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EXCHANGE

HCE

Real Issues : Real Solutions

MAY/JUN 2011

Doctors Express Value in Healthcare

HEALTHCARE EXECUTIVE EXCHANGE MAGAZINE | www.hcemag.com

Discover Why Over 60,000 Physician Offices and Urgent Care Centers Rely On Us For Supplies and More.

McKesson Delivers A Higher Level Of Commitment — For A Higher Level Of Performance For Your Practice. Founded in New York more than 177 years ago, McKesson has been a trusted provider of pharmaceuticals, medical supplies and technology solutions. Our size and expertise not only enables us to create efficiencies for physician practices and urgent care centers, but also allows us to provide valuable business solutions that go far beyond supplies. A Higher Level Of Commitment To Service McKesson delivers the products you need, when you need them. We offer over 150,000 medical surgical products, including McKesson Brand private label options with quality comparable to leading national brands. A Higher Level Of Commitment To Increasing Efficiency If you’re looking for more consistent pricing and better inventory management from your distributor, you’ll find it with McKesson. Plus, you’ll find an online ordering system that’s fast and easy to use — saving you precious time. A Higher Level Of Commitment To Reducing Costs Our consultative tive approach to your business b allows us to identify opportunities ties to manage your pract practice tice more mo efficiently so you can reduce costs. Our experienced acco account ount managers manage can recommend and provide custom solutions scaled d to meet your nee needs.

Contact your McKesson Medical-Surgical Account Manager for more information. Or call 866.McK.ANSWer (866.625.2679). As the nation’s largest, most experienced experien nced distributor of medical supplies, McKesson delivers a higher level vel of co commitment ommitment to service, to increasing efficiency, and to reducing costs for or our our physician offices and urgent care centers. We not only offer 150,000+ quality products — but also comprehensive technology solutions, ons, consistent pricing, and an easy-to-use online ordering system that can help elp your center grow.

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Real Issues : Real Solutions

CONTENTS

06 Doctors Express

IN-FOCUS STORIES 10

Hoag Memorial Hospital Presbyterian

Charlotte Radiology

17 Florida Hospital Memorial Medical Center

Peter Ross, CEO

LHP Hospital Group, Inc.

Children’s Mercy Hospitals and Clinics: The Elizabeth Ann Hall Patient Tower

King’s Daughters Medical Center

Kisco Senior Living

Lafayette General Medical Center

Davis Vision

New Parkland Hospital

Mission Health System

Healthcare Finance Group. LLC

Gracedale

Main LIne Health

50 Roseland Community Hospital 52 Adventist LaGrange Memorial Hospital

HCE EXCHANGE

MAY/JUN

2011

Healthagain As consumers discard Yellow Pages for the convenience of smartphones, capturing the attention of mobile patients searching for healthcare information and facilities has never been more critical. With iTriage, your facility information goes into the hands of smartphone-toting patients on all mobile platforms at once. Healthcare facilities now reach mobile users at the exact point of medical need with iTriage.

Developing the model Doctors Express follows a tried-and-true franchise model that is maintained across all franchisees. This includes a similar look, service offering and equipment. Peter Ross, Chief Executive Officer, has had experience with

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a similar model in home senior care, having franchised Senior Helpers, now with 300 locations

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across the country. Doctors Express has 33 centers open with 60 scheduled to be open by the end of this year. “We provide all the tools and programs, equipment, and supplies so that when you walk

Doctors Express

in each facility will look and feel the same,” Ross said. “We use the same contractor so our facilities have similar color schemes, millwork and even waiting-room furniture. “ Ross keeps the services offered specific to

Healthcare in the United States is facing numerous challenges to providing quality, timely care –- emergency room wait times, a shortage of primary-care physicians, and looming healthcare reform. One organization is working to fill some of these gaps through urgent-care facilities. Doctors Express is the first-ever national urgent-care franchise. The franchise is dedicated to one specific mission—providing highquality, convenient, low-cost care. Doctors Express’ business model offers streamlined processes and a specific goal of providing only urgent care. This includes episodic care, physicals, minor acute care and occupational therapy. The facilities do not manage chronic conditions and work closely with primary-care providers to send patients back for ongoing care.

traditional urgent care with a focus not only on providing quality health care, but also keeping an eye on the business of health care. Each center is moderately sized at about 2,000 to 3,000 square feet and offers similar services.

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“We have a full digital X-ray on site, a lab for basic urgent care and occupational health medicine, and on-site medication dispensing so patients don’t have to make another stop at the pharmacy,” he said. “All patients are seen by a physician. Our technology is not overly

Please visit http://medicstaffing.com/testimonials and see what our customers are saying about us. We are always available at (610) 733-8215 or at info@medicstaffing.com

complicated. We have quality equipment to do what we need to do.” So far, this model has served Doctors Express well. The franchise is rapidly growing and stays focused on becoming the national leader in

Real Issues : Real Solutions

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urgent care. Ross said he hopes to expand the franchise to 300 to 400 centers in the next five to seven years.

Fitting into the healthcare market As expected, hospitals were a little suspicious of the Doctors Express centers cropping up. However, Ross says the perception is changing, especially as the healthcare market looks toward reform and faces current shortages within the healthcare system. “We work closely with hospitals and try to relieve some burden on the emergency rooms,” he said. Urgent care centers save money by treating health issues that aren’t life-threatening. Ross said an urgent-care visit is about $125, whereas an ER visit can cost on average almost $600. By having patients utilize an urgent-care center, Doctors Express helps hospitals focus on the major medical issues such as stroke, heart attacks and traumas. Those visits often lead to hospital admissions and cost thousands of dollars. “Even when hospitals operate urgent-care centers, they often run them as emergency rooms,” Ross said. “We are a high-performance operation; we really drive volume and provide quick quality healthcare within the community. This should help hospitals in the long run.” Primary-care physicians are facing a shortage in this country, and Doctors Express can provide assistance in filling the gap. A Doctors Express center can usually see walk-in patients with only a 15-minute wait. Centers are open seven days a week from 8:00 am to 8:00 pm, allowing more convenience for physicals or basic sick visits. Patients are referred back to their primary-care provider for any ongoing care and Doctors Express sends their procedure notes to the patient’s physician. In addition to working with hospitals, Doctors

“We see healthcare reform as an advantage because we will be able to service and treat patients who would not otherwise be treated today.”

Doctors Express takes all types of insurance and cash, but does not treat patients without the ability to pay. With healthcare reform requiring everyone to have health insurance, Doctors Express expects to see many more patients and further relieve the burden on emergency rooms. “We see healthcare reform as an advantage because we will be able to service and treat patients who would not otherwise be treated today,” Ross said. “It is a shame when people go to the ER and run up wait times to 4.5 hours. We want to work with ERs so they can focus on the patients they treat best.” Currently, urgent care is a fragmented industry with urgent-care facilities providing a wide range of services in addition to treating basic illnesses, minor acute care, and occupational health. Doctors

Express is looking toward the future of healthcare

Express wants to continue to become the best at

reform. Although many healthcare facilities are

providing quality, convenient, low-cost healthcare

struggling with how they fit into looming reform,

and filling shortages within the healthcare system.

Doctors Express sees some aspects of reform as beneficial to patients and their services.

By Patricia Chaney

HCE EXCHANGE MAGAZINE

02 | Hoag Memorial Hospital Presbyterian

Information Hype vs. Reality Moore says that one of his primary jobs is to interpret and put into practical terms for the organization what is available and doable in information technology versus what is not. “IT is becoming part of everyone’s enabling success, and as such organizations, at times, develop expectations beyond current realities,” Moore said. “They pick up all the different papers and read the blogs, and they hear some nifty things, and they assume it’s possible or it’s being done or it’s beyond a pilot. ‘Can’t we just buy two of these and plug them in?’ they ask. Expectation management is paramount.” The job of CIO is to understand and define the

goes through a methodology that comes out on the

Technology is executed once all the parameters are

other side,’” Moore said.

committed to that product are well spent. “Sometimes this job requires, ‘No,’” Moore said. “No, that’s not possible in this time frame. No, that’s not possible with this portfolio of work. No, that’s

“A healthcare Chief Information Officer, like other CIOs in the country, has gone from being a kind of a novelty 10 to 15 years ago to being an absolute necessity today,” says Tim Moore, senior vice president and CIO at Hoag. “We’ve moved from the basement to the board room.”

more along the lines of eight percent, 10 percent or even 12 percent of a hospital’s total revenue. “There’s an exponential trajectory as far as the trend in demand with IT and the engagement with IT in healthcare,” Moore said. “It’s no longer about dif-

end-goal that it is my job to define.”

ferentiating ourselves. It is often what we do with IT

Unfortunately, though, there are very few things

Tim Moore, Senior Vice President and CIO

percent of a hospital’s revenue. The trend today is

expectation, and it’s the predictability of the product

arrive at a ‘yes.’”

Hoag Memorial Hospital Presbyterian has two acute-care hospitals in Orange County, California, and is the majority owner in a joint venture known as the Hoag Orthopedic Institute. The organization also has seven health centers and approximately 5,000 full-time employees. Their network includes 1,200 physicians and is projected to bring in about $850 million in revenue this year.

A decade or so ago, IT budgets approximated two

not possible for those dollars. There is certainly an

Moore added, “However, the desire is to always

When the seeds that were to become Hoag Memorial Hospital Presbyterian were planted in 1944, the role of information technology was not even an agenda item. As with other healthcare organizations, information technology in 2011 now plays a primary role in Hoag’s daily operations.

start and end with a great idea. Let’s make sure it

scope of the product in common business terms. predicted so that the time committed and the dollars

Hoag Memorial Hospital Presbyterian

“They say, ‘Let’s make sure that a great idea doesn’t

for which “yes” is appropriate, so often Moore has to deliver a “no.”

From Product Supplier to Business Partner One of the biggest changes Moore sees in the field of healthcare information technology is that the supplier is becoming a true business partner. “They are no longer out there taking and filling orders,” he said. “They are at the table, at the business unit, saying, ‘Let me understand what you are trying to accomplish. Let me help you with that vision.’” The technology supplier has become a big part of the developing philosophy about how a project is run.

to simply be in the healthcare business.”

