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Real Issues : Real Solutions

JUL/AUG 2010

CARONDELET HEALTH NETWORK Leadership Excellence

HEALTHCARE EXECUTIVE EXCHANGE MAGAZINE | www.hcemag.com

Real Issues : Real Solutions

CONTENTS

04 Carondelet Health Network

In-focus stories 10

All Childrenâ&#x20AC;&#x2122;s Hospital

Integrity Transitional Hospital

Lubbock Heart Hospital

York Central Hospital

St. Josephâ&#x20AC;&#x2122;s Hospital & Medical Center

Ohio Presbyterian Retirement Services

Tulare Regional Medical Center

32 UCSF Medical Center at Mission Bay 37

Bakersfield Memorial Hospital

Opelousas General Health System

44 UCLA Hospitals 48 Allina Hospitals & Clinics 51 Facility Development & Management

HCE EXCHANGE

JUL/AUG

2010

North Bay General Hospital

Stonewall Memorial Hospital

Henry Ford West Bloomfield Hospital

Grey Bruce Health Services

PrimaCare Medical Centers

Methodist Le Bonheur Germantown Hospital

Carondelet Health Network Carondelet Health Network in Tucson, Arizona, was founded 130 years ago by the Sisters of St. Joseph of Carondelet. In 1870, Seven Sisters embarked on an arduous journey—by train from St. Louis to San Francisco, by boat from San Francisco to San Diego and by covered wagon from San Diego to what was then clearly the Wild West. Their original mission involved educating children. However, just 10 years later their mission evolved into a Mission to Heal when they were asked to open and operate Arizona’s first hospital, St. Mary’s Hospital. Today, that original 12-bed hospital has transformed into Southern Arizona’s largest healthcare network. Carondelet Health Network now includes five hospitals offering more than 1,150 beds, a state-of-the-art neurological institute and 20 primary care and specialty practices. Carondelet is also an affiliate of the nation’s largest Catholic, nonprofit healthcare ministry, Ascension Health. “We aim to provide for the healthcare needs of our community, and we embrace the whole person in body, mind and spirit,” says Ruth W. Brinkley, RN, FACHE, President and CEO of the organization since late 2007 and West Ministry Market Leader for Ascension Health. Modern Healthcare Magazine recognized Brinkley this year as one of the Top 25 Minority Leaders in Health Care. Moreover, her work has gained significant recognition by the Arizona Daily Star, which noted that Brinkley is the third most influential woman in Southern Arizona, just behind the governor and Tucson’s (now former) superintendent of schools. While Carondelet Health Network provides Tucson and Southern Arizona with some of the area’s most advanced healthcare options, Brinkley also recognizes the Network’s mission to serve all people. “It’s important to us that we serve all persons with dignity and that includes service of the poor. Typically, those who are poor and vulnerable are marginalized. We want to make sure they are treated with as much dignity and respect as everyone else.”

VENDOR IN FOCUS In 2008, Carondelet Health Network opened Southern

Carondelet Neurological Institute provides a true

Arizona’s first and only comprehensive neurological

continuum of care from diagnosis, through surgery

care center, Carondelet Neurological Institute, on

and treatment, recovery, inpatient rehabilitation and

the campus of Carondelet St. Joseph’s Hospital.

outpatient rehabilitation, plus support services, such

Its mission is to provide the region with the best

as progressive community outreach and education

possible care for all neurological illnesses and

opportunities. Most impressive may be Carondelet

injuries, including stroke, brain tumors, spine tumors,

Neurological Institute’s state-of-the-art technology.

Parkinson’s disease, Alzheimer’s disease, epilepsy,

Carondelet Neurological Institute was the first

balance problems and aphasia, among others. The

facility in North America to introduce a dual-solution

Institute is a 54-bed, all-private-room facility, with the

BrainSUITE iCT from BrainLAB. This technology

area’s only dedicated Neurological Critical Care Unit.

allows a CT scanner to be housed in a “garage”

“Before Carondelet Neurological Institute opened,

between two surgical suites. Either room can employ

patients in Southern Arizona often had to be sent

the device during surgery, for example, to check the

out of town or even out of the state to be treated for

placement of surgical screws—ensuring precise

emergent and complex neurological injuries and

placement and virtually eliminating the need to bring

illnesses,” notes Brinkley. This created a hardship not

a patient back into surgery. The dual-solution is so

only for patients but also for their families and loved

unique, physicians from all over the United States,

ones. “Now, our patients have the very best quality

and as far away as Australia, have visited Carondelet

care from the first sign of a problem.” And, they have

Neurological Institute since the suites opened in

readily available support from their families and

January 2009 to see how the technology works.

social systems.

A Commitment to a Culture of Excellence

With more than 4,880 systems installed in over 80 coun-

“I believe that we should treat every one of our

tries, Brainlab is leading healthcare institutions to greater

patients and families with the highest degree of

efficiencies and improved treatment through its integrated

excellence,” says Brinkley. “That goes for everything

planning, intra-operative imaging and navigation, and pow-

from the service we provide to how we deliver those

erful radiation delivery technologies. Equipping on-site and

services. Most importantly, it extends to our clinical

remote clinicians with real-time imaging and patient data

outcomes and the safety of our patients.”

ensures that important clinical factors are incorporated into each care plan and success is measured immediately,

Brinkley believes in starting with high quality leaders who come to Carondelet already instilled with

reducing the need for subsequent surgeries.

the intrinsic values important to Carondelet’s mission. Brinkley then puts many resources toward devel-

Applying the power of treatment integration and real-time

opmental programs for those leaders and affiliated

collaboration, Brainlab is intently focused on making medi-

physicians, not to mention administrative, clinical and

cal technology and knowledge more impactful and acces-

operational teams.

sible to physicians and their patients.

“You build a culture of excellence by having shared experiences and shared values,” Brinkley

Real Issues : Real Solutions

says. “We have spent a lot of time building that shared

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culture of excellence.” Carondelet holds quarterly sessions where participants spend two days away from the hospital working on leadership qualities and skills. Brinkley also likes to use awards and recognition for great work and true leadership. “In some ways, we are like any other organization,” she says. “We have our problems, however, we try to

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recognize and reward those things we value.”

Developing a Continuum of Care Brinkley credits her outlook to her nursing background. “I never forget the fact that everything we are doing is to take care of our patients—not just while they are in the hospital, but to keep them healthy for life,” she says. “Hospital care is a very small part of most patients’ whole lifetime of experience with healthcare. It’s a very intense portion and usually takes up a fair amount of

resources; however, there is a whole health continuum that exists outside the hospital. My clinical background as a nurse helps me really understand that a patient is more than a disease that we see in a hospital.” One of Brinkley’s goals is to make sure that all of Carondelet’s employees understand they are there to serve the patient. It doesn’t matter whether they are

“Carondelet is all about high reliability, high quality, a commitment to a culture of excellence and helping our patients achieve the optimal levels of wellness.”

working in a patient care unit, food services, housekeeping, administration, shared services or revenue cycle. “Whatever we are doing, it is in service to the patient,” she says. “It’s hard sometimes to help people in non-

communities through its commitment to telemedicine.

today by assuring that all persons leave our health min-

patient care areas to recognize that they are there

“We offer services such as tele-stroke, tele-neuro,

istry feeling that they have been helped and healed—in

to take care of patients, too, yet we really try to empha-

tele-cardiology, and tele-diabetes,” says Brinkley. “It

body, mind and spirit.”

size that.”

allows patients in rural communities to receive expert

Brinkley says the focus of healthcare is and should

care close to home and helps us keep those patients

be shifting to the wellness side of the spectrum. This

as near to their families as we can. This effort is part

outlook is what she is striving to create in Carondelet

of our dedication to increasing access to care every-

environments. She strongly believes that, beyond treat-

where we can, to everyone we can.”

ing illness, a healthcare facility should be looking at how it can impact wellness throughout its community.

Meeting Community Needs

By T.M. Simmons

“Carondelet is all about high reliability, high quality, a commitment to a culture of excellence and helping our patients achieve the optimal levels of wellness,” says Brinkley. “We do all of this while

Carondelet also focuses on reaching out across South-

remaining true to our Catholic heritage and the legacy

ern Arizona’s vast desert expanses to surrounding rural

of the Seven Sisters. We continue their mission to heal

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HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

02 | All Children’s Hospital

Improvements in the New Hospital The new facility housing All Children’s includes a central energy plant that can provide 100% of the hospital’s power needs in case of an emergency. The hospital also has the ability to create its own drinking

“We take any child who is referred to us and we get quite a variety of kids who need many services.”

water. “We are the only hospital in Florida, I believe, that can provide 100% of its own power and drinking water during an emergency situation of two weeks or more duration,” says Carnes. Every child in the new hospital has an individual room with space enough for at least one parent to sleep in a bed in the child’s room and be with that child 24/7. “It provides much better patient space, clinical areas for staff, and family areas,” Carnes says. “It’s much improved over the old hospital relative to the comforts of the parent and child.” They also built the new facility with green in mind. “We used energy efficient lighting where possible, recycled materials when feasible, and other products that are easier to maintain,” Carnes says. For instance, the hospital installed all rubber flooring.

All Children’s Hospital

This means they no longer have to strip, wax, or buff. It can all be cleaned with an antiseptic agent. “It saves the environment and lowers operating costs as we no longer have to use harsh chemicals to clean and maintain floor tile.”

In January of this year, the patients and employees of All Children’s Hospital on the west coast of Florida moved two blocks north to its new location, a ten-floor hospital and five-floor outpatient care center. The 80-year-old organization is where children are sent when they are too sick to be cared for by their area community hospitals. “We serve all children, anybody who arrives at our door,” says Gary Carnes, President and CEO. “Our primary market area is the 17 counties on the west coast of Florida, but in any given year we receive a patient from every county in Florida, from 20 or more states, and several foreign countries.” All Children’s has about 2800 employees. As well as the pediatric specialty hospital, they have ten ambulatory centers and manage the neonatal units for eight other hospitals. More than sixty percent of their patients are funded through the Medicaid program and the rest are paid for through commercial insurance or are charity.

They are also completing the installation of a complete electronic medical record system that includes computerized order entry for physicians. “Just

All Children’s Hospital St. Petersburg, FL

about all our data—images and text—are now retrievable through our electronic medical record system,” says Carnes. “Multiple users can access the same electronic records and data in any location hooked to our system. This includes many physician offices and all of our outpatient centers.”

Superb Care for All Children “In my opinion, we have the most dedicated group of pediatric physician specialists, clinicians and hospital

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staff in Florida. They provide superb care to every child who comes in the door. We take any child who is

w:BrasfieldGorrie.com

referred to us and we get quite a variety of kids who

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

03 | Integrity Transitional Hospital

“We’re glad we are here to be able to serve the needs of all children.” need many services. They are very ill when they get to us,” says Carnes. He lists making sure the hospital has the right amount of personnel and assuring they are adequately trained, as one of his top challenges in running the organization. “We’re the primary pediatric training site for major area colleges who have nursing and allied health programs,” he says. “Many of the community colleges who have technical programs in healthcare also train here.” The hospital has developed its own pediatric residency program for nurses. Nurses who want to work at All Children’s complete this program that

coast of Florida,” Carnes says. “These new facilities

lasts about 22 weeks.

give us the opportunity to expand our ability to take

“The curriculum includes additional classroom

care of more kids.”

and hands-on training before they actually take patient assignment up on the floor. So they get nearly an additional half-year of training through our residency program before they are ever really required to take

“We are the safety net provider for children on the west coast of Florida. Most community hospitals are not properly prepared to care for critically ill or injured children. The most difficult cases get sent to

full patient care load assignments. It’s a very good

All Children’s. That’s our role and we welcome it. We

program and very well received, especially by young

embrace it. We’re glad we are here to be able to serve

graduate nurses who want to go into pediatrics,”

the needs of all children.”

Carnes says.

by T.M. Simmons

Welcoming Even More Children

Integrity Transitional Hospital

“We’ve always been, at least for the last 40 or more years, the major pediatric referral center on the west

A group of private investors opened Integrity Transitional Hospital in Denton, Texas in 2007. It is a 54-bed, long-term, acute care hospital (LTAC) that cares for medically complex adult patients who are critically ill or suffer from multisystem health complications or failures. “We serve everyone from wound care to renal dialysis for renal failure, ventilator management for respiratory failure, and cardiac management for cardiac failure,” says Christy Carver, CEO of the facility since March of 2009. Since Carver’s arrival, the hospital staff has worked to rewrite it’s mission and values statements. “All were wordsmithed—created—by the staff of Integrity Hospital over the last year,” she says.

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

338X463SW:Layout 1

productive, very effective, very accountable team. If you asked any of my team members what I expect of them, they’ll tell you, ‘She expects me to do my job,

Computed Radiography (CR)

my word. I follow through.”

