Indiana Orthopaedic Hospital: Jane Keller, CEO

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Physician-owned hospitals, created and operated by physicians focused on quality patient care, face challenges similar to those of corporate or non-profit organization-owned medical facilities. While all providers of medical care are looking closely at the healthcare reform debate going on in Washington, DC, the CEOs of physician-owned facilities have a different stake in the outcome of provisions that could limit their future growth.

Potential legislation being passed around Capital Hill includes language that could, in effect, ban further construction of doctor-owned, for-profit specialty hospitals and prohibit existing ones from expanding. It’s talk like this that has Indiana Orthopaedic Hospital (IOH) CEO Jane Keller watching the news more closely these days.

“Language in the healthcare reform bill pertaining to physician ownership has been a primary focus for our organization in the past year,” she said. “If we are limited in our ability to grow we feel that could limit our ability to compete in the marketplace in the future.”

Physicians from OrthoIndy opened IOH, based in Indianapolis, in March 2005. OrthoIndy is one of the largest private full-service orthopaedic groups in the U.S. and the largest orthopaedic group in the Midwest. Keller said she works closely with John Martin, CEO of OrthoIndy, making sure that the two entities are following the same paths.

Indiana Orthopaedic Hospital focuses on the treatment of orthopaedic and musculoskeletal injuries, utilizing 42 licensed beds and 10 operating rooms at its main campus. In addition, a second location houses two operating rooms, while IOH also supports three outpatient physician therapy locations and two MRI facilities throughout the Indianapolis area. In total, IOH employs approximately 250 people.


Keller noted that IOH is not yet feeling the economic effects that other facilities are experiencing, with fewer people undergoing elective surgeries. In 2009, the organization performed more than 12,000 surgeries, with 70% of those being outpatient procedures. In addition, IOH experienced a 10% increase in surgical volume from 2008 to 2009. However, she remains conservative in her exuberance.

“We need to keep a watchful eye on our volume numbers, in light of the fact that we perform elective surgeries and, in this economy, we would anticipate that people may put off having elective surgeries,” she said.

Quality Initiatives

Patient satisfaction was an initiative at IOH in 2009, with the hospital participating in a variety of quality care programs. As a result, the hospital received three-year accreditation from the Healthcare Facilities Accreditation Program (HFAP), the highest level a hospital can achieve from HFAP. Also recognizing the hospital’s quality of care, Press Ganey Associates named IOH a 2009 Summit Award Winner.

“We’re finding that we are becoming leaders in quality,” Keller said.

In addition, the hospital participates in a voluntary program offered by The Leapfrog Group aimed at mobilizing employer purchasing power to alert America’s health industry that big leaps in health care safety, quality and customer value will be recognized and rewarded. Leapfrog works with its members to encourage transparency and easy access to health care information as well as rewards for hospitals that have a proven record of high quality care.

“We have been tasked with figuring out the best way to be transparent to the consumer,” she said. “We’re trying to understand how we can back up our claims that our quality of care is high. With orthopaedics, there aren’t a lot of standardized quality metrics available, so it’s a challenge to make sure that we are focusing on the right thing.”

Far-reaching Initiatives

Looking at the big picture, Keller and the management team at IOH focus on a Five-Star Superior Service concept that includes accountability, innovation, teamwork, outcomes and excellence. Accountability is of particular importance to the staff, she said, because as a physician-owned facility, there are high expectations for the care patients receive.

“When I think about the things that I do and the decisions that I make, I consider what is best for the patient, always putting the patient first,” the CEO said.

Safety Initiatives

Part of that patient focus includes safety initiatives, whether in the form of hospital “walk-arounds” or specific programs. With the risk of falls increased for orthopaedic patients, especially if they’ve had a lower-extremity procedure, IOH instituted a Fall Risk Program that outlines protocols for caring for at-risk patients that include educating patients about their risks for falling in their current conditions.

Just introduced this year was a program standardizing patient identification bracelet colors. Indiana is one of the first states instituting this initiative, Keller said, with the potential for nationwide standardization. This is a vital patient care measure, particularly if patients are transferred from one hospital to another.

The hospital also has a method for collecting patient feedback called Concern Cards. Patients and their families have the ability to anonymously complete these cards to let IOH staffers know if there are any issues or concerns related to patient safety.

“Response to this program has been good,” Keller said. “We’ve discovered problems that we were unaware of and could be addressed and fixed.”