Managing the Flow and Direction of New Technology Moore equates staying on top of all that is new and upcoming in the field of healthcare technology to drinking from a fire hose. “You just have to learn to modulate the flow,” he said. “You have to develop and trust your resources.” He surrounds himself with people who are very good at their jobs and whom he knows he can trust to bring the right information to the table. “We meet very frequently and we talk about trends,” Moore said. “We talk about what things are going to look like a year from now, three years from now.

Moore reports directly to the Chief Executive Officer. His role, first and foremost, is to put strategic direction around how information technology is used in the organization and to be an enabling partner to the business units of the hospital. HCE EXCHANGE MAGAZINE

“It’s a very fast-moving field and you manage it—as well as it can be done—in partnership modality,” he continued. “I’m very clear when I’m meeting with my idataMD Our Mission, as a medical IT company, is to provide revolutionary innovations to improve patient outcomes, information access and financial profitability in healthcare. idatamd.com

other senior managers in the organization or other vice presidents or anybody else who reaches out to me. I share what I know; I admit to what I don’t know. I share what I’m looking at, and I’m wide open to what they are hearing and seeing and finding out what would they like my team to take a little more time with.”

Keeping in Mind the End Goal “Ultimately, what does Mrs. Smith want from her healthcare?” Moore said. “More than anything, she wants to believe that you know her. When she goes to her primary-care physician because she has a sniffle, and he listens to her lungs and sends her over to the pulmonologist, she doesn’t want to start from scratch. She wants that information to be available. And when that pulmonologist sends her for a biopsy at the hospital, she wants that continuity. She wants that information given back to her pulmonologist and back to her primary-care physician and she wants it to happen in near-real time.” That is why information technology is evolving in healthcare. It is the tool that connects patients to doctors and doctors to each other. “Too often, each doctor visit is a reintroduction of who I, the patient, am,” Moore said. “The job of the information officer is to understand the business of healthcare so that all the information moves quickly and easily between treatment providers.” By T.M. Simmons

INDUSTRY PARTNERS Medicity www.medicity.com Philips Medical Systems www.philips.com

HCE EXCHANGE MAGAZINE

03 | Charlotte Radiology

Merging Technology and Information Technology Radiology has always relied on maintaining top technology from an equipment standpoint. “The challenge is to remain on top of the constantly changing world of information technology,” Jensen said. “Integration of the information and data from our equipment with the latest software and systems is critical to our success.” Keeping the equipment current with new technology, while at the same time dealing with declining reimbursement is an ongoing challenge. “With the general economy creating a lot of jobless patients, you’ve got the pressure of trying to collect money from people who are having difficulty paying,” he said. “And on the flip side, there is declining reimbursement where you are getting paid. It’s not that you are losing volume; it’s that you are losing reimbursement per study.” Smart growth means finding increasingly innovative ways to improve efficiency and profitability. This means examining trends in healthcare and always looking for opportunities. “Our team is constantly data mining and working to improve,” Jensen said. “As we see opportuni-

Charlotte Radiology

ties, we have to be responsive enough as an organization to take advantage of those opportunities.” They are currently in the process of launching a new management service organization (MSO), for

For imaging expertise in North Carolina, people go to Charlotte Radiology, a private, independent company with 85 radiologists and 340 employees at 11 hospitals and approximately 25 freestanding centers. The practice began in 1967. Their hospital-based centers provide 24/7 coverage for everything from large Level I trauma centers to small, 24-bed regional centers. Outpatient imaging is also a main service line. “The model is based on providing good, solid, bread-and-butter radiologists, but having subspecialists in Charlotte to read those cases that are more appropriate for a deeper level of expertise,” said Mark Jensen, chief operating officer. Mammography is one of the company’s largest areas of expertise. Twelve breast centers including a new mobile unit make them one of the largest providers of mammography in the country. They have also recently opened a vein and vascular center in Concord, bringing the total number of clinics dedicated to deep-vein thrombosis, varicose-vein treatment and sclerotherapy to two. Other subspecialties include body, emergency, musculoskeletal, neuroradiology, nuclear medicine, pediatrics, interventional oncology, and interventional radiology.

Going Mobile Charlotte Radiology conducts approximately 75,000

instance. In this way, they will share their expertise

mammography screenings each year. The new

with other companies providing similar services.

mobile breast unit will allow them to take their

This will diversify their income stream, as well as

services into communities where early detec-

drive down the company’s own expenses.

tion and screening services are not always easily

Another example of diversification is in the

accessible, as well as to employer groups whose

teleradiology service line. They will take advantage

employees have difficulty taking time off work to be

of the IT infrastructure that has been developed

screened. In addition to reaching an expected 5,000

for Charlotte Radiology by offering those tools to

women per year, it will help them determine which

other providers.

locations have enough volume to benefit from the

“By exporting our expertise in other markets, we create a good, win-win scenario,” Jensen said.

addition of a standalone breast-imaging site. It is expected that health-care reform will require that

HCE EXCHANGE MAGAZINE

04 | Florida Hospital Memorial Medical Center

Health Care on a Higher Level

insurance providers pay for routine mammography

“As I look three to five years out, I think there is so

as a wellness benefit. The mobile unit will allow

much going on, and I think we’ll be part of a larger

Charlotte to quickly capitalize on the expected

organization, whatever that may be,” Jensen added.

increase in demand for mammography.

“We’ll be figuring out how to work with less money, so there will be a lot of energy expended on innova-

New Partnerships for Best Practices

tion and efficiency. But I also think that radiology, if done right, can be a leader in terms of medical

The company has also been involved in the forma-

appropriateness. There is a lot of inappropriate use

tion of a new entity called Strategic Radiology. This

of healthcare, and radiology can be a value-added

conglomeration of 15 radiology practices that are

provider in terms of how that process unfolds

diverse in geography will be a forum for continuing

over time.”

dialogue to examine the shape of the industry and to explore ways in which Charlotte Radiology and

Florida Hospital Memorial Medical Center

By T.M. Simmons

similar groups might help with that shaping. The purpose will be to look at leadership in radiology,

Communities in Florida were some of the hardest hit by the economic downturn in the United States, but despite its struggles Florida Hospital Memorial Medical Center has remained focused on providing the best experience for patients.

advocacy within the industry, and development of potential services or best-practice services that may be of interest to other groups in the future.

The Future of Radiology Practice “There’s an uncertainty that all independent-physician practices are facing right now,” Jensen said. If service integration is a goal and product of health-care reform, as expected, how do inde-

Mark LaRose, President and CEO

pendent groups such as Charlotte Radiology work within that challenge while maintaining autonomy? “Our group is focused on those challenges and opportunities,” Jensen said. “We want to ensure we remain a leader, shaping how reform happens and

“The most important thing to us is the patient experience and patients’ satisfaction,” said Mark LaRose, president and chief executive officer. “We make an effort to talk with every inpatient during the time they’re at our hospital and ask how things are going, and how their stay has been. Whenever there is any level of concern, we do our best to satisfy it on the same day.” LaRose said the center is nationally ranked between the 90th and 95th percentile in overall satisfaction and willingness to recommend on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The hospital is also among the top one percent of hospitals in the nation for clinical quality outcomes. A key to maintaining these scores, LaRose said, is having strong leaders and directors.

being successful.” “Even one weak leader can lead to low morale, which spreads,” he said. “We are focused on supporting leadership and providing education.” Real Issues : Real Solutions

narrow down the most effective supplies to use and see how that affects our cost within each service line,” LaRose said. Despite struggles, the hospital has provided new facilities for patients. The hospital facility is new, having opened in July 2009. A $15 million, 30,000 square-foot freestanding cancer center was opened on campus in 2011. These expansions stay committed to the hospital’s focus on the patient experience. “The hospital is probably one of the most beautiful I’ve ever seen. And the cancer center was designed to embrace all the needs a patient has,” LaRose said. “We have people in place that can empathize and be compassionate and helpful at the cancer center.” Another challenging initiative has been implementing computerized physician order entry (CPOE). “This is a gigantic change in the way physicians do things,” LaRose said. “We knew this would be a difficult transition, but our physicians embraced the challenge with the vision of greater safety and quality care for our patients.”

Surviving and growing in a declining community Florida Hospital Memorial Medical Center is located in central Florida, in Daytona Beach. In the past year, the county has lost about 2,200 people. The unemployment rate is 12.6 compared with 9.8 for the nation. This economy has affected patients’ ability to pay and how the staff interacts with patients. “We have had many people coming into physician offices, even when insured, saying they are unable to pay the copay or afford a procedure or diagnostic test,” LaRose said. “This has changed the way our medical staff is relating to people. We have to be flexible. We’re a service industry, and we have to be compassionate and provide the necessary care. But at the same time, we have our own fiscal needs to meet. It’s a balancing act.”

The hospital invested many resources into the implementation and communication with staff about the change. LaRose worked with physicians to improve acceptance of the system and processes that come along with it so that the hospital can see improvements in reducing medication errors. Florida Hospital is part of the Adventist Health System, which has 43 hospitals, and some of which have also gone live with CPOE. “Every community has its own culture and medical staff, but we incorporated the lessons we took from our predecessors on this system to make the transition as smooth as possible,” LaRose said. Florida Hospital is continuing to look toward the future and maintain its commitment to providing quality health care on a higher level. by T.M. Simmons

Florida Hospital is focusing on becoming more efficient throughout the hospital, particularly related to supplies. “We seek to partner with physicians to

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

05 | LHP Hospital Group, Inc. AGA AD PDF !-

Collaboration One of the core values of LHP is collaborationâ&#x20AC;&#x201D; with hospital partners, community leaders, and medical staff. â&#x20AC;&#x153;At the joint-venture level, we share governance 50/50 with our not-for-profit partners,â&#x20AC;? said Moen. â&#x20AC;&#x153;In addition, we form a local community board of trustees for each hospital that is made up of 50 percent physicians from the medical staff

and 50 percent local community leaders.â&#x20AC;?

