CEO Blog: 2014: On the things that matter, maybe our best year ever

January 14, 2015

By NHRMC President and CEO, Jack Barto


Looking back on 2014, it may have been, given the context of our current times, the best year in the 47-year history of New Hanover Regional Medical Center.

This was a year when we did just about everything well, in partnership with our physician staff, that a hospital can do. Our patient quality scores improved and were well ahead of national averages. At the patient level, this means you are less likely to get an infection, fall while an inpatient, or readmit to the hospital within 30 days of leaving. You are more likely to get every component of evidence-based effective and safe care there is to offer. And if your heart has stopped, the odds are that you will be transported to the cath lab and have your arteries unblocked in about half the time it takes in many places around the nation.

We could stop right there, as our ability to deliver quality patient care is at the heart and soul of everything we do.

But we excelled at other things as well. Our scores for patient experience were in the top quarter in the nation, and our turnover rate remained about 10%, about half what it was 10 years ago. And we managed to grow volume while at the same time reducing costs – a feat few hospitals can claim in today’s climate. When you have a combination like that, it leads to a successful financial year that flies in the face of all industry trends.

I would like to dwell on that last point a moment. Given the trends we saw coming four years ago, we began an effort we call “Geared 4 Greatness” to find operational improvements, whether they are cost reductions or revenue improvements. And this year, with the specter of reductions in both state and federal funding, I challenged our staff to find improvements before we were faced with making decisions no one wants to make. So far, in the past four years, these efforts have improved our operations by more than $70 million.

The vast majority of these improvements were done by using Lean methodology, which places the patient at the center of every process and figures out how to maximize value while reducing waste, duplication and inefficiency. As we got better at “thinking Lean” during the year, we got more creative and bold in how we were able to continuously improve our care.

So here’s another way of looking at those $70 million in improvements: We didn’t “cut” anything from patient care. Rather, these efforts improved what we do for our patients. We are fortunate to have a team in place that can allow this hospital to manage this way, rather than by cutting jobs or services. This ranks right up there with our quality achievements as our greatest success this year.

However, please keep in mind that we have the same operational and policy challenges as before. We will have to continue to deliver quality care that centers on patients and maximizing value to them and their families. Changes in market dynamics and government policy that continue to challenge all health providers cannot change our focus on providing the most efficient care that delivers the highest quality.

In 2015, look for us to continue our efforts to grow “accountable care” models in which we are paid based on how healthy we keep our patients. This spring, we will open a new standalone emergency room, NHRMC ED North, at the north end of New Hanover County, and will continue to evaluate how our overall Emergency Department can serve a different role in the community than the doctor’s office for those without a doctor. And we will continue to invest in our network of primary care doctors and medical specialists and grow our ability to treat patients in the community before they need hospital care.

I expect 2015 will be as challenging as this past year, and I know with the team we have in place that we can meet this challenge to the benefit of our patients and our community.