Digital X-Ray

The Future of Integrity

Digital Ultrasound

As well as being Joint Commission accredited, Integrity is seeking Wound Care Center of Excellence recognition. They won’t be able to apply for a hospital

Pacemaker Checks

friendly” hospital. “We do that by building career

is not well-enough understood by the general

ladders and clinical ladders for our staff and by giving

been in a hospital environment for an average of two

public. In answer, Integrity has a full time business

them opportunity to advance in their careers and grow

weeks and can plan to be at Integrity for about another

development and marketing team. They have also

their compensation,” says Carver.

four. “They are tired. They are worn out. Some of them

joined forces with the local chamber of commerce to

are very ill and they don’t want to be here, but have to

help educate the public about the types of services

care unit and upgrading laboratory and radiology

be here. We try to make it as home-like as possible,”

being offered. They’ve become a part of a program

services. They expect to install an electronic order

says Carver.

called “The Right Care is Right Here” which is an

system this year and are shopping for an electronic

initiative to keep healthcare for area residents in

medical record.

“When you come into our facility, it’s almost

The hospital is currently building a 6-bed intensive

Find out more today. Call 800-843-9729 or visit www.mobilexusa.com Mobile Diagnostics in Fast Forward

“The facility has gone through a lot in the last year, but we have absolutely tailored our selection process

they serve, the families, employees, contractors,

like tag team healthcare. You get treated by every

for our nursing staff and our respiratory therapy

physicians, referral and payor sources included.

specialty in the building and your plan of care is

staff especially for individuals who have acute care

“The core phrases that meant the most to them were

tailored to what your need is,” says Carver. “I know

experience, preferably people with intermediate care

compassion, warmth and concern,” says Carver. “Any

that there are consumers out there that would really

to ICU type experience,” says Carver.

employee who works here, they have to understand

benefit from our type of care and from the outcomes

that the moment they put on their nametag, they are

that they would receive from our facility.”

agreeing to put the needs of their patients first. We all

Digital Holter Monitor

fashioning their nursing program to be that of “nurse This is an aspect of LTAC care that Carver worries

to encompass not just the patients, but all that

EKG Cardiac Arrhythmia Monitoring

When patients come to Integrity, most have already

Denton County.

Page 1

magnet award because of their size, but they are

More than Just a Name

and values statements, they felt it was important

1:47 PM

FAST. ACCURATE. RESULTS.

to do it in a timely manner.’ I am very fair and I keep

she expects me to do it correctly, and she expects me

When the staff was reworking the mission

6/1/10

“We come to work every day wanting to do an excellent job. We may not do it perfectly, but we do our best. It’s a given we will make a mistake, but if we

work. We all have lives. We’re all human beings here,

Leading the Team

but when we come to work, we come here to care for

Carver says the only way to affect change permanently

to our attention, we will fix it. We will learn from it and

our patients.”

is to get the consensus of the team. She emphasizes

we will make sure it doesn’t happen again,” Carver

“LTACs are not new to healthcare, but I don’t think the

listening and leading by example. “If I affect change

says. “We care for people with integrity. Everything we

healthcare community has done a very good job as a

through intimidation and fear, it will be short lived.

do, we do with integrity.”

whole on educating residents and consumers about

They’ll be doing it for the wrong reasons,” she says. “I

the full continuum of care and where LTACs actually

develop a culture of family and I develop a culture of

lie on that continuum of care. I think many people

team. They see me implementing the change as well

lose out on the intensive treatment that we offer,”

as requiring it of them.”

says Carver.

“If you were to visit our facility, you would see a very

recognize the mistake that we made or if it’s brought

by T.M. Simmons

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

04 | Lubbock Heart Hospital

Growth Potential for a New Hospital “Since we are a relatively new facility, long term capital requirements in terms of facility and equipment are minimal,” says John McGreevy, Chief Executive Officer. McGreevy was hired during the construction phase of the hospital and became CEO of operations once the facility was up and running. The hospital is focused, however, on implementing an electronic health record and computerized physician order entry system, to achieve meaningful use required by the new healthcare reform legislation. Recent upgrades have been to improve the primary revenue generating portion of the hospital, the cath lab. Picture archiving and communication systems have been updated, as well as installment of a physician reporting system. “We are pushing that out to the web where our physicians can have access to their images from their practices and homes. The purpose is to help our physicians become more efficient and productive. We have greatly increased the capability of our information systems in the cath lab. We put forth about $1.2 million for that upgrade,” says McGreevy. First and foremost, however, McGreevy says the hospital will be challenged by the effects of the recently passed healthcare reform legislation. Included in the reform were certain limitations for physician owned hospitals. “We are looking at strategic direction with regard to how these changes are going to

Lubbock Heart Hospital

impact the hospital’s future growth initiative as it relates to physician and recruitment. The replacement of retiring physician owners is pivotal to the organization’s integration strategy.”

Since December 2003, Lubbock Heart Hospital has been caring for hearts in west Texas. The 74-bed, acute care hospital is physician owned specializing in the prevention and treatment of cardiac disease. Though located in Lubbock, a city of approximately 210,000 residents, the hospital serves the regional area of west Texas and eastern New Mexico, a population of about 1.2 million. The hospital includes four heart surgical suites, a complete diagnostic and imaging center, sleep disorder center and a 24/7 emergency department aimed at the treatment of cardiovascular emergencies. The hospital has both air and ground transport capabilities and can expect to receive anywhere from 8 to 20 air flights on any given month.

Possibilities include looking for another capital partner or forming a relationship with a larger player in the region. They are looking at ways to better integrate with their physicians who are suffering from loss of revenue from recent Medicare cuts and at affiliation models that will help both the hospital and the doctors.

HCE EXCHANGE MAGAZINE

05 | York Central Hospital

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â&#x20AC;&#x153;There might be a closer web that we can spin with our doctors to help them build back that revenue,â&#x20AC;?

McGreevy says. â&#x20AC;&#x153;Of course, integration in terms of information systems is another arena we are evalu-

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ating. We have the foundation in place to overcome the challenges of healthcare reformâ&#x20AC;?

Challenges Attracting talented leaders is McGreevyâ&#x20AC;&#x2122;s number one strategy for managing a hospital like Lubbock Heart. â&#x20AC;&#x153;It presents a unique challenge to bring in talented leaders to the organization that will help us continue the success we have achieved in a fiscally sound manner,â&#x20AC;? he says. â&#x20AC;&#x153;We need executives that have strategic vision. For our part, we need to maintain pay practices that are competitive. â&#x20AC;&#x153;We must have compensation arrangements that will hold them here and make them want to stay.â&#x20AC;?

recommend Lubbock Heart Hospital to friends and

Capital financing continues to be an problem

family. We feel that we have a wonderful platform

as a freestanding, independently owned hospital.

here at Lubbock Heart Hospital as a patient-cen-

â&#x20AC;&#x153;Thatâ&#x20AC;&#x2122;s simply an economic issue; itâ&#x20AC;&#x2122;s about the

tered healthcare provider. Really, thatâ&#x20AC;&#x2122;s where it all

bankâ&#x20AC;&#x2122;s willingness to lend,â&#x20AC;? says McGreevy. â&#x20AC;&#x153;The

starts,â&#x20AC;? he says.

pipeline out there is very thin in terms of access to capital financing.â&#x20AC;?

Rated High for Quality and Satisfaction

McGreevy says the key is managing with key metrics. â&#x20AC;&#x153;All of our leaders, physicians, and staff at Lubbock Heart Hospital recognize the practice standards. They know they need to follow them. Standards are hard-wired into the orders for the patient,

In spite of all this, the hospital continues to succeed

and also, the physicians are on board with them.

financially. Lubbock Heart Hospital continues to be

We have a day-to-day culture at Lubbock Heart that

one of the top rated hospitals in the nation in terms

patient satisfaction and patient quality is a number

of quality of care and satisfaction. They are a top

one priority.â&#x20AC;?

York Central Hospital

Over the past 47 years, York Central Hospital has transformed itself from a 100bed hospital serving 25,000 people to become a major regional health centre serving a population of about a half million residents. Located in Richmond Hill, Ontario the hospital serves one of Canadaâ&#x20AC;&#x2122;s fastest growing and most culturally diverse communities. The current growth rate for the area is 3.8% - a rate that is approximately twice that of the provincial average. To keep pace with the needs of its community, the hospital continues to steadily expand its facilities while planning for future expansion on both its existing site in Richmond Hill and a future hospital site in Vaughan.

tier hospital in terms of CMS core measures. â&#x20AC;&#x153;Our patients rate us in the 93rd percentile on the Hospi-

by T.M. Simmons

tal Consumer Assessment of Healthcare Providers and Systems (HCAHPS) question of likelihood to

Real Issues : Real Solutions

â&#x20AC;&#x153;The focus of these efforts is around building a strategically focused organization, refreshing our clinical vision and strategy so that we can continue to translate our actions into best practice,â&#x20AC;? says Joanne Marr, Acting President and CEO. â&#x20AC;&#x153;Part of that will involve an exercise in clarifying our actual vision, to define [what it means to be] a large community hospital in Canada.â&#x20AC;?

A Capacity Building Journey Last year York Central Hospital celebrated the grand opening of phase one of its redevelopment project. The $93.2 million expansion of its main hospital site that added 148,000 square feet of space to the hospital has helped to shorten wait times and increase the community’s access to care. Already seeing the benefits, York Central was one of only two hospitals in the province to meet targeted wait times in the Emergency Department. The hospital was also named as a Best Practice Spotlight Organization by the Registered Nurses Association of Ontario.

Precise Parklink is an innovative Parking

The construction effort tripled the size of the

Services Company with a strong presence in the

emergency department and created new medi-

Healthcare Sector. Our success at York Central

cal imaging suites. The hospital now has a new and

Hospital is a prime example of the importance

significantly expanded chronic kidney disease unit, a

of a strong partnership between facility owner

brand new intensive care unit, new and expanded staff

and parking operator. As a vertically integrated

and conferencing facilities, two new surgical inpatient

parking services firm, our turnkey solutions pro-

Institute for the Public Administration of Canada.

units, a new inpatient/outpatient mental health facility, including psychiatric intensive care, and a new and expanded Family Birthing Centre. There are ongoing

ing leading practices in the area of management and

plans in place for the continued refurbishment of the

leadership,” says Marr. “The funds have helped us to

existing campus and facilities.

develop an office of strategy management, as well as

Beyond physical capacity, the hospital has also de-

storytelling which says the way you tell stories can

patient and employee satisfaction. Recent surveys in-

have a powerful impact in changing practice. This is

dicate steadily increasing rates of patient satisfaction.

something the clinicians are in the process of learn-

Staff satisfaction surveys indicate higher than average

ing. Part of the award supports the publishing and

ratings by the perception of hospital staff that the en-

presenting of our experiences in developing our report

vironment is favorable to diverse cultures. “We need

card and pay-for-performance system at health care

to create a culture and a workplace where respect and

conferences. So not only does that money help us

inclusion is fundamental to the way we approach care,

to take our journey to the next level, it also involves

the way we do business, and the way we work with one

sharing our learnings with others in the industry.” York Central Hospital has now completed the pilot phase of a patient flow process improvement project

In the last year York Central has shown a significant decrease in staff turnover, as well as an 85%

sponsored by the Ministry of Health. With an initial fo-

reduction in the use of agency staff. Given the highly

cus on the interactions and communications between

competitive nature of the Ontario health care market,

the emergency department and an inpatient general

the increased retention of staff and reduced depen-

medicine unit,where hospital bottlenecks were most

dency on agency are solid indications that the focus on

often found, the project learnings are now being used

patient and staff satisfaction is paying off.

to improve the timeliness and quality of patient care

Future Development Focuses

to none in the industry.

develop an approach called dynamic evaluation and

veloped a multi-pronged focus that includes improved

another, as well as our public,” says Marr.

vide peace of mind and customer service second

“The IPAC grant recognizes us for demonstrat-

throughout the hospital The hospital has also done significant work in the

Many of the awards and recognitions York Central

area of mentorship in the last couple of years. “We’ve

Hospital has received come with funds for further

been very successful as an organization in bringing

development. A recent recognition for their capacity

new graduates from a variety of disciplines into the

building efforts, for instance, comes from IPAC, the

organization and offering them further development

opportunities under the guidance of experienced staff, to help create a workplace of choice,” says Marr. An Aging at Home project illustrates York’s collab-

Just One Part of the Community

orative approach with other healthcare organizations

“We are part of a broader system,” says Marr. “I

and a willingness to look outside of their own system

think that’s an important paradigm. We need to think

for answers. “We have successfully initiated new ser-

outside the walls of our organization and we need to

vices targeted to allow older adults to be cared for and

seek out partnerships and alliances in a strategic way

to stay at home longer, to receive a more significant

because we can’t be all things to all people. There are

amount of service at the community level,” says Marr.

certainly things that hospitals are particularly suited

“We have also collaborated with another area hospital

to do, and I think as hospitals we need to provide a

to develop a nurse led outreach team to long term

leadership role from that perspective and connect the

care (LTC) facilities. This allows nurse practitioners to

dots for patients and their families.”

provide onsite care to residents, and education

“We don’t need to do everything, but as part of a

for staff, to improve the quality of care in the LTC

broader system, and in partnership with other health-

facility, while reducing unnecessary visits to the emer-

care providers and other agencies, even outside of our

gency department.”

sector, we can create an actual healthcare system.” by T.M. Simmons

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

06| St. Joseph’s Hospital and Medical Center

Operational Priorities Considering the effects of a budget crisis in Arizona,

the world. The hospital constructed a new neurosci-

along with issues of unemployment and housing, CHW

ence tower three years ago. The organization sees

two years ago started a ministry transformation and

this expenditure as not only improving care for today

strategic planning process called “Transformational

but aiding in earlier diagnosis, personalized medicine,

Care.” In addition, the organization implemented the

genetics and genetic testing. In addition, the hospital

Lean Process, examining ways to improve patient flow

is scheduled to launch the Center for Adaptive Brain

and optimize the patient experience.

