O’Connor Hospital: Strength from Within
Hospitals
Monday, 01 October 2007
O’Connor Hospital: Strength from Within - Health Executive - RedCoat Publishing
This general acute care hospital maintains a balance by incorporating the advice of all of its stakeholders.

Instantly managing an almost 30% increase in patient volumes with a lower reimbursement payer mix is a testament to the strength of a hospital’s infrastructure. Handling that increase in the long term is a testament to a strong administration.

O’Connor Hospital: Strength from Within - Health Executive - RedCoat Publishing
Joanne Allen, COO
In 2005, when nearby San Jose Medical Center closed, O’Connor Hospital in San Jose, Calif. found itself in need of additional inpatient capacity. Rather than develop a master plan for a hospital expansion, the administration moved the hospital’s 20-year-old wound care clinic to a satellite location across the street and changed it to an outpatient setting.

One year later, nearby Regional Medical Center terminated its Medi-Cal contracts, and the hospital suddenly saw its Medi-Cal and Medi-Cal-managed payer mix increase from 8% to 18%. “Medi-Cal and Medi-Cal-managed contracts generally do not cover the full cost of care,” said Joanne Allen, COO of O’Connor Hospital. “It’s challenging to handle a volume increase while receiving 50% less reimbursement for those patients than you would from other managed care organizations.”

Rather than trying to offset those costs, O’Connor Hospital’s administration looked for opportunities to increase high-revenue-generating services such as cardiovascular, general surgery, orthopedics, and outpatient diagnostics. This spring, the hospital successfully opened an endovascular surgery suite to facilitate a step in that direction.

“We saw the biggest increase in patient volumes in our ED and OB departments, neither of which are big revenue generators for the hospital,” said Allen. “We want to facilitate access to our hospital for all patients while ensuring our doors will stay open, and one way to do this was to build an endovascular suite.”

Originally conceptualized from the hospital’s stent-graft program focused on treating aortic aneurysms, the $4.5 million endovascular surgery suite integrates diagnostic, surgical, and radiological capabilities. “The endovascular suite combines revenue-generating capabilities with state-of-the-art care,” said Allen. “We are treating our patients with the best possible equipment, and we are balancing our budget at the same time.”

O’Connor Hospital also added a 64-slice CT. The scanner will compliment the hospital’s 2006 purchase of Siemens’ magnetic resonance imaging scanner, the Magnetom. Together, these pieces of equipment increase the hospital’s diagnostic capabilities and reduce the amount of time the procedures take.

 

Team mentality
O’Connor Hospital is a 358-bed general acute care facility that is part of DCHS (Daughters of Charity Health System). Consequently, the initiatives the hospital undertakes are not always facility specific. In 2002, DCHS developed an IT task force focused on finding a company capable of handling core clinical and ambulatory electronic records system-wide. After an extensive search, NC-based Misys was chosen.

“Right now, we’re working with Misys to get the infrastructure and interfaces ready for all of our ambulatory areas, including laboratory, radiology, and imaging services, as well as the scheduling and billing components,” said Allen. “We’ve started the scheduling portion of it, and we’ll continue to implement the EMR in phases.” Allen estimates the radiology and laboratory interfaces will be in process by late 2007.

DCHS also sponsors a system-wide quality task force to set targets and benchmarks for each of the six local health ministries within the system. If one of the hospitals in the system achieves those quality goals, the other hospitals use those best practices to achieve similar results. One area in which O’Connor Hospital excels is caring for hospital-acquired pressure ulcers, a frequent complication of bed rest.

The nursing staff at O’Connor Hospital put together a skin integrity task force that improved the rate of prevention of hospital-acquired pressure ulcers through a multi-disciplinary initiative. The team replaced mattresses throughout the hospital, purchased digital photography equipment to note any trends, and implemented pressure ulcer packs for skin care.

The team then reengineered some of the nursing documentation and provided hospital-wide education for nursing staff. The efforts resulted in outcomes exceeding the original goals. “From March 2006 to March 2007, the rate went from 20.5% down to 3.4%,” said Allen. “The result is specific to O’Connor Hospital and is something we are extremely proud of.”

Allen believes healthcare workers, by nature, want the best for their patients and look for opportunities to improve care for them and their families. So if a strong infrastructure and a strong administration are two of the three components of a successful hospital, competent staff is the third. “Our employees have a lot of autonomy and opportunity for open communication with administration. The skin integrity task force is a great example of our staff making a difference, improving on some of our policies, and showing they truly care about their patients,” concluded Allen.

 
< Previous Story   Next Story >