Collaboration also involves keeping physicians involved in the control of the environments

in which they work. Moen said all LHP facilities have a â&#x20AC;&#x153;Physician Roundtableâ&#x20AC;? where key opinion leaders on the medical staff join with local administration and LHP administration to discuss issues

-9

â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s where key events happen to people in the communityâ&#x20AC;&#x201D; births, deaths, treatment for serious illness, recovery from accidents.â&#x20AC;?

#-9

both an executive team and a board of directors

Moen described the most common ways LHP invests

who have tremendous experience and can provide

in hospitals. The most common structure is forming

tremendous expertise to the joint-venture facilities.

a joint venture to invest in an existing hospital that

cians a seat at the table, you need to have a

LHP still recognizes, however, the role community

needs capital to expand or replace its physical plant

vehicle to listen,â&#x20AC;? Moen said.

hospitals have locally, and the organization actively

or enhance its services. LHP will also assist hospitals

encourages the involvement of the existing hospital

that want to acquire another hospital or healthcare

staff and community leaders.

facility or expand their reach within the community.

affecting patient care, strategic issues, and ways

to grow and improve services. â&#x20AC;&#x153;We believe if you say you want to give physi-

LHPâ&#x20AC;&#x2122;s goal is to assist not-for-profit community hospitals with their capital needs through joint ventures, not outright acquisitions. LHP has

â&#x20AC;&#x153;Local hospitals are usually one of the communityâ&#x20AC;&#x2122;s major employers,â&#x20AC;? Moen said. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s where key

LHP Hospital Group, Inc.

Uncertainty surrounds the healthcare market these days, and healthcare facilities, as well as physicians, are looking at ways to adapt and remain profitable. Not-for-profit community hospitals face regular challenges to find capital for new technology, electronic medical records, facility upgrades, or new facilities. Many small hospitals are joining with large health systems to survive. Physicians are evaluating all of their options, including hospital employment.

Dan Moen, CEO

One company was founded to help not-for-profit hospitals adjust and survive during difficult times. LHP Hospital Group, Inc. (LHP) is a privately held company that forms joint ventures with not-forprofit hospitals to own, operate, and manage acute-care hospitals. LHPâ&#x20AC;&#x2122;s collaborations with not-forprofit hospitals provide capital while still ensuring that the hospitalâ&#x20AC;&#x2122;s leadership remains integrally involved in decision-making.

Finally, LHP partners to develop new hospitals such as the one in central Texas.

events happen to people in the communityâ&#x20AC;&#x201D;births,

Founded in 2008, LHP is currently involved in

deaths, treatment for serious illness, recovery from

three joint ventures, with another two pending regu-

accidents. It is important for the local community

latory approval. Moen, who was a founder of LHP,

to stay involved with the governance of the hospital.

predicts the company will continue growing rapidly.

The hospital is too valuable as a community asset

He said he expects the company to have about 20

to just hand over.â&#x20AC;?

hospitals within the next five years.

Capital Investments

by Patricia Chaney

In addition to joint ventures with existing hospitals, LHP also builds new hospitals in communities that have a need. LHP has recently joined with the Seton Family of Hospitals to build a hospital and medical pavilion in a growing community in central Texas. The hospital is scheduled to be completed in 2012. Moen said the venture came about after LHP was approached by private physicians in the area. The major competitor in the community is a large not-for-profit facility that employees all its physicians. The private physicians were looking for an alternative to being employed by the hospital and â&#x20AC;&#x153;the process developed quickly.â&#x20AC;?

â&#x20AC;&#x153;Not-for-profit hospitals shouldnâ&#x20AC;&#x2122;t lose opportunities to implement a new initiative for lack of capital,â&#x20AC;? said LHP CEO Dan Moen. â&#x20AC;&#x153;We can bring equity capital to a joint venture with a not-for-profit partner, allowing our partner to take advantage of an opportunity they wouldnâ&#x20AC;&#x2122;t otherwise pursue.â&#x20AC;? HCE EXCHANGE MAGAZINE

06 | Children’s Mercy Hospitals and Clinics: The Elizabeth Ann Hall Patient Tower

“The kids deserve the best care in the community,” Children’s Mercy Hospitals and Clinics: The Elizabeth Ann Hall Patient Tower

while being able to remain in the same hospital

dren’s Mercy nurse who passed away in 2008 and

with their families. The center will provide consul-

whose vision was to create a place where patients,

tative services to more than 500 mothers each year,

families, and staff could go for prayer, meditation,

with approximately 150 babies anticipated to be

reflection, and comfort.”

born at Children’s Mercy annually.” Furthermore, the tower will add over one dozen beds to the pediatric intensive-care unit, along with two rooms specially designed for ECMO patients.

On June 18, 2010, Children’s Mercy Hospitals and Clinics in Kansas City, Mo., broke ground on a six-story, 73-bed inpatient tower. According to the hospital’s website, www.childrensmercy.org, The Elizabeth Ann Hall Patient Tower will house a state-of-the-art fetal health center, an innovative cancer center, an interfaith chapel and garden, a short-stay observation unit, and two additional patient floors with 32 beds total. The tower will also allow Children’s Mercy to expand its pediatric intensive-care and oncology units and its pediatric clinical pharmacology and radiology departments.

The community gives back

“The kids deserve the best care in the community,” Leech said. “We had to expand to meet the needs of our children.”

Children’s Mercy Hospitals and Clinics is the only freestanding children’s hospital between St. Louis and Denver, serving a large patient population. The hospital is committed to providing the best care to its young patients throughout the region. The hospital has 314 beds, a newly opened Elizabeth J. Ferrell Fetal Health Center – one of only three such units in pediatric hospitals across the nation – as well as 40 specialty services, neonatal intensive care, and a Level I pediatric trauma center. The hospital has also received Magnet certification for excellence in patient care. Children’s Mercy also includes four smaller facilities in Missouri and Kansas that provide specialty-care, urgent-care, and primary-care services.

Born of necessity Tower will be innovative, and in many ways, the

a family going through the healthcare experience,” Dr. O’Donnell said at the groundbreaking. “It is so important to provide that emotional stability and

of the funding for the Elizabeth Ann Hall Patient

support, and this is going to be something like

Tower. Bond money covered a small percentage of

you’ve never seen before. It’s going to be fantastic.”

the cost, Leech told the Kansas City Business Jour-

Following an $11 million donation to the

nal. Jonathan E. Baum, co-chair of “Happily Ever

hospital from the Hall Family, the tower itself has

After,” noted at the groundbreaking that Mercy’s

been named in honor of the late wife of Joyce Hall,

employees and medical staff donated in excess of

founder of Hallmark Card Inc.

“Someone asked me, ‘Is this is a stimulus

“My father had a lot of recognitions and deservedly so. He has a name on many things. That’s

project?’ Well, it most certainly is!” Dr. O’Donnell

great. But my mother has not,” Don Hall, the Halls’

said at the groundbreaking. “It just happens to be

son, observed at the groundbreaking. “Mother was

funded by the generosity and charitable giving of

not one to seek out recognition. She was very com-

the people in our region.”

fortable in the background…” “…Mother wasn’t directly involved in Children’s

struction, one of the leading general-building com-

Mercy Hospital, but she had a tremendous love of

tower will expand Children’s Mercy Hospital’s reach

panies in the United States, submitted the winning

children, and that makes this recognition extremely

and influence.

bid for the new facility.

appropriate,” Hall later added. “We’re not sure

For example, the Elizabeth J. Ferrell Fetal

“I was so thrilled the other day when we opened

Health Center will move to the patient tower once

up the competitive bids for this project, and we

construction is completed.

found that JE Dunn was going to be our contractor

“For the first time in 113 years, Children’s

for the project, because they have been working

Mercy is going to be delivering babies where the

hand-in-hand with Children’s Mercy for all of the

baby is at high-risk,” Dr. Randall L. O’Donnell,

17-and-a-half years I’ve been at Children’s Mercy,”

president and CEO of Children’s Mercy, said at the

Dr. O’Donnell said. “[They’ve) built so many proj-

groundbreaking.

ects, do it in such a quality way, and do it as true

According to the hospital’s website, the center will provide “…prenatal care, delivery services and

she’d want this recognition, but we’re sure we want to recognize her, simple because she deserves it.” The Elizabeth Ann Hall Patient Tower will be completed in 2012. by Patricia Chaney and Pete Fernbaugh

partners of Children’s Mercy.”

complex birth defects,” and it “…will include two

Remembering those who made it possible

specialized delivery/operating rooms, four labor

Both the new patient tower and the interfaith chapel

and recovery rooms with rooming in for dads, a

are being named in honor of those who have greatly

sibling playroom, and much more.”

influenced Children’s Mercy Hospital.

neonatal/subspecialty services for infants with

Also noted on the website, “Babies who are at

Many aspects of the Elizabeth Ann Hall Patient

psycho, social , and spiritual aspects of a child and

dren’s Mercy Hospital was able to raise a majority

In addition, Kansas City-based JE Dunn Con-

Already a leader

“It’s in keeping beautifully with the emphasis that we have at Children’s Mercy Hospital on the

Through its “Happily Ever After” campaign, Chil-

$250,000 to the campaign. Brad Leech, vice president of resource development for the hospital, told the Kansas City Business Journal that the project will ultimately cost around $68 million, but added that the hospital “really had no choice.”

The chapel’s features will include a library, a family room, and an outdoor garden.

