In the Lead

Steve Rose says that when he took the reins of Nanticoke Health Services in July 2008, it was an organization “in transition.” He pauses a moment, then discards the euphemism and admits, “It was in the red—bright red.”

 

Rose brought 34 years of experience in healthcare to the job, and during that time, he had created something of a niche in helping hospitals “transition.” In one year he and his team have turned around Nanticoke, which includes Nanticoke Memorial Hospital, Life-Care at Lofland Park and Nanticoke Medical Centers. “We closed the fiscal year [June 30, 2009] with a bit of a profit,” he says, “and so far this year we’re doing well.”

 

Rose gives credit for the turnaround, first of all, to the hospital staff. “We have good people here who were looking for a plan, and we provided that. We looked at our expenses very hard, and we looked at our growth.”

 

Under Rose, Nanticoke has added 15 new physicians and new services, including trauma, orthopedics, and interventional cardiology. Also, he says, “We established a new vascular lab with a vascular surgeon, we became the first hospital in Delaware to have a stroke center with advanced certification from The Joint Commission, we started a pediatric practice and, in January, we opened an in-patient pediatric unit.”

 

Aside from upgrading the hospital staff and its services, Rose knew that he also had to change Nanticoke’s image. Based on the hospital’s surveys, he says, “There was concern in the community we serve that the quality and customer service were not what people were expecting. We worked on our customer service, and we’re doing a good job on it.”

 

In February 2009 Nanticoke got a big assist from the Delaware Strategic Fund, which provided a $4.5 million loan. The virtually interest-free money enabled Nanticoke to purchase several pieces of equipment and hire nine physicians, 39 employees and a nurse practitioner.

 

With 115 beds and 770 employees, Nanticoke “in many respects meets the definition of a rural hospital,” Rose says. “The population we serve is a little different from some of the other hospitals in the state because we are in western Sussex County, so we are blessed to have a very diverse community, and we are striving to embrace all of it and understand their cultures.”

 

 

Page 2: Dr. Robert J. Laskowski | President and CEO Christiana Care Health System

With 10,486 employees, Christiana Care Health System is the largest private employer in Delaware and the 10th-largest employer in the Philadelphia region. So when it undertakes a major construction project, the ripple effect is significant.

 

Case in point: the $205 million expansion and renovation of the Wilmington campus. Not only is it changing the face of the city, it is bringing jobs to a job-starved state. Two hundred construction workers are swarming over the site, and when completed in 2013, the nine-story, 305,660-square-foot tower will add 600 employees to Christiana’s payroll.

 

As president and CEO of Christiana Care, a position he has held since 2003, Dr. Robert Laskowski occasionally ventures onto the construction site to check progress. But a hard hat is only one of the many he wears. In addition to serving on several national, state, and local boards and commissions, he is a professor of medicine at Jefferson Medical College of Thomas Jefferson University in Philadelphia. And as a board-certified internist specializing in geriatric medicine, he still practices his specialty. “That’s my first love,” says the 57-year-old Laskowski, “and I continue to supervise residents.”

 

Though Laskowski is understandably excited about the expansion, he says “the big news is what we’re doing inside the building.” That includes launching computerized physician order entry (CPOE), technology that makes it easier, more efficient, and safer for doctors to order tests and medications. “The days of scribbling orders down and having somebody translate them are gone,” Laskowski says. “The issue here is not just legibility, the lack of which is legendary. By organizing with the computer, you change the system of care. You get the resources of computer intelligence to help guide you.”

 

Christiana Care also boasts another rare tool: the VEST (Virtual Education and Simulation Training) Center. One of only 106 such centers in the United States, it is outfitted with mannequin “patients” controlled by computers to simulate various conditions. VEST gives doctors crucial experience in dealing with high-risk conditions so they can provide the best care when those conditions arise.

 

Laskowski suggests these innovations are signs of things to come. “We can’t continue to do what we’ve been doing,” he says. “Our responsibility is to figure out how we can afford the healthcare we want and make sure what we’re doing makes a difference.”

 

In his 15 years as president and CEO of Beebe Medical Center, Jeff Fried has seen tremendous growth in the population served by the Lewes hospital.

 

“Just in the decade from 1990 to 2000, the population of Sussex County increased by 38 percent,” says Fried. “Eastern Sussex County, which is what we define as our primary service area, grew by 50 percent.”

 

Led by Fried, Beebe has responded with growth of its own. In 1995, when he took over, the hospital had 72 doctors. Today there are nearly 180 on staff. Beebe has strengthened its clinical programs, especially orthopedics, cancer and cardiovascular services.

 

“Our cancer program offers a full range of oncology services, including medical oncology, surgical oncology, radiation oncology, with specialists in all those fields,” says Fried. “In orthopedics, the number of joint replacement surgeries we do has increased from about 100 to 600 per year.”

 

As a result of increased services, he says, patients living in Sussex County who were used to traveling elsewhere for treatment and surgery can now go to the 210-bed facility. Beebe’s staff handles demand by emphasizing evidence-based medicine to determine best practices and drive improvements in quality, safety, and patient satisfaction. “We’ve implemented huge increases in our computer information capabilities,” says Fried, “and we’re in the process now of implementing electronic medical records.”

