Phoenix Children’s Hospital: Betsy Kuzas, Interim COO & VP Support Operations

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The $588 million expansion project will make Phoenix Children’s Hospital one of the largest freestanding children’s hospitals in the nation. The project will more than double the size of the current hospital, resulting in 1.2 million square feet of space with which to treat and care for the most critically ill children of the southwest. At 344 beds currently, the hospital will have 626 beds by 2012.

“The centerpiece of our expansion is an 11-story tower that allows us to move, as well as grow, our high intensity services including imaging, operating rooms, cath labs, intensive care and our hemophilia program. It’s been a substantial undertaking for the organization,” says Betsy Kuzas, Interim COO and VP Support Operations.

Phoenix Children’s Hospital employs approximately 200 physicians in their medical group. With a Medical Staff of nearly 1,000 physicians, the hospital offers services in more than 40 pediatric sub-specialties, many of which are unique to Phoenix Children’s in the region. “We’re not just managing bricks and mortar in terms of our growth,” says Kuzas. “We have dramatically increased our medical group over the last three years, which improves access to care.”

Creating Effective Growth Opportunities

With approximately 60% of its patients covered by Arizona’s Medicaid program for low-income families, the hospital has absorbed $17.5 million in state budget cuts since early 2008. The pediatric population continues to grow. “This requires us to be very disciplined in how we plan and manage our daily operations, as well as for strategic planning so that we—in light of the economic challenges—can continue to grow,” says Kuzas.

Clinical leadership has worked to reduce length of stay in order to grow admissions and reduce the number of children who are turned away. “We want to make sure that those children that have an acuity level that is best served by a children’s hospital are able to be admitted to a children’s hospital,” says Kuzas. In 2008, they turned away 1400 potential patients. They were able to reduce that number to 800 by the following year and are currently turning away very few children.

“That’s been a real success for us because, again, it emphasizes our role of taking on the sickest kids in our community and caring for them close to home,” says Kuzas. The hospital has recently announced a strategic alliance with Catholic Healthcare West that will result in additional pediatric physicians, nurses, and staff.

Highlights of Expansion

The new facility under construction will move the hospital from semi-private to private patient rooms, a move that Kuzas says will dramatically improve patient satisfaction. Rooms have been designed with families in mind, with ample space for parents and visitors.

“We have focused heavily on sustainability,” says Kuzas. “All the way from our central energy plant through to the finishes in a clinic and in patient rooms … The look and feel will not be high end—we are looking to be an organization that is focused on the investments for the clinical programs and have a sustainable environment for them.”

Many areas of technology will be dramatically increased, as well. Imaging, for instance will move to the new portion of the hospital and MRI capacity substantially increased. Twelve additional operating rooms will be included in the new building. As a cost saving measure, approximately $100 million of the expansion project has been put into what Kuzas refers to as “shell mode.” The structure will be completed, but the interior finishing of some portions of the building will be put on hold until economic improvements make completion feasible. “That has allowed us to take substantial dollars and put them in a holding pattern. We looked at other areas where there was an intensity of dollars through construction as well as medical equipment. Rather than reduce the scope of the project, we put that portion in a shell mode or holding pattern,” she says.

Pre-construction services by an area general contractor, Kitchell, have helped to tightly manage those dollars. “We have continued to refine the design and we have continued to cost it, so we’ve always known where we are relative to budget,” says Kuzas.

Changing into the Premier Regional Pediatric Center of the Southwest

“Part of our culture is to keep that vision out front so that we continue to progress,” says Kuzas. The management teams functions on the idea of embracing change and continually moving forward.

“Change is all around and the discipline with which we’ve been able to approach that change strategically is important, but also from a day-to-day operations standpoint it has been critical. We focus on information… We look for quality indicators to continually measure ourselves against… We also look to benchmarking data to make sure we are able to take advantage of all those efficiencies in technology and/or process,” Kuzas says.

“We flex on a day-to-day basis. Persons coming into our organization are amazed at the amount of tools that we have in place to allow us to understand our overall staffing as well as to project going forward. That has been critical in managing change.

-by T.M. Simmons

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