Scott Raynes outlines what differentiates this community hospital from the for-profits in the region.

In recent years, Nashville, Tenn. has earned a reputation for being the for-profit healthcare capital of the country. Large, hundred-plus-hospital for-profit health systems dominate the region, but one independent, not-for-profit community hospital chose to move in a different direction: NorthCrest Medical Center.

Scott Raynes, President and CEO

For the next eight years it did, but when, in 2004, HCA decided to divest from hospital management to focus solely on hospital ownership, the board had a tough decision to make. When given the opportunity to fold into the HCA umbrella, NorthCrest’s board of trustees decided to keep their hospital aligned with its founding mission.

“Being managed by a for-profit entity worked well, but the board wanted NorthCrest to remain a community hospital,” said Scott Raynes, president and CEO since 2004. “The vision was to re-identify with the community by partnering with them to satisfy their healthcare needs, not only in providing acute care services at the hospital level, but also at a preventative level. I developed my senior administrative team with that vision in mind, and the rest fell into place.”

The hospital contributed automated external defibrillators (AEDs) to 20 schools within the region, including elementary, middle, and high schools, as one of its first efforts to reconnect with the community. It also participated in fund raising for the AEDs, and local businesses matched the hospital’s initial financial contribution. NorthCrest donated clinic space to the governor of Tennessee’s safety net plan, as well as the county’s health department, to provide a sliding-scale free clinic. “We also offer flu shots to emergency services personnel, such as police officers, and in certain areas of need,” Raynes said. “In a logical but somewhat unique way, we’re establishing ourselves as a community organization.”

Gateway to healthcare
As with many hospitals, NorthCrest’s ED is the gateway for between 65% and 70% of its admissions. On any given day, each of the department’s 11 rooms saw up to seven patients, but when the ED reached a census of roughly 31,000 annual visits, it was evident an expansion was needed.

In June 2007, the hospital opened its new $7 million ED, which added seven exam rooms, three triage rooms, and more than 20,000 square feet of space. “We can now triage between seven and 10 patients at once, which means we have the capacity to attend to twice the number of patients upon their arrival,” Raynes said.

Since the ED renovation, NorthCrest has consistently scored in the top 10th percentile in patient satisfaction scores for surveys cast by Health Stream, a marketing and communications organization. Raynes attributes the majority of this success to the hospital’s entry-to-exit time, which averages just over two hours and 20 minutes, despite an increase in volume. Although the design, operational structure, and added space have contributed to the department’s success, Raynes is quick to point out that the employees and physicians make it work.

NorthCrest contracts with Team Health, an ED physician contracting entity. As the second largest ED staffing entity in the country, Team Health physicians provide a broad understanding of emergency care while taking the pressure off Raynes to find and hire qualified the physicians. Team Health physicians are all certified in emergency medicine, and not having to worry about ED physician staffing allows NorthCrest’s administrative team to focus on the primary, specialty, and sub-specialty areas within the hospital. “They provide me a core group of eight physicians who cover between 10 and 14 shifts a month, and about five others pick up occasional shifts,” Raynes said. “By partnering with Team Health, we benefit culturally as well.”

Center of attention
As a community facility, NorthCrest strives to meet the healthcare needs of surrounding populations. The hospital had a number of patients coming from Pleasant View, located 15 miles from the NorthCrest campus, so the suburb seemed the perfect area in which to expand. In June, the hospital opened a medical office building with two primary care physicians, a specialty clinic, an imaging department with X-ray and CT capabilities, and a physical therapy department.

In the six months since opening, patient volumes have skyrocketed. The primary care physicians see more than 50 patients per day, and the specialties, which include OB/gyn, orthopedics, general surgery, and ENT, are quickly catching up. Raynes said patients that were previously spread all over the service area choose to come to NorthCrest Medical Center for their healthcare services for two reasons.

“We have a quality facility that is branded like our main facility, but most importantly, we have the same caliber of employees with a commitment to service and quality working in Pleasant View. Since gaining our independence three years ago, we’ve developed the customer service mantra ‘you are the center of our attention,’ and the community has responded well.”

NorthCrest, like every other hospital in the area, has an aesthetically pleasing facility, all private rooms, great technology, and highly qualified physicians. The distinction, Raynes said, lies within its culture. “We don’t tell you where to go if you look lost; we walk you there. When the doors to the elevator open and other patients or vendors are waiting to get on, we get out and take the steps. We are fully integrated in our goal, which is to become the best community hospital in the country by showing how much we care.”