Expense Initiatives

While technology costs already take a large portion of IOH’s spending budget, the organization expects that to increase as it outfits a new facility currently under construction on the south side of Indianapolis. This space, designed for outpatient use only, will be similar to the IOH main campus and the West facility in Brownsburg and will include four operating rooms, a physical therapy area and an MRI suite.

“We’re always making sure we have the most up-to-date technology to take care of the orthopaedic patient,” Keller aid. “We’ve been very successful in how we designed these facilities so it didn’t take a lot to change the flow or the pattern for the new facility.”

One example of how IOH utilizes cutting-edge technology is with a CPOE from MEDITECH. The hospital has run 100% electronic medical records since its launch.

On the medical side, orthopaedic implant costs are a huge expense line item for IOH and continue to increase in cost while reimbursements remain stagnant or decrease. Keller said they work with the vendors to keep expenses in line while at the same time retaining value.

Employee Value

Value also comes in the form of hiring and retaining quality employees. With all the changes in the economy and the workforce, IOH continues to manage employees’ expectations, Keller said.

“If our employees are satisfied with their positions, then that usually means that our patients are satisfied,” she said. “We are always trying to balance making sure that we provide a good environment for our employees to work in.”

-by Kathy Knaub-Hardy

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{ 1 comment… read it below or add one }

Adam Bash April 22, 2011 at 4:12 am

I was operated on at your Hospital on April 14th by Dr. Gregory Reveal. On the day of my surgery Dr. Reveal came in to pre-op waiting area where I was with my Fiancee and said “So..what are we doing today..just taking a bone out right?” This is when I being astounded he had no preparation in my surgery prior to coming into my room., said to him “No we discussed you taking out a bone, fusing two bones together, and tendon clean-up and/or repair.” He the replied “Oh..yeah..well we are going to take care of you. Now just remember this may not help you..ok?” and then left the room. After surgery, I am released and given a prescription for Pain Relief meds that is the EXACT same dosage level I was taking PRIOR to surgery. When I reported to my Dr. this and asked him to simply increase the strength level to try and aid my pain relief and since I am on the Norco due to low acetaminophen and its least irritable pain killer I can tolerate, why not just given me a stronger version of same med. I was told by secretary/assistant she would talk to Dr. and call me back. After aouple hours I was called back to be told the Doctor said no and had prescribed me another pill to take. Toradol..A POTENT NSAID..I am allergic to ALL NSAIDS and its in my file as well as my documented allergy to ULTRAM..(ALL R/X ALLERGIES WAS GONE OVER SEVERAL TIMES PRIOR TO SURGERY) wHICH BY THE WAY uLTRAM WAS HIS RESPONSE PRESCRIPTION WHEN i INFORMED HIS STAFF OF MY DOCUMENTED R/X HISTORY AND THE FACT HE WAS BEING NEGLECTFUL IN MY TREATMENT BY PRESCRIBING ME MEDS I AM ALLERGIC TO. DURING THIS MAELSTORM I WAS INFORMED..THAAT AFTER SURGERY DOCTOR REVEAL SPOKE WITH MY FIANCEE AND TOLD HER HE HAD PUT TWO PINS IN MY HAND. WE NEVER DISCUSSED THIS!!! NEVER WAS IT MENTIONED i WOULD HAVE PINS PUT IN MY ARM/HAND. FURTHERMORE THE HOSPITAL NEVER CONTACTED ME TO DO FOLLOW UPS FOR MY SURGERY/CARE. I WAS TREATED IN A NEGLECTFUL WAY AND CLEARLY AM A VICTIM OF MALPRACTICE AT YOUR FACILITY! YOU CANT PUT THINGS IN PEOPLE WITHOUT DISCUSSING IT FIRST. SECOND IT WAS MY RIGHT TO HAVE MY PAIN LEVEL DEALT WITH IN A NON NEGLECTFUL MANNER AND AGAIN CLEARLY I WAS A VICTIM OF THIS AS WELL. nO CONCERN WAS PUT INTO MY AFTER CARE WHEN NO ONE CALLED TO FOLLOW UP WITH ME..AND THEREBY DEALING WITH MY ISSUES MORE TIMELY AND LESS HARMFUL TO ME. I HAVE SPOKE WITH TIFFANY WHITE AND YOUR ASSISTANT AS WELL..BUT I SHOULD ALSO NOTIFY YOU AND SAY I FEEL I AM BEYOND A SHADOW OF A DOUBT A VICTIM OF NEGLECT AND MALPRACTICE AT THE HANDS OF YOUR STAFF AND FACILITY


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