Dallas Medical Center: Raji Kumar, President and Chief Executive Officer, and John Beall, Chief Nursing Officer

by HCE Exchange on October 9, 2013

Raji-Kumar-thumbNearly four years ago, Dallas Medical Center, a 155-bed hospital with four medical plazas located in the suburb of Farmers Branch just north of Dallas, Texas, was struggling to stay alive. It was losing money at a rate of $2 million a month and was on the brink of closing its doors.

In late 2009, a private investor, determining the hospital was too valuable an asset for the community to lose, brought in a management company, PSG, to orchestrate a major turnaround of the facility.

This turnaround, led by Raji Kumar, president and chief executive officer, would transform Dallas Medical Center into an efficient, quality-driven healthcare organization

Regaining the trust of staff and physicians

With a background in hospital turnarounds, Raji’s first priority was to involve herself in the day-to-day operations of the physicians and staff, making herself accessible to them and working with both to facilitate a plan that would refocus the organization’s mission.

She said their input on what was working and what was not working in the past was invaluable in accomplishing her first goal of stabilizing the workforce and attracting physicians back to the hospital.

“A hospital turnaround is not a sequential process,” she said. “You have to have many irons in the fire. But first is visibility. People need to know they have a leader, that you have a plan, and that we can get out of this, but we have to work together.”

In three years, she has recruited more than 100 physicians, including program directors with a reputation for quality. Recently Raji brought on John Beall, chief nursing officer, someone she said exemplified the qualities desired in her leadership team from his first interview. For one thing, Beall had grown up in the community and as a result, took the hospital’s quality of care personally.

“This is my community’s hospital. I live just up the street, so if I were to become ill, this would be where I would be taken,” he said. “And I want to make sure, if for no other reason than a selfish one, that good care is provided here. I have a vested interest in this hospital’s success.”

With individuals like Beall on her team, Raji had confidence about Dallas Medical Center’s future.

“It was great to know that we had a team motivated to see this place survive,” she said.

Redefining the hospital’s place in the community

In addition to stabilizing the workforce, an integral part of Raji’s strategy was the reevaluation of service lines. Dallas Medical Center had been seeing abysmal census numbers, maintaining an average census of 17 and performing only 50 to 70 surgeries each month.

A decision was made to institute three new service lines: spine, orthopedic surgery, and a workers’ compensation program. These new service lines led to a significant increase in volume, and the hospital now performs nearly 400 surgeries a month.

Rebranding and renaming the facility was another crucial step, not only in determining who the hospital was, but also in reintroducing it to the community.

“The hospital had gone through an identity crisis, so we had to rebrand,” Raji said. “It has taken about three years for people locally to call it Dallas Medical Center.”

Another important component to her strategy was community outreach. Beall said the medical center has cultivated a presence at most community events, including functions held in neighboring cities.

“We are involved in the Chamber of Commerce [and] on boards of civic organizations,” he said. “We have connectivity with ambulance services and paramedics, and we are about to forge a relationship with a nearby nursing school. Connectivity with the community is integral to the hospital’s success. We’re going to expound on that even more. ”

Reducing costs and improving alignment

Dallas Medical Center had several major issues that led to its financial struggles, Raji recalled. For example, the real estate had been owned by Metrocrest Hospital Authority for more than 30 years, but the operations of the hospital had been leased by several different companies that were not really interested in the physical plant.

“The land was owned by a different entity; operations were owned by yet another entity, and when they decided they were not going to renew their leases, there was no more investing in infrastructure,” she said. “A lot of things slipped through the cracks as a result of those two interests not aligning.”

Since coming aboard, Raji has made huge strides in reducing overall costs and has renegotiated all managed-care contracts, which is something that had previously been pushed aside. Raji also knew that partnering with a larger health system was going to be key to the hospital’s long-term survival.

“I knew six months into the job that we were going to need to be part of a bigger system,” she said.

Dallas Medical Center approached many larger systems, and in late 2012, Prime Healthcare Services acquired the hospital.

According to Raji, “Prime Healthcare picked us up based on the efforts of our team and we’ve shown we are survivors, as well as examining the market and seeing that we have a future here.”

With the acquisition, Dallas Medical Center is now moving beyond “survival mode” and into “growth mode.” Raji said the past year has been spent recruiting talent and assembling a unified team for moving forward, as well as focusing on finding the proper balance between quality and cost effectiveness.

Looking forward, the organization plans to invest about $16 million into updating infrastructure and equipment.

“Making every decision in the best interest of the patient is the key,” Beall said. “It’s somewhat of a buzzword in our industry to say that, but it can’t be overemphasized. We really have to stay focused on what is right for our patients and that means having the right people providing the care, the right leaders overseeing those who are providing the care, and the right equipment. Everything that involves that patient’s experience needs to be centered around what is in the best interest of the patient.”

For her efforts at Dallas Medical Center, Raji was recently recognized as one of the 120 Women Hospital and Health System Leaders to Know by Becker’s Review.

“We need to run the hospital right to stay alive for the community,” Raji stated. “If we are not responsible business leaders, we can’t take care of the community and patients, because we won’t be there for them.”

-by Patricia Chaney and Pete Fernbaugh

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