Oklahoma Heart Hospital: Dr. John Harvey, CEO

by HCE Exchange on August 19, 2010

The state of Oklahoma has one of the highest rates of death in the nation from cardiovascular disease, but with a world-renowned heart hospital ranked in the top one percent in the nation, you had better believe those outcomes are changing.

Oklahoma Heart Hospital specializes in one thing – cardiac care. Open since 2002, the joint venture between a group of Oklahoma cardiac physicians and the Sisters of Mercy Health Systems of St. Louis, Missouri, is leading the nation in heart care and treatment.

Building a Better Hospital

Dr. John Harvey, CEO of Oklahoma Heart Hospital, was among the original group of physicians who set out to build a better hospital for heart patients. “We really set out from the beginning to be a different kind of hospital,” he says. From the start, for instance, the group determined that they would operate on a completely integrated electronic medical record system, making them one of the nation’s first all-digital heart hospitals.

As well, during a time when many hospitals were trying to find a way to function with fewer nurses on staff, Oklahoma Heart was determined to build a hospital where experienced nurses were at the heart of patient care. An Oklahoma Heart nurse never has more than four patients to attend to at one time. In order to maintain maximum capacity of nurses, the organization does without some of the ancillary positions that take up staff space at many other hospitals. Nurses and techs end up doing a lot of work in the OR and cath labs that they might not do at other hospitals, but in exchange they have a lighter patient load and the tradeoff seems to be working.

Oklahoma Heart has an extremely high nurse retention rate (99%), and overall their nurses average around 10 years of experience. Harvey says the doctors wanted to create an environment where the nurses would never be drawn to leave simply to work at another hospital. Benefits for the hospital are two-fold. First, “we don’t have to spend nearly as much time and money on new training or people,” says Harvey, and an experienced nursing staff means fewer clinical errors.

He says another focus while creating the new hospital in 2002 was to keep the clinical error rate low. Along with electronic health records and experienced nurses, the hospital strives for standardization among its 40-some clinics and 600-some employees. “Our philosophy is that, although there may be several ways to do a procedure, if we can standardize it and get everybody to use the same one, we will reduce errors because every care giver in the hospital understands how to treat X condition. Everybody always gets the same therapy, not that there is a right or wrong, we just want to be consistent. We don’t want every doctor using a slightly different method to treat that condition. That adds to confusion and increases medical errors,” Harvey says.

The hospital is in the final stages of completing a $35 million expansion project that brings its capacity from 78 beds to 99. The last few years have found the hospital operating at capacity on a near-daily basis, so the expansion should bring some relief. Oklahoma Heart has four operating rooms and five cath labs. One operating room and five additional cath labs are being added as part of the expansion project.

Patients First

Of course, the primary mission of Oklahoma Heart is to give patients the highest quality care to bring about the best outcomes possible for their conditions. The hospital has consistently maintained some of the highest patient satisfaction scores in the nation. It received a Press Ganey Summit Award for three consecutive years, an honor going to healthcare facilities that maintain the highest levels of customer satisfaction for sustained periods of time.

Harvey says maintaining high employee and patient satisfaction go hand in hand. “Our patient satisfaction surveys have essentially been in the 99th percentile since we opened; we’ve never had a quarter that we haven’t scored that high. We think that goes back to paying attention to the patient’s needs. Also employee needs, so employees feel like [Oklahoma Heart Hospital] is a superior place to work and they project that feeling to the patient,” he says.

The organization has also made it a priority to act quickly when it comes to matters of patient and employee safety. When an issue is brought to their attention, or there is a development in technology that would benefit patients or staff in terms of creating a safer environment, those items are front-listed and action is taken immediately. “We don’t try to delay purchases for budget purposes when it comes to safety,” Harvey says.

These are the policies that have made Oklahoma Heart the number one provider of cardiac care in the state of Oklahoma with 1,200 heart surgeries per year and close to 3,000 coronary interventions. The model has been so successful that a sister site is being built in the opposite corner of Oklahoma City to serve a group of cardiologists who have admired the developments at Oklahoma Heart. That facility will be a 62-bed hospital scheduled to open in January 2010.

Challenges

One downside to being a specialty hospital, according to Harvey, is that changing rules and regulations can have a greater impact than when your sources of income are from more varied modes of medicine. As the Centers for Medicare and Medicaid (CMS), for instance, push for some of the more common coronary interventions to become outpatient procedures, hospitals that specialize in those procedures experience a big drop in revenue. There have been some lobbying efforts against physician owned and specialty hospitals, as well, so there is always legislation to watch and consider.

On the upside, Harvey says the hospital had the benefit of starting from scratch in 2002. There were no legacy systems and special interest groups already in place, so the physicians were able to create the hospital they envisioned without a lot of obstacles. “In an existing hospital, it is sometimes hard to overcome a process that has outlived its usefulness. It can be hard to eliminate programs that are no longer needed.”

“We really feel like the model we are following is a better model in terms of patient safety and patient satisfaction. Theoretically, it could be replicated anywhere, though it is not as easy when you already have a hospital place and an administrative infrastructure that is already set up.”

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