"My Best Investment": 14 Hospital Executives Reflect
Major investments by hospitals and health systems, once concentrated in new facilities and construction projects, increasingly include mergers and acquisitions of other providers, including physicians; the implementation of new IT systems and investments in major projects and initiatives, according to a report from Moody's Investors Service.
Below, 14 hospital and health system leaders reflect on the best investments they have made, and how those investments paid off — financially or otherwise.
Barclay Berdan. COO of Texas Health Resources (Arlington): I've always believed in investing in people and their futures. Over the last several years, Texas Health has invested more than $10 million per year in leadership development, employee education and growth and training.
We are constantly striving for improvement and excellence. We demonstrate this to our employees through ongoing, two-way communication, as well as through programs and offerings that show them their personal growth is valued and supported. It is also essential to nurture relationships and keep open lines of communication with all of our stakeholders. Therefore, I've always made it a priority to be visible with all of the departments I work with — this includes rounding — and I have made it a point to try to get to know as many of our 22,000 employees as possible.
Various awards, honors and recognition from external groups and organizations, along with employee satisfaction surveys and market research, continue to tell us we are doing the right things related to investing in people.
Lynn Britton. President and CEO of Mercy (Chesterfield, Mo.): You could argue Mercy's best investment was the finest electronic health record we could implement, and setting an aggressive timeline for training and utilization. Or you could make the case for the investment we're making right now, building the nation's first virtual care center. But I believe the most important investment we made was the clinical integration of our physicians. Without them being on the Mercy team, our other efforts wouldn't make much of a difference.
Ben Carter. Executive Vice President and CFO of CHE Trinity Health (Livonia, Mich.): CHE Trinity Health's investments in changing business as we know it are significant and already showing returns. We are investing in the development of clinically integrated networks to position as for population health management. We're investing in new-and-improved capabilities to support this, like data analytics and actuarial expertise, where we've increased our budget by more than 65 percent. We've also had a 300 percent increase in staffing dollars related to payer and product innovation. These are related investments and good ones, too. They are already resulting in innovative arrangements with payer partners that, paced with changes we are making in our clinical practices, are helping us take care of several high priorities. They are helping us bridge the gap between the present and the future while making changes that will really result in more access to better care and lower costs for people and communities.
Paul Conlon. Senior Vice President and Chief Quality and Patient Safety Officer at CHE Trinity Health (Livonia, Mich.): We’ve invested a lot of intellectual capital, and time implementing more than a dozen clinical collaboratives designed to improve care. Each brings experts together with research, data and technology to address concerns ranging from heart failure, to sepsis, to patient falls, and more. By developing and sharing evidence-based best practices that improve care, these collaboratives save lives and reduce cost. It's a return on investment that is absolutely invaluable.
Doug Cropper. President and CEO of Genesis Health System (Davenport, Iowa): Perhaps our best investment at Genesis Health System has come from setting the goal several years ago to be a leader in patient safety. Saving lives and reducing readmissions is worth the investment, regardless of the actual cost.
Our first step was to seek independent, outside analysis of our patient safety. The cost to implement recommended changes and train staff to hardwire a culture of safety into the health system was more than $1 million, but the results have been measurable. Our staff has reduced falls to 1.51 per 1,000 patient days compared to the national standard of 3.06; our inpatient mortality is .92 (observed/expected) compared to the national standard of 1.0; our hospital-acquired pressure ulcers per 1,000 patient days has fallen to 0.08 compared to the national standard of 2.51, and our safety events have fallen by 60 percent.
Our safety improvements have measurable return on investment but more importantly, our safety improvements have had a positive impact for our patients.
Robert H. Groves Jr., MD. Vice President for Health Management at Banner Health (Phoenix): Banner Telehealth in the intensive care unit is advanced technology that enhances the care and safety of ICU patients by teaming our on-site medical staff with intensive-care specialists who follow patients' care from a remote monitoring center 24 hours a day, seven days a week.
When a potential problem is identified, the remote care team can be immediately available via video and audio links to recommend and deliver appropriate interventions so that the potential adverse outcome is avoided.
This solution serves as a high-tech, centralized patient safety net, and provides another set of watchful eyes to provide proactive care by constantly checking early warning indicators for any sign of trouble. If a change is detected, the U.S. trained and licensed, board-certified Banner Telehealth specialists located in Arizona, Colorado, California and Israel communicate directly with the bedside ICU teams to help determine what the patient needs. Banner Health has demonstrated that our Banner Telehealth program dramatically improves patient care while reducing cost. In fact our mortality is 50 percent better than the industry standard and we accomplish that while simultaneously reducing length of stay and cost by more than 30 percent.