Function, which will bring more advanced diagnosis

“It’s about continued improvement,” Hunt said.

for brain tumors as well as aid in the study of surgical

The Lean Process was implemented after what Hunt called “major budget shortfalls” at St. Joseph’s. During an employee forum, staff members introduced

and stimulation ways to treat depression and other behavioral issues. “All of those types of things are a result of incred-

ideas for saving money - $5,000 here and $5,000 there

ibly intelligent physicians working alongside research-

– eventually totaling $60 million.

ers and moving the technology forward,” she said.

“We came up with creative ways to remove excess

Within CHW, the organization is launching a new

from our organization, and it was really driven by the

integrated information system, in addition to an elec-

staff,” Hunt said. “They gave us ideas and we kept

tronic health record system for physicians. Hunt adds

them abreast as to what they were implementing.

that they have the ability to create a comprehensive

These efforts resulted in a reduction of existing bud-

network that would allow for population management

get shortfalls from being $18 million behind to just $2

and handling chronic illness.

million behind.”

Capital Expenditures The Barrow Neurological Institute at St. Joseph’s is

“We’re building that continuum, that integrated network to deliver what we think is going to be the future care for everything we’re going through,” she said.

consistently ranked as one of the top neuro centers in

St. Joseph’s Hospital and Medical Center Starting with its founding by the Sisters of Mercy 115 years ago in Phoenix Arizona, St. Joseph’s Hospital and Medical Center has evolved into a destination hospital, serving patients close to home and thousands from around the world who come annually for the hospital’s highly specialized care. “We have an incredible organization with a long history, yet continue to reinvent ourselves and invest in the people who make St. Joseph’s special,” said CEO and President Linda Hunt. “We have set out to become a destination facility, a destination where patients, physicians and health plans believe we are the best place to send patients with special types of needs. Part of our mission is to not only improve the health of this community but to advocate for the poor and the underserved.” St. Joseph’s is home of Barrow Neurological Institute and the Muhammad Ali Parkinson’s Center . Besides neurology, the hospital’s specialties include cardiovascular and pulmonary disease, gynecological, high-risk obstetrics. In addition, for many years the hospital operated the only Level I trauma center in the state. St. Joseph’s is a 670-bed, non-profit hospital that is one of 40 hospitals that make up Catholic Healthcare West CHW, one of the largest healthcare systems in the west, covering Arizona, California and Nevada.. Hunt, who has served as president of St. Joseph’s for almost 10 years, is also regional president for all CHW entities in Arizona.

In addition to serving patients, St. Joseph’s is an academic medical center with a large medical education program that includes 200 graduate medical residents from 10 different residencies, as well as a substantial research component, Hunt said. As part of this aspect of the hospital, CHW has an agreement with the Creighton University School of Medicine and is currently going through the process of becoming a regional medical campus for the university. The hospital is also a reseach hub where more than 45 full time scientists do basic and clinical research. On average, there are more than 400 clinical trials underway at any time. While other medical organizations also provide specialty care, it’s the organization’s history of care that Hunt feels differentiates them from other medical facilities in the area. “When you talk about the culture and the values at St. Joseph’s, you find that those aspects are part of everyone here, from the administrative level to the staff level,” she said. “It’s important that our patients feel that they have come to a place of caring, not only physical caring but spiritual caring as well.”

HCE EXCHANGE MAGAZINE

07 | Ohio Presbyterian Retirement Services

Technology Partner St. Joseph’s serves as a GE Imaging Research Center, where in-house physicians and scientists, along with

coffee while at the same time sharing information about what’s going on at the hospital. “Because of the type of organization we are, we

engineers from Arizona State University, work with GE

conduct a lot of continuing education, both from a phy-

engineers to look at the next-generation of imaging in

sician and a staff standpoint, on the topic of how we

MRI and CT. Together they’re working on innovations

can communicate better and work better as a team,”

that would allow for faster imaging with reduced

she said.

radiation. This makes it easier and safer for patients to undergo vital imaging procedures, Hunt said.

Workplace Environment

Open communication is definitely a two-way street at St. Joseph’s, and occurs at all levels. Physicians can speak through a council comprised of 14 of their medical peers, using the group as a conduit for shar-

Known for its culture of “employees helping each oth-

ing issues with the hospital’s leadership team. Hunt

er,” St. Joseph’s has been selected as one of the best

believes that this, as well as other communication

places to work in Phoenix for the past six years, Hunt

efforts, makes employees feel important.

said. In addition, in 2009, the hospital was selected

a problem as anyone else in the organization,” she

to Work in Healthcare. Some of the features employ-

said. “Staff at St. Joseph’s feels comfortable working

ees benefit from includes educational opportunities,

with leadership to resolve problems. I love to have

scholarships and stipends for continuing education

their input. I love it when they disagree because many

and programs that examine new employees skill sets

times we’ve not thought of something and we go back

to determine where they can best utilize their exper-

and fix it.”

Hospital administrators reach out to staff mem-

By Kathy Knaub-Hardy

bers in a number of ways, Hunt said, but one method in particular reaches their stomachs as well as their

INDUSTRY PARTNERS

minds. Leadership personnel make regular “coffee cart rounds,” going throughout the hospital at all hours of the day and night, handing out donuts and

When it comes to expenses on the operational side of the home healthcare business, after people, technology is the number one cost, King said. With care givers going from home to home, it takes a tremendous IT effort to keep everyone connected. The laptop computer can become the most important tool when a home care provider visits a client site, she said. In addition, there is technology directly associated with caring for the elderly, such as Lifeline medical alert systems and automated medicine dispensers.

“They have as much say regarding the solution to

as one of Modern Healthcare’s Top 100 Best Places

tise within the organization.

Remote Operational Expenses

Carl Zeiss Meditec MEDITEC.ZEISS.COM

Ohio Presbyterian Retirement Services Nancy King, COO of the Senior Independence division of Ohio Presbyterian Retirement Services (OPRS), knows evolution first-hand. She began her career with this provider of home- and community-based senior care as a social work graduate student in 1983 and is now responsible for the operation of services from home health care, hospice care to adult day care and meals on wheels, overseeing 600 employees in the process. Also during her tenure with OPRS, King has seen an evolution in society’s understanding of how long seniors can remain independent and in their homes. With the parents of the country’s growing Baby Boomer population needing some form of assistance, the idea of caring for seniors at home has become more widespread. “Seniors are more aware of this option today than ever before,” King said. “They are also more aware of and comfortable with these types of programs, where someone comes to their homes to provide them with much-needed assistance. They are more interested in finding programs that will help them remain at home.” In addition, King points out that increased regulations for senior home care services, as well as the availability of technology that can assist in home care, make this a safe and more viable option. More medical professionals are entering geriatric specialties as well, creating a larger pool of personnel to handle the unique needs of senior citizens who are living longer than ever before. Founded in 1922, OPRS is a non-profit, faith-based organization located in Columbus, Ohio. Senior Independence one of three subsidiaries that make up the organization, served 75,000 individuals last year, according to King. Another subsidiary, OPRS Communities –– maintains 11 Continuing Care Retirement Communities throughout Ohio, housing 2,600 residents. In addition, the OPRS Foundation raises funds for people served by the organization, to support ongoing projects and to provide services for those who cannot afford to pay.

Make it Happen In keeping with the organization’s key values of kindness and trust, King described a program called “Make it Happen,” through which OPRS employees provide little extras for seniors to make their lives special. For example, she tells the story of one of their clients, a 90-year-old woman, who wanted to go skiing one last time. The staff organized a trip to make that happen for her. In another case, staff members helped a client reconnect with his daughter, who he had not seen in many years. “Our employees perform the regular tasks of their jobs on a regular basis,” King said. “This program is about going above and beyond the every day activities and providing something special. The clients and their families are going to remember these special things

Senior Independence provides training for individuals

more so than the baths and meals served.”

and families to help them understand their options when it comes to advanced care planning and ad-

Trust

vanced directives.

Quality assurance is key with an in-home care busi-

Oftentimes, King said, the decision-making pro-

ness, King said. Employee behavior is monitored and

cess can be confused by what she calls today’s “cure

clients are surveyed on a regular basis to make sure

philosophy.”

that there are no breaches of confidence. With 400,000

“The healthcare community wants to diagnose and

“Moving forward, a big challenge is determining how we keep the Medicare benefit intact and have a reasonable reimbursement for all healthcare services,” and the independent living,” she said. “That doesn’t meet the larger need. Our goal is to be the YMCA of

client visits every year, King said she needs to know

cure and that’s good,” she said. “But sometimes, in

that she can trust her staff to not only take proper

the last six months of life, that isn’t what people want.

senior services.”

care of clients, but to follow through on promised

They may want a quality of life at home that doesn’t

pick-up times and other appointments.

involve being in the hospital or undergoing a lot of

Medicare Issues

“We have to be trusted by our clients,” she said.

diagnostics. We help people understand what medical

“We go into their homes unsupervised, providing one-

care could be like for them in the future and then help

on-one care. It’s a very scary thing for clients to have

them make decisions ahead of time.”

to open their doors to someone. We need to earn our

One online resource available to clients and their

clients’ trust every day.”

families is iCaregiver.org, an award-winning Web site maintained by OPRS that provides information on

Senior Healthcare Challenges

such topics as care-giving issues, senior healthcare terminology, challenges and solutions, and options

One of the biggest challenges faced in senior health-

and resources. King notes that the organization is

care today involves the decision-making process for

working on a new program, iPartner, designed to help

the elderly and their families. The decision whether

organizations similar to OPRS develop their own line

or not to remain in the home and seek in-house care

of home- and community-based services. To be

versus finding an appropriate continuing care retire-

a leader in the senior healthcare field, she believes

ment community requires a great deal of research

that OPRS needs to offer more than just once piece of

and faith in the providers of senior healthcare today.

the continuum.

Through a program called “Respecting Choices,”

“We can’t just offer the nursing, the assisted living

Another challenge King faces is dealing with insurance companies and managed care. While the privatization of Medicare is different in various parts of the country, the situation has been a tremendous challenge for providers and seniors to deal with, she said. Oftentimes, the process is too complicated to understand and seniors end up joining plans without sufficient knowledge of the plan and what it offers. “Moving forward, a big challenge is determining how we keep the Medicare benefit intact and have a reasonable reimbursement for all healthcare services,” she said. By Kathy Knaub-Hardy

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

08 | Tulare Regional Medical Center

Tulare Regional Medical Center Items of No Compromise Construction on the original Tulare Hospital began in 1949 and more than half a century later, the organization is breaking ground for an expansion project that will position them to continue meeting the needs of their region. Shawn Bolouki took over as CEO of Tulare Regional Medical Center two years ago. Said Shawn, “When I arrived at Tulare Regional Medical Center there wasn’t a permanent management team. The first six months I hired a Vice President of Business Development, a Vice President of Human Resources, a Chief Clinical Officer, a combined position of Chief Operations/ Chief Financial Officer (COO/CFO) and created the position of Chief Compliance/Quality Officer.” The 112-inpatient bed facility was projected to lose more than a million dollars the year Bolouki arrived. “The first year I was here, we turned it around and the hospital had a positive operating margin of $2.8 Million. We are now focusing on the expansion project.”

“My management philosophy is really very simple,”

past 20 years, you really have to build a compelling

said Bolouki. “The keys to success are; no compro-

reason for employees to understand why changes

mise on quality of patient care, and no compromise on

are needed.”

compliance requirements with regulatory agencies.

