlenecks and deficits in medical care in the district for the first time. [... You] present a large-scale renovation program for the Bad Säckingen site. [...] The large variant, which is ultimately decided by the district council and the city of Waldshut-Tiengen, provides for renovations and fire protection measures for 12.7 million euros. In addition to the restoration of the operating theater, the house is to be increased from 80 to 120 inpatient beds. This is to secure the hospital operations in Bad Säckingen for at least 15 years. This is the time it takes to build a central hospital. It is also decided to start planning accordingly. "
“After the initial mood of optimism, nothing happens for months. [...] Because of the gradual reduction in medical services [...] doctors and nursing staff are leaving the hospitals in ever greater numbers. "
In April only “an ambitious schedule for the central hospital is presented. The house, for which there [...] does not even have a location, should be ready by the end of 2029. It will have 400 beds and cost 208 million euros. "
At the end of May 2017 “the Bad Säckinger operating rooms will be cleared and all equipment will be transported to Waldshut. Doubts about the sincerity of the hospital management and the shareholders are fueled. [...] The idea of transferring the Bad Säckingen Hospital to a civil society is receiving more and more popular support. "
With a “memorable appearance” in July, Minister of Social Affairs Lucha declared “a permanent two-location solution a clear rejection. He also doesn't want to know anything about a bourgeois hospital. Such a facility will not receive an operating license from the state. ”The only solution is the central hospital. He notes, however, that Spitäler Hochrhein GmbH has "not requested any subsidies for maintenance measures for years [...]." The ministry also has no further plans or applications for the renovation in Bad Säckingen, which was decided in February. "
Change of management
For 2016, the shareholders expect a loss of 16 million euros. The hospital's managing director Simone Jeitner and her deputy Peter Lepkojis will resign in July. In July, Jeitner is replaced by Hans-Peter Schlaudt. He "is considered a redeveloper [..] wants to calmly analyze the overall situation of both houses and announces a concept for further action for October."
In October, the new managing director Hans-Peter Schlaudt ...
“Three options for the future of hospital care. The most promising is the renovation of both houses with the simultaneous start of the central hospital planning. However, by the decisive district assembly on October 25, the situation had developed so badly that, in the opinion of the managing director, only the immediate closure of the Bad Säckingen hospital remained. The Waldshut-Tiengen municipal council approves this proposal. The district council postponed a decision because the committee felt taken by surprise. "
District assembly on November 8, 2017
In the run-up to the district council meeting, Waldshut district administrator Martin Kistler recommended that “the district councilors close the hospital in Bad Säckingen on Wednesday, November 8, 2017. In addition, the planning of a central hospital for the district should begin with the service and space planning as well as the entry into the location search. Whether a "health campus" can be built in Bad Säckingen is to be examined. [...] District Administrator Martin Kistler fully embraces the argumentation of Hans-Peter Schlaudt, the managing director of Spitäler Hochrhein GmbH, and recommends closing the hospital in Bad Säckingen on December 31st. Until the completion of a central hospital for the district, expected in 2025, the hospital in Waldshut should be upgraded. According to the proposal, the costs until then will be between 91 and 117 million euros. [...] Literally, it goes on to say: 'Due to the personnel situation and the neglect of the location for many years, it is no longer possible at the Bad Säckingen location to continue to offer high-quality care for patients in the future.' In order to secure the company's existence and to prevent a further dramatic deterioration in the situation, the Waldshut site must be protected. [...] According to the template, the managing director Schlaudt coordinated his proposals with the Ministry of Social Affairs. The state pledges its financial support for only one location. "
Closure of the Bad Säckingen Hospital
“Amid great protest by the population, the district council decided on November 8th (800 citizens at the district council meeting) to close the Bad Säckinger Hospital at the end of the year. The personnel development does not allow continued operation, argues managing director Schlaudt. Against this background, the decision to turn the hospital into a health campus where, among other things, surgery is carried out and where there are inpatient beds is being made, goes under. The funds originally earmarked for the hospital renovation in the amount of 12.7 million euros will also flow into the new facility. "
