6 minute read
Interview: John Couris, CEO
Efficient care
Rather than building more hospital wings and buidings, emphasis on efficiency could help drive costs down
John Couris CEO & President Tampa General Hospital
What are the most in-demand services for the hospital and what does that say about healthcare in Tampa Bay? Overall, we are growing in almost every area. Part of it is population growth and the other is that we are a tertiary, quaternary hospital that takes care of rare and complex cases. We have patients coming from all over the state and in some cases all over the country to Tampa General Hospital. By the end of September, we had already performed 100 liver transplants for 2019. That puts us in the Top 10 programs in the country. But the real story is that we had a zero 30-day mortality rate, which is critically important for liver transplants. We are very proud of that. There are many things that we can’t control as a hospital. We are always looking to recruit and maintain top talent. We focus on how to do a better job on capacity and care navigation. What happens with healthcare in places like Florida, and in Tampa is that hospital wings and buildings are being built all over the place under the argument that the communities are growing. Plus, there is a need to increase bed availability. I think that is the wrong way to go about it. When you do that, you are adding to the cost of healthcare unnecessarily. When you build new buildings, you are having only a short-term positive economic impact. Our attitude here is to find ways to make our 3 million square feet more efficient and more patient-centered. We focus on finding solutions to drive the cost of healthcare down and the quality up. If we can modernize and reengineer our work, getting better at what we do through efficiency and quality of service without having to build unnecessarily, and putting equipment and people and processes at the right place and time, we can lower costs and pass on that value to the patient.
How is new technology being deployed at Tampa General Hospital?
Our new CareComm center is an 8,000-square-foot technology hub that deploys artificial intelligence, predictive analytics and reengineering to rebuild healthcare from the inside out. We were the first in Florida, the first in the southeast and the fourth in the world to employ this model. It is actually one of the main drivers behind our listing as one of the Becker’s Top 40 most innovative hospitals in the country this year.
CareComm includes 38 LCD displays that monitor the ebb and flow of the entire institution, 30-plus team members from 10 departments running 20 artificial intelligence applications, all managing the flow of the medical center. We have been able to eliminate a half day of stay, and we have been able to take $10 million of inefficiencies, real money, out of the system, and that is only in the first 10 months.
( ) there are often more job postings available than qualified staff to fill them. Florida is the No. 1 state facing growing demand but not enough nurses to meet it, according to Rasmussen College. More than 40% of Florida nurses are approaching retirement age in the next 10 years, according to the Florida Center for Nursing. Although some colleges are developing new fast-track degree programs to mitigate the issue, Tampa’s population is still growing and demand is outpacing supply. In June 2019, according to ABC Action News, several local hospitals were actively hiring for significant numbers of nursing positions. Baycare Health had over 400 openings, AdventHealth Tampa had close to 90, Tampa General Hospital had around 100 job openings for registered and licensed practical nurses, while Brandon Regional Hospital had around 30 open positions. It’s not just nursing. Many areas are facing a similar challenge. “(Talent attraction) is an ongoing challenge. We are partnering with Hillsborough Community College, while we also look to the universities. The talent that comes from a community college setting is very important to us. We hire people in call centers, for example, who have to speak to relatives right after a donor passes away. Our staff will ask that family member very critical questions about the person they just lost. It takes a very special individual to work in our call center,” said Betty Viamontes, chief financial officer of Lions Eye Institute for Transplant and Research.
Although Florida typically has an image of being a retirement community, average ages are decreasing in Tampa. In 2018, the median age of all people in Tampa was 34.6, compared to 37 in 2017. But the state is still backing facilities for older residents, including two new nursing home projects that were approved in July, one of which – a $21 million, 90-bed project – is in Hillsborough County. The state is able to support the older generation largely because of a burgeoning working population entering regions like Tampa Bay. In 2018, almost 64% of the population was under 45.
And it is not just elderly care that is seeing investment. New centers of excellence are springing up every day. In August, St. Anthony’s Hospital in St Petersburg announced it would undergo a $152 million renovation to add a new 90-bed patient tower featuring private rooms. Several existing hospital facilities will be relocated to the new building, including cardiology, inpatient dialysis and pre-admission testing for surgical patients.
The Brandon Regional Hospital is also expanding to tackle growing neonatology care. The hospital filed stormwater permits in July to convert the first floor of the neighboring building into shell space while the upper floor will house an expansion of the Neonatal Intensive Care Unit. The $23.5 million undertaking will add 14 additional beds across 8,273 square feet of new space, while renovating 14,636 square feet of the hospital’s existing property. It is expected to be completed by 2021.
Health Policy One of the most significant developments for Florida’s healthcare system in 2019 was the repeal of the certificate of need (CON) law, which evaluates the need for any expansion of medical facilities. Any hospital looking to establish new campuses or treatment centers in Florida had to apply through the burdensome CON process, which often left healthcare facilities tied up in paperwork and healthcare facilities unable to provide additional services for patients. Deregulation means the requirement will be repealed for specialty hospitals, such as children’s hospitals but will still be required for nursing homes and long-termcare hospitals.
Already hospitals are taking advantage of the overhauled regulations. Largo Medical Center in Pinellas, Baptist Health in Duval County, Orlando Health Arnold Palmer Hospital for Children, Nemours Children’s Hospital in Orlando and Cleveland Clinic in Weston have all shown interest in expansion of their facilities but have been unable to go ahead because of CON regulations. Baptist Health and Cleveland Clinic both intend to establish an adult bone marrow transplantation program, while Orlando Health Arnold Palmer Hospital for Children wants to open a new pediatric heart transplant program.
The Affordable Care Act (ACA) was also back in the courts in 2019 as a group of Republican attorneys general and two governors argued that the act ( )
