Letter to G a Rothery and Memo to S R Sapirie, Subject: Fourth Annual Report of the Oak Ridge Hospital for the Year Ended 30 Jun 1953

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Office Memormdam UNITED STATES GOVERNMENT Cornunity Affairs Division AYNUAL YEPORT OF T% OAK XEEE HOSPITAL, INC. Enclosed are f i v e copies of the Fourth Annual Report of the Oak Ridge Hospital, Inc., f o r the year ended June 30, 1953. A sufficient number of copies of this Report are available this office should you desire additional ones. As stated ( 5 cys)

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FOURTH ANNUAL REPORT OAK RIDGE HOSPITAL, INCORPORATED OAK RIDGE, TENNESSEE FOR THE YEAR ENDED JUNE 30, 1953

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FOURTH ANNUAL REPORT OAK RIDGE HOSPITAL, INCORPORATED OAK RIDGE, TENNESSEE FOR THE YEAR ENDED JUNE 30, 1953 BOARD OF TRUSTEES George A. Rothery, President George H. Dykes, Secretary Oral Rinehart, Treasurer John D. DePenio, M.D., Chief of Medicine, Chief of Staff Dana W. Nance, M.D., Chief of Surgery Lewis F. Preston, M.D., Chief of Pediatrics Charles J. Ragan, M.D., Chief of Obstetrics and Gynecology

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EYE, EAR, NOSE AND THROAT OBSTETRICS AND GYNECOLOGY ON LEAVE OF ABSENCE OBSTETRICS AND GYNECOLOGY EYE, EAR, NOSE AND THROAT

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Carl D. kffries Director E. Dean Van Hoorer Laura M. Lovell Chief Dietitian Julia M. Gresne Executive Housekeeper Robert E. Simpson Purchasing Agent Hymon Africk Chief Pharmacist John Geffel Maintenance Superintendent Silvia Aliberti Medical Records Librarian Director of Nursing Chief Telephone Operator

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ANNUAL REPORT OF THE PRESIDENT FISCAL YEAR ENDED JUNE 30; 1953 The annual meeting of the Board of Trustees was held on Wednerclcry, June 17, , At this meeting the following officers were re-elected for the coming year: George A. Rothery, President; Logan B. Emlet, Vice-President; George H. Dykes, Secretary; Oral Rinehart, Treasurer. Board members Carl C. Martin and George H. Dykes, whose termsexpired, were reelected for three-year terms. Submitted atthis meeting wasa communication dated May 22, 1953, from C. Vanden Bulck as Contracting Officer for the United States Atomic Energy Commission, wherein the Board was notified, in accordance with the provisions of Article I V = TERM of Contract No. Ala-1-GEN-252, as amended, that the Atomic Energy Commission notified the O a k Ridge Hospital, Inc., of theexercise of i t s option to renew said contract for a period of three (3) yean beginning July 1, 1953, and continuingthroughthe thirtieth (30th)day of June 1956. The Board indicatedacceptance of this extension with one exception. During the past year, m e difficulty wos encountered on the subject of collections and collection procedures. It i s the Board's desire that these restrictionsbe made more reolisticin view of the collections problem, and the President i s negotiating this subiect with the Contracting Officer. In connection with the above, i t may be of interest to note that the average collections of hospitals in the United States, as published, was 87.92% last year. Collections in our hospital in the past year are estimated to have been 9996 of charges for services. Reportsof Director G. D. Jeffries andothen for the p a s t fiscal year are a part of this report. Yourattention i s againcalled to the final net-cost figurer of $128,991.35. Afteradjustment for bad debts for 1952, this isa decrease of $44,414.31. koin, this isa very satisfactory result. It i s anticipated that, for the fiscal year 1954, the net-cost figure will approximate that of this year. During the month of January, the hospital facilities were utilized to their full extent, as the result of a severe influenza epidemic throughout the community. While of necessity there was some waiting for admission, the lack of complaint on care and facilities i s a good commentaryon the fine job done by the personnel of the organization. During the year, the hospital property h a s been normally maintained w i t h the following extraordinary repin or copital improvements: 1. Icemaking machine purchased and installed. 2. After proper bid, contract was let and work was started in June on the rehabil itation of the e1ectrical:system throughout the hospital property. 3. In connectionwith certain changes for efficiencyand modernizing in the X-ray Department, as indicated in the report of Dr. Ball, arrangements were made whereby a new fluoroscopic machine of modern type and adaptable to requirements of this department was secured at a minimum cost by trade-in of the old machine. The approved intern program was followed through so that, beginning with the first part of July 1953, interns w i l l be port of the hospital organization.