Bolouki says the constant challenge in his job is

In addition, focused customer service is paramount.

that he has to clearly explain to the employee’s the

For any organization to be successful, it has to be

current status of the hospital and how it is perform-

financially viable and fiscally disciplined.”

ing. If Tulare Regional Medical Center continued on

Bolouki believes in open dialogue. “Considering

the same path, it was not going to be a successful

all the pending changes in healthcare, there is no

organization and I needed to change the way we do

such thing as over-communicating. Keep everybody

business.

informed of what the challenges are, then when we

“Change is difficult because we are human

make difficult decisions, they will understand the

beings. We are afraid of the unknown. If the orga-

reason behind our decisions,” he says.

nization is going through this process and I do not

“Tulare Regional Medical Center has many long-

communicate, there will be a lot of unknowns for our

term employees,” he said. “They have their culture

employees and they will become anxious. They can

and values. When I came into the organization and

not really stay focused on implementations neces-

needed to make changes, I had to look at how to make

sary for change. That’s why you communicate and

changes within the context of the existing culture. If it

communicate. There is no such thing as

seems that everything has been working fine for the

over communicating.”

Siemens offers a comprehensive portfolio of solutions and technologies that helps deliver an optimum healthcare experience while ensuring a more sustainable environment. Our mission is to find answers to the toughest questions facing healthcare and help our customers deliver the highest quality of care at the lowest cost possible â&#x20AC;&#x201C; ultimately providing more personal care for more patients. As an innovation leader for more than 160 years, Siemens is engineering the delivery of healthcare to help our customers prevent, diagnose and treat disease in

many different areas. Right now, I am building this fa-

ways never before possible.

cility. Iâ&#x20AC;&#x2122;m constantly thinking about what is happening with the construction or what trends will impact the

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cost of the raw materials. I am following the changes in healthcare and the impact of the healthcare reform and I worry about the final product and how this is He also believes in deadlines and accountability. â&#x20AC;&#x153;I

going to impact Tulare Regional Medical Centerâ&#x20AC;&#x2122;s

tell my colleagues that accountability starts with me,â&#x20AC;?

reimbursement.â&#x20AC;?

he says. â&#x20AC;&#x153;In order to build any organization, you need

The state of California has more than a $19 Bil-

a lot of good and dedicated people. I think the role of

lion shortfall in their budget; Bolouki canâ&#x20AC;&#x2122;t help but

CEO is to act more like a coach and assemble a team

wonder how this is going to affect the hospitalâ&#x20AC;&#x2122;s ability

with the specific expertise the organization needs and

to get paid by the state government. Last year reim-

then through direction the team works together to

bursement was cut by 10%, which had a net impact

produce the result.â&#x20AC;?

of $1.5 million to Tulare Regional Medical Centerâ&#x20AC;&#x2122;s

Expansion

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their primary care clinics, so Bolouki had to assume

The expansion project is expected to be completed

operation of those clinics to make sure community

in 2012. It will include a 115,000 square foot medical

members have access to quality care and the popu-

tower. Additions will include a 26-bed emergency de-

lation served in those clinics didnâ&#x20AC;&#x2122;t end up in Tulare

partment (400% increase in capacity), six new surgery

Regional Medical Centerâ&#x20AC;&#x2122;s Emergency Room.

suites, 16 private birthing rooms, a new nursery and

%\ LQWHJUDWLQJ LPDJLQJ ODE GLDJQRVWLFV DQG KHDOWKFDUH ,7 ZH FDQ DGYDQFH WKH VFLHQFH RI PHGLFLQH DQG WKH HFRQRPLFV RI KHDOWKFDUH

bottom line. Then the County decided to close some of

â&#x20AC;&#x153;The number of the patients coming to our emer-

a new NICU, 27 private medical surgical rooms, and a

gency room has grown by 12% in the past year. When

state-of-the-art imaging center. Bolouki has already

I look at the trends in healthcare, I wonder, what is

been able to reduce the cost of construction by more

going to happen next?â&#x20AC;? Bolouki says. â&#x20AC;&#x153;Tulare Regional

than $5 Million by consolidating purchases of high end

Medical Centerâ&#x20AC;&#x2122;s mission here is focusing on quality

equipment from a single vendor.

patient care, demonstrated in our core measures and

The new facility will be energy efficient, to meet

customer service; we are doing very well, better than

the standards set by the State of California and we are

the hospitals in surrounding areas. Tulare Regional

also looking at possibilities such as solar power. â&#x20AC;&#x153;But

Medical Center is the only hospital in the Central Val-

my goal is a true operational efficiency,â&#x20AC;?

ley with 2 national accreditations, The Joint Commis-

says Bolouki.

sion and Det Norske Viritas (DNV). Quality counts.â&#x20AC;?

Staying Prepared

by T.M. Simmons

â&#x20AC;&#x153;I cannot predict the future, and that keeps me on my toes,â&#x20AC;? Bolouki says. â&#x20AC;&#x153;I am constantly looking at so

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HCE EXCHANGE MAGAZINE

09 | UCSF Medical Center at Mission Bay

UCSF Medical Center at Mission Bay In 2014, women, children and cancer patients will have a brand new 289-bed hospital complex in San Francisco. The finished product will be an 878,000 square feet expansion of University of California San Francisco (UCSF) Medical Center, one of the top-10 academic medical centers in the country. It will be located adjacent to the current Mission Bay Research Campus which is part of a 303 acre redevelopment area of the city. The current and expanded Medical Centers serve not only San Francisco and the Bay Area, but provide specialized care to patients from all over the United States. Ground breaking for the construction project is expected to take place in late 2010. “The planning for this project really began in 2000, so this is a long-term endeavor. It’s also been a marathon. Obviously, for UCSF we had to develop a vision for what this campus would be and that vision culminated in plans for specialty services for children, women, and cancer patients,” says Cindy Lima, Executive Director of the Mission Bay Hospitals Project. Lima has worked at UCSF in hospital administration, operations and facilities planning for 22 years now.

Creating New Facilities from the Ground Up

began with a very tight deadline for completion.

Current medical facilities for UCSF are operating at

stages. “The challenge was to help people see the big

capacity. “We have long waiting lists of patients who

picture and that we needed to be reasonable and ob-

need our specialized care,” says Lima. As well, seis-

jective so that we could keep the project manageable

mic regulations for buildings in the state of California

and affordable,” says Lima. “The organization very

mean that some of the older facilities will have to

much needed this project to happen and was flexible.

be closed in the near future. This means the project

Everybody sacrificed in one way or another, but man-

Forty different user groups were involved in the initial

HCE EXCHANGE MAGAZINE

aging the different planning groups, with everything

241,'%6 &'.+8'4; 57%%'55 ;17 %#0 %1706 10

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nication and the decisions that were being made, this was a big job.â&#x20AC;? The community at large was also consulted. For instance, the group proposed to have the cityâ&#x20AC;&#x2122;s first hospital-based helipad, a subject that had traditionally been met by resistance in San Francisco. â&#x20AC;&#x153;Luckily, our campus is within two blocks of San Francisco Bay and that will work to our advantage since the primary path of the helicopter would be over the bay to the medical campus. We had years of meetings just around the helipad, including a test flight that involved the community, and we were ultimately successful in getting unanimous approval by the San Francisco board of supervisors,â&#x20AC;? says Lima. Now the architect, general contractor and all the subcontractors are at work creating a virtual 3D building model of the new facilities. â&#x20AC;&#x153;We are working to maximize efficiency and Lean production and drive those dollars out,â&#x20AC;? says Lima. Fundraising is well under way to cover the projected 1.5 billion dollar project. The group has successfully reduced $200 million from the originally approved budget amount.

Building Green The new facility should be among the greenest hospitals in the country as they target LEED gold certification. The building plans include 60,000 square feet of

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10 | Bakersfield Memorial Hospital

rooftop gardens and another 150,000 square feet of

patient-centered facilities and jobs to the broadest

landscaped areas on the ground. They expect to save

impact of advancing health worldwide.”

two to four million gallons of water each year, includ-

“We want to make this facility the best it can be.

ing a system which takes the blow down water from

In doing that, we’ve attempted to learn as much as

the cooling towers and treats it, then uses it to irrigate

we can from others, to be creative, to think outside

the rooftop gardens. Bio swells around the perimeter

of the box and deliver benchmark facilities that not

of the parking areas will clean storm water on site.

only meet all the needs of our patients, from infec-

“We feel that we will be able to be 50% more

tion control to healing environments to operational

energy efficient than the average US hospital, which

efficiencies, but also to meet the needs of faculty and

includes an array of different strategies,” says Lima.

staff that deliver the care and also meet the needs of

“One of the things we’ve addressed uniquely is that

our visitors,” says Lima. “UCSF is a large and com-

we’ve gone through an unprecedented screening of

plicated organization. Getting everybody moving in the

the materials that will be used in building for toxicity,

right direction, especially during our program plan-

carcinogenicity, endocrine disruption and a variety of

ning, was very challenging, but in the end extremely

filtering criteria. The industry is not quite ready for

successful. Working with the community has kept me

this. We’ve had to do chemical screenings and the

awake at times, but after years of meetings and years

questions we are asking are not always welcomed by

of working through issues, we are all very proud of the

industry, but I hope we’ll put more pressure on them

way things are turning out.”

to develop healthful materials that we can use inside our centers as part of our mission to heal and to care for patients.”

Improving Health Worldwide

Bakersfield Memorial Hospital

by T.M. Simmons

The largest regional medical center in California’s Southern San Joaquin Valley began as the small community hospital of Bakersfield in 1956. It now has 406 beds and has been affiliated with Catholic Healthcare West (CHW) since 1996. It offers a full-range of specialty services from cardiac and orthopedics to neurology.

Towering Expansion

on top of an existing occupied floor.” Two departments

Bakersfield Memorial Hospital recently completed a

were temporarily relocated while the steel and major

114-bed patient tower which was built right on top of

components of construction were assembled. Then

the existing hospital. The tower was built in response

that first floor area was renovated. When the tower

to the California seismic law, which right now is ex-

was complete, those departments and some addi-

pected to take effect sometime in 2013. In anticipation

tional ones were able to move in.

By building these new facilities near the current

of that law, the hospital added a 24-bed intensive care

research campus, UCSF expects to further propa-

unit, 60 private rooms for general medical care, and

the footprint and the existing steel they could build

gate the medical discoveries which are taking place

30 private post-partum rooms for moms and babies.

on top of,” says Peters. “It was a pretty tricky project

there. “We see the impact as very far reaching, from the most intimate, local sense in terms of creating

“The challenge on this particular project,” says Bruce Peters, Chief Operating Officer, “was building

“Our architects were constrained somewhat by

for them. The beauty of it was—as long as it took to design and build—we ended up coming in on time and

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

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care, and eliminate duplicate medical records. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;ve actually implemented a new process that has allowed us to capture more co-pays and co-insurance at the front end of the visit and thatâ&#x20AC;&#x2122;s allowed us to collect a lot more revenue that weâ&#x20AC;&#x2122;ve historically missed either because of inaccurate billing or the inability to capture

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information.â&#x20AC;? They are also working to get discharged patients

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home earlier in the day. â&#x20AC;&#x153;Our average discharge time was late afternoon, around 4pm, and weâ&#x20AC;&#x2122;ve been able to move that back several hours.â&#x20AC;?

especially with something this complex.â&#x20AC;?

just another quality improvement effort. It was a

Other plans include expansion of the hospitalâ&#x20AC;&#x2122;s pediatric service line. A pediatric intensive care unit will be the first in the county. â&#x20AC;&#x153;Currently, patients

fundamental change in the way we do business,â&#x20AC;? says Peters. Early in the process, the hospital began to realize

have to travel two hours or one hundred plus miles

significant savings in dollars, in the half million-

north or south to get to a childrenâ&#x20AC;&#x2122;s hospital. Ba-

dollar range for work done by these pilot teams.

kersfield expects to have itâ&#x20AC;&#x2122;s its new unit open by the

â&#x20AC;&#x153;For our emergency department, it really helped our

end of the year.â&#x20AC;?

throughput. Getting people into beds or getting them

Another enhancement to the hospital added

out the door when theyâ&#x20AC;&#x2122;d been treated,â&#x20AC;? says Peters.

by the new construction is that they secured the

â&#x20AC;&#x153;We significantly reduced our wait times and are

infrastructure for wireless capability throughout

closer to some of the national benchmarks. It was a

the hospital. â&#x20AC;&#x153;We made sure we will have a good IT

tremendous effort in the emergency department that

backbone and plenty of capacity to handle any future

is ongoing.â&#x20AC;?

additions and upgrades,â&#x20AC;? Peters says.

Transformational Care

Once they got through the pilot program phase, they started adding more teams who will continue to work alongside the teams that got started last

In April of 2009, Bakersfield became one of the pilot

year. In the OR, for instance, they are looking at

hospitals for CHW for a Six Sigma type project they

turnaround times between rooms and effective

call Transformational Care. They began with four pi-

scheduling. In registration, they are working toward

lot teams in the spring and summer of last year. â&#x20AC;&#x153;We

more accurate and complete forms which will result

worked to teach all the tools, to do all the training

in better billing processes, better coordination of

â&#x20AC;&#x153;Some of this sounds pretty fundamental, but going through the transformational care process has

%8,/'(5 of

really helped us get there,â&#x20AC;? says Peters.