The district council and the Bad Säckingen municipal council “decide to start the conception of a health campus under the leadership of the city and district. The hospitals are also represented in an accompanying steering group. [...] A social plan ensures that the clinic employees employed in Bad Säckingen will continue to work until September 2020. There should be no redundancies for operational reasons. "
“In front of around 800 angry listeners, the district council [on November 8, 2017] sealed the fate of the clinic by a large majority, which could not be averted anyway. Now a health campus and a center for geriatric medicine are to ensure that at least certain medical areas are still covered in Bad Säckingen and that the spa remains a health location. "
Health campus project for Bad Säckingen
In order to dampen resentment in the citizenship, new facilities had to be specified quickly: In addition to expansions in the Waldshut hospital, Bad Säckingen's mayor Alexander Guhl felt “forced to 'develop something that has future prospects' at short notice. And from his point of view that is the cross-sectoral health campus and the center for geriatric medicine. "
“The district wants to provide 12.7 million euros, which were actually earmarked for the renovation of the hospital. The city of Bad Säckingen, the district and the Spitäler Hochrhein GmbH are to be joint sponsors, and in addition to outpatient care, there will also be special geriatric and rehabilitation offers there, including inpatients. On the other hand, appropriate staff must also be found for a health campus, which the hospital was supposedly so difficult to find. "
For further medical care in Bad Säckingen see: Bad Säckingen Health Campus
Review of Spitäler Hochrhein GmbH (2015)
The Bad Säckingen hospital was closed on December 29, 2017. An overview of the financial situation only succeeded gradually - in March 2018 to 2015:
“The hospital manager Hans-Peter Schlaudt presented the annual financial statements of Spitäler Hochrhein GmbH for 2015 to the district council with a delay. For the management of the hospital company at the time, which runs the hospital in Waldshut and until recently managed the Bad Säckingen district hospital, there was no discharge from the district parliament, but there was also no statement from District Administrator Martin Kistler. "
"The annual financial statements for 2015, confirmed by the auditors of KPMG, show an annual deficit of EUR 5.8 million with total assets of EUR 23.7 million."
In the previous year, 2014, the shortfall was minus 2.3 million euros. The reasons for 2015 were the declining operating results (see below: Income ) of the two hospitals and a "write-down of almost two million euros on loan receivables and the book value of the medical center Medicum GmbH in Waldshut-Tiengen, a wholly owned subsidiary of the hospital company."
“The balance sheet of the Hochrhein hospitals at the end of 2015 shows debts of 11.7 million euros, 2.4 million more than a year earlier. The lion's share was towards the shareholders - Spitalfonds Waldshut-Tiengen and Landkreis Waldshut - who had repeatedly poured in money, eight million euros. "
Income and expenses (personnel)
“The regular hospital benefits brought in 44.43 million euros (previous year 46.37 million), in Waldshut 28.1 million, in the trumpeter town 16.4 million euros. In addition, there were 2.3 million from optional benefits and 2.7 million from outpatient benefits. [...] Waldshut also slipped - after a small plus in the previous year - with 1.9 million euros in the red. The smaller house in Bad Säckingen also reported a minus of 1.9 million, less than in 2014. Makes 3.86 million deficit from hospital operations. "
- “In both hospitals, an average of 713 employees and 104 trainees cared for around 17,000 inpatients, in 251 (Waldshut) and 182 (Bad Säckingen) beds. [...] Personnel expenses fell by one million to 38.75 million euros. "
Exit of the city of Waldshut-Tiengen as a partner
“Waldshut-Tiengen wants to leave Spitäler Hochrhein GmbH. If the district council follows the vote of the municipal council, the district will be solely responsible for the Waldshut hospital from July 1, 2018. The building remains the property of the city. "
Development after the closure in Bad Säckingen
After a short transition phase after the admission freeze and as few patient transfers as possible, “the medical practices in the hospital were assured that they could stay in the building until the end of 2018. The emergency doctor's room and the helipad should also be retained for the time being. In these points, the offer was initially guaranteed until March 31st. "
The Waldshut-Tiengen municipal council and the district council agreed that the city should withdraw from the Spitäler Hochrhein GmbH on July 1, 2018. Hans-Peter Schlaudt: “The district, which is also responsible for the inpatient care of the population in the district, has now also the sole design option. "
“We observe that the western district avoids us. In view of the closure of the Bad Säckingen Hospital, I understand the disappointment of the people in the western district ”.
