Mon Health System and CAMC Health System will combine under the umbrella brand, Vandalia Health.
Mon Health System and Charleston Area Medical Center (CAMC) Health System have signed a letter of intent to merge into one health system, the organizations announced on Thursday.
The combined health system will operate under an umbrella brand called Vandalia Health, while Charlestown, West Virginia-based CAMC and Morgantown, West Virginia-based Mon Health will maintain their "unique and historical" identities.
"Combining the strengths and unique attributes of two established and well-regarded health systems advances the best interests of West Virginia patients and families whose lives and well-being depend upon our services," David L. Ramsey, CEO of CAMC Health System, Inc, said in a statement.
Through the merger, the nonprofit organizations hope to expand care while managing health costs and expanding the care continuum across the communities the two organizations serve in West Virginia.
Additionally, "The history and tradition of our respective hospitals, and the renowned clinical providers in our communities, will help propel the success of this partnership," David S. Goldberg, CEO of Mon Health System, said in a statement. "We look forward to working together to expand access to highest quality, affordable care for West Virginians, close to home."
The two organizations will file a certificate of need on April 15, and hope to close the transaction as soon as possible, following regulatory and governance approvals.
While the organizations' did not say if there will be layoffs following the merger, the organizations did say in an FAQ post that "both parties are hiring continuously to meet the needs of their patients, and anticipate this will remain the case."
The merged hospital would comprise of Mon Health's three hospitals: Mon Health Medical Center, Mon Health Preston Memorial Hospital, and Stonewall Jackson Memorial Hospital, and CAMC's four hospitals: Memorial Hospital, General Hospital, Women and Children's Hospital, and Teays Valley Hospital.
In a statement released to WVNews, U.S. Senator Joe Manchin of West Virginia said, "CAMC and Mon Health have provided quality healthcare to countless West Virginians for decades. Today's announcement is the beginning of a new era for healthcare in the Mountain State, and will further help to improve healthcare in our rural areas."
The current chief transformation officer for Centra Health and Virginia Commonwealth University alumnus, Michael Elliott, PharmD, MSHA, FACHE, will join the health system in May.
VCU Health System announced it has elected the organization's first COO.
Michael Elliott, PharmD, MSHA, FACHE, will lead operations for the Richmond, Virginia-based academic health system starting May 15.
Elliott, who is an alumnus of Virginia Commonwealth University, will be responsible for integrating the health system's organizational strategic plan and operations. The health system is comprised of VCU Medical Center, Community Memorial Hospital, Tappahannock Hospital, Children's Hospital of Richmond at VCU, and MCV Physicians.
"Implementing this new COO role at the system level is a pivotal step as we continue to develop equitable, high-quality, cost-effective, and integrated clinical programs across all our hospitals and clinics," Art Kellermann, MD, senior vice president for VCU Health Sciences and CEO of VCU Health System, said in a statement. "Dr. Elliott has a strong record of improving the performance of integrated health systems that span the entire continuum of care, which made him stand out among a talented pool of candidates from across the country. As a VCU alum, he is no stranger to our organization and reflects our longstanding commitment to give outstanding care to our patients, steadfast support to our team members, and an excellent education to our learners."
In his current role, Elliott serves as senior vice president and chief transformation officer for Centra Health, a nonprofit health system in Lynchburg, Virginia. His responsibilities include leading the organization's business development, strategy, community health, government relations, and external affairs. He's also responsible for the Centra Foundation, which provides money to develop and direct resources to support Centra.
He also previously served as Centra's senior vice president and COO. During his tenure at Centra, he led the development and launch of the Community Health Department, which focuses on community health equity. He also helped coordinate a regional COVID-19 vaccination effort and education initiative during the pandemic.
"Operational excellence matters because it allows us to expand services into more communities," Elliott said in a statement. "VCU Health is continuing an exciting journey of growth, and I am excited to strengthen our operational efficiency to better serve our patients, team members, and the community at large."
All three execs currently serve in leadership roles for the Colorado-based health system.
Centura Health, a non-profit, faith-based healthcare organization headquartered in Centennial, Colorado announced three new CEO appointments this past week.
