Rockingham Memorial Hospital: Smooth Move - Health Executive - Red Coat Publishing - Inside Healthcare

When Jim Krauss came to Rockingham Memorial Hospital in 2000, he didn’t anticipate developing plans for a replacement hospital. Nor did he anticipate transitioning to the role of president and CEO. But eight years later, that’s what’s happened, and he couldn’t be more pleased.

Jim Krauss, President and CEO

Krauss originally came to Virginia-based Rockingham Memorial as COO and senior vice president and was tasked with evaluating the nonprofit’s strategy moving forward. He found that the hospital’s previous plans had been accomplished, but nothing was planned for the future.
“I evaluated the ages and infrastructure of the buildings and asked what kind of growth we expected in the future,” said Krauss, now president and CEO. “We realized our facility wouldn’t meet the needs of the community, which triggered a more formal evaluation of our long-term options.”

The administration conducted market, architectural, and financial assessments and realized a 100-year-old facility with six additions built over a number of years couldn’t efficiently handle the region’s projected growth. To add to the pressure of developing and beginning to implement plans for a replacement facility, in 2006, Rockingham Memorial’s president and CEO announced his retirement.

“The board considered me a candidate and wanted to internally promote their COO to the CEO role,” said Krauss. “Because Carter Melton, our former president and CEO, had given an 18-month notice, we developed a plan to make the transition seamless and to promote confidence among our employees and our community members.”

Restructuring for the future
After receiving board approval, Melton worked with Krauss to hand over the reigns. Melton introduced Krauss to the state and federal legislators he’d developed relationships with during his 30-plus years at Rockingham Memorial. The transition also included restructuring the senior leadership team by assessing the challenges of the future, determining what the characteristics of a successful senior leadership team of the future would be, and considering what senior leadership positions needed to change.

As more than half of Rockingham Memorial’s business is ambulatory in nature, one of the changes included creating a new position called vice president of ambulatory care services. The position of vice president of business development was also created, and the position of vice president of patient care services was changed to vice president of acute care services and chief nurse executive.

“Our physician executive was our vice president of medical affairs. We changed that title to senior vice president of clinical effectiveness and CMO because it better described the purpose of that job,” said Krauss. “We also promoted our director of IT to vice president and CIO.”

Facility upgrades
The process of identifying operational changes for the new facility spans both the prior and the new senior leadership teams. And rather than developing an operational strategy for the new hospital alone, the administration enlisted the help of the hospital’s employees. More than 30 teams and hundreds of employees were involved in the operational planning and review of the preliminary architectural drawings.

“We wanted to plan the way we operate the new hospital such that the architects could design it that way,” said Krauss. “The prior executive team, many of whom are on the new executive team, did that work, but even today we’re still making operational decisions about how we’ll run the new hospital.”

On the IT side, the administration decided to replace the hospital’s core clinical system because its current product was being phased out. The development teams also tackled issues ranging from how the new facility would produce patient meals to how to get medications to patients in a more effective way to how certain departments should be co-located for efficiency.

“The list of operational decisions we needed to make for our future was in the hundreds,” said Krauss, “including how we distribute supplies to the organization, where we warehouse those supplies, and do we use a cart exchange versus other systems. We’ve also decided to move to all private patient rooms.”

Rockingham Memorial is currently licensed for 270 beds, but its highest census typically reaches 220. The new facility will include 238 private patient rooms, with the ability to expand with two floors that can be built on the top of the hospital. In addition to developing family areas within the patient rooms and on the patient care floors, the administration took into consideration simple features to improve the safety of its patients, such as installing dimly lit handrails in each room to reduce falls when patients need to move about their rooms at night.

The team also read a study that suggested designing all procedure rooms the same way would improve ease and efficiency for employees. “We’ll gain between 3% and 5% staffing efficiencies with the design of the hospital, but our region is growing, so we’re also adding services, such as the recently launched open-heart surgery program,” said Krauss. “We’ll probably need to increase our staffing numbers eventually, but the region’s growth and our improved efficiency will balance out initially.”

Major undertaking
Krauss anticipates Rockingham Memorial’s move to its new facility will take place in the second quarter of 2010. To fully prepare for the move, the hospital hired a consultant to plan what will need to happen in the next two years.

“Among other things, we have to consider how to train our mechanical technicians on the new HVAC system, how to train our staff in environmental services for the new flooring and finishes we’ll install, and how get the nurses acclimated to the new patient room layouts,” said Krauss. “We’ve formed transition teams, and we have internal staff members who have hours dedicated specifically to planning the transition.”

Although two years sounds like more than enough time, Krauss said it’s not too early to begin planning to make the transition seamless for both patients and employees. “We have to balance the safety, efficiency, and comfort of all of the hospital’s stakeholders, as well as project where we want to be in the next 10, 20, and 25 years. The list of what we need to do is enormous, but once we’re finished, we will look back and proudly say we successfully accomplished a major undertaking in Rockingham Memorial’s history.”

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