Balance sheet 2018
In 2018 the deficit was 2.36 million euros in 2028. "Significantly less than in previous years [...], but in the cash flow statement the cash flow, the result from operating activities, is estimated at minus 8.2 million euros."
The district and, despite leaving the GmbH, the city of Waldshut-Tiengen are still responsible in 2018: “The district town is foregoing reclaims of around four million euros. In 2018, the shareholders of the Kreis and Kreisstadt contributed nine million euros to the capital reserve. "
“The revenue from general hospital services fell by 8.5 percent to 32.7 million euros. On the other hand, after the closure of Bad Säckingen, dearly paid third-party staff, such as fee-paying doctors, had to pay 60 percent less money than in the previous year, 2.8 million euros. "
Since November 9, 2018, the official name of the hospital in Waldshut has been: Klinikum Hochrhein GmbH .
2019/20: location and outlook
The planned northern extension to the hospital in Waldshut was delayed in 2019 "due to a busy construction industry" and further in 2020 due to the corona pandemic.
Financial position
“In the business plan for this year [2019], a worsening of the result was once again set. Reason: Furthermore, contaminated sites in the public image, a “persistent difficult personnel situation”, vacant chief physician positions and increased personnel costs for external staff must be expected. The auditors of KPMG [...] attest a 'bad operating result', but proper management. By 2018, there was a lack of business "control instruments" in order to be able to react to developments in the hospital in good time. "
In the medium term, the management of Klinikum Hochrhein GmbH expects the Waldshut hospital to "have a deficit of up to one million euros per year."
Before that, the house in Waldshut will be expanded and modernized for 24.8 million euros in 2019/20, of which the departed partner city of Waldshut-Tiengen will have to raise up to 14 million.
Problems
Until the opening of the central clinic in Albbruck, the Waldshut hospital has to cope with the basic and standard care in the district on its own, but the trend that patients from the western district prefer external clinics has continued. 284 fewer beds than in the previous year were occupied.
There would also be problems with recruiting. "According to the managing director, the causes are structural: small departments, a lack of concentration of medical tasks, but also 'limited training rights of individual chief physicians' make it difficult to attract qualified people."
New approaches and successes
"With medical focuses that go beyond basic care, managing director Hans-Peter Schlaudt would like to make the Hochrhein Clinic more profitable."
- “The newly created position as chief physician emergency room has proven itself. In the course of this, the rooms in the emergency room were also rebuilt. At the same time, the outpatient examination center was opened. "
- “One of the most renowned cardiologists in Germany” has been won as “Director of the newly created Center for Internal Medicine”. 2020: Opening of the cardiac catheter laboratory.
- The newly created "Center for Orthopedics, Spine and Trauma Surgery" opens with a new director.
- As an academic teaching hospital of the University of Freiburg, the Hochrhein Clinic has been teaching an average of 80 trainees annually since 2014. Since April 2020 two young women from the district will be “completing a midwife training. [...] The apprenticeship lasts three years, with the practical part taking place in the clinic in Waldshut. […] “The training will also be offered for two people in the coming year. We plan to be able to offer these over the long term, ”the hospital announced.
Status in the corona crisis
Visiting restrictions lifted
“Contrary to the state ordinance”, “the ban on visits ('to protect patients and staff') has been extended for a few days in the clinic. […] 'The situation is now stable and we are moving in reasonable steps towards normality', said [Managing Director] Schlaudt. ”In a press release he (described) the visitor regulations imposed by the state government“ […] as a further stress test. Because with full occupancy, the staff not only have to care for 300 inpatients and around 200 outpatients, but also to document, observe and equip around 300 other people. "From now on - May 28th -" can be in consultation with the doctors again a limited number of visitors will be admitted to the hospital in Waldshut in accordance with state regulations. "
Balance of the phase March to May 2020
During the meeting of the district council on May 13th, 2020 in Unterlauchringen, "After a long time without a fatality, the hospital manager Hans-Peter Schlaudt also reported the transfer of the last Covid-19 patient from intensive care to the normal ward". The Hochrhein Clinic “set up the isolation areas at the beginning of March and canceled all planned operations from March 18. 70 isolated beds and 30 ventilation places were available for Covid 19 patients. In fact, there was a maximum of 20 inpatient cases for a short time around Easter. [...] Since May 4th, normal operations in four rooms have been in operation again in the operating theater. "
"55 Covid-19 infected patients (were) treated. [...] 'Unfortunately, despite ventilation, 16 patients with an average age of 84 years could not be saved, whereby the Covid-19 infection was not the actual cause of death in every case.' "Schlaudt warned," that patients who suffer from symptoms Always suffer from nature, regain confidence in the hospitals and go to them. '"
Open letter to Minister of Health Spahn
In a letter dated July 30, 2019, Hans-Peter Schlaudt pointed out what he considered to be a serious 'design flaw' in the legislation on staff requirements in hospitals:
“In spite of all the appreciation for their basic idea of strengthening the caregivers, there were unfortunately fundamental errors or room for interpretation. The introduction of the minimum staffing levels is now understood by the cost units in connection with the reimbursement of care costs as an upper staff limit. […] This means that the cost bearers declare that they only bear the costs for the minimum staff. Every additional position should be financed 'by whoever'. "
Since the determination of the “minimum staffing levels” is carried out on the basis of statistical criteria, “this derivation” - as an example, according to Schlaudt - “fails to recognize the poor structural conditions in many clinics.”
