Saint Alphonsus Regional Medical Center: Vision to Fruition - Health Executive - RedCoat Publishing - Inside Healthcare

Transforming a vision into a reality is never an easy task. But in the 11 years since her appointment to president and CEO of Saint Alphonsus Regional Medical Center, Sandra Bruce has done just that.

Sandra Bruce, President and CEO

When she arrived at the Boise-based healthcare facility in 1997, she saw a clinically sophisticated organization with the majority of services delivered from the hospital’s main campus. To better serve the community, Bruce realized Saint Alphonsus needed a delivery system that went to the people rather than making them come to the hospital.

“The vision was a distributed model of healthcare with four distinct focuses,” Bruce said. “We’ve since added ambulatory medical centers that, although they don’t have any overnight beds, offer everything you can get at a hospital. We also have a network of roughly 150 employed physicians across four cities so people can access healthcare closer to home. The final setting of care I’m most excited about is what we call telehealth.”

With robotic telehealth possibilities in mind, Bruce began to look through hospital trade magazines and, with the help of a planning committee comprising board members, doctors, senior leaders, community members, and patients, invited vendors to what she now calls Healthcare College. The weekend-long event was a chance for vendors to tout their future wares and explain what was on the horizon in the next five to 10 years. One of the recurring themes of the weekend from an architectural and facility perspective, said Bruce, was that healthcare environments in the future will need to be much more flexible and versatile.

As she met with architects to build the fourth focus, the Center for Advanced Healing, Bruce came across the Center for Health Design, a not-for-profit organization in California. “They started the Pebble Project. When hospitals build something new, they’re invited to learn from all of the center’s research as long as they are willing to do research on their own projects and contribute to a growing body of knowledge,” she said. “We were the fifth hospital in the nation to participate.”

Healing environment
The Center for Advanced Healing is both the name of Saint Alphonsus’ 1 million-square-foot campus and the name for the 400,000-square-foot patient tower. Completed in January, each of the nine floors in the $122.1 million tower is service line delineated. Floor two includes 16 OR surgical suites. The third holds a 32-bed ICU. The fourth, fifth, eighth, and ninth floors house neurosciences, oncology and medical/surgical, general surgery, and orthopedics and joint care, respectively, with the sixth and seventh floors left vacant for future expansion.

The tower’s all private rooms and clinical conditions effectively meet the standards to deliver safe, effective care, but Bruce and her team added another dimension: the environment as a component of the healing process. Rooftop gardens, waterfalls, music, and outdoor walking paths follow the tenets Saint Alphonsus learned with the Pebble Project, which suggests patients with a view of nature leave the hospital earlier or require fewer pain meds. And then there is the art.

“We commissioned all original work, staying as regional as we could,” said Bruce. “The artists met with us, and an art committee interviewed them letting them know what we were looking for.”

In addition to helping patients and their families feel more comfortable in the facility, the tower added an element of comfort for the hospital’s employees. In building the ORs at the front of the hospital, the design team realized one long wall separated an area that would become a staff corridor. They decided to enclose it in glass. “The OR staff has a beautiful view of the foothills too,” Bruce said. “We also created quiet rooms, which are different than typical break rooms, for nurses to go, have a cup of coffee, and reflect.”

From an operational perspective, the design team incorporated as many employee wishes as possible to create fewer steps for them and enhance their communication systems. In the ICU, nurses asked for, and received, a nurse charting station between each patient room with windows on each side of their charting station. With the touch of a button, blinds embedded in the glass give patients privacy while also enabling nurses to observe both patients at once.

“By listening to your staff, it makes a difference in their satisfaction and on the job happiness,” said Bruce. “They had significant input into the design of their units, within the parameters of evidence-based principles around the healing environment.”

Well-rounded healthcare
Although the Pebble Project led Bruce down a path of high-touch healthcare, she knew for a well-rounded healthcare experience, technology was imperative. With a goal of developing a telehealth program, the hospital invested in 10 InTouch RP-7 Robots. Two remain on Saint Alphonsus’ campus while the others were distributed to smaller, rural hospitals in the region. After the Healthcare College, Bruce also invested millions of dollars in service-line-specific robots, including a daVinci Robot for the OR and a pharmacy robot that, in many states, eliminated the pharmacy tech requirement because it never makes a mistake.

The hospital is almost completed with its system-wide EMR implementation as well, the last piece of which is physician order entry. Once completed, the PACS and online nursing and clinical documentation will be available to patients through the hospital’s already five-year-old patient portal, bringing a higher level of transparency to the patients.

“Our investments are geared toward getting patients out the door with less pain and complication,” said Bruce. “We also want to balance hi-tech with hi-touch by creating warm, friendly, and reassuring environments. It’s one thing to be healed by technology, but we all need the human spirit revived and cared for as well.”

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