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History: 1970s - Growth of Community Service

Introduction | 1930s | 1940s | 1950s | 1960s | 1970s | 1980s




Unprecedented events occurred during the Seventies - anti-war rallies, spurred by the lingering Vietnam conflict, raged on college campuses; Watergate shocked the nation; the first peacetime gas shortage created lines that were blocks long; and changes in social mores stirred increasing controversy.

In healthcare, with the advent of Medicare, the Heart-Cancer-Stroke legislation and the advances of science, demands upon the health care system were accelerated. Health care became a right of all people and the hospital became the core of a new health care system.

Response to increasing demands for service meant that Windham Hospital would once again need to expand the existing facility and, once again, the community would rally in support of its local community hospital.

Philanthropy has played a vital role in the history of Windham Hospital. Without the generous support of individuals, businesses and organizations, construction of the original building, successive additions, renovations, and acquisition of modern diagnostic equipment would not have been possible.

A capital fundraising campaign took place in 1970 to help finance a major expansion of emergency and out-patient services, as well as adding two floors for medical and surgical patients to the South Wing. The last part of this proposal was eliminated in the final development plans. Utilization review, discharge planning and the gradual shift to ambulatory care had reduced the need for additional in-patient beds.


The Southeast/Southwest Addition was started in 1971 and completed in 1973. It added 55,500 square feet of hospital space. The total cost of the project was $5.5 million. Community residents, businesses and organizations donated over $1,120,000. The remainder of the cost was financed through a Hill-Burton grant of $800,000 and CHEFA tax-exempt bonds.


In 1970, the medical staff recommended the appointment of a Medical Director of the Emergency Room. The volume of emergency room activity had increased to a point that it could no longer be reasonably handled by the private attending staff.

Edward R. Browne, M.D. came to Windham Hospital in August, 1971 as the hospital's first full-time Emergency Room Director. He had spent several years in the Stafford area and attended many cases at Windham. Through prior contact, he was impressed with the caliber of the medical staff, the atmosphere of the hospital and the excellence of care and service. He welcomed the opportunity to create a modern Emergency Department at Windham Hospital.

Upon arrival, Dr. Browne immediately became involved with planning the new Emergency Room. He suggested revisions improving patient flow and staff efficiency. As medical director, Dr. Browne was responsible for the physical area, as well as clinical staffing, policies, procedures, departmental structure and organization. His secretary, Pat Naumec, joined him in 1972 just before the new service opened. Ms. Naumec began her Windham career in 1955 at the switchboard. Before transferring to the Emergency Room, she had also been the secretary in Radiology.

The new emergency room was ready to open on April 26, 1973. This date was the fortieth anniversary, to the day, of the opening of the original Windham Hospital. Transition from the old emergency room to the new began at 3:00 a.m., a time when activity was expected to be at its lowest point. The Maintenance crew came in to assist with the move. Both emergency rooms were staffed and running until the transition was completed at 7 a.m. The new Emergency Room recorded its first patient at 7:25 a.m.

The new facility contained eight treatment rooms, including rooms for major trauma, coronary care and orthopaedics. Twelve to fifteen beds or stretchers could be accommodated. Support space for a large nursing station, waiting areas and utility rooms was incorporated into the physical layout. The Emergency Room was renamed Emergency Services and gained departmental status in 1974.

Dr. Browne remained with Windham until his retirement in 1986. Throughout his tenure he was active in the field of emergency medicine on regional and state levels. He helped develop the survey criteria and categorization of emergency rooms.

Advances were being made throughout the hospital. The comments of Dr. Rosenberg, Chief of Staff, in his annual report describes clearly the progress made at Windham by 1973:

Continuing to adapt to the advance of medical knowledge and technology and to the changing need and expectation of patients, the hospital completed its construction of the new departments of emergency service, radiology, laboratory, pediatrics and electroencephalography and established a new out patient receiving area.