“The principle of 'lower limit equals upper limit' offers no leeway and does not do justice to the house-specific characteristics. And that with a nationwide shortage of nurses. "
The consequence would be a compulsion to reduce inpatient care, since understaffing could be compensated for here in particular. There is a risk that “in the end the patients will be left to fate at home. [...] The value and importance of the health system are primarily judged according to the one-dimensional economic figures and a simplified centralized perspective. [...] Without functioning clinics in the center of regional health care, the people in the country will lose and the regions will bleed to death. "
Schlaudt closed the letter by offering to be available for discussion; also on topics such as the "implementation of generalist training, ensuring outpatient care and the excessive bureaucracy."
Remarks
- ↑ The sources for this and the following chapters up to contemporary history should be drawn from the works listed under literature .
- ↑ “Just two years after the new start in the spa town, the two district hospitals (Stühlingen and primarily Bad Säckingen) were due for loss compensation of 1.8 million D-Marks. The shortfalls persisted. In 1987 the district cut the nursing school by a third as an austerity measure. In 1988 CDU spokesman Gernot Strohm complained in the district council of 'a high deficit'. ”(Heinz J. Huber: Bad Säckingen Hospital , Südkurier, October 10, 2017).
- ↑ The uncertainty in the context of the conflict horizon also spreads to other houses - even Waldshut. The hospital kiosk in Bad Säckingen also wants to close on June 30th. "The lack of willingness to talk to the hospital manager Simone Jeitner is criticized."
- ↑ With the transfer of the hospitals in Bad Säckingen and Stühlingen to Hegau-Bodensee-Hochrhein-Kliniken GmbH in 2004 , Uwe Lorenz was managing director until his resignation in December 2014 (even after the Bad Säckingen hospital was 'brought back' in 2011). “He was temporarily replaced by his deputy Peter Lepkojis. In November 2016, Simone Jeitner followed, from whom the company separated in July 2017 after the restructuring engineer Hans-Peter Schlaudt had been brought into the management. ”(The overview of the changes in: Heinz J. Huber: Annual financial statements of Spitäler Hochrhein GmbH for 2015 - No discharge for the then management , Südkurier, March 9, 2018.)
- ↑ No information is currently available on the 2016 and 2017 balance sheets.
- ↑ The construction of the Waldshut hospital is strongly 'nested', as the building complex was expanded several times by 'additions' without overall planning due to the constantly increasing space requirement in the post-war period. This leads to long distances between different specialist departments (also when moving patients to treatments), also to the fragmentation of departments and, in fact, to an increased need for staff.
Web links
literature
- A. Birkenmayr, A. Baumhauer: History of the city of Waldshut. reworked by J. Ruch. Waldshut 1966.
- Hospital of the Holy Spirit, founded in 1411. Waldshut Hospital. Festschrift for the inauguration of the new building on December 15, 1928. Waldshut 1928, DNB 362377189 .
- J. Isele: The Heilig Geist-Spital zu Waldshut 1411/1422. Waldshut. no year
- J. Ruch: The Waldshut Hospital in the past and present - 1411 to 1974. Typescript (unpublished) undated
- K. Sutter: Health care of the Upper Austrian town of Waldshut until the Peace of Pressburg (December 26, 1805). unpublished manuscript 1995.
