Larkin Community Hospital: Sandy Sosa-Guerrero, CEO

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Being surrounded by large tertiary-care hospitals would be a challenge for many community hospitals. Larkin Community Hospital in South Miami, however, not only has a thriving patient base, but is also performing better than many of its competitors in embracing innovation and benefiting from several healthcare reform initiatives.

“We provide excellent clinical care,” Sandy Sosa-Guerrero, CEO, said. “Our patients come here because we are able to provide comprehensive care with an emphasis on coordination of care throughout the continuum of care. We value working with our physicians and community partners to ensure that patients receive evidence-based recommended care in a safe and comfortable environment.”

Focus on innovation

Larkin is a 142-bed acute-care hospital offering medical and surgical services in addition to comprehensive outpatient, rehabilitation, and diagnostic services. Larkin has remained financially sound and has consistently been ranked as one of the most cost-effective healthcare providers in South Florida.

Most recently, the facility has added a state-of-the-art PET CT and angiography unit in the main hospital building. Larkin has also made a $10-million investment in a new neurosurgery center that will contain the most advanced radiosurgical capabilities, especially with the installation of a Eleckta Gamma knife unit, along with the latest MRI and PET CT technology.

This state-of-the-art facility has been designed utilizing the most advanced technique in healthcare design to facilitate patient flow and care efficiencies.  It will be headed by world-renowned neurosurgeon Dr. Aizik L. Wolf who treats patients from all over the United States, Latin America, and Europe.  His extensive skill and expertise in gamma-knife surgery has led to this minimally invasive procedure being performed on an outpatient basis with the patient experiencing minimal hospital time and extremely fast recovery time.  These services will further augment existing programs in arthritis and pain management as well as newly developed cancer center.

As part of its focus on innovation, Larkin has also embraced many of the initiatives set forth under the three-part aim directives championed by the Center for Medicare and Medicaid Services (CMS).  Under the “triple-aim” approach, improving the U.S. healthcare system requires the simultaneous pursuit of three aims–improving the experience of care, improving the health of populations, and reducing per-capita costs of healthcare.

One of the first triple aim-related initiatives completed by Larkin was the full implementation of electronic medical records. Larkin was also an early volunteer for the Joint Commission’s Project RED (re-engineered discharge), a pilot project to improve discharge procedures and reduce readmission rates. This collaborative allowed the hospital to experiment with various approaches in order to find effective ways to bring about change in the hospital rate of readmission.

As results formed and processes were redesigned, follow-up nursing and resident visits were implemented, as well as strong case-management coordination of aftercare services. About 20 percent of Medicare patients are readmitted to the hospital within 30 days nationally with rates in Florida averaging 23 percent. The program hopes to reduce that number through these discharge planning and education strategies. Initial data indicates that these efforts have led Larkin Community Hospital to an initial reduction of  readmission rates by 10 to 20 percent.

Focus on education

Another focus of the facility has been its commitment to post-graduate medical education. Larkin has implemented a graduate medical education program in partnership with NOVA South Eastern University (NSU) and developed residency programs in family medicine, psychiatry, podiatry, internal medicine, and neuromusculoskeletal medicine.

Additionally, residency programs in dermatology and palliative care have recently been granted approval while several other programs are in various stages of the approval.  Through this rapid expansion of its graduate programs, Larkin expects to become a statutory teaching institution within the next couple of years.

“We want to train the next generation of physicians” Sosa-Guerrero said.

The Department of Health and Human Services recently awarded a Health Resources and Services Administration (HRSA) grant to Larkin Community Hospital and NSU’s medical school. This five-year federal grant will help educate medical residents to provide expert care for patients living in rural and underserved communities. The HRSA grant will be used to develop training programs for NSU’s College of Osteopathic Medicine’s affiliated medical-residency program at Larkin Community Hospital.

Furthermore, the HRSA grant will create curriculum and clinical training in medically underserved communities, which include rural and urban areas where physicians and medical services are scarce.

The funds will also be used to develop training in other areas such as all-hazards preparedness, genomics, and medical informatics. One of the grant’s goals is to encourage more primary-care residents to become practicing physicians in these underserved areas.

Focus on partnerships

Another strength of the facility is the strong relationships it shares with its community partners, which include three Federally Qualified Health Centers (FQHC) and a network of community clinics that offer comprehensive primary and specialty care.   The FQHC benefit greatly from having the hospital residents rotate through its sites to augment the medical care provided at the clinics, while the hospital has a more extensive network to provide care and support to its patient base and the community.

The three FQHCs in the hospital network–Helen B. Bentley Health Center, Borinquen Medical Centers of Miami Dade, and Miami Beach Community Health Center–have expressed great satisfaction with the support they are receiving from the program as they are able to offer their patients access to specialist and other hospital-based programs and services.

Larkin is also establishing Wellness Centers in partnership with the Miami Dade County School System, the Children’s Trust, and the University of Miami School of Medicine. These centers will provide comprehensive services in family medicine and behavioral sciences for underserved students, their siblings, and their families, as well as additional educational opportunities for the residents.

Focus on the future

With its emphasis on innovation, education, and community partnerships, Larkin Community Hospital is well-positioned to benefit from the changes expected in the healthcare arena.

Larkin’s leadership team has focused on embracing and adapting to this change by maximizing opportunities to engage with other partners in collaborative and mutually beneficial partnerships that improve quality and patient care throughout its community.

-by Patricia Chaney

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