As part of its increasing outward orientation, the hospital added a Venereal Disease Clinic to the several clinics now functioning in hospital quarters (Mental Health, Pediatric, Crippled Children, Speech, Neurosurgical, Planned Parenthood, Women's Cancer Detection and Visual Screening.)

The new areas and renovated sections accommodated expanded service commitments and provided challenges to the medical staff in its organization and supervision of services. Innovative responses were seen in Emergency Services Department, where entry into the care delivery system takes place for an increasing percentage of patients each year; and where referral for follow-up and close working relationships with private offices can be critical to the success of diagnosis and treatment. Radiology has begun to take preoperative chest films at the time of admission, and has added isotopic scanning procedures to its armamentarium with dramatic improvement in diagnostic ability.

General surgeons are developing amazing skills in direct visual examination of the stomach and large intestine, made possible by the fiberoptic scopes. Electroencephalography has become a growing service. The pediatricians, now three in number, have designed and realized the much improved setting for the care of sick children. Laboratory has spent much of its effort in settling in and redesigning its work areas but also developed radioimmune isotope procedures for digoxin and thyroxin measurements and has considerably expanded its outpatient facility and expedited the testing of elective surgical patients upon admission.

The medical department has been leading the staff program of continuing education with new rules for physician participation and with excellent didactic programs for doctors and nurses, including the training of nurse practitioners. The ear, nose and throat department pioneered the use of qualified physician assistants and has assisted in developing procedures for reviewing the privileges of physician assistants and nurse practitioners in activities previously limited to the physicians themselves. The delegation of professional task is a challenging new approach to improving the quality and quantity of patient care. The psychiatric department has grown to four active members and has begun the definition of regulation for the care of patients with psychiatric disorders as well as nurse training programs in psychiatry. At the year's end, expected additions to the staff include a dermatologist and possibly an ophthalmologist in the year ahead.

Other areas in evidence by 1973 included a coronary care unit, cardiac monitors, a respiratory care department, modified obstetrical rooming-in, emergency room cardiac monitoring, EMT course, and epidemiology.

Under the direction of the Department of Medicine, the Coronary Care Unit was opened in February, 1970. Its purpose was to provide initial emergency care for heart attack patients. Monitoring equipment gave the medical staff and specially trained nurses instant electronic readings of a patient's heart rhythm. If the patient's condition changed it would be detected immediately by the monitor and the medical team would go into action. The patient now received help within seconds, improving survival rates by 30%.

Windham's third pediatrician, John Lee, M.D., arrived in 1971. In 1972, a pediatric clinic was started and a parent-child resource center opened in 1975. A major renovation of Pediatrics, with the addition of a large playroom, was completed in January, 1974. This had been made possible largely through a $100,000 contribution of the Auxiliary. In 1977, after the death of Dr. Anderson, this clinical area was named the James T. Anderson Pediatric Unit.

Utilization management, advancing technology and changes in medical practice all had a profound effect on hospital admissions, but was especially noticeable in Pediatrics. By 1970, there had been a 36.6% drop in admissions on that service with a 80% decrease in emergency pediatric cases. Concurrent with utilization management, family education, which led to earlier diagnosis and improved treatment, lessened the need for children to be admitted to the hospital. These factors began a trend that would eventually test the viability of an inpatient pediatric unit.

In the early part of the 1970's there was a shortage of physicians at Windham. This problem was compounded by the fact that other members of the professional staff were nearing retirement age. Under the guidance of medical leaders such as Drs. Hale, Lawrence and O'Brien, appointed Coordinator of Professional Services in 1974, an organized medical recruitment program brought twenty-three doctors to the area in less than three years. Known as a man of the highest professional standards, Dr. O'Brien sought to attract the best physicians to the community. This tradition of excellence remains today as Windham Hospital can boast a medical staff that is over 90% Board certified.

One of the first areas that required Dr. O'Brien's attention was Pediatrics. Drs. Anderson and Nepomuceno were seeing 70-80 patients each day. Charles Okstein, M.D. arrived in 1975, bringing additional service to the community.