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According to the hospital’s website, the 3,000

risk for serious complications will have immediate

square-foot Lisa Barth Interfaith Chapel and Gar-

access to the pediatric subspecialists they need,

den is being “named in memory of a longtime Chil-

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

07 | King’s Daughters Medical Center

pital went through a series of layoffs, having to eliminate about 54 FTEs. The hospital was able to turn a negative eight-percent operating loss into a positive three-percent operating gain by the end of the fiscal year. Hoover said the staff maintained a sense of family throughout the hard times. “During the layoffs, I had four or five employees come by my office and offer to give up some of their King’s Daughters is a national organization with hospitals throughout the country; the hospital in Brookhaven was founded by a local affiliate. “The foundation of all we do is service to others,” said Chief Executive Officer Alvin Hoover. “We believe in giving ourselves to others in their time of need.” Hoover said that although an employee does not need to be a Christian to work at the hospital, the organization looks for characteristics such as “love, joy, peace, patience, kindness, goodness, gentleness and self-control. These are characteristics all caregivers should have.” Even in difficult economic times, the hospital has maintained a sense of family and has continued to provide compassionate care to patients, which Hooper partly credits to the Christian basis of the hospital. “I believe that our openness about the religious foundation for our hospital causes us to be held to a higher standard, but I think it has paid off for us,”

King’s Daughters Medical Center

Hoover said. “We are willing to put those values out there and state our mission, but we have to back it up, and we have.” This is reflected in the hospital’s patient-experience scores. In 2008, King’s Daughters had the second high-

King’s Daughters Medical Center has a simple mission “to provide quality health and wellness in a Christian environment.” The hospital is located in Brookhaven, Miss., a city of about 11,000 deep in the heart of the Bible Belt. Although many organizations are faith-based and have values inspired by beliefs, King’s Daughters emphasizes the Christian part of its mission and has a legacy steeped in tradition and history. The King’s Daughters organization was founded in the late 1800s by 10 Christian women with the mission of ministering to people in need. One of the women, Margaret Bottome, was aboard a ship on a voyage home from Europe when a young man died. He had no family members on the ship during his illness, and Bottome became dedicated to establishing a group of women who could minister to people in need like the young man.

est HCAHPS scores in the country. Locally, the hospital was recognized as the No. 1 hospital in Mississippi for medical care and patient satisfaction.

Keeping a sense of family during difficult economic times

hours if it would save somebody’s job,” Hoover said. “Our employees will donate time off to employees who are going through tough times and have used up their PTO. They really care about each other.” Hoover said the hospital has been taking the opportunity to prepare for coming reform by being proactive. The most recent initiative has been to improve documentation by hiring a clinical-documentation specialist. “We have provided the tools and resources to our physicians to make sure they have what they need to document everything they do correctly,” he said. “We have encouraged our clinical-documentation specialists to obtain certification, and last year when they were certified, they were two of the only four certified clinicaldocumentation specialists in the state.” This initiative has improved the hospital’s case-mix index. In addition, Hoover said the hospital has been undergoing renovation to upgrade facilities and expand where needed. King’s Daughters has expanded the emergency department, added ICU and surgical beds, increased orthopedic services, and is implementing an electronic medical record. The hospital is looking forward to the future and positioning itself to continue serving the local community. “Healthcare is not what it used to be,” he said. “To be successful, you have to anticipate what changes are coming and be ready to make changes to adapt. We are positioned as well as any hospital to respond to reform. And we will continue to provide good healthcare.” By Patricia Chaney

King’s Daughters suffered, as most healthcare organizations have, with the downturn in the economy. King’s

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Daughters is a private, not-for-profit, 122-bed hospital with annual revenue of about $160 million. It provides mostly general acute care. At the end of 2008, the hos-

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HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

08 | Kisco Senior Living

Kisco Senior Living

the same campus, because if they are happy, they

Itâ&#x20AC;&#x2122;s your residentsâ&#x20AC;&#x2122; Weâ&#x20AC;&#x2122;re just here to make them more comfortable in it.

The challenge is making additional services cost effective. Through a technology upgrade that is expected to take 12 to 18 months, Kiscoâ&#x20AC;&#x2122;s goal is

When Andrew Kohlberg purchased his first retirement community in 1990, his plan of action was simple. He asked himself where he would want his own parents to spend their retirement years. He thought about the services and setting they would want.

Andrew Kohlberg President and CEO

donâ&#x20AC;&#x2122;t want to move when their needs change.â&#x20AC;?

to build a platform so that services offered can be unbundled. Rather than including all services and amenities with standard rent rates, for instance, a resident will be able to pick and choose what best suits their lifestyle.

Twenty years later, Kisco Senior Living has more than 3,000 residents living in 18 communities in six states--Florida, Virginia, North Carolina, California, Nevada and Texas. A new senior living community is currently under development in Hawaii. In spite of the recession, Kisco has experienced success in recent years in three key measurement areas--financial performance, resident satisfaction and associate engagement.

â&#x20AC;&#x153;Letâ&#x20AC;&#x2122;s say one person wants one meal a day and another person wants three meals a day,â&#x20AC;? says Kohlberg. â&#x20AC;&#x153;Or the option of massages, therapy or other services on an a la carte basis. You really need a strong technology platform to manage all that information and billing.â&#x20AC;?

â&#x20AC;&#x153;We have our principles, values and beliefs that we use to run the organization,â&#x20AC;? Kohlberg, founder of Kisco Senior Living, president and CEO, said. â&#x20AC;&#x153;We use them as a road map to make decisions as an organization.â&#x20AC;?

As well as an expansion of services offered, efforts will be concentrated on developing future sites in states they currently serve. The most recent state

Kisco communities include a variety of resources and levels of care. The communities include IL, AL and a few memory-care apartments, all of which are located on the same campus. Communities may also house wellness centers, social and service clubs, scenic gardens and walking trails, dining halls, and various other amenities. The new development in Hawaii will include a Main Street with shops, restaurants offices and services.

Six Dimensions of Wellness

less likely to retreat and become reclusive and sit in

Kisco looks at its communities as supporting wellness on multiple levels.

their apartments and watch TV all day.â&#x20AC;? Kohlbergâ&#x20AC;&#x2122;s vision for Kisco is community in which residents become participants and engage in social pro-

â&#x20AC;&#x153;We look at the whole person and really try to

they have moved into, Texas, has several locations where Kohlberg sees Kisco Senior Living fitting well. They are the largest independent provider in North Carolina at the moment, and he views North Caro-

Our professionals are trained to listen to your residents. To treat their property t with respect. And to make their homes fresh, clean and inviting for guests. Because we do more than meet your residentsâ&#x20AC;&#x2122; needs. We help them feel more at home.

ment from design to the way we select staff and who we

vocational dimensions of wellness.

hire,â&#x20AC;? Kohlberg said.

The key to Kiscoâ&#x20AC;&#x2122;s success is their focus on welcoming and engaging new residents immediately. Resident ambassadors greet new community members and help facilitate the welcome process. Associates are well-versed in a welcoming routine, as well. â&#x20AC;&#x153;The transition to a senior community can be a difficult time,â&#x20AC;? Kohlberg said. â&#x20AC;&#x153;We have found we have the most impact to their long-lasting health and stay at the community if they are welcomed well in the first 30 days or so. They tend to do better in the community long-term, and they become more engaged. They are

More than Upscale Living Though buildings and amenities are part of the equation, the atmosphere of warmth and family-like community is the greater emphasis for Kisco. Expansion of services that cover the continuum of needs is high on the list for the future.

â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;ve always managed the business for the long term,â&#x20AC;? says Kohlberg. â&#x20AC;&#x153;From a customer perspective, we always think, â&#x20AC;&#x2DC;What does the customer want?â&#x20AC;&#x2122; For example, we want to invest in larger residents want and thatâ&#x20AC;&#x2122;s what their families want.

â&#x20AC;&#x153;It really starts with a warm and friendly environ-

emotional, intellectual, physical, social, spiritual and

Always Think in Terms of What the Customer Wants

campus projects because we think thatâ&#x20AC;&#x2122;s what the

grams and other opportunities that suit their needs.

engage the residents,â&#x20AC;? Kohlberg said, citing the

lina and Virginia as ripe for expansion.

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Choice. Weâ&#x20AC;&#x2122;ve always purchased communities based on the long term perspective of what we think is best to develop and maintain a sustainable, long-term organization over the next 10 or 20 years. â&#x20AC;&#x153;It takes a long time to build up a management team and a reputation in a community where you can deliver great care year after year after year, and thatâ&#x20AC;&#x2122;s what it takes to become a really viable, sustainable business model.â&#x20AC;?

â&#x20AC;&#x153;Thatâ&#x20AC;&#x2122;s what we think most customers, residents and their families want,â&#x20AC;? Kohlberg said. â&#x20AC;&#x153;The customer wants more choices and a greater spectrum of care on

Real Issues : Real Solutions

By T.M. Simmons

09 | Lafayette General Medical Center

Growing for Health

percentile. That same period saw pediatrics ranked

Lafayette General Medical Center is the largest

in the 99th percentile, and emergency-room satis-

acute-care hospital serving Acadiana, the southwest

faction rates rose to the 90th percentile. ER visits

corner of Louisiana. It is the fifth-largest em-

grew from 45,000 to 55,000 per year.

ployer in their community with approximately 1,800

The organization did not seek LEED certifica-

employees. In the last year, through the construc-

tion, but embarked on the renovation with energy

tion process, the hospital has added more than 35

efficiency in mind. Callecod estimated that Lafayette

physicians to their campus. The inpatient census has

will see a 25 to 30 percent reduction in the amount of

gone up, as well.

energy used simply because of design elements and

“We actually grew in volume through the midst

the all-new heating, ventilating and air-conditioning

of a construction project,” Callecod said. “At the

system. The new hospital introduces elements such

same time, we raised our patient satisfaction rates.”

as rubberized flooring which is slip resistant as well

Press Ganey scores went from the 35th to the 95th

as antimicrobial. It also has copper-based materials on high-touch surfaces because such material has been shown to reduce infection.

FLEXCO Flexco has partnered with Marie Lukaszeski, the actual designer for the Lafayette General Hospital for several years now on projects. This has been one of the most rewarding jobs in getting to work with Marie due to all of the design elements that Marie was able to put into this job. It was a pleasure to work with the installer, Corner-

Lafayette General Medical Center Total renovation is the current theme for Lafayette General Medical Center. The hospital was built in 1963 and last upgraded in 1983. The $70 million renovation project will add 54 square feet to each patient room. Upon completion, the hospital will have 387 beds and a facility-wide facelift.