Josh Neff will serve as CEO of Colorado Plains Medical Center (CPMC) in Fort Morgan Colorado; Jeff Carrier will serve as CEO of Western Plains Medical Complex (WPMC) in Dodge City, Kansas; and Angie Simonson will serve as CEO of St. Tomas More Hospital in Cañon City, Colorado.
Centura, which is jointly owned by Catholic Health Initiatives and Adventist Health System, signed an asset purchase agreement with LifePoint Health in February to acquire CPMC and WPMC. Neff and Carrier will assume their roles following the completion of the acquisition, which is slated to be finalized later in the year.
Neff, who currently serves as VP of integration and rural health, joined Centura in 2018. In his new role he will lead Colorado Plains Medical Center.
In his current role, he leads a team of critical access hospital CEOs. Additionally, he has created long-term operational and sustainable implementations for Centra Health's 16 affiliate hospitals.
"Not only does Josh bring an unmatched level of expertise to rural health care, he embraces the rural lifestyle and understands the importance of keeping medical care close to home," Tom Gessel, group president of Centura’s Greater Colorado and Kansas Operating Group, said in a statement. "By joining our connected ecosystem of hospitals, the patients and caregivers at Colorado Plains Medical Center will gain a new level of medical excellence and leader who is personally [committed] to compassionate, whole-person care."
Carrier currently serves as CEO of two of Centura's Kansas hospitals, St. Catherine Hospital in Garden City and Bob Wilson Memorial Hospital in Ulysses, a position he's held since 2021.
In his new role, he will also lead the acquired WPMC.
"Jeff is an innovative health care leader who has a proven record of enhancing the overall quality and safety of patient care,” Gessel said in a statement. "His deep understanding of rural health care and his commitment to the community drives his strategic vision for how our hospitals care for the whole person – mind, body and spirit."
Simonson currently serves as the director of operations for ambulatory services at Centura, and has an almost decade-long tenure with the organization.
In her new role, she will lead St. Thomas More Hospital, a 25-bed hospital with emergency and acute care services.
"St. Thomas More Hospital has served this vibrant community since 1938, and with Angie’s leadership, we look forward to continuing to grow the services we offer our friends and neighbors," Gessel said in a statement. "We are committed to offering high-quality care that allows our patients to stay close to home."
CEO Paige Dworak answers three questions about the process of the organization's name change and new brand identity.
What's in a name?
For CareWell Health Medical Center, it means reaffirming an organization-wide commitment to the community of East Orange, New Jersey with a new start.
Previously known as East Orange General Hospital, CareWell Health Medical Center is an independent, boutique community hospital, and the only independent, acute care hospital in Essex County.
In October, the hospital was acquired by a new ownership group led by Paige Dworak, FACHE, who is the first woman owner and CEO of the hospital.
Along with the COO, CNO, and CMO, she led a rebranding effort for the hospital that started earlier this year, which will be followed by expanded services, and investments in staff and technology.
Dworak recently spoke with HealthLeaders via email about the process of the organization's name change and new brand identity.
HealthLeaders: Where is the organization currently in the brand identity rollout?
Paige Dworak: The new brand was unveiled in early January of this year, and we have we have moved swiftly to transition to the new brand identity: launching a new website, social media platforms, ID badges, stationery, signage, and more.
HL: What drove the leadership team to conduct market research and evaluate consumers’ perceptions of the brand?
Dworak: This was not a decision we came to lightly – we understood the history and the deep roots this hospital has in the community. We also understood that to continue to serve our community well we needed a new beginning through a reimagined brand and name. There had been skepticism about the hospital in recent years under the previous ownership, and the new ownership group felt strongly that we must go back to being an independent community hospital and reinforce the trusted role we served as the community hospital of choice.
HL: How did the leadership team conduct the market research?
Dworak: Our leadership team spent several months conducting market research to evaluate perceptions of the previous brand. In developing the ethos of what would become CareWell Health, we engaged in a thoughtful, iterative process to tap into what made this hospital the cornerstone of our community for over a century. Extensive and thoughtful interviews were conducted with employees and community stakeholders.
Market research was conducted to evaluate perceptions and reality of our current brand. Analysis was done to determine what the current system did well and where improvements needed to be made. And a formal process was followed to ensure this evolution was truly in the public’s best interest. After many hours of research and interviews with prominent members of the East Orange community and beyond – we conceived this new brand, which represents our commitment to revitalize this vital historic hospital and signals a fresh start for this organization.