 

Beebe is providing exceptional care, at least according to HealthGrades, which ranked both Beebe and Christiana Care Health System as the only Delaware hospitals to score in the top 5 percent in its ratings, based on analysis of 27 treatments and procedures.

 

Like many hospitals throughout the country, Beebe also has expanded its outpatient services, opening imaging and lab facilities across Sussex County. In July 2009 it opened a much-needed walk-in care facility in the Rehoboth Beach Kmart. Beebe also operates the Beebe Health Campus on Del. 24, Beebe Lab Express, Wound Care and Diabetes Management Services, Sleep Disorders Center, Gull House Adult Activities Center and a Home Health Agency.

 

Keeping people out of the hospital is the goal of such facilities, says Fried. “Hospitals are very expensive places to receive care. Whether it’s having someone go to one of our walk-in centers rather than our emergency department, or whether it’s taking care of someone at home by utilizing telemedicine and home health nurses instead of coming to the hospital, those are things we need to focus on.”

 

Page 4: Terence M. Murphy | CEO of Bayhealth Inc., and President and CEO of Bayhealth Medical Center Inc.  

Aromatherapy. Pet assisted visitation. Twenty-four-hour patient-directed visitation.

 

Those are just a few of the innovative techniques that for the past two years have helped Bayhealth Medical Center win plaudits from J.D. Power and Associates for Outstanding Inpatient Experience.

 

The innovations were adapted from Planetree, a nonprofit organization that has been a pioneer in personalizing, humanizing and helping patients, families and staff better understand how to deliver care. Through its five-year partnership with Planetree, says Bayhealth president and CEO Terry Murphy, “We treat the spiritual, emotional, as well as the medical needs of a patient, which I think is unique in the state of Delaware.”

 

Southern Delaware’s largest healthcare system, Bayhealth includes Kent General and Milford Memorial hospitals, Middletown Medical Center and several satellite facilities. Each year, Bayhealth admits more than 17,000 patients and records upwards of 73,000 emergency department visits.

 

Murphy, 49, was hired in 2001 as administrator of Milford Memorial Hospital. Six months later he became Bayhealth COO. He was appointed to his current position in October 2009. He believes the biggest challenge facing today’s health systems is treating an aging population, along with the attendant chronic conditions of that population.

 

“We’re integrating technology and management of information, moving toward electronic medical records,” he says, citing such examples as smart IV pumps to provide a safe environment and reduce medical errors, digital mammography, and a fully integrated picture archiving communications system.

 

Along with the recognition from J.D. Power, Bayhealth is proud of its cardiovascular surgical program, which for several years has been ranked No. 1 in Delaware with the highest (five-star) rating by HealthGrades, a leading healthcare ratings company, for cardiac surgery and critical care services.

 

In Dover, Bayhealth is in the midst of a major building expansion that will be completed next year. “We will be doubling the size of our emergency department, establishing an integrated cancer center, a new parking garage and central utility building,” says Murphy.

 

The St. Clare Medical Outreach Van is more popular than any Good Humor truck. When the van makes a stop, a line of people is usually already there. And the van doesn’t have to announce its arrival by ringing a bell. “The homeless network gets the word out,” says Julie Hester, president and CEO of St. Francis Hospital.

 

Four days a week, in collaboration with the Ministry of Caring, St. Francis sends the van to the poorest sections of Wilmington. Since 1992 more than 80,000 patient visits have been conducted from the van. The van’s staff vaccinates children who are uninsured, dispenses medications for people with prescriptions they cannot afford, and provides ongoing medications for people with chronic illnesses and acute medical problems.

 

Equipped with two examination rooms, a bathroom, a central intake-work area for staff and a bilingual physician, the van treats “a lot of chronic illnesses—diabetes, blood pressure control, things like that,” Hester says. “Because of the economy, we’ve seen a lot more folks using the van. Our goal is to not turn anyone away.”

 

Ministering to the poor is part of St. Francis’ mission, one that Hester has fully embraced since moving to Wilmington in August 2009 from Jeanette, Pennsylvania, where she was head of Mercy Jeannette Hospital, part of the same Catholic Health East network as St. Francis. She understands that the population St. Francis serves is changing due to a growing number of African-American and Hispanic patients. “So we are gearing some of our programs toward that population,” she says. “For instance, the No. 1 diagnosis for African-American men is prostate cancer, and we did our first pre-prostate screening program last year. It was a sellout. If we can get them to come and be checked, that’s what we should be about.”

 

Hester also keeps the hospital’s 1,000 employees focused on her mantra: “We will be the best place for patients to receive care, the best place for physicians to practice, and the best place for employees to work.” In pursuit of those goals, St. Francis is converting to electronic medical records. In January it introduced the state’s first in-patient hospice unit.

 

Hester believes that by focusing on quality and services, “financial outcome will follow” for her 395-bed hospital. In the meantime, she says, “Our mission is to be a transforming, healing presence in our community.”