Plaza Medical Center of Fort Worth: Greg Haralson, Chief Operating Officer

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Plaza Medical Center of Fort Worth has been in operation since 1974. For the past ten years the 320-bed hospital has been in the process of reinventing itself based on five major service lines related to cardiovascular, neuroscience, orthopedics, oncology, and specialty surgeries. Plaza has been recognized twice as a “top 100” heart hospital in the nation. It is the only hospital in the southwestern United States to have a hip and knee replacement programs certified by the Joint Commission.

“We have a relatively small emergency department—about 16,000 visits a year—although 42% of our ED visits end up needing an admission,” says Chief Operating Officer, Greg Haralson.

End of Renovation and Continued Initiatives

When Haralson first arrived in December of 2005, the organization was in the middle of a $100 million renovation project. That project was completed last year, and included six additional operating rooms, as well as the complete renovation of all the existing rooms. “We did all this while maintaining existing operations in all those areas, as well as the entire hospital while we renovated each floor and moved patients to different to areas. As well, we expanded the lobby and completely renovated cafeteria. All of that happened while continuing operations. From day-to-day, maintaining the flow of everything proved to be quite a challenge,” says Haralson.

Now, among other things, Haralson is turning his focus to emergency department initiatives. “I think many of the folks you talk to have the same situation in terms of patient flow and making sure patients aren’t in holding too long in our emergency department and that those who  don’t need admittance are moving through the system quickly and getting back to their homes and families as soon as possible,” he says.

Plaza has set a goal of 130 minutes turn around time for each patient who enters the emergency department. “We’ve had quite a bit of success, but at Plaza we have a significant hill to climb,” says Haralson, “because of the number of patients who get admitted and those specialty services that drive a lot of admissions from the operating rooms and from the cath labs to our beds. There is a lot of demand for beds here at Plaza. That’s my biggest challenge this year, to really improve the through-put and flow of our emergency department.”

Refreshing Technology

Alongside the structural renovations, the hospital has been investing in technology upgrades. An electronic medical record is in place, though it is not yet being used for physician order entry. “We have a seasoned medical staff and they’ve been a little bit slow to adapt to technology as far as signing off on records,” says Haralson. “But they are working very well through the patient care aspects of it. That has been a positive for us.”

New generator and the switch-gear necessary to go with that have been added. They modernized the elevators, as well. “You don’t see a lot of return on those types of things, but you are certainly glad you work for a company that is willing to make those investments. It keeps us moving, keeps things flowing.”

An Employee Sense of Ownership

The path to becoming a Magnet Hospital has proven extremely positive. “The nurses began to take pride of ownership in their jobs,” says Haralson. “That was going to happen whether we achieved the magnet designation or not. Just heading down that path transformed our organization. It was a very tangible element, gave us a sense of empowerment. The best hospitals have the best nurses and this really became an easier hospital for which to recruit nurses. It is easier to find critical care nurses because the climate and the culture are conducive to nurses wanting to be here.”

If staffing continues to be a challenge, Haralson says the difficulty lies in finding the right balance. “How many folks do we need in the organization at any given time?” he says. “When you look at 40 to 45% of your overall dollar being spent in staffing costs, you have to make sure you always have your eye on that ball.”

“My philosophy has always been that if I’m serving those who serve the patients, then we are going to be in the right frame of mind. We’re going to have the right things we need, the supplies we need, the staff we need, the physicians we need,” says Haralson. “If I’m actively listening to what their needs are, then we are going to meet those needs.”

-by T.M. Simmons

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