Brent Hubbard has more than twenty years of experience in the healthcare sector and has held leadership positions in healthcare organizations across the Midwest.
INTEGRIS Health has finished its national search for the health system's open COO position.
Brent Hubbard, FACHE, will assume the role of COO of Oklahoma's largest nonprofit health system on May 2, the organization announced this week.
"Brent has extensive experience working in multiple systems and markets, including in for-profit and not-for-profit health systems," Timothy Pehrson, CEO of INTEGRIS Health, said in a statement sent to HealthLeaders. "I am confident he has the experience and expertise to drive consistent positive outcomes for our health system. We are pleased to have Brent return to Oklahoma and join INTEGRIS Health.”
Hubbard has more than twenty years of experience in the healthcare sector and has held leadership positions in healthcare organizations across the Midwest.
In his most recent role, Hubbard served as president and COO of Mercy Hospital Springfield Communities in Missouri, which is part of Mercy Health System. Since 2016, he's led the strategic directions of seven hospitals, and oversaw administrative and operations for 7,500 employees.
Prior to that role, he served as COO of Mercy Hospital Fort Smith Communities in Arkansas. He also served as COO at Medical Center of McKinney in Texas, which is a 281-bed hospital which is a part of HCA Healthcare, and has held additional leadership positions across organizations in Texas, Tennessee, and Oklahoma.
According to the press release, Hubbard believes in continuous process improvement, and has extensive experience in achieving operational excellence, improving physician and workforce engagement, and improving quality and patient outcomes.
Jeff Alter shares his leadership strategies as the new CEO of the integrated healthcare organization and outlines the growth strategies to expand access to care while lowering costs for patients.
Summit Health, formerly known as Summit City MD, is on a mission to expand access to care and lower costs through its integrated network of urgent care, primary care, and specialty care facilities.
The organization has more than 2,500 providers across more than 340 locations in New Jersey, New York, Connecticut, Pennsylvania, and Oregon, and was formed when physician-owned Summit Medical Group and urgent care provider CityMD merged in 2019.
Since the merger, the healthcare organization has had a strong growth strategy, which former CEO Jeffrey Le Benger, MD, spoke about in an interview with HealthLeaders in 2021. Le Benger has since changed roles and is now the executive chairman for the management company's board.
In October 2021, Jeff Alter succeeded Le Benger as CEO of Summit Health and continues to lead the organization's growth strategies. In a recent interview with HealthLeaders, Alter shares his leadership strategies as the new CEO and outlines the organization's growth strategies to expand access to care while lowering costs.
This transcript has been edited for clarity and brevity.
HealthLeaders: What have been your priorities as CEO over the past 5 months or so?
Jeff Alter: Prior to joining as CEO, I was on the board of City MD. I'm honored and privileged to be the leader. We have experienced an enormous amount of growth over the last couple of years and we'll continue to have that going forward.
Initially, what I wanted to do is take some of my experience running larger enterprises and begin to adjust our organization here to think about how we would be structured to manage an ever larger and growing organization. So, we made some organizational design changes.
Secondly, I'm very focused on the culture. We put together Summit Health, a merger between Summit Medical Group and CityMD, and then the pandemic hit. We had some more work to do around bringing two cultures into a single culture. Then just in December, we brought in two new, large acquisitions, New Jersey Urology and West Med, so I'm focusing a lot on a refined mission, vision, and values that takes a little bit from the acquired companies and beginning to forge a new culture.
Then continuing the growth. We believe our model of connected care is the way to change the way healthcare is delivered in the United States, so we don't want to slow down on that either.
HealthLeaders: What is Summit Health's growth strategy and how does it fit in the organization's overall strategy?
Alter: We primarily want to cover the New York, New Jersey, and southern Connecticut region. With both a great front door to healthcare—which is the CityMD Urgent Care, we do believe that that is a differentiator for our medical group, the ability to have 154 access points is important—and then we want to continue to build out the multi-specialty groups in New York. We've got a great multi-specialty practice in New Jersey, and now up in Westchester with the acquisition of West Med.