Not only was Dr. O'Brien successful in the recruitment of primary care physicians, his service to the hospital and the medical staff was unequaled. As a specialist in cardiology, he opened the Cardiac Treatment Center and was instrumental in liaisons between Windham and the University of Connecticut Health Center. In 1978, a system of "Professors' Rounds" - usually found only in medical centers - brought faculty members from the University of Connecticut Health Center to Windham on monthly visits. Visiting faculty discussed special medical topics with the staff physicians and advised on patient treatment.

By 1973, cardiac monitoring was used in the operating room and towards the end of the 1970's telemetry was installed on the fifth floor. Cardiac stress testing and a Cardiac Treatment Center, made possible by a substantial gift from Father Murphy of St. Joseph's parish, were the newest ventures in cardiac service.

Windham Hospital was selected as a pilot institution for the new Federal Professional Standards Review Organization (PSRO) in 1975. For the first time, external organizations reviewed and made judgments independent from those providing the care.

The growth of surgical specialties created more demands on the Department of Anesthesiology which provided medical supervision for the Recovery Room, the hospital-wide resuscitation program and, as the Respiratory Care Department developed, supervision for that new, important area. The Chief of Anesthesia remained medical director of Respiratory Care until the arrival of Robert Bundy, M.D., pulmonary specialist, in 1986.


With the completion of the Southeast/Southwest Addition, the Radiology Department moved to its present location, containing eight rooms, including five diagnostic rooms, two nuclear medicine rooms, and one special procedure room. Space was provided for clerical functions, a physician's reading room, and storage.

The 3M hi-light system was installed in the new deparnnent. With this system, film was handled in yellow light; eliminating the need for special darkrooms; time and cassettes were saved; and the x-ray technician did not have to leave the patient. Windham was one of the first Radiology departments to use this system. In the early years after its installation, many visitors came to see the new lighting system. One day, 13 people visited from Europe. This system eliminated the position of darkroom technician, whose time was converted to that of equipment and maintenance processing technician.

In September 1978, the gamma camera, a nuclear scanning device, was installed. The new equipment was used to locate and study the size, shape and function of internal body organs.

By the late 70's, Windham could no longer allocate in-patient revenues to support the Mental Health Clinic. The service was merged with those offered by Natchaug Hospital. However, after two years, the state would no longer fund the clinic at Natchaug because it was a private institution and thus United Social and Mental Health Services was created.

In 1970, the first cardiac pacemaker was placed at Windham Hospital by Dr. Bopp. He had been recruited by Drs. Major and Whalen to join the surgical staff in an effort to stay abreast of advancing technology developing in thoracic and vascular surgery.

As a result, an increasing number of complex pulmonary and vascular procedures began to fill the operating room time. These included esophageal resection, radical pulmonary resection, carotidendarterectomy, renal artery bypass, complex aneurysm repair and others. Together with the talented surgical residents from Yale, Drs. Major, Whalen and Bopp continued the reputation throughout Connecticut that Windham Hospital remained an excellent center for advanced surgery in a rural setting.

All will agree that Dr. Whalen was a skilled and compassionate surgeon, as well as medical staff leader during his tenure at Windham Hospital. He was an inspiration not only to the surgeons but to the entire medical staff. In 1983, the Yale residents presented the prestigious Edward H. Storer Award for Excellence in Surgical Teaching to William A. Whalen, M.D. and Raymond K. Bopp, M.D.; over one hundred and fifty residents passed through the program; many of them now full professors of surgery at universities throughout the United States.


Gerard Lawrence, M.D., after completing four years of residency at Yale New Haven Hospital and a fellowship at the University of Edinburgh, introduced total joint replacement to the community. It is a little known fact, but as late as 1972, due to Federal Drug Administration restrictions one was required to have a special license to perform total joint replacement. The process required the use of Methylmethacrylate, a bone cement, which at that time was still under investigation. Windham Hospital became the second institution in the state to perform total joint reconstruction. This was a major breakthrough in care for members of the community who suffered from arthritic conditions.

