This academic medical facility stabilized its reputation by building a partnership at the hospital, university, and state levels. Marty Bonick explains how.

In the past decade, the largest osteopathic teaching hospital in the country changed ownership four times. Despite finding a permanent home with parent company Ardent Health Services in August 2004, the transitions of the previous years created an undercurrent of instability throughout Tulsa Regional Medical Center.

Then, in May 2006, TRMC entered into an academic affiliation agreement to formally recognize its standing as the official teaching hospital of the Oklahoma State University College of Osteopathic Medicine. Although the hospital has worked with the college for years, the 50-year agreement created a way for Ardent Health Services, OSU, the hospital, and the state to collaboratively find a way to bring stability to the hospital.

Another aspect of the agreement included changing TRMC’s name to OSU Medical Center while keeping the basic tenets of its management structure in place. “The academic affiliation agreement involved some changes in our board’s management structure, but it also created a liaison committee to work on issues between the hospital and the school,” explained Marty Bonick, president and CEO of OSU Medical Center. “Reaching this agreement is a milestone for our hospital, the OSU Medical School, and the entire state.”

Changing perceptions
Tulsa, Oklahoma is one of the 50 largest cities in the US. However, it is the only one in that category without a publicly supported hospital. Enter OSU Medical Center. The hospital is located downtown in the poorest part of Tulsa. Consequently, it’s become the city’s default public hospital.

“We’re a private corporation, which means we have to find our own funding,” said Bonick. “However, we don’t have a private foundation to support us as most private not-for-profit hospitals do. Because we see a disproportionate amount of the indigent population in our city, we feel a lot of financial pressure.”

Tulsa was once financially independent and didn’t require much state assistance due to a booming oil industry. Consequently, even though the oil industry bottomed out, Tulsa continues to receive less state funding than its sister city, Oklahoma City. However, as a result of the academic affiliation agreement, the state put together the OSU Medical Authority—a state entity able to receive appropriations from the state.

“Oklahoma’s state legislation pledged $40 million over the course of the next five years, starting in the summer of 2006, to make improvements to our hospital on behalf of the residents,” said Bonick. “The authority has received $20 million so far and has three more legislative sessions to receive and use the remaining $20 million.”

Although the funds will not remove the issues regarding indigent care, they will address one of OSU Medical Center’s biggest issues: an aging facility. Bonick and his team are in the midst of designing new OR, obstetrical, and neonatology units, as well as new offices, classrooms, and sleeping quarters for the graduate medical
education programs.

In addition, the university is planning on taking some of the funds it received from the state through a tobacco tax settlement to build a new super clinic on OSU Medical Center’s campus, which will house many of the university’s clinical programs, and an urgent care center. Bonick said all of the changes in the past year have been to bring stability to the hospital, which is already seeing many positive results.

“Each year we take roughly 35 interns into the residency program. Two years ago we had about 120 applications for those 35 positions. We just finished our most recent recruiting season, and we had 365 applications for the same number of positions.”

Measuring quality
Because of the numerous ownership changes of the past decade and the hospital’s position as a private not-for-profit hospital, the $40 million pledged by the state will only help OSU Medical Center keep up with the industry’s technological advancements rather than lead it, as is the case with most academic medical centers.

Bonick and his administration are balancing that reality by keeping their employees focused on the hospital’s mission statement, which is to provide the best possible healthcare experience for each patient that walks through the doors.

“Because our ownership changed so many times in the past decade, our people developed somewhat of a survival instinct,” explained Bonick. “We want to change from a mentality of surviving to thriving by getting our employees focused what they can control, which is the level of quality and service they deliver to their patients.”

Eighteen months ago, Bonick implemented the Studer Principles and centered every aspect of the hospital’s infrastructure on the five pillars of people, service, quality, finances, and growth. Since then, he’s seen OSU Medical Center’s agency nursing rates drop and, compared to last year, the hospital has already saved $1 million by reducing its contract labor. “That savings illustrates an improvement in our culture as our retention and recruitment efforts have improved,” said Bonick.

From a quality perspective, OSU Medical Center reduced its door-to-balloon time from the 200-minute rate of two years ago to about 45 minutes or less. It’s also improved its ED and reduced patient wait time from four and a half hours in 2005 to less than two hours today.

“By taking a challenging public/ private relationship, putting it together in a creative way, and finding a unique solution to get the state, university, and hospital involved in this process, we’ve made progress in stabilizing our hospital,” said Bonick. “We’re not completely through with our turnaround, but we’re well on our way to having a good foundation laid for this hospital to be successful in its future.”