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Cliff Speer, RN, of Fox Chase Cancer Center in Philadelphia, praises the specialty hospital’s staffing ratio, which is never higher than two patients to one nurse during day shifts, and 4-to-1 during the evenings.

Recovering from quadruple bypass surgery, a woman rested in the critical care unit at Edward Heart Hospital in Naperville, Ill. She admired her spacious surroundings—cherry wood floors and furnishings that gave the room the ambiance of an upscale hotel. Even the medical equipment was discreetly concealed behind custom cabinets.

Christine Michaels, RN, had cared for the patient since the woman’s release from surgery. Although it was late in the evening, the woman’s family remained by her side.

Because Edward has no set visiting hours, family members could come and go as they pleased and even spend the night at her side.

The patient was in a specialty, or “boutique,” hospital, one of the newest and fastest-growing trends in health care. These new medical centers are for-profit ventures that specialize in specific high-revenue procedures including cardiac, cancer and orthopedic care. The federal government estimates that about 100 specialty hospitals are in operation nationwide.

For nurses such as Michaels, specialty hospitals offer more favorable staffing ratios than larger hospitals, increased job satisfaction and the ability to offer personalized care to a smaller number of patients.

“I love working in a specialty hospital,” said Michaels, who has been on staff at Edward since it first opened a year ago. “I truly feel my job allows me to give my patients the best possible care.”

After graduating from nursing school, Michaels conducted an internship at Edward and liked the way the specialty hospital operated. She was given six months of training, compared to the six weeks that many of her fellow graduates received at other hospitals, and she continues to gain extensive on-the-job experience as new equipment is introduced in the cardiac field.

At Edward, patients are brought directly from surgery to the CCU rather than to a recovery room. As with many specialty hospitals, Edward offers low staffing ratios with nurses typically caring for only one or two patients on any given shift.

Most boutique hospitals allow patients to remain in one room throughout their hospital stay and to see the same nurses daily. As a result, the hospital stay for patients at a specialty hospital is often shorter than that of a standard hospital.

“I think working in a specialty hospital allows nurses to be more in tune with the needs of patients and their families,” Michaels said. “Patients are always telling us how pleased they are with the care they receive here.”

Source of debate

Although many nurses and patients praise the concept of boutique hospitals, the trend has received criticism from some nonprofit organizations and community hospitals.

These organizations argue that because boutique hospitals specialize in high-volume inpatient procedures including cardiac and orthopedic surgery, they are taking revenue from general hospitals that rely on these surgeries to cover the cost of critical services including emergency rooms and burn units.

At Butler (Pa.) Memorial Hospital, nurses are disputing plans to build a separate for-profit specialty outpatient surgery center. They argue that the new facility could affect the existing hospital’s finances, patient safety and nursing jobs.