During the 70's, the hospital added Donald Glugover, M.D., Douglas Griswold, M.D., Ronald Leavitt, M.D. and Robert Moskowitz, M.D. to the Medical Staff. In 1975, Drs. Lawrence and Collins introduced arthroscopic techniques to the Windham community. Beginning initially with diagnostic endeavors, they quickly went on to more elaborate surgical operations. The initial procedures, done with hand held instrumentation, required the surgeon to look through a small telescope-like instrument. Several years later the technique improved with the use of microscopic, fiberoptic instrumentation that allowed the use of a television monitor.


Obstetrics saw many changes during this decade. A Lamaze childbirth program was implemented; and sibling visits were allowed. In 1976, with the help of Auxiliary funds, Windham purchased a fetal heart monitor to assist in the diagnosis and treatment of problems arising during labor and delivery. Fathers were allowed in the delivery room during cesarean sections; Windham was the third hospital after Boston and Queens to permit this practice. In July, 1977, a newly furnished room for natural childbirth opened and classes for prepared childbirth were offered to couples. In 1978, candlelit dinners were served to new parents, helping them celebrate the birth of their child. In 1979, genetic counseling began; a pre-natal clinic for high risk, low income mothers started and a neonatal special care unit, allowing infant monitoring, was made available.

Many of the changes occurring in Obstetrics were fostered by the enthusiastic nursing staff. Paula Cahalan, R.N. was a leader in this area and worked closely with the Obstetricians in establishing new services.


By the 1970's, Nursing had become more specialized. New technologies and services were introduced; nurses jobs became more complex, and emphasis was placed on in-service training and continuing education for the staff working in Critical Care, Emergency Service and on the medical and surgical units.

In 1975, an unfortunate breakdown in communication led to a nursing strike, the first in the state of Connecticut. This labor action continued for two years before all issues were settled. While there are varying opinions about what caused the strike, one that prevails is that Nursing was now emerging as an independent profession. As their role in patient care and management became more sophisticated, they were searching for autonomy and authority within the organized health care system.


A major change for pharmacy occurred when modern quarters were made available in the new Southeast/Southwest Addition. The pharmacy moved from a small, antiquated one room area to the large, four room pharmaceutical complex, where it resides today.

The pharmacy hired licensed pharmacists, providing better coverage, supervision and education. By 1972, Windham had registered pharmacists on site seven days a week and published a bi-monthly newsletter. It now provided clinical training to apprentice pharmacists. In 1979, Mr. Andre LaCombe became the Director of Pharmacy Services and supervised a 15 member department consisting of 6 pharmacists, 6 technicians, a clerk and secretary. When Mr. LaCombe left in the 1980's, Robert Theriault Jr. became Director.

The Food and Nutrition Department responded to the shift to ambulatory services by providing out-patient dietary instruction. A special focus was placed on individuals with chronic health problems - cardiac disease and diabetes.

The Respiratory Care department began in the 1960's. Originally service was offered to in-patients only and was provided by Louisa Pounch, R.N., a nurse anesthetist. In 1970, Gary Jones was hired as Respiratory Care Technical Supervisor, followed by John Flood in 1975. As the department grew, pulmonary function tests, the drawing of arterial blood gas samples, and spirocare treatments were added to the department's responsibilities. Respiratory Care Technicians now provided therapy to in-patients and out-patients. The new service grew rapidly and by 1977 department statistics showed 22,188 treatments given, 153 pulmonary function tests done and 4,952 spirocare procedures performed.

On January 17, 1978 the Emergency Service Department set a new record, 89 patients were treated within 12 hours. Most visits were related to the weather--a layer of ice covered streets and sidewalks throughout the area.

The severe winter of 1978 was highlighted by Blizzard Larry on February 6th. Personnel and supplies could not get through to the hospital. The hospital staff on duty as the blizzard struck worked double or triple shifts and slept in the Mason Nurses Home. Throughout the blizzard, patient care continued uninterrupted.