Hospitals in California

The COO Role in Healthcare â&#x20AC;&#x153;I think anybody who wants to get into hospital work, or get into the role that I am in, you really have to be able to work well with people,â&#x20AC;? says Peters. â&#x20AC;&#x153;This is a people business, so people skills are of primary importance. We can teach you everything else; policy, procedure, forms, this and that. But being able to relate to people, being able to work with people, work with physicians, work with all the other outside constituentsâ&#x20AC;Ś you really have to be part politician,

Rudolph and Slettenâ&#x20AC;&#x2122;s training and services are unique to healthcare construction, and include expertise in infection control, site planning, logistics and working around operating facilities, and understanding OSHPD requirements.

part manager, part counselor, part visionaryâ&#x20AC;Ś a lot of different parts that come together in administration.â&#x20AC;? â&#x20AC;&#x153;Just become a student of people. That would be my advice. Itâ&#x20AC;&#x2122;s hard work, but itâ&#x20AC;&#x2122;s extremely re-

To build your hospital with quality and expertise, call Dianna Wright at (650) 216-3610.

warding work.â&#x20AC;? by T.M. Simmons

^^^ YZJVUZ[Y\J[PVU JVT Real Issues : Real Solutions

as ranked by California Construction in 2008

photo by RMA Architectural Photography

with the staff so it was clear to them that this wasnâ&#x20AC;&#x2122;t

/LFHQVH

under budget. You donâ&#x20AC;&#x2122;t get to say that very often,

“the best way to find out what is good and bad and what you need to fix is by having one-on-one conversations.”

11 | Opelousas General Health System

Becoming One Healthcare Entity “One of the things we wanted to make sure of was that we didn’t have two competing hospitals, but that we would become one entity, one medical staff, one cadre of employees that are all part of the same medical family,” says Fornoff. The overall plan was to move most of the subacute services to the second facility, now called the Opelousas South Campus. Both hospitals maintain

GILSBAR

24/7 emergency departments, for instance, but

Recognized as a pacesetter in the health benefits in-

through media efforts the hospital has worked to

dustry, Gilsbar holds solid partnerships with brokers

portray its second campus as a walk-in clinic type of

and employers across the nation. Gilsbar’s com-

atmosphere rather than a trauma environment. The

prehensive and thought leading benefit solutions,

ambulances continue to deliver people to the main

employee engagement strategies, and commitment

campus which manages about 25,000 cases per year.

to client satisfaction are some of the many qualities

The second campus sees another 10,000 to 12,000

that set Gilsbar apart. Benefit advisors, employers,

walk-in visits annually.

affinity groups, insurance carriers, and individuals

Opelousas General Health System Opelousas General Health System is a community hospital that was founded over half a century ago. It started as a 60-bed hospital and has grown into a 286-bed hospital with three campuses, 1,200 employees and about 200 physicians on staff. The hospital is unique for the state of Louisiana in that it is a hospital trust authority. This means that it doesn’t pay taxes, like any other not-for-profit hospital in the state, but it has been granted additional authority relative to purchasing. In short, the hospital is allowed to gain debt similar to a private entity.

Moving some services to the second campus

trust Gilsbar to provide market driven benefits and

has allowed Opelousas to focus on doing some

risk mitigation solutions.

much needed upgrading and remodeling on areas of

gilsbar sets the pace... In an industry that is constantly changing, Gilsbar is setting the pace for health plan management. Gilsbar’s 360° Benefit Plan Management® program is a holistic approach to self-funded health plan management that removes barriers to controlling healthcare costs and creates a culture of health through member engagement.

In the last five years, Opelousas has built a new patient tower and emergency department and purchased the competing hospital in town. “This service area was big enough to have maybe one and a half hospitals,” says Gerald Fornoff, President and CEO. “It became evident that because of our unique structure and them being proprietary, to joint venture would take years, so we agreed that the best thing would be for us to do an outright purchase. That was completed in May of last year. We’ve now embarked upon a major restructuring to best utilize both facilities.” 2100 Covington Centre • Covington, LA 70433 • (800) 445-7227, ext 830 • www.gilsbar.com

HOME CARE • HOSPICE • LONG-TERM ACUTE CARE • PRIVATE DUTY LHC Group is a leading provider of home health care services which specializes in joint ventures and acquisitions. LHC Group agencies produce strong clinical outcomes while managing expenses responsibly. Partnering with LHC Group can help ensure your patients receive the highest possible quality care that physicians and families in your community can count on for years to come.

the primary campus. “We are kind of playing some dominoes—moving some areas temporarily while we redo some of the floors, rooms and stuff like that— just some of the cosmetic things—because we’ve been so crowded over the years we’ve really had difficulty

At LHC Group, our philosophy is simple—

getting in and renovating rooms. Once that is done,

It’s All About Helping People.®

we’ll start to relocate departments,” Fornoff says. Managed by Compass Health, an adult psychiatric unit at the second campus has recently opened. “Across the country, one of the biggest problems all emergency departments have is when an adult psychiatric patient comes in and they need to be placed in an inpatient setting. Sometimes they’ll spend 24 hours in the ER and then we’ll have to put them in an acute care bed under guard while waiting to find a facility to accept that patient,” Fornoff says.

300 LOCATIONS | 19 STATES | 7,517 EMPLOYEES JOINT VENTURES | MANAGEMENT | ACQUISITIONS For information contact Daryl Doise, Executive Vice President /Chief Corporate Development Officer at 866.LHC GROUP or visit our website at www.lhcgroup.com.

“Placing patients is difficult, especially in Louisiana for some reason. Some of that will be resolved with the opening of the new psych unit. I think that is a step in the right direction.”

A Top 100 Wired Hospital

A True Community Hospital

Four years ago, Opelousas was listed as one of the top

Employees of Opelousas are encouraged to be

100 wired hospitals in the country. Our Information

involved in the community. “My name tag says Mr.

Technology department is currently half way into a

Jerry. It says Fornoff under there somewhere, but I

three-year project to install a complete new, state-

want people to see my first name before they see my

of-the-art, order entry system. “We’re right on target

last name,” says Fornoff. “That’s our culture.”

with those benchmarks that will allow us to get some

One technique they use is to put the Opelousas

of those federal dollars back for putting in those

name on everything they can—t-shirts, bags,

systems,” says Fornoff. “Another big effort here is

jackets—so that their employees are identified with

trying to go to that paperless environment. We’re

the hospital. Then people in the community tell them

getting there – slowly.”

stories about experiences with the hospital, good and

At this point, all charts have been scanned into the

bad, and the employees return with these stories

system and can be accessed by an Opelousas physician

to the hospital committees so that they can work

from any web portal. Charts can be reviewed, changed,

together to keep satisfaction levels high.

and electronically signed. “All those things that used

“On day one, we try to instill upon our employees

to lead to incomplete charts are now kind of a thing of

that they are the marketing arm of the hospital,”

the past,” says Fornoff. “It’s kind of an interim step as

says Fornoff. “We serve the patients, physicians,

we complete order entry for physicians. Pretty soon

employees, and people who have never been patients.

they’ll be able to do all those things in their offices as

The best relationships, the best way to find out what

far as getting people to admission status, pre-ordering

is good and bad and what you need to fix is by having

tests, and seeing results of the tests that they’ve had

one-on-one conversations.”

for all of their patients.”

by T.M. Simmons

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

12 | UCLA Health System

18,000 Opportunities to Connect The entire health system has about 10,000 staff members, 2,000 physicians, 1,500 residents, and 3,000 volunteers. “That’s about 18,000 people who connect to us,” Feinberg says. “Right up front, we hire people we believe are service minded.” All potential employees, from nurses and physicians to those who perform billing and housekeeping services, are screened by a process developed by the Ritz Carlton. “Despite the nursing shortage, we get about 2,000 applications for every open nurse position here at UCLA. We can be very selective to get the absolute best, not only from a technical standpoint, but also from a compassionate standpoint,” he says. They’ve created a series of DVDs that walk all employees through the proper way to interact with patients. They cover everything from how to enter a room to introduce yourself to how to inform a patient what your purpose is. Are you cleaning a room? Are you a physician asking permission to examine a patient? All employees are taught to communicate what is happening and to let the patients know what they can expect next. “It’s in your job description and we monitor it. Every charge nurse is watching every nurse. Did they go in the room and properly introduce themselves? Did they go over personal questions,

UCLA Health System The UCLA Health System is made up of four hospitals; Ronald Reagan UCLA Medical Center, Santa Monica-UCLA Medical Center and Orthopaedic Hospital, Stewart and Lynda Resnick Neuropsychiatric Hospital, and Mattel Children’s Hospital UCLA. The system also includes a faculty practice group. The hospital system sees about a million and a half patients each year and receives approximately five of those patients each day via helicopter. They do more organ transplants than any other hospital in the United States and are ranked as the #3 hospital in the nation.

“We are thrilled that we’re ranked by US News and World Report as the number three hospital in the United States behind Johns Hopkins and the Mayo Clinic,” says Dr. David Feinberg, Chief Executive Officer of UCLA Hospital System and Associate Vice Chancellor of UCLA Health Sciences. “But most importantly, what makes us get up every day and every night to go to work is what our patients tell us. We are very, very patient centered.” Individual units of the hospital typically rank in the 96th through 99th percentile on patient satisfaction surveys of 6,000 United States hospitals. “We’re a very large academic medical center, but we get very small when we connect with you and your family,” says Feinberg.

HCE EXCHANGE MAGAZINE

positioning questions, pain questions? Did they exit

on his own using the joystick. The robot comes into the

appropriately?â&#x20AC;? Feinberg says. â&#x20AC;&#x153;That goes all the way

room. It has the doctorâ&#x20AC;&#x2122;s face on the screen. It interacts

through the organization. I probably spend 40% of

with the patient. It can use the stethoscope. It can look in

my time literally walking around and meeting with

a patientâ&#x20AC;&#x2122;s ears. It can bring up the medical record and

patients in their rooms. Everybody gets my business

can talk to the patient about what they are seeing on the

card and everybody gets my cell phone number.â&#x20AC;?

screen,â&#x20AC;? says Feinberg.

Leading High Tech

about two seconds the idea that they are talking to a robot

The newest hospital on the UCLA campus, opened

vanishes and they are back, talking to their doctor.â&#x20AC;? he

in 2008, is likely the most technologically advanced

says. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s really about connectivity. One of our doctors

hospital in the world. Every room of the 520-bed

here does it almost every night before he goes to bed â&#x20AC;Ś He

hospital can be converted into an intensive care

will go and make rounds before he goes to sleep and the

unit. Advances include robot surgery for prostate,

families literally come out and say, â&#x20AC;&#x2DC;Oh, Doctor, are you

gynecological, and cardiovascular conditions. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;ve

going to come in to see us tonight? Theyâ&#x20AC;&#x2122;re talking to the

also used a lot of robots to make rounds and to

robot as if it was him. Well, it is him.â&#x20AC;?

â&#x20AC;&#x153;From a patient standpoint, itâ&#x20AC;&#x2122;s phenomenal. After

connect our doctors with patients when our doctors

',6 6 &,3 &, /,1 /,1(6 (6 $UFKLW $UF KLWHFW HFW FWXUH FW X XU XUH ,QW QWHUL QW HU RUV HUL R %UDQGH %UD QGH HG ( G (QYL QYLURQ URQPHQ PHQ HQWV 3ODQQL QLQJ QJ 6 6WUD 6 WUD DWHJ W LHV 8UEDQ 8UE D 'HV DQ 'HVLJQ LJQ

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Patients First

are not at our hospital,â&#x20AC;? says Feinberg. Using robots developed by InTouch Technologies,

â&#x20AC;&#x153;I believe that everything else will work itself out if we

physicians can make rounds with a laptop and a

focus on taking great care of the patient,â&#x20AC;? says Feinberg.

joystick. The doctor could be across the street, or

â&#x20AC;&#x153;We take care of our friends and neighbors.â&#x20AC;?

on the other side of the world. Robots can enter and

$5($6 2) 35$&7,&( $YLDWLRQ 7UDQVLW &RUSRUDWH &RPPHUFLDO &LLYLF Y +HDOWK WKFDU FDUHH +LJKHU +LJ KHU (G (GXFD XFDWLR WLRQ Q . ( . (GXF GXFDWL DWLRQ RQ 6FLHQF 6FL HQFH H 7H 7HFKQ FKQROR RORJ\ J\