David Callecod President and CEO

The new hospital will maintain the existing steel and concrete from the original structure, while expanding the building on all sides. This was pivotal for Lafayette. Building the 10-story structure from scratch would have more than tripled the construction cost. However, when they were renovating the women and children’s area a few years ago, they recognized that the outer ledge of the building was load bearing and equivalent to the inner floors. “That’s when the contractor and our architectural firm began thinking about this not as a problem, but as an opportunity related to the expansion that we needed to do in the coming year,” David Callecod, president and CEO, said. “The team got together and started looking at how we could renovate and add approximately 60 beds and position ourselves well for the future. We will have a low-cost structure, yet a brand-new facility ready to face reform.”

Real Issues : Real Solutions

Lafayette General has long been known to its community as a leader in technology. They have two da Vinci robotic surgical systems in use, as well as a CyberKnife, a radiosurgery system designed to treat well-defined tumors at any site in the body.

healthcare

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10 | Davis Vision

As part of the renovations, they will add a Varian

“We are no different than any other business that

TrueBeam for radiotherapy and radiosurgery. By

has to deal with the recession and deal with the

being able to deliver higher doses to smaller areas,

economic downturn,” Callecod said. “It behooves

this will allow them to add to the complexity of

all facilities to relook at how to provide high-quality

cancer cases that they can treat.

care as efficiently as possible and squeeze out

“This is by far the best technology in the market

the waste.”

for delivering radiation therapy,” Callecod said. “We

He added, “I see health reform as an opportu-

now employ six full-time medical oncologists and

nity to continue to focus on high-acuity care and to

provide services in our large, 18,000 square-feet

partner with surrounding hospitals to ensure that

infusion center, as well as in satellite sites around

they provide the highest-quality primary care that

Acadiana. It is a comprehensive approach to the

can be delivered in their communities. Five years

treatment of cancer that includes not only medical

down the road, I see us having truly established

oncology, but also radiation and surgical oncology.

ourselves as a large, multi-hospital system in

As well, nurse navigators help the patient and fami-

Acadiana, providing the highest acuity and the most

lies deal with the diagnosis of cancer. It has been

intensive care in our region. Our hospital is certain-

warmly received by the community and has really

ly going to play a part in solving the issues we have

changed the way cancer is taken care of

with Medicare and Medicaid in our state.

in Acadiana.”

Davis Vision

“We have four or five programs that are cur-

The hospital also has two new Philips Cath Labs

areas, we are as good as anybody. As an organiza-

off the reinstallation of the Cerner electronic medi-

tion, we are on a journey to excellence to get all of

cal record.

our programs to that level because that is what the

“We are having best of breed established throughout our organization as has been tested in

In a tumultuous health care market, Davis Vision has been an understated leader in its own niche—managed vision care. Until recently, the company has stayed relatively under the radar, operating mostly in Pennsylvania, New York and other northeastern states. But that is soon to change with the company’s expanding sales force and managed-care options.

rently in the top five percent in the country. In those

going into place, and they are getting ready to kick

people of Acadiana deserve. I believe we are positioned to be that center of excellence for Louisiana.”

other facilities to improve productivity, efficiency, quality and also reduce medical errors. We’re very

By T.M. Simmons

excited about this partnership with Cerner as it is going to be a total reimplementation of the way we do business, using best practices that have been

Steve Holden, President

Davis Vision is no small company. With 55 million members and a national provider network that has more than 32,000 points of access, Davis Vision has established itself as a leader in managed vision care. Davis Vision is owned by HVHC Inc., which provides access to laboratories, retail vision stores, and a frame-design company.

used throughout the country.” Callecod said.

Preparing for the Future

Real Issues : Real Solutions

“We have three main clients--the member who comes in to a store or office, providers, and benefit-plan managers,” said Steve Holden, president of Davis Vision. “We have a niche and are able to give value to each client.”

People who can’t see well, can’t do their jobs well.

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Learn how regular eye exams and advanced eyewear options available through a vision benefit can help save you money – and boost employee productivity.

near future.

• Poor or miscorrected sight can reduce an employee’s productivity up to 20 percent.1

a larger geographic area. The sales force also

• Businesses can gain up to $7 for every $1 invested in vision coverage.2

HealthySightWorkingForYou.org

Vision continuously improves benefits to clients. The most recent investment the company has made is in its laboratories, focusing especially on its antireflective coating equipment. Holden said he anticipates this to be a high growth area in the With the success the company has had in the northeast, Davis Vision has also invested in a larger sales force to promote its vision-care benefits to regularly obtains feedback from clients, which Davis Vision uses to proactively develop next-generation vision products.

Future growth and challenges “Vision care is a relatively inexpensive, high-value option, but in this economy, our clients are challeng1. Daum K., University of Alabama School of Optometry 2. The Vision Council © 2011 Transitions Optical, Inc. Transitions and the swirl are registered trademarks of Transitions Optical, Inc. Photochromic performance is influenced by temperature, UV exposure, and lens material.

ing what they spend money on,” Holden said. “We haven’t seen a lot of people leaving yet, but there is some pressure for companies to offer voluntary plans where members pay the full cost. There may be less of a group signing up if that happens.” Despite uncertainty, Davis Vision maintains the highest quality care and best service to its member base. It is the only managed-care organization

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prices through its frame-design company, Davis Vision places a large frame selection – Davis Vision’s Exclusive Collection -- in independent stores. Rather than having a handful of frames covered in full, Davis Vision members have more than 220 to choose from. And of course, members may upgrade to higher-cost options or use a generous allowance toward any frame at the provider’s office. “We are unique in the industry for having placed a frame selection in independent offices,” Holden said. “We think our customers are finding this to be

Meeting the needs of clients

of value. On average, 80 percent of our members go home with frames that are covered in full through their plan.”

Davis Vision is skilled at meeting the unique needs

Davis Vision provides members access to

of each set of clients. For members, Davis Vision is

independent-provider locations, as well as their

committed to providing the most value – lowest out-

retail locations, Eye Care Centers of America. The

of-pocket cost and broadest array of covered-in-full

company also offers competitive pricing to appeal

frames. By having access to frames at wholesale

to benefit managers.

whose lab network and customer-service center are certified to ISO 9001:2008 standards. The lab is also COLTS-certified for Prescription Accuracy and FDA Conformance. Davis Vision ensures the quality of its provider network by operating an in-house NCQA certified-provider credentialing process. These types of distinctions are unique in the industry, and Davis Vision has been fairly modest about these achievements, but that’s looking to change. “Davis Vision is one of the largest vision benefits companies in the industry,” said Tom Davis, chief marketing officer. “We’ve not celebrated our growth publicly, but we are going to become a national player. We offer the best value in the managed vision care industry in terms of benefits and out-ofpocket expense.” By Patricia Chaney

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

11 | New Parkland Hospital

Preparing for the Future

This area also houses space for hospital staff, includ-

Seven years might seem like a long time, but for the

ing three nurses who work as clinical liaisons, to

size and scope of the project, keeping everything in

provide an information link between the architects,

order and on target for completion is an enormous

engineers and consultants and more than 500 stake-

undertaking.

holder or user contacts.

“As a public hospital, there are multiple authori-

“The ability to continually inform each other

ties who are all in play,” said Walter Jones, senior

across the partition, at the copy machine or in the

vice president of facilities development. We are

break room has been incredibly valuable and very ef-

governed by a seven-member Board of Managers who are appointed by the five elected Dallas County Commissioners.” “We elected to select and engage several teams to execute the project in a collaborative manner. While we are not quite using integrated project delivery method to do the project, we have borrowed heavily from that model,” Jones added. The teams were brought together early and they leased 48,000 square feet of retail space directly across from the new site to give all parties involved a place to work together. “We have our master architect, our construction manager at-risk, our program controls manager and all of our major consultants. They reside in this one area, and it’s where my office is as well,” Jones said.

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New Parkland Hospital The current Parkland Memorial Hospital was built in 1954 in Dallas, Texas. In the nearly six decades since, Parkland has become an overcrowded and undersized facility that has fulfilled its mission of “Dedication to the individuals and communities entrusted to our care.” Parkland serves as a public, safety-net hospital and an academic teaching hospital.

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In 2007, the Dallas County Commissioner’s Court gave the approval for a bond election so voters could decide if a new health care campus should be built. In November 2008, the Dallas County taxpayers overwhelmingly approved the bond by an 82 to 18 percent margin.

Walter Jones Senior Vice President of Facilities Development

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Real Issues : Real Solutions

When it comes to your healthcare technology needs, only one consulting team covers it all. It happens to be the same team that pioneered the field 23 years ago, with unsurpassed IT, technical and clinical expertise, and a track record that assures your healthcare technology projects return value now and for the long term.

fective in terms of communicating the information on a project of this size and scope,” Jones said.

Building to Accommodate in 2014 and Beyond The larger the project gets the more crucial flexibility becomes. The goal is not only to build infrastructure that will be prepared to house healthcare needs in 2014, but to build infrastructure that will also be flexible enough to accommodate healthcare needs 50 years beyond. Predicting what might happen in terms of IT and medical equipment can

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be daunting.

We are proud to partner with Parkland Hospital.

what the newest device system in 2014 will re-

“We won’t necessarily be able to build exactly quire,” Jones said. “What we are attempting to do

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is design and construct a building that is flexible enough in terms of layout, design of the room and floors and such, that as change happens, we will

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2014, in 2015 it may be something different.” Designers work from the assumption that the peripheral pieces may change, but the backbone, the pieces of the system that are embedded in the

comes because changing it is far more difficult,

each of the nursing floors, but it’s highly likely that

building must be robust and prepared for whatever

disruptive and expensive. Based on the flow of data

computers won’t even need to be fixed because

needs today, for instance, and how rapidly those

they’ll be in everybody’s pocket,” he added. “I need

needs are increasing, accommodations are being

to plan for mobility, and I need to plan for a lot of

incorporated now to prepare for how much infor-

convergence of different tools and devices that are

mation may be travelling through that network

doing individual things right now that will probably

five, 10 or 15 years from now. The building may

converge into whatever device it is a clinician will be

be designed to be wireless, but leading up to the

using to deliver care in the future.”

antenna that makes the system wireless is a bundle

“It’s a highly collaborative project in the best sense.

of cables that must be laid within the structure of

Tips on Building Big

the building itself. The last thing you want is to find

“On a project of this scale, it all goes back to engag-

upon opening that you’ve maxed out the infrastruc-

ing the consultants. You have to engage as many as

ture of your IT capacity.

you can, as early as you can. Co-locate them. That

“Our CIO has said that the rate of technology

level of communication is invaluable and highly ef-

changes is not linear, it is hyperbolic. That’s the

ficient in getting a project like this done accurately

real challenge in terms of projecting. You look at

and keeping it on time. I think that’s probably the

technology that was first available four years ago

biggest advantage we have here,” he said.

and ask how that changes the way you do things.

