Completion of a $16.5 million project to expand and upgrade Moloka'i General Hospital will enable patients to undergo treatment that in the past would have required costly off-island care.

The 15-bed Moloka'i General, part of The Queen's Health Systems, is the island's only hospital. It serves a resident population of 7,500, two-thirds of whom are Native Hawaiian.

Moloka'i General president Janice Kalanihuia said that with a finite patient pool and practical limits on the kinds of medical procedures that can be performed at the small, rural facility, the redevelopment project required officials to find "a delicate balance of providing services that are really good for the community but are safe to be delivered on island."

Officials also decided to reduce the 30 licensed beds by half, since the average patient count was only two or three on any given day, she said.

Construction was completed in two phases over four years so the Kaunakakai hospital could remain open during the project. The first phase, finished in 2005, saw construction of a 12,000-square-foot addition with space for an emergency room, acute-care beds and imaging services. The $7.5 million addition received funding from federal, state and county sources.

The $9 million second phase, finished late last year, focused on making improvements to the original 40-year-old hospital building. Kalanihuia said a 1996 code compliance survey pointed out a long list of electrical and structural deficiencies, which was not surprising to hospital employees used to placing buckets under roof leaks.

The improvements made room for laboratory space, a chapel, a conference room and business offices with up-to-date computer wiring.

The project also enabled the Women's Health Center to move from a separate building into the hospital proper. The center handles 3,000 visits annually and has been using certified nurse midwives to attend childbirths since 1985.

Also new is a special procedures room where colonoscopies and other procedures not previously available on Moloka'i can be performed. Kalanihuia said the prospect of having to travel off-island for such procedures often discouraged residents from seeking cancer-screening examinations and other important medical treatment.

"This means that patients have services that will keep them home. They don't have to spend money to go off island," she said.

The second phase included doubling space in the medical office building used by visiting specialists from Honolulu and the two internal medicine physicians based on Moloka'i. The U.S. Department of Veterans Affairs also uses the building for its periodic clinics.

The two local physicians handle 9,000 to 10,000 patient visits annually, while the hospital's emergency room sees 4,500 patients a year.

In addition to government funding, the Phase II project received support from the Office of Hawaiian Affairs, Queen's Health Systems and the Harry and Jeanette Weinberg Foundation.

Local photographer Dewitt Jones donated $75,000 of his artwork to put the final touches on the completed project.

A celebration to mark completion of the redevelopment was held Jan. 30.

"It's not fancy. There's no marble or koa, but for us it's fabulous," Kalanihuia said.