Destination medical centers have emerged as key players in healthcare, offering essential care when hospitals reach capacity or lack specialized resources for life-saving procedures.
Hartford HealthCare’s St. Vincent’s Medical Center in Bridgeport, Conn., is a prime example of how a hospital can evolve into a regional hub for advanced medical services, attracting patients from across New England.
“From my perspective, the outcomes at destination medical centers for patients are better when there are higher concentrations of specialization at those hospitals,” Ryan O’Connell, MD, vice president of medical affairs at St. Vincent’s, told Becker’s. “It really serves patients better, and there’s a lot of evidence that people are safer and do better with higher volume specialists.”
Since joining Hartford HealthCare, St. Vincent’s has become a critical link in a network of destination medical centers, capable of providing complex care across state lines. In one instance, a patient from Brattleboro, Vt., was transferred to St. Vincent’s after what was initially diagnosed as a mild heart attack. Further evaluation revealed a more complex cardiac condition, necessitating a surgical aortic valve replacement — a specialized procedure not readily available in smaller, rural hospitals.
“There are very specialized services that we’re not able to provide, like ECMO — extracorporeal membrane oxygenation — but almost anything else we are able to take care of, from heart surgery to complex ICU care,” Dr. O’Connell said.
St. Vincent’s operates within Hartford HealthCare’s Care Logistics Center, a 24-hour call center that coordinates patient transfers across New England, and occasionally across the globe, ensuring that patients receive care at the most appropriate facility based on capacity and specialized services.
“The CLC assesses who in our system has capacity,” Dr. O’Connell said. “They have a real-time view of bed capacity at each site and can route patients based on the level of care required.”
This logistical network ensures that even when St. Vincent’s is at capacity, patients can be routed to another facility within the Hartford HealthCare system. All seven of the health system’s acute care hospitals have the capability to accept transfers. “For example, our flagship Hartford Hospital, which specializes in advanced heart failure care, may provide something we may not have the resources to handle,” he said.
Transforming a community hospital into a destination medical center comes with significant challenges. From a clinical perspective, ensuring 24/7 coverage across multiple specialties is paramount.
“We had to ensure that we had reliable, 24-hour coverage for all the services we offered,” Dr. O’Connell said. “For interventional stroke care, we have two neuro-interventionists. They alternate because no one person can be on call 24/7.”
Operationally, the process is equally demanding.
“We have a director who is in charge of scheduling, making sure that the right physicians are on call and that the logistics center has the updated schedules,” he said. Additionally, maintaining robust supply chains and ensuring the availability of advanced medical equipment is crucial to sustaining operations at a high level.
Attracting top medical talent and securing physician commitment are both critical components of the equation, but these processes are far from easy, according to Dr. O’Connell.
“We provide the tools, resources and sometimes compensation to make it worthwhile,” he said. “But it’s more than that. Physicians need to know that they’re going to do the part they have expertise in and that we’ve removed all the logistical barriers so they can focus solely on patient care.”
Dr. O’Connell’s role as VP of Medical Affairs requires him to be perpetually on call. “I have to be ready to take the call around the clock,” he said. “It’s part of the commitment to providing a high level of care and ensuring that no patient is left waiting for a critical procedure.”
For hospitals aiming to transition from community care to regional referral centers, Dr. O’Connell’s advice is clear: “You need a 24/7 mindset — with the right infrastructure, committed physicians, and a well-oiled logistical network to ensure patients receive timely, specialized care.”