“It’s exciting to do a project like this,” he added.

That’s probably going to be the same level of

“You can never be too prepared or have too much

change you see in the next four years,” Jones said.

understanding of what it is going to take to imple-

“I’ve got plenty of places for computers in the

ment and execute the project.”

rooms, plenty of places for computers at decentralized stations in the corridors, plenty of places

By T.M. Simmons

for computers to be in work areas in the core on

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

12 | Mission Health System

Building with a vision All building projects start with Mission’s strategic plan. “All projects are considered within our overall capital capacity,” said True Morse, Director of Facility Planning. “From that point, we work closely with business leaders in the operations side of the house to match the program and scope with our business needs.” Project leaders stay aware of budget throughout the building process, including budget requirements for the transition process. “For projects over $250,000, we obtain initial planning funds to arrive at a preliminary scope so that the budget obtained in the previous fiscal year is a firm budget, not conceptually based,” he said. Once the new facility is ready to be occupied, Mission has a detailed process for transitioning from one facility to the next. The first step

Mission Health System

is identifying all departments impacted by the move and speaking with them on how they will be affected. “We have routine accountability meet-

With technological advances, increased patient loads and healthcare facilities merging or consolidating, building expansion is a major focus of most American healthcare systems. Mission Health System, in Asheville, North Carolina, has building expansion and transition down to an art. The health system has a total of 873 beds, more than 600 physicians and about 6,000 employees at its location in Asheville. Mission Hospital is the primary facility with two adjoining campuses and other off-site facilities along with involvement in three community hospitals. Mission serves as the tertiary medical center for the 20 counties of western North Carolina.

True Morse Director of Facility Planning

The hospital’s largest current project is building a 117,000 square-foot outpatient cancer center. This $59 million project is expected to be open by 2012. As a companion project, the hospital is also widening and extending a public road to create better connectivity between the hospital campus and the cancer center. The health system also added a new wing for surgical services and critical care to its Memorial Campus. This new space replaced outdated facilities and allowed more room for advanced technology. Mission also has other smaller expansion, renovation and ambulatory projects.

ings with leaders up to the occupancy date to assure that the public and internal staff are

ties can easily be in place for years, and planning

aware of what is going on and why,” Morse said.

construction projects with the ability to grow as

“In clinical and nonclinical areas, we identify

technology changes is key.

actions that need to take place, whether staff-

Morse said the primary impact of technology

ing or scheduling, to assure they support the

on construction is in floor dimension and space

occupancy itself and post-occupancy startup.

above the ceiling to house advanced technology

We begin planning in the budget year prior so

that requires greater airflow, as well as room for

that any budget impacts are reflected in those

data distribution.

departments’ requests.”

Building with growth and flexibility in mind

“Our drivers for flexibility are column spacing, floor to ceiling height, and the basic footprint of plumbing and HVAC to allow upgrades to technology in patient rooms,” Morse said. “From a design

Technology is growing rapidly, creating chal-

standpoint, we assure to the best of our ability that

lenges for existing building space and for

we increase the space provided so that the day we

planning growth in new facilities. New facili-

open, we have not consumed all the space.”

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

Strong yet gentle skin care

Over 100 years of infection prevention technologies

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“We look at space and workflow to ensure the facilities themselves do not impact, but more importantly support the goal of zero preventable harm.” This is especially important as the system moves toward a more and more integrated electronic medical record. Where caregivers once had individual pieces of paper that were dispersed among them and then added to the combined patient record, now they need access to a computer terminal to interface with the medical record. This means many more computers for access, either at desk locations or mobile locations. Throughout the planning and construction process, Morse said there is always a direct tie to Mission’s strategic goals. This helps ensure that strategic initiatives are supported with the new

STERIS Corporation One area Morse anticipates technology growing and impacting design is in pathways for data and power. “We want to make sure we have capacity to add things later in those concealed areas,” he said. “We put in a percent factor for growth to accommodate

STERIS Corporation is a leading provider of infection prevention and surgical products and services, focused primarily on the critical markets of healthcare, pharmaceutical and research. Our mission is to provide a healthier today and a

unknown future needs.”

safer tomorrow through knowledgeable people

He said after Facility Services, Information Systems is the next department with which his team works closely. “We have routine meetings with them to review

and innovative infection prevention, decontamination and health science technologies, products and services.

facility design. For example, Mission has embarked on a safety initiative to achieve zero preventable harm within three years. “Achieving this initiative has a ripple effect in analysis and clinical approaches and how we design the facilities,” Morse said. “We look at space and workflow to ensure the facilities themselves do not impact, but more importantly support the goal of zero preventable harm.” Mission has developed a successful, detailed process to manage construction projects from

all facility initiatives because of the impact they have

For more information, please visit

initial planning all the way through occupancy. He

on our data center’s capacity to move data,” he said.

www.steris.com or call 800-548-4873.

stresses that the keys to success are maintaining a

“As we work on distribution cabling, we work closely

direct tie to the organization’s strategic goals and

with them on matching projected

tracking projects through all phases on perfor-

size and needs of the facility with their ability to

mance dashboards to ensure Mission is adhering to

move data.”

budget and schedule. By Patricia Chaney

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

13 | Healthcare Finance Group. LLC

Healthcare Finance Group. LLC Healthcare providers are slowly starting to rebound from the 2008 financial meltdown and are looking to secure more capital to improve their market positions. But many still face uncertainty in light of healthcare reform and reimbursement challenges. In this climate, it’s important for providers to work with reliable lenders who have proven experience in the healthcare industry.

Isaac Soleimani, CEO

Intelligence Perhaps one value on which HFG prides itself is its expertise in healthcare lending. “You really need to specialize in healthcare lending and understand its nuances,” Soleimani said. He said that often when the healthcare market is

Healthcare Finance Group has been working to meet provider’s financing needs for 11 years, with a zero loss experience during that time. HFG specializes in senior debt financing, offering secured revolving credit facilities and cash flow-based loans from $5 million to $100 million. Chief Executive Officer Isaac Soleimani said that HFG’s expertise and commitment to solid lending practices has allowed it to weather the economic storms.

hot, general lenders will come in and make loans that

“We are one of the select lenders that have continued to do business in this segment, and we have continued to grow,” he said. “This is due to our disciplined credit culture and our unwavering focus on meeting our clients’ needs.”

izes in healthcare. As a result, HFG remains steadfast

are not ideal for their clients. This leaves the lender and the borrower in a difficult position when the market falls, and the lenders usually move out of the industry. Healthcare Finance Group, however, specialand doesn’t leave the industry when the industry is under pressure. “One of our challenges has been dealing with

During the 2008 financial crisis, lenders were not able to secure capital, but Soleimani said those markets have opened again to credible companies with good credit histories, like Healthcare Finance Group. Healthcare Finance Group has a set of core values that drive the business they do and, ultimately, help them achieve success and the favor of their clients. These values are integrity, intelligence, discipline, dedication and teamwork.

Legal Counsel to Lenders, Investors and Providers in the Healthcare Industry

the generalist lenders who have little expertise in

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healthcare and who come into the healthcare lending market as activity increases and the capital markets open. An inexperienced lender can make mistakes

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that hurt not only the lender, but the borrower as well,” Soleimani said. One way that HFG has dealt with this situation has been to educate some of these lenders by bringing them in as co-lenders on large transactions led by HFG. “We act as the lead lender, underwriting the

Dedication and Teamwork Healthcare Finance Group is dedicated to its mis-

Integrity

transactions, structuring them properly, closing them

sion of being the premier lender to healthcare pro-

“Our clients rely on us to give them good advice, and

and monitoring them,” Soleimani said. “Then we can

viders. This dedication continues as HFG looks to

we always treat them with honesty and respect,”

bring in lenders who want to be in healthcare, but

expand the products and services it offers, building

Soleimani said. “We deliver what we promise, with

don’t have the expertise. They can take pieces of the

its syndications platform and doing larger middle-

no surprises.”

transactions, which is good for them and is good for

market transactions. The group also offers invest-

us because it allows us to do larger transactions and

ment banking services and plans to selectively offer

offer more services.”

subordinated loans.

He said Healthcare Finance Group strives to be clear and transparent in its decision process, notifying potential borrowers as soon as possible of their status. In client surveys, integrity and treating clients with respect has served HFG well. “Our clients have a unique experience with

“We deliver what we promise, with no surprises.”

NEW YORK

WASHINGTON, DC

Teamwork has also been a strong foundation

Discipline

for HFG, not just internally but with clients and

Discipline has been a major force in HFG‘s suc-

other investors. Clients know the team working

cess since its inception. Soleimani said that HFG

with them on their transaction, as well as the ex-

us, and we passionately strive to provide value to

has always had a strong, disciplined credit culture,

ecutive management team. They also have access

them,” Soleimani said. “Every year our clients com-

while remaining focused on clients and on meeting

to members of the executive team at any time.

plete a survey ranking us from one to five on various

their needs. HFG evaluates borrowers in terms of the

matrices. We are consistently ranked above 4.5 by

healthcare market as a whole, what debt load is ap-

to grow and offer new products and services to its

our clients.”

propriate, and how likely the borrower is to be able to

clients. Adherence to these values will be a key part

pay it back.

of HFG’s continued success.