The growth formula right now, it's about 40/40/20: 40% de novo, most of our CityMDs are de novo builds and about half of our multi-specialty builds are also de novo. The other 40% would be mergers and acquisitions (M&A). And then about 20% partnership.
I'd like to rebalance that so it's about a third each; so, a third de novo builds, a third acquisitions, and a third partnerships.
One of the reasons why healthcare costs in the United States are high is because everybody thinks that they have to do everything themselves. I do believe that there are opportunities for likeminded partners to work together and not have to recreate everything ourselves.
HealthLeaders: How is Summit Health utilizing partnerships to help with access to care?
Alter: There are three or four logical areas: palliative care, home health, ambulatory surgery centers, and then what I'll call super specialties: complex cancer, complex muscular skeletal. So, those are the areas that we are looking to partner most with. We can partner and have our patients be served well through our partners.
HealthLeaders:Why is it important to Summit Health to continue to expand care and continue to grow?
Alter: I see here at Summit Health a different way to practice healthcare. Taking out the silos of health care, making sure all our patients are seen as one care team, across whether it's they need cardiologists at some point in their life, or they just need a convenient care visit to make sure they don't have COVID, or they have the flu, or they have an allergy that needs to be taken care of inside our CityMDs.
I would say the single reason we are growing is because we believe this model can make a difference in both outcomes and cost for the residents of our area. We have a medical practice out in Bend, Oregon, and we're looking at other markets as well to where we think this model would do well.
We want to be able to serve as many patients as possible with this model that we believe can be a differentiator in the U.S. healthcare system.
HealthLeaders: A year ago, Summit Health unveiled a new brand identity and logo. Has the rebrand had an effect on the organization coming together?
Alter: The rebranding is going along. I would say under my tenure, what I want to reinforce is that we have two consumer brands underneath Summit Health, meaning not only the combined company, but also where our multi-specialty loyalty relationships lie. We don't want to lose focus on the fact that CityMD is also a strong consumer brand, one more episodic, more urgent and convenience based.
We're refining that now. You'll see two different advertising campaigns, one for our multi-specialty practices under Summit Health and then the CityMD urgent care as well.
Culture is one of the focuses early on—to bring together two consumer brands into one company and a single culture by taking parts of each one of the predecessor company's culture. It was the vision of City MD to create healthier, kinder communities, and we think that's a compelling vision for the entire company and so that has now become a rallying point for both sides of our company. Then we'll slightly refine work around our values, sharing parts of the predecessor companies and driving through that.
We start with the patient and focus on the patient. We treat everyone with kindness and are working hard to make sure that we can make our patients the healthiest in our market.
HealthLeaders:What other initiatives are you looking forward to leading this year?
Alter: I would say one of the most exciting for us is to begin to refine our population health programs and be able to use data in a different way, to engage with our patients that need us to keep them healthier. We believe that data and prediction of our patient's health status is important in making sure their gaps in care are closed. I'm excited about that because that is the payoff of all the work that we do, at the end of it all, a patient that is healthier and is living life and not worrying about their diseases.
We continue to refine our model and grow in our marketplace. You'll see just in the last couple of months we've opened up two new multi-specialty sites in New York City. We are beginning to look at other markets, primarily as a first step would be an expansion of CityMD into a market like South Florida, and we do believe our model is exportable to other regions.
The change includes dropping "system" from the organization's name, and introducing a new logo and omnichannel branding campaign.
Henry Ford Health has dropped "system" from its name.
The Michigan-based, nonprofit health system announced this week it has a new, "evolved" brand, which includes a name change and a new logo to emphasize the organization's focus on the health journey of its patients, communities, and workforce.
"Given the collective challenges of the past two years, there has never been a more important time for Henry Ford Health to renew our promise to our communities," Wright Lassiter III, president and CEO of Henry Ford Health, said in a statement. "We want every life we touch – whether it’s a member of our team, a patient, member, or a community partner or neighbor – to know that we will be the dynamic partner and relentless advocate they need."
The new branding hopes to unite all of the health system's offerings, which includes primary and preventative care, complex and specialty services, home health, pharmacy and healthcare retail, and its research and academic mission.
