Bakersfield Memorial Hospital: Bruce Peters, Chief Operating Officer

by HCE Exchange on August 19, 2010

The largest regional medical center in California’s Southern San Joaquin Valley began as the small community hospital of Bakersfield in 1956. It now has 406 beds and has been affiliated with Catholic Healthcare West (CHW) since 1996. It offers a full-range of specialty services from cardiac and orthopedics to neurology.

Towering Expansion

Bakersfield Memorial Hospital recently completed a 114-bed patient tower which was built right on top of the existing hospital. The tower was built in response to the California seismic law, which right now is expected to take effect sometime in 2013. In anticipation of that law, the hospital added a 24-bed intensive care unit, 60 private rooms for general medical care, and 30 private post-partum rooms for moms and babies.

“The challenge on this particular project,” says Bruce Peters, Chief Operating Officer, “was building on top of an existing occupied floor.” Two departments were temporarily relocated while the steel and major components of construction were assembled. Then that first floor area was renovated. When the tower was complete, those departments and some additional ones were able to move in.

“Our architects were constrained somewhat by the footprint and the existing steel they could build on top of,” says Peters. “It was a pretty tricky project for them. The beauty of it was—as long as it took to design and build—we ended up coming in on time and under budget. You don’t get to say that very often, especially with something this complex.”

Other plans include expansion of the hospital’s pediatric service line. A pediatric intensive care unit will be the first in the county. “Currently, patients have to travel two hours or one hundred plus miles north or south to get to a children’s hospital. Bakersfield expects to have it’s its new unit open by the end of the year.”

Another enhancement to the hospital added by the new construction is that they secured the infrastructure for wireless capability throughout the hospital. “We made sure we will have a good IT backbone and plenty of capacity to handle any future additions and upgrades,” Peters says.

Transformational Care

In April of 2009, Bakersfield became one of the pilot hospitals for CHW for a Six Sigma type project they call Transformational Care. They began with four pilot teams in the spring and summer of last year. “We worked to teach all the tools, to do all the training with the staff so it was clear to them that this wasn’t just another quality improvement effort. It was a fundamental change in the way we do business,” says Peters.

Early in the process, the hospital began to realize significant savings in dollars, in the half million-dollar range for work done by these pilot teams. “For our emergency department, it really helped our throughput. Getting people into beds or getting them out the door when they’d been treated,” says Peters. “We significantly reduced our wait times and are closer to some of the national benchmarks. It was a tremendous effort in the emergency department that is ongoing.”

Once they got through the pilot program phase, they started adding more teams who will continue to work alongside the teams that got started last year. In the OR, for instance, they are looking at turnaround times between rooms and effective scheduling. In registration, they are working toward more accurate and complete forms which will result in better billing processes, better coordination of care, and eliminate duplicate medical records. “We’ve actually implemented a new process that has allowed us to capture more co-pays and co-insurance at the front end of the visit and that’s allowed us to collect a lot more revenue that we’ve historically missed either because of inaccurate billing or the inability to capture information.”

They are also working to get discharged patients home earlier in the day. “Our average discharge time was late afternoon, around 4pm, and we’ve been able to move that back several hours.”

“Some of this sounds pretty fundamental, but going through the transformational care process has really helped us get there,” says Peters.

The COO Role in Healthcare

“I think anybody who wants to get into hospital work, or get into the role that I am in, you really have to be able to work well with people,” says Peters. “This is a people business, so people skills are of primary importance. We can teach you everything else; policy, procedure, forms, this and that. But being able to relate to people, being able to work with people, work with physicians, work with all the other outside constituents…  you really have to be part politician, part manager, part counselor, part visionary… a lot of different parts that come together in administration.”

“Just become a student of people. That would be my advice. It’s hard work, but it’s extremely rewarding work.”

-by T.M. Simmons

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