Richmond University Medical Center: Michael Breslin, Chief Executive Officer

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Michael-Breslin-thumbMichael Breslin has been serving as Richmond University Medical Center’s chief executive officer for over a year, having become the organization’s acting CEO last September, then accepting the role of permanent CEO earlier this year.

He had previously served Richmond as executive vice president and chief financial officer, roles that left him acquainted with the business side of running a 510-bed organization, but not necessarily acquainted with the practical side of care delivery.

For this reason, when he was appointed CEO, he made it his chief goal to step away from the financial functions of the organization and become more familiar with its day-to-day functions.

“There’s a certain mindset change in terms of focusing on quality, physician alignment, and expansion as opposed to reporting numbers and looking at budgets and in trying to realign my thinking to be more strategic in nature as opposed to financial,” Breslin said.

He began making regular rounds within the units—environmental rounds, patient-safety rounds, patient-satisfaction rounds—allowing himself to be present on the floors and available to the patients and staff.

“In the finance role, you’re trying to put together reports and you’re analyzing data and you’re reporting to department heads, but probably not doing patient and physician interaction to the level a CEO is,” Breslin said. “It was just making sure I was more available and interacting more with our stakeholders.”

What he discovered was an organization confident in the care it provides and in its role as one of only two hospitals on Staten Island, which has over 500,000 residents, no public hospital, and is the only New York City borough to have no health and hospital enterprise in the area.

Richmond University Medical Center, therefore, plays a pivotal role within its community.

“There’s an absolute need and there’s a whole county of patients that otherwise may have been serviced by the public hospital and other boroughs,” Breslin said. “We want to make sure they are getting the world-class care they deserve.”

Making expansion and investments top priorities

Richmond University Medical Center is looking to expand in all areas. The organization has added capacity to its sleep center and is striving to be a pulmonary center of excellence by making its pulmonary offerings more cohesive.

Its pain-management center is first-rate, as is its wound-care center, but most people on the Island seem to be unaware of the latter’s presence, Breslin said, so Richmond is consulting with physicians and other medical professionals on ways to aggressively market the program.

U.S. News and World Report recognized Richmond’s state-designated stroke center for the outstanding outcomes it has produced, and Richmond has added more monitoring equipment in its ER, as well as designating more beds for stroke and epilepsy.

Breslin said the center opened its new cath lab in October of this year, and the organization was prepared to focus on asthma, diabetes, and cardiac care in the near future.

Furthermore, its clinical affiliation with Mount Sinai Hospital is helping Richmond grow these and other programs, and the center is hoping to harness Mount Sinai’s clinical prowess to great benefit on the Island.

Richmond has also made major investments in IT infrastructure and has met Meaningful Use Stage 1 and anticipates Stage 2 certification in late 2013. In April, Richmond went live with computerized physician order entry (CPOE), and a partnership with Meditech has yielded a proficient IT platform within the center, while eClinicalWorks has linked its physician offices and outpatient clinics.

“Staying ahead of the curve from a technology standpoint, whether it’s clinical technology or data technology, is just critical,” Breslin said.

A renewed focus with greater communication

If healthcare reform has done anything, Breslin said, it’s prompted his medical team to be more aware of outcomes and preventable quality indicators.

“I think that’s a long overdue focus of hospitals,” he said. “It’s got us looking outwards as opposed to inwards.”

Richmond has partnered with local federally qualified health centers to see what they can do together to ensure community needs are being met. The Affordable Care Act has increased the communication between hospital executives and medical professionals as both strive to understand the factors behind readmissions and certain outcomes.

“For the first time in a while, we’re having a much more open, collaborative dialogue with doctors and payers about how to do things together that will make the community healthier,” he said. “Certainly alignment is important. I think doctors are starting to see how challenged the environment is. They are starting to ask the question of where they fit in to the new world order, if you will. I think the more progressive-thinking ones are realizing that collaborating and partnering with the hospitals to provide the best care, the needed care in the needed areas for the community, is the best strategy.”

He added, “We just want to reverse engineer. If we’re not at an expected level of outcome, why and what is it going to take to get us there?”

A future in which alignment is king

In the coming years, Breslin and Richmond are looking to align with a premier academic center or health system. It is Richmond’s belief that standalone hospitals will not be the ideal model for the reform era.

As they await the best fit, Breslin said he and his team are continually improving both the administrative and patient sides of the house. He wants to evolve into an institution that’s reflective of an environment in which populations are managed more effectively and more diligently.

“We want to be more of an institution that has a presence in the community and especially an institution that provides services in the areas where right now the objective measures would suggest are lacking,” he said. “We want to be that smaller outpatient-minded institution, but when patients show up at our door for an emergency or inpatient services, they’re getting high-quality efficient care that patients are pleased with and that pleases payers to have us in their networks.”

-by Pete Fernbaugh

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