An omnichannel campaign was also unveiled during the announcement, which shares the stories of patients, team members, and community partners. The "I am Henry" campaign will have a 60-second anthem spot debuting during March Madness coverage near the end of March.
"The COVID-19 pandemic caused all of us to challenge ourselves – to reimagine what healthcare can and should be for our communities," Heather Geisler, Henry Ford’s EVP and chief marketing, communications, and experience officer, said in a statement. "We discovered: We are Henry, and together, every day, we each have a role to play in the health of our community. What we’re unveiling today is the start of a new journey. So much more than a logo or tag line, it’s a public declaration of our brand promise and a powerful way to unify us. We are Henry, and together, every day, we define and redefine what Henry Ford Health is all about."
The new name and logo will be added to Henry Ford Health's largest facilities first, including the organization's five acute-care hospitals, administrative building, and One Ford Place. Additional upgrades will follow a multi-year phased approach.
Henry Ford Allegiance, a 475-bed health system in Jackson Michigan, will also assume the Henry Ford Health brand, and will change names to Henry Ford Jackson Hospital.
Aurelio M. Fernandez, III, FACHE, will end his six-year tenure as president and CEO at the end of April.
Memorial Healthcare System's president and CEO will be retiring at the end of April, the Hollywood, Florida-based health system announced earlier this week.
Aurelio M. Fernandez, III, FACHE, has led the nonprofit health system over the past six years, and leaves a transformational legacy, the press release stated.
"My tenure as president and CEO has been the most rewarding time of my career," Fernandez said in a statement. "Memorial has a great culture and I’m very proud of the work our employees do every day for patients and the community."
During his time as president and CEO, Fernandez led five strategic initiatives that "invigorated Memorial" and had a positive impact on the community and the health system's safety, technology, clinical integration, expanded services, and enhanced culture.
During his tenure, Memorial Hospitals earned "A" grades for safety from The Leapfrog Group; the health system broke ground on its $125 million Memorial Cancer Institute in South Florida; Memorial Hospital Miramar opened the first four floors of its new medical pavilion in Miramar, Florida; the health system opened the Joe DiMaggio Children's Health Specialty Center in Wellington, Florida; and oversaw the expansion of the Joe DiMaggio Children's Hospital in Hollywood, Florida, increasing the hospital from four to eight floors.
Fernandez has been an innovative healthcare leader in Florida for 45 years and has worked at Memorial for more than 15 years. He served as CEO of Memorial Hospital Miramar and later served as COO of the health system in 2012.
Prior to joining Memorial, he served as CEO at Hialeah Hospital and Florida Medical Center for Tenet Healthcare. He also served as executive director for Tenet Network Management.
A national search is currently underway for Fernandez's successor, the South Broward Hospital District Board of Commissioners recently announced. Finalists are expected to be selected in late March and April and will meet a broad range of the health system's stakeholders prior to the Board's vote.
Chief marketing officer, Alexandra Morehouse, shares how the health system utilizes technology in its at-scale, consumer-first marketing strategy.
Consumers know what they want. And if you listen, they will tell you.
Alexandra Morehouse, who has served as chief marketing officer of Banner Health since 2015, uses this philosophy in the organization's marketing strategy along with a strong utilization of technology.
The health system, which has hospitals, urgent care and emergency care locations, home care and telehealth programs, and imaging practices across Arizona, California, Colorado, Nebraska, Nevada, and Wyoming, operates with a mission that Morehouse created: making healthcare easier, so life can be better.
In a recent interview with HealthLeaders, Morehouse shares how Banner Health utilizes technology and active listening to successfully cater to the organization's consumers and to make healthcare easier.
This transcript has been edited for clarity and brevity.
HealthLeaders: How would you describe the marketing division's role at Banner Health?
Alexandra Morehouse: The role of marketing at Banner is to be the leader for putting the customer at the center of everything we do. You'll notice that I use the word customer, not patient, and that is deliberate because with the rise of high deductible health plans, where most of us are paying for a lot of our healthcare out of pocket. We act and think like consumers, and we want to be treated with a level of customer service and our expectations are being set by Amazon and Netflix.
Marketing at Banner is quite different than marketing at other health systems. I am the executive leader for our digital transformation work, which we embarked on five years ago, and that has been called our digital front door. That was a five-year, and a tens of millions of dollar investment in that technology platform so that we could integrate all the things that most health systems have fragmented.