Soleimani said he expects to see HFG continue

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

14 | Gracedale

Gracedale In northeastern Pennsylvania, a county institution caused an emotional debate among residents about private versus government ownership. Gracedale is a county-owned, 725-bed nursing home that sits on 365 acres in a suburban community in Northampton County. It is one of the largest nursing homes in Pennsylvania and provides services for residents, including physical, speech, occupational, and recreational therapy; onsite audiology, dental, podiatry, orthopedic, psychiatric, surgery, urology, and ophthalmology clinics; dementia units; worship services; hospice services; and respite care.

different way of thinking, ways to become more state

Marcus said it is “difficult for government to justify

of the art,” said Ross P. Marcus, director of human

capital improvements, and a nursing home, like any

services for Northampton County. “We had become a

facility, needs constant improvement.”

little settled in our ways, and the permanent admin-

As with most healthcare facilities, Gracedale

istrator continued in the consultant’s path to upgrade

also faces reimbursement challenges. Being a pub-

procedures and improve Gracedale.”

lic facility, the majority of residents receive Medic-

The interim administrator also revived Gracedale’s quality-improvement process, working hard to address any citations from the Department of Health surveys.

Battle for ownership

their quality-improvement process and the facility’s

In late 2010, Northampton County government

commitment to care.

proposed selling Gracedale to a private company

Marcus emphasizes the “familial” attitude of staff

as a result of the state’s efforts to reduce Medicaid

members toward each other and residents as being a

expenditures and because of the county’s financial

turning over Gracedale to a private company, as they

key part of these improvements. Most employees have

challenges. Benefit costs, reimbursement rates,

were concerned about their job security in this dif-

been with Gracedale for 15 or more years.

and state budget issues also factored into the

ficult economic climate.

“Gracedale is a large part of our employees’ lives,”

Gracedale has been part of the community since 1951 and strives to provide the highest-quality care for residents. The nursing home has about 560 fulltime employees, most of whom belong to one of two labor unions. A few years ago, Gracedale changed leadership and hired a new administrator who helped upgrade the facility and modernize some processes. “When our previous administrator retired, we brought in a consultant who served as the administrator on a temporary basis and exposed us to a

to be reduced in the coming years.

A recent Gracedale survey highlighted the success of

Marcus said. “It’s not just a job. They get to know resi-

Advances in care

aid, benefits that have been and will likely continue

county’s decision to put Gracedale up for sale. During the debate, some negative comments

The unions and a group of family members of residents organized a petition that resulted in having

dents and do little extras to make residents’ lives more

were made about Gracedale to help justify the

the question added to the election ballot so the com-

pleasant and enjoyable.”

sale. Marcus said this was a difficult time for

munity could decide where ownership should lie. In

employees, as they heard these comments, and it

May 2011, the community voted three to one in favor

“affected morale.”

of keeping Gracedale government-owned. This vote

Challenges of being public As a government institution, Gracedale faces funding

Furthermore, the push to privatize the facil-

will keep Gracedale under government control for at least the next five years.

challenges, especially since Pennsylvania, like most

ity, a revered institution in the community, did not

state governments, is looking for ways to cut spending.

go over as smoothly as government officials had

“Partly it’s because, what the public listen to?”

hoped. A heated debate arose within the county

Marcus asked. “Did we (the government) really make

ects, such as upgrading Gracedale’s aging facilities.

over quality of care and the ability for Medicaid

our case persuasively, or did we beat the drum the

Although upgrades have been made, including replac-

patients to continue receiving affordable care at

way the opponents of the sale did? Probably not. It

ing leaky windows and renovating the HVAC system,

Gracedale. Employees also had misgivings about

does show to a certain degree how well-respected

This challenge affects capital-improvement proj-

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

15 | Main LIne HEALTH

“We strive to always treat every individual in our care with respect.”

Applying evidence-based design and sustainability in future projects Magnatta said one integral piece to the success of large capital projects is to assemble a team at the beginning. She assembles a team of individuals from within the Hospital System, including the Hospital president, operations vice presidents, materiel management, etc., as well as architects, construction representatives and others to ensure everyone has input and all questions can be answered from the outset. “It is important to do all your homework before you take a project forward,” she said. “We talk to hospital presidents and operating vice presidents

Gracedale is and how much Gracedale is viewed

that we haven’t thought of and ways of maximizing

about their needs and put together a return on

as part of the community.”

revenue that we haven’t thought of,” Marcus said.

investment analysis. Then, we always make sure

A strong supporter of selling Gracedale, Mar-

During the election debate, Marcus said that

cus has strong reasons for why it should

the labor unions, who opposed the sale, promised

have happened.

that they’d be willing to “give back” if Gracedale

“I was in favor of selling the facility because

“So now, it’s time for them to honor those state-

county-operated nursing homes in Pennsylvania

ments,” Marcus said, “because our fringe benefits

because of the separate reimbursement rate for

cost us about double what a private nursing home

Medicaid, and because Medicaid is such an impor-

pays. So a private nursing home’s fringes would be

tant part of Gracedale’s financial picture,” Marcus

running at about 34 percent of salary. Ours run 68

said. “I also saw that private nursing homes in the

percent of salary. “

area had become enough of the Medicaid populaincome individuals in need of nursing care would be adequately cared for, but the residents of Northampton County have expressed their view.” Since the voters have spoken, Marcus feels the

tatives from all areas of the project allows us to

remained publicly owned.

of the relatively pessimistic financial outlook for

tion that we were secure in knowing that low-

we have the right team in place. Having represen-

Main LINE HEALTH In today’s uncertain healthcare market, facilities design faces some daunting criteria—to be state-of-the-art, flexible, environmentally friendly, efficient, and perhaps most important, affordable. These factors present unique challenges for hospitals and health systems, many with aging facilities that are looking to meet the high standards and growing needs of the baby-boomer generation.

He later added, “Maybe we’ll have to revisit the issue in a few years.”

Mission of compassion and respect Regardless of ownership, Marcus said Gracedale remains committed to compassion and quality care.

pathway going forward is clear.

“Our employees are encouraged to treat

“What we are determined to do is continue operating a nursing home with a high quality of

residents as if they are their loved ones and never

care and a well-maintained facility and will now be

lose track of the human element,” he said. “In the

looking at ways of reducing the cost and maximiz-

Department of Human Services, we are caring for

ing revenue, “ he said.

the most fragile among us, and that’s a special

To achieve this, Gracedale has issued a request for proposal (RFP) in an effort to find outside management for the facility. “We are hoping that there are firms that have enough experience with both county and private

responsibility. We strive to always treat every individual in our care with respect.” By Patricia Chaney with additional material by Pete Fernbaugh

nursing homes who have ways of reducing costs

Real Issues : Real Solutions

JoAnn Magnatta Senior Vice President, Facilities Design and Construction

“I have been in the facilities design and construction field for 27 years, and I believe that we are in the middle of the most challenging times for both the healthcare and construction industries,” said JoAnn Magnatta, senior vice president of facilities design and construction at Main Line Health. “It is exciting and challenging at the same time. We have to work harder than ever to produce buildings and facilities that will meet the needs of healthcare in the future at a reasonable cost.” Paoli Hospital, part of Main Line Health in suburban Philadelphia, Pa., has approximately 200 beds. The hospital recently completed a large capital project. The hospital built a $144-million, 259,000 square-foot pavilion, which included a parking garage and new patient tower. This patient tower opened in July 2009. Magnatta and her team are applying lessons learned from that project to a current $530 million expansion project at Lankenau Medical Center, an acute-care hospital within the Main Line Health System. The new Lankenau Medical Center will house a 1300-car parking garage, a new patient tower with all private beds, cardiology services and a new diagnostic and treatment area. The project also includes a new central utility plant, upgrades to the cancer center and upgrades to the research facility.

understand equipment needs, what new technologies may be on the horizon, and plan flexibility into the project.â&#x20AC;? Magnatta said the team is in place for the Lankenau Project, scheduled to open within the next two years. The project will apply many

Serving the Industry Since 1926 Commercial, Industrial & Institutional 3548 â&#x20AC;&#x153;Kâ&#x20AC;? Street Philadelphia, PA. 19134 Tel: 215-743-1376 Fax: 215-743-3606 www.jprainey.com

evidence-based design practices, especially those

healing environments. These features will carry

learned through the Paoli Pavilion.

over into the new patient rooms at the Lanke-

The Paoli Pavilion was a Pebble Project, one

In addition, the Paoli Pavilion incorporated

research effort to discover and share best prac-

green elements that will also be applied in fu-

tices in healthcare facility design. One application

ture design projects. Magnatta said sustainabil-

of this was in patient-room design. Magnatta said

ity is an important part of construction projects,

before building rooms in the Pavilion, the design

and the Lankenau project is aiming for LEED

team worked with staff and end users to develop

gold certification.

mock-up rooms.

â&#x20AC;&#x153;We have made a commitment to ourselves

â&#x20AC;&#x153;We replicated a patient room down to the

WE SUPPORT THE MAINLINE HEALTH ORGANIZATION

in our power to build sustainable buildings and

other users to critique them,â&#x20AC;? she said.

incorporate as many LEED elements as pos-

Paoli is still measuring the outcomes from patient falls. The new room design incorporated

The rooms feature significant natural light and are designed to be safe, spacious and great

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sible,â&#x20AC;? she said.

this, but one result seen so far is a reduction in

the bathroom.

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and the community that we will do everything

spigots used and invited physicians, nurses and

hand rails throughout, especially from the bed to

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nau facility.

of only 50 in the nation. The Pebble Project is a

Some buildings in the Main Line Health Sys-

â&#x20AC;&#x153;We have made a commitment to ourselves and the community that we will do everything in our power to build sustainable buildings and incorporate as many LEED elements as possible.â&#x20AC;?

tem have already achieved gold certification.