As an academic medical center, about half of UCLA

exit elevators and go pretty much anywhere they

hospital business is from the local community, but the

are needed. â&#x20AC;&#x153;Literally, the doctor drives the robot

extraordinary high tech measures also mean they are

8&/$ 1HXURVFLHQFH 5HVHDUFK %XLOGLQJ ,QVWLWXWH IRU ,QIRUPDWLFV /21,

Perkins+Will creates â&#x20AC;&#x153;smart environmentsâ&#x20AC;? that inspire people, connect research, and accelerate discovery. Working in tandem with clients, we address

the hospital for much of the western United States

the complex functional issues of planning, program-

and, in some cases, the world. â&#x20AC;&#x153;There is nobody

ming, and design with award winning solutions that

else doing what we do and thatâ&#x20AC;&#x2122;s about half of our

support cross-collaborative research. For clients

business,â&#x20AC;? says Feinberg. â&#x20AC;&#x153;If we take care of those

large and small, public or private, we ensure that

two communities, Iâ&#x20AC;&#x2122;m sure those two communities

environments are responsive, high performance, and

will make sure that UCLA remains healthy regardless

environmentally progressive, whether a project is a

what happens in healthcare reform or surrounding

new facility, renovation, or addition.

financial issues.â&#x20AC;? â&#x20AC;&#x153;Our entire strategy is built around taking great care of patients. We have the best doctors and the

â&#x20AC;&#x153;Our entire strategy is built around taking great care of patients.â&#x20AC;?

best nurses, but ultimately, making sure that the care is what I would want for my own family, that is my strategy.â&#x20AC;? by T.M. Simmons

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

13 | Allina Hospitals & Clinics

Building for Collaboration “We bring a deliberate approach to determining our needs based on our patient care model and align that with what we need to build,” says Leow. “We are not just building to compete, but seeking opportunities where we can build to collaborate. We are looking to seek out synergies with potential partners to see whether we can build healthcare facilities that can bring the care options to our patients rather than approach them as two competing organizations.” For instance, they have partnered with the Mayo Clinic in Owatonna, MN where Allina brings the hospital component to the community and Mayo provides clinical services. There they built a new, 38-bed hospital to replace the old one. Partnerships aren’t always limited to other healthcare organizations, however. As one example, they are currently collaborating with the Minneapolis College of Art and Design to provide a real world practicum for the students who are going through the program on a replacement clinic in Ramsey, MN. “Whatever design approach we bring to this clinic will also be looked at from a design college perspective,” says Leow. “They bring their creative problem solving processes to help us check whether or not we are practicing what we are preaching in terms of creating a healing environment for our patients and their families.”

Allina Hospitals & Clinics

Not only will Allina be examining clinic design elements with the students, they will also tap into the fine arts department to bring some insight to the students about how Allina has been providing for the

Allina Hospitals & Clinics is non-profit network that includes 11 hospitals and more than 60 clinics in Minnesota and western Wisconsin. Choy Leow is the Director of Design for Allina Design & Construction, a service within the system. Leow provides conceptualization, programming, and planning leadership for facilities creation and renovation for the organization. He’s been with Allina for seven years.

healing arts program. “Deliberate decision in placing art in our system is not just another predication, it also brings design that is evidence based and a totally functional display of purposeful arts that helps contribute to the healing of the patients,” says Leow.

Sustainable Facilities “We are approaching evidence based design cautious-

In such a large system, there is always some sort of construction underway. It might be a new office or an entirely new hospital building. Bill Dunham, Director of Construction for Allina Design & Construction, estimates that the group completes an average of 300 projects per year. Together, Dunham and Leow bring the complete design and construction package to Allina’s internal system.

ly,” says Leow. “Knowing that a lot of the work is still, to a certain extent, theoretical … it’s kind of a constant debate we have internally, whether this is the right time to be integrating an evidence based design.” As a non-profit, Leow says the organization has to carefully consider the dollars they spend. “We made a

Real Issues : Real Solutions

14 | Facility Development & Management, LLC

conscious effort not to adopt LEED certification methods, for instance,” Leow says, because of the additional costs that would be incurred. Instead, the group decided to adopt the Green Guide for Health Care. “We can still practice being green, but not incur additional

“everything from the envelope to the systems that help sustain our care environment.”

costs in the process.”

Growing Ambulatory Surgical Centers A typical FDM center has been a two operating room facility, most often owned by physicians. The size of

At the same time, the group feels that it is impor-

ambulatory surgical centers is growing, however. A

tant to be leading the way in creating a better health-

three or four operating room facility that is joint-owned

care environment. “We make it a two-way street ap-

back and making sure we target our resources to

by physicians and a hospital might be more typical of

proach,” Leow says, “between us as the consumer and

maintaining what we currently have,” says Leow.

those being developed today. FDM usually maintains

as a contributor to the evidence-based design effort.”

“We want to make sure that the facilities and the

a minority interest of 10% of less. “We require that we

care environments that we have invested so much re-

have an equity interest because part of our job is to act

source and dollars in will continue to fulfill and meet

as a mediator between the hospital and the physicians,”

our needs. We are, in 2010, focusing on strengthening

says Hetrick. “The hospitals want us to manage the

Leow says the economic situation of the past few

our infrastructure—everything from the envelope to

physicians and the physicians want us to run the center

years is bringing about a change for Allina. The orga-

the systems that help sustain our care environment.”

in a manner unlike a hospital. There is some traditional

Shifting from Expansion to Maintenance nization remains very liquid in terms of finances, but the focus is changing. “We are now kind of throttling

hospital/physician conflict and part of our role there is by T.M. Simmons

to mediate that.”

Facility Development & Management, LLC Edward Hetrick was part of a small physician practice management firm when the group was asked to help develop its first ambulatory surgery center in 1992. Over time, that aspect of the business grew and Hetrick eventually branched off from the original business to found Facility Development & Management. FDM develops, manages, and has equity interest in ambulatory surgical centers. They primarily do business in New Jersey, but are expanding into New York as the certification process for ambulatory centers in that state becomes more favorable. The company has partnered with clients to develop more than 45 ambulatory surgical centers throughout the US with a wide variety of specialty services since 1992. All of their centers are Medicare certified and/or state certified. “For the first eight years, all we did was develop centers and move on,” says Hetrick. “In 2002, one of our clients asked us to stay and continue managing the center. Since then, we have started to provide full-service management where we actually place an administrator at the center who is our employee on a full-time basis.”

HCE EXCHANGE MAGAZINE

Brach Eichler L.L.C. Congratulates Our Friend and Colleague Edward Hetrick and Facility Development & Management On Their Outstanding Achievements and Industry Leadership

As well as development, FDM consults and helps ex-

what is now possible. “We are performing procedures

isting surgery centers bring in new doctors as many of

that ten years ago would not have been possible. As a

the original partners are getting to the age of retire-

direct result of technology, now they are routine,”

ment. “We are working on the restructuring, changing

he says.

ownership of the centers,” says Hetrick. “I think many of the centers up and running are going to be taking a

The Future of FDM

look at ongoing operations, ownership structure, and

Hetrick says his company has come this far via word

what can be done to improve the quality of cases.”

of mouth, and in many respects that’s how he expects

ance plans, effectively bringing the reimbursement

efforts to a certain degree. It’s minimal,” he says. “We

for procedures down since they are no longer paid as

will do a certain amount of display and trade shows.

out-of-network providers, they look more and more

I also speak at several conferences. It’s really about

to FDM for management solutions, as well. “When the

getting our name out there, getting it recognized, so

reimbursement tightens up, the management practices have to tighten up also,” says Hetrick. “The centers will be viewing professional managers and management companies much more favorably because we have the experience, we have the expertise, and we

101 Eisenhower Parkway Roseland, New Jersey 07068 t. 973.228.5700 Q f. 973.228.7852 www.bracheichler.com

have the personnel who can come in and effectively drive efficient management of those centers.” FDM has picked up several established centers in recent years that are simply looking for cost-effective management solutions. “We are taking them through the process, making them change the culture, and putting in the necessary processes/systems that they will need as they move into the future,” Hetrick says.

Congratulations, Ed, Ellen, and the staff at FDM ROBERT M. ZACCONE, A.I.A/ARCHITECT PRESIDENT

to see it continue. “We’ve started some marketing

As surgical centers have partnered with insur-

What Technology has Made Possible Advancements in technology have been part of the impetus for the growth of ambulatory surgery centers

“making them change the culture, and putting in the necessary processes/ systems that they will need as they move into the future.”

that when someone mentions needing our services, someone else says, ‘Oh yeah, we use FDM,’ or ‘They are someone you should look at.’ They go, ‘Oh yes, I’ve heard of them.’ We’re really looking at the basis of referrals, but to get our name out there so when we are referred there is name recognition.” by T.M. Simmons

in recent years. “At one point in time, the technology

{Specializing in Health Care Facilities and Ambulatory Surgical Centers}

ROBERT ZACCONE & ASSOCIATES, P.C. ARCHITECTURE PLANNING INTERIOR SPACE DESIGN

was so big and expensive that it had to be centralized in a hospital where both the patients and the physicians could come together in one location to utilize it,” says Hetrick. “But technology has moved along to the point where it is now getting small enough to be moved out of the large institutions and into the free standing setting.” Hetrick sites spinal surgeries as just one example where the technology has played a drastic role in

212 White Ave., Old Tappan New Jersey 07675-7411 Tel: 201.767.9575 | Fax 201.767.5541 rzaarchitect@earthlink.net www.rzaarchitect.com HCE EXCHANGE MAGAZINE

15 | North Bay General Hospital and Northeast Mental Health Centre

In Process “We’re obviously in the process of doing a lot of different things,” says Bouchard. The move to the regional health centre is scheduled for the end of January of 2011. They’ve implemented a full line of automatic drug dispensing units at the Northeast Mental Health. Those units will be partially implemented at the North Bay General before being fully implemented in the new building. Technology adds a lot of flexibility to healthcare that didn’t exist before. “It takes the distance out of the equation,” Bouchard says. “Because it doesn’t matter if you are miles away or thousands of miles away from computer connectivity standpoint. One of the major challenges in northern Ontario is the huge distances between sites and some of our campuses.” The region is bigger than Texas, bigger than France, according to Bouchard. “It’s a huge, huge land

North Bay General Hospital and Northeast Mental Health Centre

mass. Physicians now have more information available electronically and we’re going to have physicians anywhere in the northeast with access to that information. I think people are buying into it. More by necessity—they don’t all like the technology—but they see the benefits. Typically, whenever there is a

A couple of decades ago, many health systems did not yet have a specific department for information technology. For those that did, managing IT for a hospital system primarily involved keeping the internal systems up and running. The IT manager might have been the guy who went around the hospital showing employees how to use new software or rebooting computers when things went awry. Though Marc Bouchard has a job title that is fairly new in terms of careers in healthcare, his duties are critical to the heart of any modern healthcare organization. “Basically, I overlook all information technology operation, as well as privacy rules and regulations, and reinforcement,” he says. Bouchard is the Chief Information Officer and Chief Privacy Officer for the North Bay General Hospital and the Northeast Mental Health Centre. The two organizations are in the process of an amalgamation to create the new North Bay Regional Health Centre in Ontario, Canada. Bouchard also works closely with the Northern and Eastern Ontario Diagnostic Imaging Network (NEODIN), one of the many projects being undertaken to bring a full electronic health record online for the regional health authority and the 68 hospitals in it. Bouchard’s North Bay General Hospital was the first to begin utilizing the network. He also chairs a children’s information management system project that provides services to approximately 90 agencies that span two local health integration networks.

problem, technology is part of the solution.” Especially in a rural area, it’s difficult for small to medium sized hospitals to maintain all the specialists they might need. For example, the ability for a small hospital to source radiology services with a larger centre is a benefit made possible by technology. Another example is pathology. “We have a really good set of pathologists here at the North Bay General,” Bouchard says, “But not all hospitals are as lucky and often run into problems in covering for vacations

“We have a really good set of pathologists here at the North Bay General.”

and that sort of stuff. The general pathologist is very rare now. Most people are going into areas that are very specialized. So you’ll see pathology is going to an area now that is very specialized which will make it more difficult for smaller sites to provide all services. Technology will carry the larger role of making sure

HCE EXCHANGE MAGAZINE

GE Healthcare

Confidence in Dynamic Times Our technology infrastructure supports the secure exchange of patient data in virtually any scenario â&#x20AC;&#x201C; between providers across geographical regions. The infrastructure also enables the sharing of data between the patient and provider, enriching the relationship and promoting greater health awareness. A connected healthcare ecosystem is central to realizing the universal goals of improving health outcomes and reducing healthcare costs. At GE we have developed Global eHealth Solutions that leverage our years of experience in clinical information exchange to create an environment for care providers to realize the value of eHealth connectivity within their existing workflows. As a strong, stable technology partner, GE can help you remain confident in these dynamic times by providing the expertise you need to implement a health information exchange that supports your organizationâ&#x20AC;&#x2122;s needs. www.gehealthcare.com/ehealth

down the road. That is something that fits in considerGE Healthcare is a global healthcare IT leader, with

ation of anything you really do. Generally speaking, itâ&#x20AC;&#x2122;s

advanced clinical expertise in workflows, emerging

just good procurement practice.â&#x20AC;?

industry standards and demonstrated implementation

you can access the services of the sub-specialty be-

methodology. By collaborating with industry leaders

cause the smaller sites donâ&#x20AC;&#x2122;t have the critical mass.â&#x20AC;?

the GE Healthcareâ&#x20AC;&#x2122;s Centricityâ&#x201E;˘ portfolio brings pow-

An Evolving Role in Healthcare

patient information and enable knowledge-based

Successful Implementation of Information Technology

patient care. Our Goal is to help you do more with less

â&#x20AC;&#x153;Stay away from leading edge,â&#x20AC;? Bouchard advises.

new healthcare system of the future because itâ&#x20AC;&#x2122;s being

and improve quality, cost and access. Healthcare IT

Heâ&#x20AC;&#x2122;s had experience being the Beta site for new

redefined as we speak. Itâ&#x20AC;&#x2122;s being invented. In the past,

Re-imagined.

technology in the past. â&#x20AC;&#x153;Honestly, itâ&#x20AC;&#x2122;s a lot of pain and

the physicians were on their own and now we are get-

tribulation. On the other hand, you end up with the

ting to a place where we are redefining the way a lot

latest technology and a direct line into the builder, so

of things have been done,â&#x20AC;? says Bouchard. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s a very

there are pros and cons of doing that.â&#x20AC;?

exciting time to be in healthcare.â&#x20AC;?

erful tools that integrate across platforms to manage

He says the key to bringing new information tech-

â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s a very exciting time to be in healthcare.â&#x20AC;?

nology onboard successfully is to define the scope of

â&#x20AC;&#x153;Really, whatâ&#x20AC;&#x2122;s interesting about being a CIO in the healthcare industry is what it can be. You can build the

by T.M. Simmons

your program very well, and then make sure everybody understands what is expected of them. As far as vendor selection, Bouchard says good

INDUSTRY PARTNERS

Congratulations to Marc Bouchard, the North Bay General Hospital and the Northeast Mental Health Centre for your leadership and commitment to excellence in healthcare. We are proud to partner with you.