Most health systems grow by acquisition, and Banner's no different. We acquired our imaging entity, we acquired all of our 50 urgent cares, we acquired our rehab and physical therapy. When you acquire other entities like that, they typically have their own back-end computer systems. That means there has to be a lot of integration of the technology to make sure that no matter where consumers show up at Banner, they get a consistent experience, we know who they are, and more importantly, we give them a personalized experience.
HL: How does consumer and patient experience play a role in Banner Health's marketing strategy and the overall system strategy?
Morehouse: When I joined Banner, I worked with the board and rewrote our mission statement and then we created a consumer persona. We call her Sophia. She's a busy mom, who's married and has two kids, and four sets of parents and in-laws that she's looking after as well. She's chronically short on time, always short on money, and we use that persona at the center of every strategy slide that we have.
We frame all our strategic work around the customer. And so that has become part of the language of how we work at Banner and how we set strategy.
HL: How are you utilizing fresh and innovative ways to make it easier for consumers and patients to interact with your health system?
Morehouse: As part of our digital front door, we have a symptom checker. At the height of COVID when nobody could get through to their doctor, or nobody wanted to come in person, you could go through a symptom checker online and at the end it will tell you: you need to go to urgent care, or you need to schedule an appointment, or it could say please go to the ER right now.
We also have a health risk assessment that's a digital survey that allows you to check your likelihood for health risks. And that in turn would hand you off to make an appointment.
Our most important piece of technology is a CRM tool that allows a 360 view of all of our customers. It doesn't matter where you show up at Banner, they're going to know who are, your other family members, who's your primary care doctor, who are your other doctors, what was the last visit you had with Banner, have you had your flu shot, have you had your COVID vaccine? It stores all of your history. And just as importantly, it stores your preferences. That's the heartbeat of the entire digital front door, this CRM system that allows you to manage personal relationships at scale.
We know from an Accenture study that was released [in January] that what patients want the most from a health system is personalized communication, because healthcare feels sort of impersonal, they want that personal touch. Our CRM system is what allows us to do that and it does it in various sophisticated ways.
We also handle 50,000 calls a week. We have natural language programming, which is a kind of machine learning that recognizes certain words, that allows us to analyze all 50,000 calls every week and see what the topics that people are most concerned about, so that we can have scripts ready for the reps. We can also push out information on our website and our blog.
HL: Banner Health has a large footprint. How do you meet individual community needs while also having a consistent digital experience for your consumers?
Morehouse: We have a very deliberate strategy and I invented a name for it, it's our "Glocal" strategy. So, it's a global strategy, and because we're trying to basically grow at scale, all of these tools allow you to operate at scale, and that allows you to reach more people and be more efficient. We have global strategies that cover about 80% of the strategy.
Then the local is the 20% where we have people on the ground working with local media outlets, for example, especially in some of our rural communities. Their personal relationships with media outlets [are important]. We do local events, like the rodeo in some of our western states.
We take a global approach for cost efficiencies and then a hyperlocal approach on the ground.
Digital transformation is about scaling, and for virtually every health system, it is putting Humpty Dumpty together, which is the challenge because we all grow through acquisition.
When I started this digital transformation, we had nine different physician directories and none of them talked to each other. We had to consolidate all of those position directories together.
We had 400 phone queues, and seven different telephony platforms, all of them on prem, meaning they weren't in the cloud. We had to consolidate all of those phone queues. When I get calls from other health systems, that's what they're most interested in. How did you consolidate and transform your calls? Because they're expensive, they're central to the customer experience, and most people struggle to get it right.
Getting your physician directory in good digital order and getting your phones in good digital order is absolutely pivotal to any digital transformation.
HL:What steps should health organizations take to keep up with consumer demands and expectations, and to overall have a better marketing strategy?
Morehouse: That is an easy one-word answer: listen. Listen in many places and then adapt.
We set up these 20 listening posts when we put our natural language programming in place because the good news about customers is you never have to guess. They are telling you every single day what they want, what they like, what they don't like.
