UMass Memorial Medical Center: Dr. Walter Ettinger, President

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The hub of healthcare for central New England is UMass Memorial Medical Center, a three-campus organization with 781 beds located in Worcester, Massachusetts. They partner with four other community hospitals under the name of UMass Memorial Health Care. They are also the primary teaching hospital for University of Massachusetts Medical School.

“We have about 550 residents and fellows and about 450 medical students,” Dr. Walter Ettinger, president of UMass, said. “We are also a teaching site for a number of other programs. We have about 1,000 nursing students come here every year for their clinical rotations from schools all around the region.”

The hospital is a level one trauma center for both pediatric and adult patients. They have a level three neonatal intensive-care unit. As well as being the tertiary care center for the area, they are a community hospital providing about 60 percent of the care within the region.

A Focus on Integrated Care

Care at UMass begins when an ambulance first picks up a patient.

“We coordinate that care for heart-attack victims and stroke victims and others right through to the time they are discharged to rehabilitation services,” Ettinger said. “That’s one of the things we are most proud of–our integrated care models, our clinical integration and the quality it has achieved.”

Even though UMass Memorial is an academic medical center, their highest priorities are better care for patients and the improved health of the community.

“We put the needs of our patients first,” Ettinger said. “We view our success as a combined enterprise and not as the work of individual entities.”

The UMass heart and vascular program includes other hospitals in the region as well as their own medical center. They are number one for heart-attack survival in the state of Massachusetts and number five in the country.

Leading Healthcare Reform

The state of Massachusetts has been at the forefront of the health-reform movement, even before it was nationwide. As a state, they have achieved almost 97 percent coverage of their population.

“The recession hit and that really drove home the point that we need to get costs under control,” Ettinger said. “The financial healthcare crisis isn’t a function of coverage; it’s a function of the recession, and in the face of that recession we are looking at ever-increasing costs. I would say people across the aisle, although this is a blue state, support what we are doing and are still enthusiastic about what Massachusetts has done.”

As the state began making changes that are now being asked of hospitals across the nation, they have remained in the top five in almost every category of healthcare in terms of access and quality of care.

The business model of healthcare is changing, however, and Ettinger said that pay-for-service will soon be a thing of the past.

“I believe it is a permanent change, and I believe it is transformational change,” he said. “The focus is largely economics. The country just can’t afford this anymore.”

Empowering the Employees

“I am really excited about using the lean process to take the waste out,” Ettinger said. “The reason I get so excited about that is it involves the people really doing the work. One of the things that I think is absolutely necessary is to have a really committed and engaged medical staff and professional staff. One of the ways to do that is to give our doctors, our nurses, our pharmacists the power to go home and say to their spouses, ‘I have the power to improve the care, and I have the power to make this a better place to work. I can affect change.’ Lean is a great way to do that.”

As an example, UMass recently had a luncheon celebrating a reduction in waste for their trauma team. Two members who work in the trauma registry had been reviewing their processes and went to the supervisor with a report that they’ve been doing since 1991.

“It takes each of us half a day to complete it,” they reported. “We don’t think anybody actually looks at it anymore.”

“I think one of the key things is to get close and just admire and respect the people who really do the work, the folks who are taking care of the patients and those who support them,” Ettinger said. “I’ve always said we’re a team organized around the patient and everybody should know what their path to the patient is. For the doctors and nurses, that’s easy, but if you’re an IT person or a finance person or a house cleaner, what do you do that really enhances that patient experience? I think it’s important for people to recognize that they are performing extraordinary tasks in your organization every day. You’ve got to keep remembering that. It is the key to everything.”

-by T.M. Simmons

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