Shriners Hospitals for Children in Spokane is reducing its staff by about 10 percent as it converts to a “micro hospital” with more focus on outpatient care.

Just under 19 full-time equivalent positions are being eliminated from the workforce of about 200, said Peter Brewer, hospital administrator. Some of the work will be outsourced.

Shriners will keep its 30 licensed beds. Like other hospitals across the country, however, Shriners is seeing more outpatient-oriented care while the need for overnight, inpatient care declines, Brewer said.

The Spokane hospital is among 22 Shriners locations in the U.S., Canada and Mexico. The facilities began in the 1920s to treat children with polio and orthopedic conditions.

The hospital, at 911 W. Fifth Ave. in Spokane, serves children up to age 18 with orthopedic conditions, ranging from issues that require multiple surgeries to fractures that can be treated with same-day surgery. Patients receive treatment regardless of their families’ ability to pay.

The Spokane facility in the past has been on a short list of Shriners hospitals slated for closure because of low inpatient numbers. According to the hospital’s 2015 annual report, about 75 percent of surgeries were outpatient procedures, and that figure was expected to keep growing. The hospital saw 11,000 kids in the outpatient clinic that year. Most came from Washington, Idaho, Montana, Alaska and Canada.

Transforming to a micro hospital will help the Spokane operation reduce costs and stay financially nimble, Brewer said.

“Shriners Hospitals for Children is supported by charitable donations,” he said in a news release. “We have a responsibility to ensure these donations are spent in a way that sees the most patients treated with the highest quality care in the most efficient manner.”

The Spokane hospital will continue to provide physical, speech and occupational therapy, prosthetics and other complimentary services, said Scott Mullen, chairman of the board of governors.

He said the hospital also is exploring opportunities to grow, including partnerships that would allow children to be treated in locations more convenient to where they live.