We have a rapid listen and respond system set up, so depending on the circumstances, it will either be once a week or once a day. In normal times, our more usual cadence is once a week. Based on what we're hearing, we bring metrics, and based on what we're hearing from the prior week, we instantly change what our messaging strategy is going to be for the coming week.
Your ultimate report card is Google My Business and that is something we wouldn't normally hear about. When you do a search, and then the top three show up and they're sort of highlighted, that's where you want to be. Before our digital transformation, we were at 3 million Google My Business views a year. We closed last year with 180 million. This is a measure of how relevant you are to the public.
Our stated mission is healthcare made easier so life can be better. We got the digital IQ award for ease of use, and that was again from listening to the customers all the time. 85% of all healthcare searches start online. If you get the digital transformation right, make it give the information they want, and then make it easy to transact, people show up.
Doing marketing and doing marketing at scale are two different things. To do marketing at scale, you have to leverage technology. This is the ultimate success metric when you have a successful digital transformation in place.
UH president and CEO, and President Biden's new pick for undersecretary for health at the VA, Shereef Elnahal, MD, MBA, details the steps taken to improve the hospital's finances, quality, culture, and community trust.
When Shereef Elnahal, MD, MBA, joined University Hospital (UH) in 2019, the safety-net hospital was struggling.
Elnahal, who was recently nominated by President Joe Biden to serve as undersecretary for health for the Veterans Health Administration, became president and CEO of UH after New Jersey Gov. Phil Murphy signed an Executive Order to install a monitor in the organization following concerns around the hospital's quality of care and financial struggles.
The organization experienced margins in the red, a disconnect between leaders and the workforce, and distrust from a community that the organization had promised to support.
At that time, the hospital faced many challenges including:
Operating at a $12 million loss
Having an earnings before interest, depreciation, and amortization (EBITDA) of just over 2%
Receiving a D from LeapFrog in quality after having received an F two grades prior
A disconnect with the community
A disconnect between the top management of the hospital and the workforce
Elnahal served as the commissioner of the New Jersey Department of Health until he took the reins of UH. Since Elnahal took the top leadership spot, there have been improvements in the hospital's finances, quality, culture, and community trust and engagement.
In a recent interview with HealthLeaders, Elnahal details the steps taken to move the hospital from a struggling to thriving institution.
Creating a strong culture and improving quality care delivery
Addressing the organization's workplace culture was the first action item Elnahal focused on when he joined UH.
"Reestablishing trust with the community was of course important, and that was at the tip of the spear of our priorities," he said. "But … I had to convince our own team and our own staff that we have their best interests in mind."
The key disconnect that he found was that the workforce needed an advocate to fight for them, and to fight for a better internal working structure, he said. He also needed to identify what the team at the top levels of the hospital needed to feel empowered and informed to address the needs of the frontline workers.
"The talent on this campus … have always wanted to do right by the patients in this community. That was one of the first things I discovered when I arrived here," he said.
After Elnahal took over as CEO of UH, he said the organization recruited Dr. William Holubek, who reinstituted quality improvement efforts in the hospital.
Holubek, along with the chief nursing officer, Dr. Carl Kirton, established what Elnahal calls a "Lean A3 Management System" for the hospital.
Part of the system included that every frontline worker, including clinical and non-clinical workers, engaged in meaningful daily huddles. This opened up communication between the workers and leadership so that the workers could openly share feedback and the leaders would share the organization's priorities and next steps.
"There was a two-way conversation happening for the first time in many places in the hospital around the safety of the care environment," Elnahal said.
"That cascaded up into tiered huddles to a level where senior leadership of the hospital attended a daily huddle every morning where they would hear all those problems that are surfacing from the frontline," he added.
Elnahal said that the organization addresses its problems by tackling them with critical thinking and breaking down the top contributors to those problems. Then key people are accountable for financial metrics and quality metrics, which they report to senior leadership.
"We've seen substantial improvement just by instituting those structural things, while at the same time coaching and guiding folks on how to implement [change,]" Elnahal said.
Through these efforts, UH improved the efficiency of its care delivery, and decreased its length of stay by 7.3%. Additionally, the organization improved quality measures of several common hospital acquired conditions, including reducing central line-associated bloodstream infections by 40.3%, reducing catheter-associated urinary tract infection by 47.1%, reducing C. difficile infection by 22.6%, and reducing surgical site infection by 86.2%.