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Real Issues : Real Solutions

57 HCE EXCHANGE MAGAZINE $0

16| Stonewall Memorial Hospital we’re working on to continue to meet core measures

Stonewall Memorial Hospital

as far as how we take care of our patients and how we treat them.”

Emphasizing Community in Rural Healthcare In central west Texas, the population is sparse and there are a lot of miles between cities. That hasn’t stopped Stonewall Memorial Hospital (SMH) in the town of Aspermont from leading the way for rural healthcare. SMH is a 20-bed, critical access hospital with an 80-bed nursing home, a rural health clinic and an ambulance service. It is also able to offer a full complement of therapy services including physical therapy, occupational therapy, and speech therapy. The hospital is staffed by two medical doctors, a nurse practitioner, and approximately 130 total employees “One of the things I’ve always appreciated about rural healthcare is that we have a really dedicated staff that reflects the values of rural America,” says Nathan Tudor, CEO and hospital administrator. “You’ve got people taking care of their friends and neighbors. It becomes a little bit more personal when you are taking care of the people you see at church, the people you see at the grocery store and the people you see at the football games on Friday nights.”utilizing the network. He also chairs a children’s information management system project that provides services to approximately 90 agencies that span two local health integration networks.

Small, but Leading Change

The formal organization that has emerged from this

SMH is one of four rural Texas hospitals working to-

group effort is called the Texas Midwest Health Infor-

gether to bring an electronic health record into opera-

mation Exchange. “Basically, each patient that is seen

tion. “We have formed the first rural health informa-

in my clinic, if they were to end up in the emergency

tion exchange in the country,” says Tudor. “If

room of another clinic, their medical record would be

we weren’t able to work together, none of us would

available for that physician. As a region, we thought

have been able to have an electronic health record,

that was the most important thing. How could we help

but by combining forces, we’ve been able to do some-

people here? How could we provide a tool like this to

thing incredible.”

serve our patients?”

The joint effort has given the small hospitals involved a leg up in regards to technology. Together

Patients First

they could afford a system which will help them meet

“I’ve had a lot of great mentors in healthcare,” Tudor

government mandates, but better yet, improve health-

says. “But one of the things I was told early on that has

care for their rural patients. The upgrade, which is

stuck with me is that the first priority is to take care of

expected to be online by November of 2010, includes

your patients. Everything else can wait till morning.”

billing and financial system improvements. SMH has

In the fifteen months since Tudor joined the organi-

also completed upgrades to its nurse call system

zation, they’ve implemented 52 new policies on safety

and imaging capabilities. “We’ve implemented a lot

and compliance issues. One of the items they’ve been

of telemedicine with regard to mental health, which

tracking, for instance, is diabetes management in their

oftentimes is overlooked, especially in rural areas,”

patient population. “The EHR is giving us the ability to

says Tudor.

track a lot of data,” says Tudor. “That’s one of the things

Real Issues : Real Solutions

I go every day and say good morning. I keep an open door policy and employees are allowed to come in at any time and share their ideas with me. Being more of a listener is essential because employees have

Tudor admits that attracting and keeping talent can

the best ideas and finding ways to implement them is

be difficult. “Not everybody is cut out to be in a rural

something I see as crucial.”

hospital because there are so many challenges,” he

“Obviously, in a rural facility we can’t do every-

says. “Obviously, cash and access to capital dollars

thing. We can’t be all things to all people, but we can

are a struggle for every rural hospital, but we do the

focus on our core business and that is taking care of

best we can here. We’ve been able to remain strong,

patients. We can do that as well as any hospital in

financially, and have made great strides to improve

the country.”

our standing in that area. We’re very secure as an organization right now from a financial perspective.”

by T.M. Simmons

“I like to give my people the tools they need to be successful. I think it’s important in a rural area that you are actively engaged in the community and you are seen in the community. One of the things I like to do is called management by walking around. That’s one of the things nicer about being in a small facil-

INDUSTRY PARTNERS Oracle Transcription www.oracleti.com

ity. I can round on the patients twice a day, check in on them, and check in on their families. I think that’s important,” Tudor says. “Same with my employees.

Prognosis Health Information Systems www.prognisishis.com

17 | Henry Ford West Bloomfield Hospital

A True Center for Wellness

help her create personalized programs based on com-

Obesity is the number one epidemic in the United

plementary medicine or diet and workout routines.

States and leads to the most common diseases cancer, and heart conditions. “We feel we need to

Good Food is Part of the Whole Health Equation

play a very proactive role in helping our communities

The hospital’s Demonstration Kitchen (DK), includes

address obesity,” says Grinsven. “We have created

a 90-seat auditorium with a state of the art kitchen

activities and programs here which actually attract

line in the front. “We felt that if we wanted to address

healthy people to come here and partake in well-or-

obesity, we had to focus on food,” says Grinsven. “Tra-

ganized, fun, caring activities to help the community

ditionally, food is not something many hospitals can

become healthier.”

be proud of, but we decided we were going to

affecting the country’s state of health—diabetes,

Upon entering the hospital—which sits on an area of wetlands and woodlands and is designed to

have to have the finest food culture in healthcare in this country.”

look like a lodge—customers know that they have

Celebrity Chefs at the hospital work primarily

arrived at a place that has a different attitude. Vita,

with sustainable agriculture products and there is no

the hospital’s wellness institute, includes elaborate

cooking out of packs or cans. Daily cooking classes in

healing rooms, water therapy pools, a body and

the DK feature lessons for people with specific health

mind studio and a workout facility. Integrative care

concerns or just people who want to learn how to eat

includes massage, acupuncture and chiropractic

healthier. In six months the hospital will open the first

therapies. When a woman visit’s for a check up, for

culinary learning institute for healthcare, teaching fel-

instance, she isn’t just teamed with a doctor; she

low health care systems and other institutions how to

also meets with a certified health coach who will

transform their food culture for the better..

Henry Ford West Bloomfield Hospital

Approximately 150 people visit Henry Ford West Bloomfield Hospital in Michigan each day, not because they are sick or in need of emergency healthcare, but to dine at Henry’s, the hospital’s café. Welcome to “Main Street”, the main corridor of this one of a kind facility, where all the products revolve around health, wellness and sustainability. Henry Ford West Bloomfield opened in March of 2009 and currently has 160 of its 300 inpatient beds open. It is one of six major hospitals within the Henry Ford Health System, which also has 27 outpatient medical centers. “We have created a very unique concept here. We are not your typical, traditional hospital,” says Gerard van Grinsven, President and CEO. Grinsven was recruited from the luxury hotel industry in 2006. “Our position in this facility is to be a community center for wellbeing. Foremost, we deliver clinical excellence and patient safety, but we also feel that we have to play health coach to the communities we operate in.” HCE EXCHANGE MAGAZINE

employees,” says Grinsven. The hospital experiences 50% less turnover than would be expected in a new hospital. Missed days and sick days are lower, as well. “Our medical errors are down because our employees

Kahn is proud to have served as Architect/Engineer for the beautiful Henry Ford West Bloomfield Hospital

communicate. Our engagement with the customers is tremendous and our customers are giving us the thumbs up.”

Creating a Sustainable Hospital “We believe, ultimately, that what we do will decrease healthcare costs,” says Grinsven. “70% of medical errors happen because of lack of communication … so when you have a highly engaged, talented work force they communicate better with each other, which means you will reduce medical errors. We see that already happening in this facility, which means less malpractice payments, which means reducing costs… A highly talented and engaged workforce will engage so much better with the patient, the family member and the physicians. Those customer will go out into the community and be your best ambassadors.” “I’m a big believer that you need to create a highly “We are really investing in the well being of our

“What we’re actually trying to accomplish is to chal-

community,” Grinsven says, and the community is

lenge an entire industry in order to advance the entire

responding. They created a catering department in

industry to cutting edge innovation. Hopefully other

response to the number of community members

organizations might be inspired to do similar things.

wanting to hold board meetings and social events at

Our outcomes are assuring us that this is a model that

the hospital. “We already have nine wedding inquiries.

is working.”

Can you believe that?” he says, “To get married at

A Talent Based Organization

the hospital?”

Another component of the hospital’s operations

Changing the Culture of Hospitals Everywhere

that Grinsven says is crucial to the success they’ve experienced is in their approach to hiring. All potential

Amidst the innovation, the hospital itself is not to

emotionally engaged workforce. You start creating a culture where every single employee feels valued— that they are being invested in—and they feel that they can grow and develop and are empowered to make decisions. That means your innovative ideas will triple. Innovation doesn’t start with the CEO and your senior leaders, it starts with your people… Through that kind of culture you will see significant improvements in your outcomes. That’s my leadership philosophy.” by T.M. Simmons

employees, including physicians, are first screened

be overlooked. All trends in terms of emergency room

through a natural talents interview conducted by Tal-

volumes, surgical volumes and admissions are up. In

ent Plus, a human resources consulting firm head-

addition, their patient satisfaction scores rank them in

quartered in Lincoln, Nebraska. “It helps us under-

the top one percent in the country..

stand the natural talents of each individual. Does this

“Of course, we are here to deliver clinical excel-

individual have talents for relationships? Does this

lence to the community we operate in. Our foremost

individual have talents for compassionate care?”

focus is being the safest hospital in the United States,

Skill set and experience become the second-

but we took that one step further and said we need to

ary characteristics reviewed in potential new hires.

find a way to integrate wellness into our communities,

Talent Plus helps determine where in the organiza-

not just from a clinical perspective, but also from a

tion an individual can best be utilized. “What we have

coaching perspective.”

created is a culture of highly emotionally engaged

Real Issues : Real Solutions

“We are really investing in the well being of our community.”

www.albertkahn.com

Health Care Design and Kahn. The Perfect Ratio.

25 | Grey Bruce Health Services

HIS Responsibilities

medication list is automatically sent to their prac-

Croft has direct responsibility for the HIS department,

titioner,” Croft said. “The on-line availability of the

as well as clinical records area, telecommunications,

list should go a long way toward solving a lot of the

biomedical engineering, switchboard and library

medication problems that patients present with in

functionality.

our emergency departments.”

One major project on Croft’s plate right now is

Croft also spends time working with the South

the integration of a number of family physician offices

West Community Care Access Centre (the region’s

in the community where GBHS sends live inter-

primary provider of home health care services),

face messages back to the different office software

ensuring that automatic referrals are being sent

vendors. Currently, 100 physicians receive electronic

for patients who qualify for care through the

information from GBHS’ servers. This information

CCAC. This work has moved beyond the automatic

transfer includes lab results, admission and dis-

referral processes and is moving towards the

charge summaries and radiology results, sent directly

capacity to provide CCACs with advanced notice

to physicians’ offices rather than gathered through a

of pending admissions to prevent hospital visits

portal. The next phase of this project involves includ-

or alert CCAC that a home evaluation is required

ing a medication reconciliation that would be sent to

for patients preoperative. This decreases system

family physicians at the time of a patient’s discharge

slowdowns when transitioning a patient from

from the hospital. “On discharge, the patient’s current

acute care to home care.

