Great Plains Regional Medical Center: Virtuous Circle
Hospital Systems
Written by Jill Rose   
Tuesday, 01 April 2008
Great Plains Regional Medical Center: Virtuous Circle - Health Executive - Red Coat Publishing
Rob Lake explains how spending money in the right places led to breaking ground on a state-of-the-art facility in rural Oklahoma.
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There are many success stories in healthcare today—hospitals gaining marketshare from new technology, strengthening financials with better revenue cycle management, and revamping their reputation with better customer service. Unfortunately, few of those stories are from rural hospitals, many of which are struggling to keep their volumes up and their financials in the black.

CEO Robin Lake - Great Plains Regional Medical Center: Virtuous Circle - Health Executive - Red Coat Publishing
CEO Robin Lake
Not so at Great Plains Regional Medical Center in Elk City, Okla. This 76-bed hospital went from losing money eight years ago to building a new $60 million facility set to open next year. CEO Robin Lake says this feat was accomplished through a combination of Disney-style customer service, corporate-type cost controls, an aggressive recruitment program, a progressive and supportive board of directors, and a willing medical staff.

Essentially, when Lake joined the company in 1999, he and his executive team began creating a virtuous circle. By spending money on customer service training and on physicians and equipment to create a sophisticated surgery and radiology program, the hospital began attracting additional marketshare. Lake’s team used this momentum and revenue to recruit more talented clinicians, upgrade equipment in other departments, and improve the hospital’s aesthetics.

Today, the hospital is in the midst of the ultimate upgrade: a 150,000-square-foot state-of-the-art facility that will serve the community well, providing the type of care one might expect to find in a much larger city. Lake said his team considered simply renovating the existing facility, but doing so would have cost more in the long run without achieving goals like better patient flow.

“Right now, we have to take patients down the main hallway to go to the OR. That’s not ideal,” said Lake. “The new design incorporates ‘off-stage’ areas just like Disney, and the patient-care areas are all 50% to 100% larger. Having a place in the patient room where the family can be comfortable, with Wi-Fi access, is also important.”

Fingers crossed
The hospital’s recent success in growing the bottom line allowed it to finance $20 million of the project from its coffers and secure bonds for the remaining $40 million. Thus far, the project is on schedule and on budget, and Lake has his fingers crossed it will remain so.

While he and his administrative team, particularly CFO Don Ikner, are spending as much time as possible on the project to keep things running smoothly, they count on other managers to step up to the plate. “We joke about how they don’t want us in their business anyway,” said Lake. “They have a good sense of what they need to run by us and what they don’t.”

Even as Lake and others spend time on the building project, the staff’s focus on customer service and recruiting continues unabated. Every two years, team members (employees to you and me) receive intensive training in the Disney style of management; new members participate in training every quarter.

Recruiting is never easy, particularly in rural areas, but Lake said the hospital is experiencing success from its investment in a distance learning program with partner Western Oklahoma State College. Rather than traveling the 55 miles from Elk City, nurses in training (for an RN or LPN degree) attend classes via videoconference.


Great Plains built the classrooms, endowed several faculty chairs, and committed $250,000 over five years to the program. The hospital also offers full scholarships to anyone in the community who would like to get a nursing degree, to be paid back by working at the facility. “It’s been a win-win,” said Lake, noting that money spent to educate a local person is a better investment than recruiting from outside the area. “Someone from Western Oklahoma is more apt to stay here and like it.”

All stacked up
At this point, readers will not be surprised to hear that Great Plains is often held up as a model in rural healthcare. It has been named as one of Oklahoma’s top 30 places to work two years in a row by ModernThink Best Companies Group, and Thomson Healthcare’s Medstat Group has asked Lake to speak about its benchmarking program.

Every quarter, physicians are given a report showing expected mortality versus actual, expected complications versus actual, and how their cost per case stacks up against other hospitals.

Lake said at first the hospital benchmarked itself against other Oklahoma hospitals, then it moved to the US national average, and it now uses Washington state, which he said is considered the gold standard. “At last count, we had 18 physicians beating that standard. Although we certainly want everyone to have a good outcome, when you look at an expected mortality of 59, and the actual mortality is 22—that’s quality,” he said.

Rather than resisting the inevitable when it comes to practicing evidence-based medicine, Lake said the medical staff has embraced the program, which includes a certificate for dinner at a nice restaurant in Oklahoma City for each quarter they meet their numbers. Similarly, the physicians are eager to adopt new technology. “We don’t have to ask them to support it; they’re way ahead of us. They say, you put it in, we’ll use it,” said Lake.

This attitude may seem remarkable to some in healthcare, but it’s par for the course at Great Plains, where frequent communication is central to management’s mode of operation, and if someone writes you up, it means they observed you doing something remarkable.

“I have seen some of the most incredible things here,” said Lake. “There was a bad wreck here on Christmas Eve. The mom passed away, but the two kids survived. It was about 14 hours until the dad could get here, so one of the nurses went out and bought Christmas presents and stayed all night with the kids. When I caught up to her, I asked her to let me know what she spent so I could reimburse her. She said it was nice of me to offer, but no thanks.”

 
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