Additionally, the hospital conducted a culture of safety survey in 2021, which showed substantial improvements in all arenas over the two years prior, he said.
Forbes also recognized UH as one of the Best Employers by State for 2021.
Elnahal said that the improvements seen are a team effort across the organization, including the executive team, the frontline staff, and the board.
"[The board members] have been very supportive," Elnahal said. "They've held us accountable on execution, which is exactly what a board relationship should be."
Along with building trust with its workforce, UH also needed to build back trust from the community it serves, which includes minority and underserved communities.
Elnahal saw a large disconnect between the organization and the community, potentially the biggest disconnect of the hospital's history.
"That means a lot because, frankly, The Newark Agreements rededicated this campus out to the community it serves," he said.
"I keep The Newark Agreements on my desk. It was negotiated during a different time of racial reckoning in this area. The events of George Floyd reconstituted a lot of those conversations and brought them to the forefront," he said.
"I knew that we had to do better on quality and patient safety, we had to do better financially to better sustain this hospital as a public asset going forward. But most importantly reestablishing that trust with the community as an important partner, that would not only serve with patient care, but also through jobs hiring and more procurement from the community, and better support to the community, overall," Elnahal added.
"As much as being present was important for our own staff, being present in the community was equally important," he said.
The engaged staff stepped up and volunteered to do community-based events with the hospital, he said.
"I recall an incredible visit to the Portuguese Cultural Center here in Newark. It's a social club that is in part based on soccer, but also in part based on being a critical pillar of community support. As a result of that engagement where I met leaders and met folks who have deep healthcare needs that weren't necessarily being met, we're going to have a Portuguese liaison, who is not only Portuguese speaking but also trained in all the things that a community health worker would need to know to advance the agenda," he said.
"Those things are so important because they not only are symbolic in the sense that you're actually there and you can do care, they allow you to circle back and deliver and execute on what's needed. And we delivered on so many other things since then."
Additionally, UH guided the community through the COVID-19 pandemic.
It was among the trial sites selected during the Moderna vaccine trial, based in a minority community. The hospital was also the first hospital to administer the vaccine to the public in New Jersey.
Leaders, including Elnahal, hospital physicians, and COVID experts conducted public forums to answer questions and educate the community, "to rebuild trust and maintain trust with the community on things like vaccination, but also therapeutics, restrictions, and other measures that were needed to reduce virus spread," he said.
"A lot of misinformation and mistrust can be tackled directly with direct engagement."
The hospital also sent vans out into the community to do mobile vaccinations. The organization has provided more than 47,000 vaccines to the community, bringing the number of fully vaccinated people to 24,000.
Financial and operational levels
UH also saw a large improvement in in financial performance since Elnahal joined.
In order to make those changes, the organization had to look at its revenue cycle from top to bottom to make sure the organization was being compensated for all care delivered, Elhanal said.
"This isn't to line the pockets of particular individuals; we're a not-for-profit organization. Every single dollar we've made we reinvested in the infrastructure and the capital needs of the campus," he said.
Investments made included upgrading equipment and buying new radiology equipment. The organization has also made a number of needed capital upgrades to the hospital campus, he said.
"The most important story behind our turn around financially is the fact that we can reinvest in more of our capital needs," Elnahal said.
After several years operating in the red, the organization went from operating at a $12 million loss to reporting a $48 million surplus in the last fiscal year, Elnahal said. The organization's EBITDA also grew 6% in that time.
The organization also focused on growth, including growing new service lines and partnerships.
"All of that paid off. We've seen many more discharges from our hospital than in the previous couple years. This fiscal year, we've seen more emergency room visits, but most importantly I've seen many more clinic visits, so we're engaging people in the community before they need to be hospitalized, which is telling," he said.
"We're competitive, we raised rates across the board with union contracts, So this financial boon did not come on the back of employees. We never had a reduction of workforce we've never had a furlough throughout the pandemic. It's important to mention that," he added.
With the increase in capital, the organization is also looking to build a new campus in 2022.
"This is something the community deserves, it's something that the community was promised when The Newark Agreements were signed and codified and written," Elnahal said. "It's another opportunity to build a nucleus here."