Richmond University Medical Center: Richard Murphy, President & CEO

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Formerly called St. Vincent’s, the hospital that began on Staten Island, New York, in 1903 as a center to care for tuberculosis patients had become a sprawling medical center known for its care of women and children and delivering around 3,000 babies per year. The hospital has undergone its own series of births and rebirths in recent years. When the network of St. Vincent’s hospitals folded due to bankruptcy, and the brief alliance with another hospital system also failed due to financial troubles, the hospital found itself standing alone. In 2007 it became Richmond University Medical Center.

“Richmond effectively established itself as a new organization,” says Richard Murphy, President and CEO. “It changed its name from St. Vincent’s Staten Island to Richmond University Medical Center and it then proceeded to reconstitute itself as a 510-bed hospital operating on Staten Island.”

Richmond provides both inpatient and outpatient care. They are internationally recognized as a reproductive medicine center and specialize in high-risk pregnancies. Their neonatal intensive care unit maintains higher than average survival rates.

Beginning Again

“As you might imagine, much of what the system needed at that time—IT functions, accounting functions, receivable cycle management functions—many of those things were held by the corporate parent companies and did not exist within the hospital. Richmond had to be essentially created as it launched itself,” says Murphy. “The first year of its existence, 2007, working with limited financing, as well as limited working capital, the hospital began to put those systems in place. It was a very, very rocky start-up.”

Richmond lost a little more than $14 million that first year on a $250 million budget. By June of 2008, the hospital was continuing to record operating losses and running very short on cash. That’s when Murphy was brought in to implement a turn-around plan.

Murphy began by tackling the systems that needed to be in place. It was a fairly structured process, but strategic planning also included evaluation of core measures and the hiring of an additional 160 nursing staff. The hospital is a medical teaching facility, as well. “We’re affiliated with New York Medical College with a very strong link to medical education and residency training and those programs have also blossomed with the turnaround,” says Murphy.

“The good news is that 14 months later, we sit here with about a $5 or $6 million surplus,” Murphy says. “The future looks fairly bright in terms of operational performance. We still have a lot of sins of the past to deal with, where the facility was underinvested and such, so there are a lot of things we’ll have to address for the long term, but at least for the last 14 months, we’ve essentially implemented a very significant turn-around of the organization both financially and qualitatively.”

Harmony through Management

“I think of management like a music score,” says Murphy. “You try to create an organization in which roles and responsibilities and authorities are aligned almost like a music score—lines run horizontally … people work within their individual areas of responsibility at every point from A to Z. We’re all working to achieve the same outcome.”

Murphy has created a “no blame” culture. He wants employees to walk not with their heads down, but with heads up, looking forward in order to tackle the next challenge and conquer the next problem. He believes in transparency in leadership and works to meet his employees in informal settings to encourage flow of communication.

“That has taken us a long way,” he says. “Employees and others look for the leadership culture to express those values consistently. Then the employee culture can say, ‘These are the people we want to follow.’”

“I think once people realize you are not going to be in a recrimination mode, that you are looking for positive input, you almost end up with overflowing sentiment from your employees,” Murphy says.

Standing Strong

In spite of the financial and systems-creating turbulence of recent years, Richmond finds itself medically stable. The hospital made the 2009 New York State honor roll list for performing above average on treatment of postoperative pulmonary embolism. They’ve also received accolades for exceeding expectations for low rates of hospital acquired infections.

The hospital is working on all levels of performance evaluations. “We’re trying to work with independent practitioners to ally the practice model within their private practice setting,” Murphy says. “A lot of physicians are looking to tie in with something or someone who can help them navigate the whole field of quality outcomes. We’re working very hard with our medical staff on integrating those concepts, and also working to back those up with integrating physician IT systems with hospital IT systems so that we can translate data back and forth between the two practice sites.”

“We’re all working alongside each other. We’re not working in spite of each other or in opposition to one another; we’re working a continuum to get from where we are to where we want to be,” says Murphy. “If there are resources issues or somebody sees a better way to resolving the problem, we put that on the table and we discuss it. By the end of the day, we have a better solution and better execution.”

-by T.M. Simmons

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