Marquette General Health System: Change It Up - Health Executive - RedCoat Publishing - Inside Healthcare

When Gary Muller left West Jefferson Medical Center in New Orleans to join 335-bed Marquette General Health System in Michigan’s Upper Peninsula a few months ago, he brought a little heat with him. Not literally, of course—wintry mornings in the UP mean Muller frequently wakes up to temperatures well below zero. But efforts to increase productivity and changes from the board level on down are keeping Muller and his team fired up.

Gary Muller

General has a long history of excellence as a Level II trauma center, a cardiology center of excellence, and a progressive telemedicine program. Up until two years ago, it also boasted of financial stability.

But the hospital lost $6 million in both 2006 and 2007 due to problems with physician practice expenses and employee retirement plan funding, and Muller was hired to continue the board’s efforts to turn the financials around. Muller said he was pleased to see the board had already hired Wellspring Partners (part of Huron Consulting).

“They’ve been here since August and are assisting in the performance improvement initiatives in every area of the hospital,” he said. Muller, along with the board and Wellspring, plan to increase revenue and decrease expenses to the tune of $17 million per year by improving revenue cycle management and increasing efficiency.

That figure sounds ambitious, but Muller said the hospital is already halfway to that goal and expects to hit or exceed the $17 million mark by the end of July, when Wellspring’s engagement is due to end.

One reason for the initiative’s success, said Muller, is the board’s willingness to start at the top. “To the board’s credit, they recognized there was a need for change at the board level,” he said. Eight board members of 13 have left since September, and in January, five new members were announced. Marquette’s upper management followed suit and announced a management reorganization. “When you have change in an organization, it has to be supported from the top,” Muller noted.

Moving cheese
Perhaps it’s all those years spent in the Big Easy, but Muller manages to find the light side of even this degree of change. Reorganization efforts are referred to as moving cheese, a reference to Spencer Johnson’s Who Moved My Cheese and an easy word-play on the area’s Green Bay Packer cheeseheads.

A cheesehead award ceremony was held at a recent leadership meeting, and as changes continue to unfold, Muller plans to use recognition, humor, and a great deal of communication to build support and enthusiasm.

Both of the hospital’s physician groups (employed and independent) are also heavily involved with minimizing disruption due to change. Muller said members of the hospital’s 260-physician medical staff, led by chief of staff Dr. Debra Morley, are considered partners in the change.
Members of the physician practice plan, comprising 115 employed physicians and 35 allied health professionals, have also bought into the change and are looking forward to receiving performance reports that will be tied to their compensation. “I think this is a key in healthcare leadership,” said Muller. “Whether you’re an administrator, a physician, or a nurse, you need to have goals and rewards that go with meeting them. If you don’t meet them, you know you need to do something different.”

Providers in the physician practice plan have a greater sense of empowerment by participating in governance. Internal board meetings in partnership with executives at Marquette General Health System are key in building success, according to Muller. The physician practice plan governance team has formed a number of committees, including compensation, quality, and finance.

Three for the money
With the financial situation stabilizing, Muller and his team are turning their attention to three programs that will be extremely important to the hospital going forward. The first is telehealth, a program that began more than 10 years ago and has become a differentiator for Marquette.

Each of the health system’s 21 clinics, located across the UP, has telehealth capabilities, which Muller said are used for meetings, education, and clinical evaluation. “We have a hand surgeon here in Marquette, and he obviously cannot travel all over the UP to see patients, but he frequently sees patients at multiple sites through telemedicine,” he said. “For example, he might confer with a patient in Sault Ste Marie, which is 160 miles away, and the physician there will follow up with the hand surgeon’s care plan.”

Muller believes hospital adoption of telehealth systems will become a trend in the next few years and predicts another trend: hospital labs as profit centers. Marquette General has developed a large reference lab as a separate company, providing services to all UP hospitals, downstate Michigan hospitals, and even facilities in Florida.

The key to keeping costs down with a lab like this, Muller said, is automated testing equipment. “With this technology, smaller hospitals can get the same test done at a reference lab for less money than they can do it themselves.”

The third program is perhaps the most unusual, a leadership training program developed with Northern Michigan University and provided to hospital management and staff free of charge. Muller said education is essential to creating a learning culture. “We are going to develop the type of leadership culture that brings people here to learn how to be better doctors, nurses, and administrators,” he said.

The program will begin in May with three months of weekly sessions for board members, senior executives, and medical leadership. Other programs will follow quickly for staff members at every level, each designed for a unique audience.

Muller said a similar program was a huge success during his tenure in New Orleans, to the point where 15 top leaders applied for year long programs involving monthly sessions. At the very least, you are providing necessary training for people to do their jobs well and move up in the organization, he said. But having seen the effects from this type of program, Muller says it goes further than that. “The real benefit is that the culture changes to the point where people in the hospital look at things like business with a twist on quality. It’s very exciting.”

< Previous Story		Next Story >

CURRENT ISSUE

CATEGORIES

HEALTH SOLUTIONS