Meeting the needs of the future Main Line Health continues to look for ways to meet the needs of todayâ&#x20AC;&#x2122;s challenging healthcare market. As with many health systems, Main Line Health has to evaluate capital investments in light of the aging infrastructures of many facilities. The need to upgrade is always being weighed against the need to expand programs or add new services. Magnatta said that having a strong team in place on any project and only going forward with projects for which your team is 100 percent on board is the best chance for success. â&#x20AC;&#x153;Take your time to make sure your planning is accurate. Understand the market, and never assume you know it all. Ask questions of your team and listen carefully to the answers.â&#x20AC;? By Patricia Chaney

3KRQH )D[

HCE EXCHANGE MAGAZINE

16 | Roseland Community Hospital

Roseland Community Hospital

Earmon Irons, CEO

One of the largest employers in the second congressional district on the South Side of Chicago is Roseland Community Hospital, a small community hospital licensed for 162 beds, but with an active capacity of about 100 beds. The campus also includes a medical office building. The hospital employs upward of 450 people and has a net revenue of approximately $65 million per year. Roseland first opened in 1924.

hospitals by 2014, and we’re positioning ourselves to

“We are a safety-net hospital, which means a significant portion of the patients we serve are selfpay,” Earmon Irons, CEO, said. “That means a high percentage of the people who come through our emergency-room doors are underinsured or have no insurance at all.”

related illnesses. Wounds that are difficult to heal

do that.” In April of 2010, for instance, they opened an outpatient wound-treatment center that has hyperbaric

JENKINS ELECTRICAL

chambers. A study of the market showed Roseland that the population in and around the hospital was 76 percent more likely to die of untreated diabetes-

Chuck Jenkins

are common in diabetic populations, therefore having

7300 S. South Shore Dr. Ste. 1102 Chicago, IL. 60649

hyperbaric-chamber therapy in the wound-treatment center made sense for Roseland.

The hospital is subsidized by the state and federal governments because of the high percentage— approximately 25 percent—of self-pay patients. These subsidies help to offset some of the $20 million that had to be written off as bad debt last year.

behavioral unit later this year. This is sorely needed

“We don’t come anywhere near regaining it all, but we receive some help from the federal and state governments,” Irons said.

enterology, a community diabetes education and

Roseland has a target of opening an adolescenton the South Side of Chicago. Other new service lines will include “gastroprevention center, and a women’s health center of excellence - with state-of-the-art Labor and Delivery Suites - of which there’s a high demand,” Irons said. “The birth rate is still relatively high in our community, and our hospital is only able to capture about

Growing Toward Economic Viability

much needed by the community and should help the

Roseland has gone through a rough patch in the

hospital develop the necessary revenue to become

last decade, but the organization has started to

more competitive with other area hospitals.

20 percent of the births because we find mothers

experience something of a turnaround within the

“We have outlined seven service lines that the

preferring to give birth at more modern facilities. “We’ve engaged a hospital planner, and we’ve engaged a consultant who has done the service line analysis and evaluation,” he added. “They have pro-

last five to six years. For example, Roseland’s

hospital will begin to provide over the next five

vided us with the service-line evaluations and guided

losses have been reduced.

years,” Irons said. “To determine those service

us in what service lines we should be providing.”

A brand-new emergency room was added in

lines, we first evaluated the needs of the commu-

2009 that grew their space from 2,000 to 15,000

nity. We also had to decide what type of contribution

square feet. As the sixth busiest emergency

margin, cash-wise, these service lines would gener-

Building with More Growth in Mind

room in Chicago at the time, the much-needed

ate to the hospital, because in the future we’re go-

When building the new emergency room, Roseland

addition was welcomed. Emergency-room visits

ing to have to be economically viable by depending

constructed a foundation that would allow for the

were up about 40 percent in the year following

upon our cash flow to sustain us.

construction of two more floors when the time came.

that improvement.

“Healthcare is changing and one of the changes

“We are very proud of our state-of-the-art

That additional 30,000 square feet of space will

is that most, if not all of the self-pay that we cur-

eventually house new intensive-care units, as well as

emergency room, and it is the cornerstone of our

rently get will gain some type of insurance,” he

improved and expanded operating suites.

strategic plan as we move forward,” Irons said.

continued. “That means our subsidies are going to

Building on that success, Roseland is in the

“Those are not service lines, but are an integral

be significantly reduced as more of our revenues

part of what the hospital does,” Irons said.

process of moving forward with a strategic plan

will derive directly from the patients that patronize

Irons said the hospital completed its strategic plan

that includes added service lines. These lines are

us. We will have to be competitive with all the other

earlier this year and settled on a core set of values.

These values promise all patients, guests, and staff dignified, respectful, and compassionate treatment and promise the community a commitment to quality service, wise stewardship of resources, and diversity. “We are building on our turnaround and beginning to propel our hospital into the future so it will be competitive by catapulting our services in the community to a newer and higher level,” Irons said. “We are really excited about all the positive things that are happening here at Roseland Community Hospital” by T.M. Simmons

HCE EXCHANGE MAGAZINE Real Issues : Real Solutions

17 | Adventist LaGrange Memorial Hospital Grange Highlands, Western Springs, Willow Springs,

ness of their respective operations, and being a catalyst

and Indian Head Park.

for progress within their core measures as indicators of

In 1999, Hinsdale Hospital and Columbia La Grange Memorial Hospital ended a 44-year competi-

Leaders were also expected to be “intrapreneur-

tion when AMH acquired both hospitals. Separated

ial,” meaning that they were to run their department

by 2.2 miles and the I-294 Tollway, AMH merged the

as if it were their own business. Success in this area

two organizations. It was a plan that made sense on

meant each leader would have to take ownership of the

paper. In fact, tremendous growth was predicted.

entire job, as well as his or her revenue and expense

What followed was a decade-long struggle to make Adventist profitable.

Key values moving the organization forward In an effort to turn around profits and move the orga-

About Adventist La Grange

success in this area.

lines. They would have to understand the marketplace, be aware of industry trends, and tuned in to customer needs and desires. Enriching the patient experience and receiving patient feedback would be the keys to success

back to basics.”

an adherence to SHARE principles in their work ethic. They were to maintain a disciplined “employee culture”

Adventist La Grange is a 205-bed hospital, provid-

internally with employees and leadership. This in-

where reward, recognition, and corrective action were

ing all major specialties, outpatient and inpatient

cluded clearly spelling out the expectations for ALMH

never overlooked.

primary care, trauma care, and wellness services. It

leadership.

has a freestanding cancer-treatment center pavilion

per unit of service, constantly monitoring the ED, and

It also boasts an off-site rehabilitation center and a

“problem identifiers.” Now, leaders were expected

installing Wi-Fi. ALMH also identified which depart-

family-practice residency program.

to be “problem solvers.” To chart this, leaders had to

ments were over their budgets and developed a specific

maintain a “results dashboard” that tracked out-

timeline for getting back on track financially.

comes. They had to maintain a record of the plans

hospitals and medical facilities in Chicago’s western

used to achieve those solutions.

and southwestern suburbs. Adventist La Grange has about $160 million in net revenue annually. Adventist is located in Cook County. Its primary service areas are La Grange, La Grange Park, La

Second, leaders were expected to be good corpo-

General Contractor · Construction Manager · Design-Builder

“We needed to create an environment where people feel they can give an honest, straightforward answer,” Wright said. “We also needed consistency in messag-

“The ACO structure is a great unknown,” Wright said.

rate citizens who understood and supported ALMH’s

ing. That has helped to get buy-in and understanding of

“There is a new set of expectations, new terminology,

mission, vision, and directives. Wright saw complying

where we’re trying to take the organization.”

new players. We are aligning with medical staff in the

with corporate mandates, ensuring regulatory readi-

In addition to regular monthly meetings, Wright

community to be positioned for this new structure,

began having a special leadership meeting twice a year

although we aren’t exactly sure what is going to be

that resembled a “fireside chat” to encourage more

expected of us yet.”

open conversations among administrators and leaders.

Adventist LaGrange Memorial Hospital During the past two years, Adventist La Grange Memorial Hospital has proven that through efficiency, hard work, and clear messaging a hospital can turn around profits. In 2006, Adventist La Grange opened a new patient-care center on campus with 171 private rooms. This patient tower brought a high debt load to the hospital, which was already struggling to make a profit with its patient base in Chicago’s western suburbs. Despite the debt load, Chief Executive Officer Rick Wright said the hospital began making a profit in 2009 just three years after opening the patient-care center.

Despite what changes come, Wright said that

He also started employee forums on a quarterly basis to

being part of a larger health system increases the

encourage communication with staff and to allow him to

hospital’s security, and he knows the hospital will

deliver consistent messages to employees.

remain open. “More affiliations will probably come in the

Planning for the future

future,” he said. “It is important for us as a region to

The hospital is working on some capital projects in the

have a stronger negotiating presence in our market.

coming year, including cath labs, a renovation of the

But we are a strong, viable organization, and our first

physician lounge, and a wound-care center that will fea-

commitment is to serving the community. We will not

ture hyperbaric oxygen therapy (This opened in Decem-

compromise on quality.”

ber 2010.). Adventist is also relocating its wound-care facility from off-campus to the main campus.

Rick Hyperbar

www.walshgroup.com

A five percent change in the budget was also pro-

As Wright defined it, this meant going beyond being

Health (AMH), which owns numerous not-for-profit

31 3 122 56 5633 54 5400 400 00

posed. Other changes included managing to expense

on its 32-acre campus and about 1100 employees.

Adventist La Grange is part of Adventist Midwest

Chic Ch icag ago, IL 6060 60 6 07

Additionally, leaders were to see themselves as standard bearers who demonstrated proficiency and

Leaders were expected to be results-oriented.

929 W. 92 W. Ad daaams mss m

in this area.

nization forward, Wright said the hospital “had to go The first step was to communicate the situation

Walsh Construction t is proud to be the t builder of Adventist n LaGr La Gran Gr ange Memorial an o Ho osp spit iittal a.

As with all healthcare organizations, Adventist is

By Patricia Chaney with additional material by Pete Fernbaugh

preparing for an uncertain future with the accountable care organization (ACO) structure on the horizon.

“The past two years have been record-setting in terms of finance,” Wright said. “This has been the culmination of our journey toward profitability since 1999. It’s a story of efficiency and teamwork.” HCE EXCHANGE MAGAZINE

MAY/JUN

2011

Real Issues : Real Solutions

HCE Exchange Magazine EDITORIAL Editor-in-Chief Tiffany Ford Editor: In-Focus John Abraham Contributing Writers Teresa Pecoraro Jacqueline Rupp David Winterstein Meghan White Tracy Simmons Kathy Knaub-Hardy Editorial Associates Levent Nebi Deepa Bhatia Lori Ryan Anami Mittal ART DEPARTMENT

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