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The medical staff members have continued their cooperation in maintaining high ethical standards and good medical practice. All members of the active staff were reappointed for the ensuing year by the k r d of Trustees on recommendation of the Medical Board. The Board also reappointed the following for the new fiscal year: Dr. John DePersio, Chief of Medicine and Chief of Staff; Dr. Dona Natice, Chief of Surgery; Dr. Charles J, Ragan, Crews was reelected by the staff to the Medical Board. pointed Radiologist. Dr. Kerman had devoted part time to the hospital, the balance being in research in the ORlNS hospital. Dr. Ball i s devoting full time to our hospital in the practice of radiology. During the year, fifteen employees received gold pins in recognition of five years of continuous service with the hospital organization. A total of 119 employees have thus far received these five-year service pins. Two of the Boardmembers gave talks to civicclubs during the year aspart of the program to keep the public informed of the work of the hospital. Carrying on its programof attempting tosecure modern hospital facilities, the h r d continued discussions with the Atomic Energy Commission. It was determined by the Atomic Energy Commission that it would not request funds for construction of a new hospital in Oak Ridge in the fiscal year 1954 budget. They stated that this determination indicated recognition of the fact that maintenance of the existing hospital building i s uneconomical, but the determining factor was i t s relationship to community disposal. The Board w i l l continue its efforts to secure new andefficient hospital facilities and to eliminate the continuing deficit of this institution.

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REPORT OF THE DIRECTOR To the President and Board of Trustees Oak Ridge Hospital, Incorporated Statistics for the year under review reveal that a total of 8,640 patients was admitted by O a k Ridge Hospital during tho year - a reduction of 284 when compared with the 1952 fiscal year. This number includes 960 births, which was 27 more births than occurred the previous The factor bringing about the reduced demand for hospital services appears to have been the new hospitalization insurance plan adopted by Carbide employees, which provides that payment of a part of the charges in medical cases i s the responsibility of the.’patient. When comparedwith the previous year, there has been a further reductionof $44,414 in the netoperating cost. Had the hospital occupancyremained as highas during fiscal year1952, the net cost would have been further reduced by about $29,000. With proper adjustments for bod dabts (which were not included in previous yearly operating stotements), the following table summarizes the results attained since your Board assumed responsibility for the operation of the hospital: A breakdown of the items contributing to the average patient day cost during the year I s as Salaries and woges (7.8 hours at $1.55) Drugs and medicines Heat, light, power, and water Housekeeping, maintenance, and kitchen supplies Printing, office supplies, and telephone Other services and supplies Total per diem cost For the services reflected in the above costs, the patientswere charged an average of $14.06

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Employeeswere paid salarierand wages amounting to an over-all average of $241.67 a month during the year. The average paid during fiscal year 1952 was $226.43. The minimum monthlymlary i s $155.00; the minimum hourly wage, $0.87. These minimum-payscales are the hiring rates for untrained workers. The hospital equipment appears to be entirely adequate for our needs i n a l l departments, though the buildingrare deteriorating rapidly due to the temporary nature of the construction. Respectful ly submitted,

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REPORT OF THE MEDICAL BOARD To the President and Board of Trustees Oak Ridge Hospital, Incorporated The work of the professional staff was carried out through the p a s t year without any unusual incident, and agood spirit of cooperation with hospital administration has been in evidence Early in the year, a Tissue Committee was established and has been functioning well. Its monthly tabulations have revealed a high correlation between operative findings and preoperative diagnoses. To the present, there has not appeared to be any need for corrective measures. The Tissue Committee, in addition to reviewing cases i n which tissue issubmitted, also receives notification of operative procedures in which no tissue i s removed, such as laporotomiesand lysis of adhesionoperations and uterine suspensions, and in these cases may review the clinical record. During the year, several operative procedures were placed i n the category of major ones. These were saphenous vein ligation, hemorrhoidectomy, and tendon repair. Also, rules were put into effect to clearly establish the responsible surgeon. The direction of the Nursery was transferred from the Obstetrical Department to the Chief of the Department of Pediatrics, who has appointed an Advisory Committee. It was not felt that there was an urgent need for a change, but i t i s in conformity with recent trend, Routine professional accounting reveals the performance of the staff to be well within acceptable limits. For example, there were no maternal deaths i n 965 births, and there were only 17 Caesarean sections, or a rate of 1.796. The autopsy rate was 48%. There were several changesin staff membershipwith the following additions: Dr, Robert P. Ball, as head of the Department of Radiology; Dr. Herbert Kerrnan, who went to the University of Louisville as associate professor of Radiology, was placed on the consulting staff in Radiology; Dr. Nathan Williams, general practitioner i n Clinton, to the activestaff; Dr. Paul R. Marsh and Dr. William Holden, both general practitioners, to the active staff; Rogers of Knoxville to the consulting staff in Thoracic Surgery; and Dr. William Willien to the courtesy staff with privileges i n Dental Surgery. On the minus s i d e of the ledger, we have temporarily lost Dr. Dan Thomas to the Navy. or. Robert Tromly has left for a three-year training period in surgery at the John Sealy Hospital in Galveston, Texas. We are again without the services of a urologist, as Dr. V. Frank Carey left O a k Ridge in March. Continued efforts w i l l be made to replace him. Sinceapproval for internship lost year, only one intern, Dr. kmesM. Kingery, was obtained for the year, so the clinical clerkship program w i l l need to be continued. A complete training program has been set up by the Intern Committee and w i l l undoubtedly result in a satisfactory year for the intern.