Keith Jennings. CIO of Massachusetts General Hospital (Boston): I saw a quote attributed to Richard Branson recently: "Train people well enough so they can leave, treat them well enough so they don't want to," which is the moral of my story.
I had a very talented team of developers, whizzes at a dying technology, who were getting antsy, rightfully so, about their future. With their permission (or at least the illusion of choice), I gave them an enormous stretch goal — automating a critical business [patient scheduling] using brand-new technology.
This "investment" (or prudent risk-taking) paid tremendous dividends. For the team it recharged their skills, and years later, most of them are still with us. For my hospital, it opened a new segment of informatics and formed a team who could exploit it. For me personally — the team's future successes helped establish my own bona-fides as a visionary leader who can provide innovative solutions in a timely and efficient manner to support Mass General's mission.
Dennis Laraway. CFO of Memorial Hermann Health System (Houston): Memorial Hermann Health System views "investments" in a number of ways; perhaps the most important are those investments made in our core business model. Investments recently made in care delivery, including a new heart failure and transplantation program which quickly launched Memorial Hermann onto the national stage as one of the busiest heart transplant programs in the country, serve as a clear example of the vast capabilities invested by Memorial Hermann for the greater Houston community.
In addition, recent investments in the Memorial Hermann Accountable Care Organization have enabled our system to begin transitioning payment models from volume-to-value, including more than 350,000 lives contracted under the ACO to date. Our ACO is also a Track 1 participant in the Medicare Shared Savings Program — which saved the government more than $33 million through the initial reporting period ending Dec. 31, 2013 — and is one of, if not the most successful ACO in the nation to date.
Moreover, due to the uncertain and changing times in healthcare, generating higher returns from existing assets is a paramount priority. To the point, Memorial Hermann is now embarking on more than $1.2 billion in investments in hospital campus expansion projects, including a comprehensive 'Master Plan' project at Memorial Hermann-Texas Medical Center, as we look to keep pace with population and economic growth and better serve the healthcare needs of the Houston community.
Antonio Martin. COO and Executive Vice President of New York City Health and Hospitals Corporation: The best investment I made for HHC was Breakthrough, HHC's approach to problem solving and improvement based on Toyota's Lean methodology. HHC has saved over $400 million since we started using it. But also, it gives us a standardized way to innovatively tackle problems.
Scott Nordlund. Executive Vice President of Growth, Strategy and Innovation at CHE Trinity Health (Livonia, Mich.): We have been investing our time and capital to develop a more diversified care delivery network, including post-acute, physician, ambulatory and managed care investments that increase access and complement our strong acute delivery capability. We also are focusing on best-in-class partnerships with retail partners, technology innovators and other health systems that share our commitment to transforming health care and managing population health.
Patrick O'Hare. Senior Vice President and CIO of Spectrum Health (Grand Rapids, Mich.): As a CIO it would be fairly typical for me to mention some application or technology that we have acquired and implemented as being the best investment. However, I think the best investments that we have made are hiring and developing our talented workforce. Having the right staff is what will make or break any organization.
Daniel Post. Senior Vice President of Clinical Programs at Loyola University Health System (Maywood, Ill.): Loyola University Health System has made substantial investments in its Patient Access Center, including people, process and technology. We've created patient-focused and service line-oriented teams, modernized our facilities and optimized technology. Our goals are to have calls answered live, 24/7, by the third ring and to offer an appointment within 24 hours. These efforts are paying off with improved patient satisfaction and a 10 percent increase in new patients.
Louis A. Shapiro. President and CEO, Hospital for Special Surgery (New York City): There isn't any question, the best investment we have made and that any organization can make is in its people and culture. Culture is a foundation for success and as CEO my role is to manage and nurture the HSS culture.
This practice continues to provide HSS with opportunities to ensure future success by building on best practices embedded in our organization's culture to continually raise the bar for excellence; measuring outcomes and rewarding behaviors that promote our goals and culture, teaching new skills to adapt to the changing external environment and promoting a culture of innovation that provides a safe, empowering environment for members of the HSS family to offer constructive feedback and champion new ideas and processes.
Tim Stover, MD. President and CEO of Akron (Ohio) General Health System: The Akron General Health System has invested many millions of dollars over the past two decades to develop its three Health & Wellness Centers, large outpatient community-based facilities that bring together a range of clinical outpatient services with exercise
and retail-oriented health services, all in an effort to improve the health of our community. The focal point of each of Akron General's Health & Wellness Centers is its LifeStyles medical fitness facility, a state-of-the-art fitness center where exercise programs are directed by physicians and focus on the prevention and treatment of lifestyle-related disease, illness and injury through regular participation in medically supervised physical activity, nutrition and health education. This effort has resulted in better health for thousands in our community.
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