- E. Wasmer: On the history of the Waldshut hospital. From the old Heilig-Geist-Spital to the modern hospital. Waldshut 1958.
- H. Jenss, L. Rabanser: History of the hospital. From Heilig-Geist Spital 1411 to Waldshut Hospital 2007. Waldshut 2007.
Individual evidence
- ↑ Unknown: Hospital merger is imminent. Südkurier, November 11, 2010. Fusion of hospitals in the Waldshut district . Accessed May 14, 2020.
- ↑ Albbote-Nachrichten: Hans-Peter Schlaudt remains managing director , Albbote, July 23, 2020.
- ↑ Monika Ohlheide: Some of the infected show no symptoms , Albbote, August 19, 2020.
- ↑ Susanne Schleinzer-Bilal: A Short Path Can Save Lives , Albbote, August 24, 2020.
- ↑ Juliane Schlichter: Large construction site in front of the clinic , Albbote, August 27, 2020.
- ↑ Paul H. Boerlin: Leonhard Thurneysser as principal. Birkhäuser, 1976, ISBN 3-7643-0866-4 , p. 28.
- ^ CG Fecht: The Grand Ducal Baden Districts Waldhut, Säckingen, Lörrach Schopfheim. CR Gutsch, Waldshut 1859, p. 159.
- ↑ Previous quotations in the chapter: Cardiology Hochrhein: Chronicle of the discussion about the Bad Säckinger Spital . (pdf) . Accessed on May 14, 2020. The chronicle is based on the newspapers Südkurier / Albbote, Badische Zeitung and press releases. It has been checked - the online versions of the newspapers can be accessed, but can only be viewed in full with registration.
- ↑ Hrvoje Miloslavic: Things are moving forward again in the hospital . Badische Zeitung, October 28, 2011 . Accessed May 14, 2020.
- ↑ Cardiology Hochrhein: Chronicle of the discussion about the Bad Säckinger Spital .
- ↑ Quotations from: Cardiology Hochrhein : Chronicle of the discussion about the Bad Säckinger Spital .
- ↑ Cardiology Hochrhein: Chronicle of the discussion about the Bad Säckinger Spital .
- ↑ Quotes in the chapter: Markus Baier: Bad Säckinger Spital closes for good. Südkurier, December 28, 2017. Chronicle of a decline . Accessed June 7, 2020.
- ↑ Axel Kremp: The Bad Säckingen Hospital should close at the end of the year . Badische Zeitung, November 3, 2017 . Accessed May 14, 2020.
- ↑ M. Baier, Südkurier, December 28, 2017.
- ↑ Daniela Frahm: Bad Säckingen closes its hospital , Netzwerk Südbaden, January 3, 2018. Access on June 9, 2020.
- ↑ Information and quotations: Heinz J. Huber: Annual financial statements of Spitäler Hochrhein GmbH for 2015 - No relief for the management at the time. Südkurier, March 9, 2018. Accessed June 9, 2020.
- ↑ Felix Held: After the closure was announced: How do you close a hospital? , bz - newspaper for the Basel region. BZ Basel, December 8, 2017. Accessed June 10, 2020.
- ↑ Kai Oldenburg: Clinic managing director wants to regain trust after Waldshut-Tiengen has left Spitäler Hochrhein GmbH . Südkurier, May 17, 2018 . Accessed June 10, 2020.
- ↑ Quotes in the section: Heinz J. Huber: The management of the Hochrhein Clinic expects a deficit of up to one million euros per year in the future . Südkurier, July 22, 2019 . Accessed June 10, 2020.
- ↑ Quotes in the section: Kai Oldenburg: New offers and specialists should make the Hochrhein Clinic fit for the future . Südkurier, August 8, 2019 . Accessed July 4, 2020.
- ↑ Susann Duygu-D'Souza: Clinic trains midwives , Albbote, June 23, 2020.
- ↑ Juliane Schlichter: Hochrhein Clinic reopened to visitors. Albbote, May 28, 2020.
- ↑ Heinz J. Huber: On the way to normality. Albbote, May 16, 2020.
- ↑ Melanie Völk: Consultation hours and planned operations again. Albbote, May 9, 2020.
- ↑ Print of the open letter (pdf) at: myDRG news archive . Accessed June 14, 2020.