However, the hospital said today that 70 of the positions are already vacant because of a hiring freeze, and that Queen's will try to find jobs in the medical center for those workers whose positions are being eliminated.

Layoffs will take place only after all efforts to fit the staffers into other jobs have been exhausted, the hospital said. Queen's also is offering its employees a voluntary early retirement program to create other vacancies.

Queen's said it eliminated 140 management positions last year, but was able to convert most of the management posts into staff jobs.

Karen Winpenny, a Queen's spokeswoman, said today that 16 managers were laid off and an additional six took early retirement last year in the first phase of restructuring.

The second phase is aimed at reducing costs by $12.5 million over the next 18 months, Queen's President Arthur Ushijima said in a press release.

Of that, $7.5 million will come from the personnel changes and the rest will be from nonpersonnel items such as purchasing.

Ushijima said Queen's, like other hospitals in Hawaii and on the mainland, is experiencing lower admissions and reduced payments and expects those trends to continue. "These are indeed difficult steps for us to take. Because the health care industry is undergoing fundamental changes, QMC must change too," he said.

Ushijima said Queen's must continually improve its operational and financial performance.

Queen's now has 2,874 employees. The 90 occupied positions being eliminated equal a little more than 3 percent of the total.