Piedmont Fayette Hospital: Michael Burnett, COO

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Piedmont Fayette Hospital, located in Fayetteville, Georgia, has seen tremendous growth since its opening in 1997. For the past thirteen years, the hospital has grown from 100 beds to 143 and has filed with the state to get an additional 14 beds.

The hospital has been focused on meeting the needs of its rapidly growing community, adding multiple services, and is now moving toward improving efficiency.

“I believe growth can hide a lot of flaws,” said Michael Burnett, the hospital’s chief operating officer.“Our goal now is to improve upon operations and efficiencies.”

Going through rapid growth

Piedmont Fayette Hospital is a not-for-profit community hospital and is part of a larger Piedmont Healthcare system of four hospitals. Since 1997, the hospital has added a cath lab and obstetrical services, as well as obtaining a daVinci robot.  The hospital also began offering an interventional cardiac program. All of these services were previously not available in the community.

Most recently, in 2010, the hospital opened a cancer center with the first linear accelerator in the county. The cancer center was a major initiative for the hospital, and took a patient-centered approach with a goal of treating the patient’s whole experience in dealing with the disease, while still providing state-of-the-art care. The cancer center includes a wellness component that offers nutrition classes, cooking demonstrations, yoga, a library and support programs for the community.

“In the past, particularly in cancer care, we have always taken good care of our patients clinically, but not always in terms of the whole experience, addressing what they are going through with cancer,” Burnett said. “So that is why we opened the wellness center, which we were able to do through philanthropic support. It has been rewarding to see how patients and the community are responding.”

Improving efficiency

With the fast growth Piedmont Fayette has experienced, the hospital is now working to improve on efficiency.

“We have been focused over the past few years on “Lean” and trying to look at ways to eliminate waste in our processes,” Burnett said. “We have done this with emergency department patient flow, admission flow on the units, and we‘ve seen some great success in these areas with staff participation in the lean projects.”

Burnett said the hospital has also teamed up with Medassets to evaluate supply chain management, which is also seeing improvement.

Healthcare reform is also a constant concern when evaluating efficiency. “We are focused on what healthcare reform means,” Burnett said. “One initiative is finding ways we can breakeven with Medicare cost coverage, which we currently lose on. That’s part of becoming more efficient. We try to address what’s happening with reform, but not at the expense of our patients and employees.”

Another aspect to efficiency is technology. Piedmont Fayette has fully implemented CPOE and electronic charting. The hospital is evaluating how to invest in a fully integrated system to be more connected with physicians and the organization.

“We are looking at ways to integrate electronically with employed and non-employed physicians, primary care physicians and specialists, as well as with our sister facilities,” Burnett said.

Changing the physician relationship

In light of growth and healthcare reform, Piedmont Fayette is facing a changing environment with physicians and trying to find the best relationship.

“We are team oriented within the system and hospital,” Burnett said. “Our initiatives are often physician led; each quality team has physician representation. But with reimbursements being cut, we are looking at ways to partner and do business with our doctors, whether through management models or employment.”

This is a common challenge in many hospitals, and Piedmont Fayette is working through challenges in physician relationships, all within the scope of healthcare reform. Employment models have worked in some areas of the hospital.

“Probably the best example we have right now is all of our cardiologists at the Piedmont Heart Institute are employed,” Burnett said. “We have seen some great alignment as far as supplies and quality initiatives. It was tough to get to that point though, and it took a lot of negotiation and cooperation.”

He also cautions that what works for one specialty may not necessarily apply to another. The hospital always works to stay transparent, looking at these decisions with physicians and working on things as a team.  Burnett also said that the hospital has seen more requests for employment from physicians, developing those models will be an ongoing opportunity and challenge for the hospital.

-by Patricia Chaney

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