Community support eased transportation problems. The Willimantic Fire and Police Departments and other emergency voluntary forces in surrounding towns drove patients and staff to and from the hospital. The manager of the local Stop and Shop supplied bread and fruit when provisions ran low. Radio WILI broadcast an appeal for snow shovelers, resulting in response from 30 youngsters who cleaned the sidewalks and uncovered the vital fire hydrants.

At Administrator Ogrean's suggestion in 1972, the Auxiliary dropped the word "women" from their name. Men were now invited to join and Mr. Ogrean became the first male member. Mr. Ogrean also encouraged men to join the volunteer efforts of the Auxiliary. Called the "Blue Coat Brigade", Mr. Ogrean and sixteen other male volunteers helped in the Emergency Room and provided patient transportation services in x-ray and on the patient floors. This brigade of men in blue coats was seen hard at work each Saturday.

In November, 1972, John Hudak retired from the Purchasing Department. June Harvey, at the suggestion and encouragement of Mr. Ogrean, took courses at the University of Hartford to prepare her to be Purchasing Agent. Mr. Rod Coriarty became Materials Manager. With the 1973 addition, twice as much space was provided for the Stockroom.

The Personnel function was overseen by Mr. Ogrean and Assistant Administrator Frank Ritchie during the 1960's and early 70's. Annual wage review, job performance evaluations, codification of personnel policies, a pension program, group health insurance, and tax sheltered annuity programs were developed. Prior to these developments, personnel matters were informal, without systems in place.

As this function grew, Mr. Kenneth Tremblay was hired as Director of Personnel in 1973. Mr. Tremblay first served as an intern for a year through a special military discharge program. Mr. John Hooker, another intern from the University of Connecticut, became the first full-time industrial engineer at Windham in 1972.

Pat Dye, Director of Public Relations, took over the Annual Appeal effort in 1974, the first time a staff person was assigned to this vital program. Thanksgiving mailings attracted a $25,000-$30,000 response each year. A more formal comprehensive development program was on the horizon.

The hospital hired a professional fund raiaser in April, 1979. A prospect donor file of 15,000 names was prepared for the 1979 Hospital Appeal. The community was divided into ten audiences with everyone receiving some kind of personal contact, raising $110,000 from this effort. A planned giving program and a formal memorial giving program were initiated at this time, as was the solicitation of local, state and national foundations.

Throughout the 1970's, changes were occurring rapidly in the healthcare field. Expanding medical technology and new forms of treatment gave rise to soaring health care costs. Per diem hospitalization costs rose to over $100 and continued to rise until they exceeded $200 per day.

On October 1, 1973 state legislation created the Commission on Hospitals and Health Care (CHHC) which soon began to implement regulations intended to place immediate restraints on the rise of health care costs. The rationale of the requirements were often difficult to follow and a reasoned balance between care and cost seemed threatened.

In 1974, Windham presented its budget, just short of $7 million, to the Commission for approval and rate setting. This began a new era in hospital finances.

The reports of the 1970's are filled with discussions on inflation wage adjusunents, demands of health care workers for fair pay, budget cuts by the CHHC, and the introduction of alternatives in treatment that sought to moderate health care costs.

In 1974, Mr. Ogrean left Windham Hospital to assume leadership responsibilities elsewhere. Paul P. Somoza assumed the position of administrator for a brief period, followed by Frank E. Ritchie who remained administrator from 1975 to 1980.

In the 1970's, boilers were changed to natural gas with a savings in energy costs of over $15,000 in the first four month period. The original brick chimney stack that was built in 1933 was removed - a landmark gone forever!

In 1976, the hospital purchased the Catalano property and Professional Building. The only change to the hospital plant after 1973 was the addition of the Butler Building in the early 1980's, a small temporary structure, intended to relieve some of the pressure for more space required by developing out-patient services.


STATISTICS

1979

ADMISSIONS 6,628
PATIENT DAYS OF CARE 42,854
LENGTH OF HOSPITAL STAY (days) 6.7
BIRTHS 449
OPERATIONS 3,498
EMERGENCY ROOM VISITS 90,128