Grey Bruce Health Services

Maintaining continuity of IT systems is a challenge under the best of conditions. The task becomes even more of a challenge when the sites in the network are more diverse and scattered. That’s the situation Rob Croft faced as CIO of Grey Bruce Health Services (GBHS), an amalgamation of hospitals serving Grey and Bruce counties in Ontario, Canada. While the main facility is located in Owen Sound, the network also includes rural hospitals in Lion’s Head, Markdale, Meaford, Southampton and Wiarton. In addition to supporting six hospitals on one network, the system includes South Bruce Grey Health Centre and Hanover and District Hospital, bringing the total to 11 separate sites on one database. Croft, who has been with GBHS for 30 years, currently runs the I.T. platform for the patient care systems as well as a number of other applications. Croft says, “The biggest challenge for an organization like ours is the criteria used to match patients, as we need to share information with a multitude of systems some provincial and some local. They all have a different ways of matching patients

and when we factor in the complexity of 12 sites this problem grows exponentially. With the amount of information we’re sending out to these repositories, we have to question the risk involved when the information doesn’t match.” During his seven years as CIO, Croft was involved with the negotiations with Hanover and District Hospital and South Bruce Grey Health Centre to bring their IT services in-house. Those partnership arrangements have gone extremely well, he said, bringing together support from the other organizations and the commonality of moving a system forward for the overall population. “We are unique in our partnership arrangement in that we run the front and back-end of most applications for all those sites,” he said. “Our sites have taken ownership over the design decisions and have ended up with a unified single system. This has allowed flexibility and standardization of our approach of care for the overall population.”

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them to the point where we’re getting some real benefit out of them now.”

Healthcare IT Trends A healthcare trend that Croft sees spilling over into the IT world is the need for patients today to have access to their medical records. Patients are much more informed today and as a result the desire is to have as much information as possible when it comes to their healthcare history and current medical conditions. While printed materials might Lexmark technology solutions complement your strategic initiatives through electronic forms, bar-coding, output control, downtime solutions, and more.

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be acceptable for now, eventually, patients will want that information in an electronic format. “The IT community is going to have to get its head around understanding that demand from an IT perspective,” he said. “How do you populate personal health records? How will all that come together? Will there be portal solutions? It’s just

Print Less. Save More.

a matter of time before this issue becomes a key focus of our work. ” With this trend, as with any new healthcare-

the ultimate goal of making the end-user’s experi-

related technology, come financial concerns on the

ence better.

part of the institution providing the service. Croft

“Having the expertise of being in a healthcare

notes that as healthcare budgets tighten, keeping up

Process Planning

organization works at all different levels has given

“You want to run the latest and greatest while at

A challenge Croft faces in IT services involves pro-

the same time get the most use out of your existing

cess and change management, as well as involving

systems,” he said. “It’s a tough juggling act for our

the right people to make those change management

organizations. It’s costly to remain on old systems,

decisions that reflect on the technology that is being

as maintenance fees increase, but it’s also tough for

introduced. To assist with that process, Croft and his

organizations to afford new technology.”

staff are completing the necessary workflow map-

When Croft first joined GBHS, the trend was

ping, then building the system to support what they

more about staying current with the latest technol-

want to achieve with that workflow.

ogy because that was perceived as the right thing to

“We’ve had hundreds of years to perfect the

facility for 30 years and understanding how the

with the latest technology becomes an issue.

do. While he doesn’t go so far as to say it was a mat-

paper world, and now we’re being asked to move

ter of technology for technology’s sake, he does see

that world into an electronic world,” he said. “It’s

a movement toward more of the philosophy behind

going to take a number of years to perfect it. As we

getting value out of the technology. He believes it’s

work our way down this road, we’re starting to see

more about looking at the technology differently, to

applications mature, and we are now able to tweak

feed repositories or not to duplicate data entry, with

“You want to run the latest and greatest while at the same time get the most use out of your ex isting systems.”

me a huge advantage,” he said. “We’ve been able to blend our technology to make sure that it covers a number of different departmental needs and we’ve built solutions that cover all sectors of the healthcare system. This integrated approach is what has made us successful.” By Kathy Knaub-Hardy

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

20 | PrimaCare Medical Centers

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V [V PUMV aPYTLK JVT WYPTHJHYL -VY TVYL PUMVYTH[PVU JHSS VY N

ters (PCMC) to improve every aspect of its health-

Serving Patients with Courtesy, Convenience and Compassion

care revenue cycle. From increasing its ability to

â&#x20AC;&#x153;Our mission is to provide quality healthcare to the

accurately collect payments at the time of service,

patients in the communities we serve with courtesy,

to decreasing its claim denial rates, ZirMed has

convenience and compassion,â&#x20AC;? says Dr. Don Dil-

provided a full suite of products that has helped

lahunty who has served as CEO/president of the

PCMC reduce its workload and increase its ef-

company for the past ten years. He has been involved

ficiency and profitability.

with PrimaCare for twenty years as both a practicing

ZirMed, Inc.

PrimaCare Medical Centers

PrimaCare opened its first center in the Dallas area in 1979. The urgent care network grew and was acquired by a hospital system in the late 1980s to serve as a referral source. In 2000, the same system chose to divest itself of the clinics and the entity was purchased by a group of PrimaCare physicians. PrimaCare Medical Centers is now one of the largest urgent care networks in the Dallas metropolitan area with a primary focus on acute illness and injuries that are not life or limb threatening. All eleven centers are open seven days a week and no appointments are necessary.

ZirMed has worked with PrimaCare Medical Cen-

physician and in an administrative capacity. He also serves as president of the Urgent Care Association of America, an industry trade group which represents over three thousand urgent care professionals throughout the United States. Patients can be treated at a PrimaCare center more quickly and at a lower cost than at a typical emergency department. Staff includes board certified physicians in family practice or internal medicine. They also have certified Physician Assistants and

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

McKesson Medical-Surgical At McKesson Medical-Surgical, our commitment to your practice goes far beyond supplies. Our

We’re committed to a higher level of service, so you can reach a higher level of success.

knowledgeable representatives work with you

Nurse Practitioners. Including full and part time staff,

to understand your needs and constantly seek

PrimaCare Medical Centers have about 250 employ-

new ways to help improve your practice. With a

ees who work extended evening hours and weekends.

comprehensive line of quality products at competi-

Personnel are cross trained so that staff has multiple

tive prices, we make it simple to do business with

skills they can utilize in the operations of the centers.

a single supply partner – even providing reliable

Last summer, the centers were accredited through

next-day delivery. And our innovative technologies

the Joint Commission.

and services make your job easier, enabling you

Much of their capital expenditures of late has

to run your practice more efficiently. Simply put,

focused on enhancing quality including an upgrade of

we offer a higher level of commitment to you for a

diagnostic equipment. “Last year, if you had the abil-

higher level of performance at your practice.

ity to purchase, it was a very good time to buy since equipment vendors, due to the economic recession, were eager to cut deals,” says Dr. Dillahunty. They added computer radiography to all eleven centers. They also bought new hematology analyzers.

Managing Multi-Site Locations “If you are dealing with a multi-site group, one of the issues you have to focus on is communication. You have a corporate hub that has to reach out to the various sites,” says Jennifer Stephenson, PrimaCare’s Executive Director. “We have center medical director at each location who works with all of the providers scheduled at that location. Then we have a center manager who works with the employees. We have three disciplines at our centers, clinical which includes nurses and medical assistants, lab/x-ray techs and patient representatives.” We have quarterly discipline meetings so that all employees are informed as to what is going on with the company and their specific job. Also, among the efforts to keep the lines of com-

McKesson Medical-Surgical is more than a supplier. We are your partner in helping to improve your practice. We offer a complete line of quality products at competitive prices, along with knowledgeable representatives that work with you to understand your needs and constantly seek new ways to help you improve your practice. From our SupplyManagerSM to Revenue Cycle Management, our technology and services make your job easier, freeing you to focus on what matters most.

munication clear and open, they have a newsletter. The newsletter focuses on the employees and makes sure they are up-to-date on all developments. “We try to remind people that we do need to understand what our mission is, as well as our vision – to be the premier urgent care network in the North Texas region,” says Dr. Dillahunty.

To learn how our higher level of service can benefit your practice, call us at 866.McK.ANSWer (866.625.2679) HCE EXCHANGE MAGAZINE

Dr. Dillahunty emphasizes integrity and respect for

â&#x20AC;&#x153;Everyone has a role to play and people have good ideas that they can share with us as an organization.â&#x20AC;?

both relations with patients and relations between employees. â&#x20AC;&#x153;Everyone has a role to play and people have good ideas that they can share with us as an organization,â&#x20AC;? he says. â&#x20AC;&#x153;We can improve our collective intelligence, learn to do things better, provide better customer and patient service, make operations more lean, reduce our overhead, and fulfill our mission by incorporating these good ideas into

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our day-to-day operations.â&#x20AC;? Retention of employees has also been less of a problem with the economic downturn. In addition, PrimaCare has taken a lot of steps to make sure they get the right hire initially. They have put a lot

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of time and effort into determining the background

clinical personnel to people in our central billing of-

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ficeâ&#x20AC;&#x201D;we try to really look at who is most successful

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The Future of Urgent Care

and values that will make them successful?â&#x20AC;? says Stephenson. â&#x20AC;&#x153;No matter where we are hiringâ&#x20AC;&#x201D;from

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health care reform legislation, I think both urgent care and the patients we serve stand to benefit,â&#x20AC;? says Dr. Dillahunty. â&#x20AC;&#x153;We in the urgent care industry provide quality, cost-effective and convenient care to thousands of patients on a daily basis across the United States and we believe our future is brightâ&#x20AC;?. by T.M. Simmons

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27 | Methodist Le Bonheur Germantown Hospital

New Construction Highlights With the current renovations, a group of patients and families, as well as hospital associates and physicians were utilized to help decide what the new facilities should look like. “That has been the foundation for some nice attributes in the new building that we think are unique,” Kenley says. “The rooms are designed to encourage family and spouses to remain [in the Women and Children’s Pavilion] with our patients. The rooms are more spacious and have sleeper sofas, for instance.” Methodist Le Bonheur Germantown is the first neonatal intensive care unit in the region to have private rooms. “That’s a big change from the way we operated in the past where we literally had one big room,” says Kenley. “Now each baby has a private room and in that room there is space for the parents to be able to stay while the baby is there in the NICU. It’s a huge step forward in patient and family-

Methodist Le Bonheur Germantown Hospital

centered care.” From a technology standpoint, the building is state-of-the-art. There is a minimally invasive innovative surgical suite that supports physicians doing GYN procedures as well as other minimally

Methodist Le Bonheur Germantown Hospital is one of seven hospitals of the Methodist Le Bonheur Healthcare System, making it part of one of the largest hospitals (all Methodist hospitals are licensed as one) in the country. The hospital started as a community hospital and has grown to become a comprehensive full-service tertiary care hospital in Shelby County Tennessee and the surrounding area. It serves a population of approximately half a million. The hospital is in the midst of completing a significant expansion project that will add 100 beds, bringing the licensed bed complement to 309. In February of 2010, the Women and Children’s Pavilion, a freestanding facility connected to the main hospital via a tunnel, came online. “It provides all the positive attributes of a specifically focused facility and all of the efficiency and safety of being a tertiary care campus,” says William Kenley, CEO. The hospital is now working to renovate 100,000 square feet of the main campus. Some aspects new to the hospital include a 16-bed intensive care unit, two medical/ surgical floors, and the expansion of the cardiac cath capabilities with a third lab being added. “We are also adding a new main entrance to the facility which will aid in patients being able to find their way into the facility. We have a great deal going on right now,” Kenley says.

invasive procedures. The hospital has also recently added the da Vinci® Si HD Surgical System.

“I should also point out that we are aggressively on our journey to implementing a full electronic medical record, including computerized physician order entry on all of our campuses,” says Kenley. He was CEO of the Methodist North facility up until May of last year where he was able to experience being first in the system to come online. Methodist Le Bonheur Germantown Hospital will come online in 2011 which will make Methodist Le Bonheur Healthcare the first hospital system in the MidSouth to have Coputerized Physician Order Entry (CPOE) systemwide. The building has been designed for wireless features, in a way that supports the direction technology is going in current times.

Clarity in Focus on the Goal “My philosophy is that first we all need to understand what our goal is,” says Kenley. “There needs to be great clarity around that. It’s something we’ve always had in our organization, but we are always working to sharpen.” Leadership at Methodist has defined five strategic pillars; teamwork, quality and safety, loyalty, patient volume, and financial performance. “In each of those we have specific objectives. We use that as our roadmap for our organization. I use it for my agenda for our administrative team, our leadership team, and for each of our departmental

“My philosophy is that first we all need to understand what our goal is.”

meetings,” Kenley says. “If you were to come here and interview a member of our staff, they would be able to tell you things they are specifically working on that will drive performance within our key

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