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The k d f c a l Board expresses its appreciation to the staff for its continued cooperationand to the Director and Board of Trustees for their efforts to improve hospital facilitietandoperation. Chief of Staff

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on October 1, 1952, Dr. Herbe? Kerman returned to the Univenityof Louisville after two yean as radiologist to the Oak Ridge Hospitul and Oak Ridge Institute of Nuclear Studies. Or. Kenan didsuperior workat both places. He made a host of friends while in Oak Ridge, und i s a distinct loss to the hospital staff. In recognition of his excellent contributions, Dr. Kermon has been appointed as a Consultant Rcdiologist to the Oak Ridge Hospital e OroRobert Ball was appointed radiologist to succeed DI . Kerman. Other changes i n personnel were: chief technician, replaced by Miss Harriet Erogan; and Miss Claire Browning, technicion, replaced by Mrs. Dean Hawkins. Currently, the staff of thedepartment consists of one radiologist, one chief technician, one assistant chief technician, two technicians, two relief technicians, one assistant technician, two laboratoryassistants, one secretary, and one receptionist e At the present time, two rooms are equipped w i t h class-A, top-line diagnosticmachines for both fluoroscopy and radiography. Also, phototimers are i n use on both serialographs, which adds materially to the quality of work done. There i s no limitation to types of diagnostic procedures because of equipment. The film-processing room has been remodeled to permit developing only in the dark, while .--heremainder of the processing i s done in daylight. All processing equipment i s new and of the best grade. The daylight processing adds greatly to the smooth operation of the department and permits prompt inspection of recently exposed films. A new chemical drying unit has replaced the former electrical-coil unit. Complete f i l m processing i s now accomplished twenty minutes from the time of exposure, as compared with sixty toeighty mhuter A Land-Polariod x-raydeveloping unit has been obtained for x-ray services in the operoting room. The total time required to process a paper film after exposure i s one minute. All the work i s done in daylight i n or adjacent to the operating room, thereby diminishing the time required to keep the patient under anesthesia. The isotope laboratory i s now finished and i n operating shape. Applicators for radium, or isotopes such as cobaItd0, are being investigated for use i n theropy. During the past year, isodose curves have been charted for different size portals and filters in use on the 250-kv, constant-potential, Westinghouse Qwdrocondex Machine These valuable data were obtained through the services of Dr. Richardson and associates at the b k Ridge Institute of Nuclear Studies.

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The total number of examinationsfor the year i s 9,231. When the stereoscopicexaminations of tho chest using 4- by lO-inch films are added to the others, i t makes a total of 10,280. The total for the previous year i s 9,683. The number of therapy treatments i s 941,in contrast to 1,712 theprevious year. This difference i s due, in part, to encouragementof type lesions to be treated by the radiologist, and to a difference i n manner of tabulating a treatment. The total number of patients treated i s essentially the same.

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A summary of work accomplished i n the various departments of the Laboratory shows the Blood Provided to Others There was a turnover of six of the ten employees, During the year, a number of procedures were modifiedand evaluation of some new methods was carried out. The major changer consisted of replacing routine red-blood counts with rnicrohematocrits. Considerable nonroutine work went into evaluation of the method and apparatus prior to its incorporation into the laboratory routine A new schedule for chemistry procedures was established to allow for more efficiency. There were no major changes in the laboratory equipment. An air-conditioning unit was instolled in the bacteriology department. A high-speed centrifuge was obtained for micro-

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DEPARTMENT OF ANESTHESIA A total of 3,324 anesthesias was given during the year, of which there were 2,447 surgical anesthesias and 877 obstetrical anesthesias. A total of 6 diagnostic or therapeutic nerve blocks was performed. During the year, two relatively new agents were …