Grady Health System: Michael A. Young, President & CEO

by HCE Exchange on September 19, 2010

Georgia’s largest hospital, one of the nation’s largest public health systems, dates back to 1892 when a 3-story, 110-bed facility was built by the city of Atlanta. It was named for the 1880s editor of the Atlanta Constitution, Henry W. Grady, a man who envisioned a “new south” in the post-reconstruction era and wanted to improve access to healthcare for the city’s poor.

The 953-bed Grady Memorial Hospital now stands in the heart of the city. Nine neighborhood health centers, a health and rehabilitation center, and a children’s healthcare affiliate make up the Grady Health System which employees 5,000 staff and manages 921,000 patient visits per year.

As a safety net for the city’s uninsured and public health recipients, the organization provides millions of dollars per month in unreimbursed healthcare. It is founded on a history of serving the public’s healthcare needs, but such generosity brought the organization to near extinction by 2007. Plagued by losses in the $30-40 million range per year, the hospital risked losing its accreditation. In early 2008, Atlanta’s business and  community leaders stepped in to create a nonprofit corporation charged with administering the hospital system. A new 17-member board was appointed, the Robert W. Woodruff Foundation pledged $200 million over four years, and in September of 2008, a new president and CEO was brought on board to ensure the turn-around of the city’s most relied upon health resource.

Michael Young, coming to Grady Health System with more than 28 years of healthcare industry leadership, says, “It is important to me that everyday, I make a difference. This is about as big a test as possible.”

A Living, Breathing Organism

Grady Health System is an organ vital to the southeast’s system of healthcare. If Grady were to close in Atlanta, all of Georgia would be affected. Physician availability would decline. “Our patients are not coming to our clinics for fun,” Young says. “There is no way they would find their way into the private offices out there. No one else could afford to pick up [our patient load], so you’d have a lot of very sick people out there.”

Twenty-five percent of all the physicians practicing in the state of Georgia received some or all of their training at Grady. It is the teaching hospital for doctors from both Emory University and Morehouse schools of medicine, and in the past 30 years, Grady has developed specialty programs which aren’t available anywhere else in the state.

As well as housing the regions only level I trauma service, Grady operates the city of Atlanta’s ambulance service. Grady is home to Georgia’s only poison center, hosts one of the nation’s largest burn units, and is the comprehensive sickle cell center for the state of Georgia. Grady has one of the top five infectious disease programs in the country and the only behavioral health emergency room and adolescent program in the city of Atlanta.

“These are all programs that everybody else has gotten out of, either because they are really hard or because of the unique people needed,” says Young.

Equality in Medicine

Young sets two guidelines for patient care; equality and compassion. “We’ve treated everybody who walks through the doors for a hundred years now,” he says. “All patients should be treated the same, from the homeless guy under the bridge to the president of the university. No one should know what the payer mix is. No one should know what insurance a patient carries.” Every patient should be treated “as if they were your mother.”

Grady was founded on a strong commitment to the healthcare needs of the underserved and Young believes continuing that commitment is vital. However, he says “you run [a hospital] like a business,” and “you hold people accountable.”

“You teach people what they need to know, you hold them accountable … you give them good projects and interesting jobs. They do those well and then the institution moves forward. It’s easy to attract good people,” Young says. “We’ve been able to develop people here internally. We’ve worked with them and they’ve done more than they ever thought they could do. We’ve also been able to bring in some good people from the outside. It’s a good mix.”

Directing Dollars and Image to Change Course

The biggest challenge, of course, is money. “We see lots of patients and have little cash flow,” says Young. As well, Grady Health System suffers, at least in part, from image issues. Young is working to get the community to reengage with Grady. The area was steeped in poverty, but government programs in recent years have changed the realities that typically go hand-in-hand with low-income neighborhoods. “It’s a pretty nice community now,” says Young. “We have very little crime here and a large security detail to make sure [it stays that way].”

Grady has traditionally been thought of as a hospital for the poor and underserved, and part of fixing the cash flow problem will be changing that image, letting the public know about the high quality programs Grady has and the specialty services the healthcare system provides. “We need to get the word out about what we do well,” says Young.

Upgrading the facility and systems, all the way around, is also a priority for the new president. “The first two rounds of capital were pretty easy to spend,” says Young. Needs were obvious. The 15-year-old cath lab was crucial for suitable cardiology services. Radiology was upgraded from analog to digital. Key clerical needs were addressed. “We were 100% paper,” says Young.

The system joined VHA in order to gain access to comparative quality programs across the country. Young views it as one of the best quality programs out there. VHA provides the quality data to needed to provide benchmarks for Grady services.

“I’m not into gimmicks,” says Young. “The reality is that quality comes from hard work. Look at your day, see what your opportunities are, and face it like a leader.”

The Job of Rebuilding Grady

Young is optimistic about Grady’s future. They’ve already acquired $50 million in private fundraising and their initial goal of raising $125 million seems achievable. Young’s last hospital went from last in the county to the hospital of choice in four years, and he knows that the job of rebuilding Grady Health System is not one to be left to a single man.

“Rebuilding of Grady is everybody’s job,” Young says. “Every man, woman and child in Georgia. Every organization. Every government. Because we serve everybody.”

-by Tracy Million Simmons

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