Below, three executives share key lessons learned from recent initiatives to improve hospital capacity and operations. From opening a new hospital to scaling hospital-at-home and optimizing systemwide efficiency, their experiences offer actionable takeaways for leaders navigating similar challenges.
Editor’s note: Responses were lightly edited for length and clarity.
Russell Cox. President and CEO of Norton Healthcare (Louisville, Ky.). In 2022, Norton Healthcare announced it would build a hospital in an area of our community where a new hospital hadn’t been built in more than 150 years. Norton West Louisville Hospital opened in 2024. Lack of access to specialty care, emergency services and inpatient care in the neighborhoods that make up West Louisville presented a significant need for residents. Opening this hospital was the right thing to do for our community, and that’s how we measure success.
In building this hospital, we had an opportunity to really listen to what people wanted to see in this facility — not just from a clinical standpoint, but also how they wanted to feel when they walked in the building. Through community engagement, collaborations and partnerships, we developed a new approach to building facilities that we will continue in the future.
Iahn Gonsenhauser, MD. Chief Medical Officer of Lee Health (Fort Myers, Fla.). Implementing Lee Health’s hospital-at-home program has exemplified the critical importance of leveraging technology to deliver hospital-level care where a patient has the best opportunity for success. A key takeaway from this effort is the necessity of integrating advanced technology to ensure continuous monitoring and effective communication between patients and healthcare providers. Patients are equipped with devices and wearable monitors that transmit real-time health data to medical teams, facilitating prompt interventions when needed.
This experience has reinforced the value of patient-centered care models that prioritize comfort and convenience without compromising quality. Patients benefit from recovering in familiar surroundings, which can lead to improved sleep, reduced stress and enhanced overall well-being. Additionally, this approach helps alleviate hospital capacity constraints by reserving inpatient beds for those with severe conditions. By implementing the program gradually and strategically, we can better understand patient needs and make immediate improvements to enhance their experience.
Going forward, embracing technological advancements and flexible care delivery models will be essential in addressing capacity challenges during southwest Florida’s busy winter season and enhancing patient outcomes. Investing in such programs not only meets patient preferences but also optimizes resource utilization within healthcare systems.
Ghazala Sharieff, MD. Corporate Senior Vice President and Chief Medical and Operations Officer of Scripps Health (San Diego). During COVID, we learned to focus on load-balancing as a system rather than thinking as separate hospitals — a focus we continue to have today. Our load-balancing efforts include sometimes transferring inpatients who are more stable when criteria for emergency department transfers are not met. Taking a systemwide perspective was especially helpful during a recent surge of respiratory cases at one of our hospitals.
We’ve also learned great lessons in how to improve repatriation efficiency. In August 2022, we implemented new repatriation standard work focused on a commitment to providing care for Scripps patients by reducing cycle time and organizational cost. We learned the keys to success are connecting physicians first for acceptance rather than waiting for a bed to be identified (30 minutes to accept commercial plans/60 minutes to accept senior plans); development of repatriation diversion if there is no capacity to accept repatriation patients at another Scripps location; and patient transfers to the ED until an inpatient bed is ready.
From our baseline of 2021, our results were exceptional. Total repatriation transfer requests in 2024 were 1,098, down from 2,219 in 2021; average time for case state to physician acceptance went from 1 hour and 51 minutes to 46 minutes; declination rates dropped to four from 484 and there were zero admissions out of network in 2024, compared to 51 in 2021.
