Florida Hospital Altamonte: Continuing the Healing Ministry of Christ

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Robert-Fulbright-thumbFlorida Hospital Altamonte, a 340-bed community hospital, is the leading health-care provider for Seminole County, located in central Florida near Orlando.

This market is dominated by three health-care systems, each of which has a hospital in the county: Florida Hospital, a not-for-profit organization; Orlando Health, another not-for-profit organization; and HCA, a for-profit health system.

Florida Hospital now owns about 50 percent of the market share, but it has had to fight its way to the top of the pack after a slump in the early 2000s.

Returning the hospital to its mission

Florida Hospital Altamonte opened in 1973 as the first satellite hospital to the system’s main campus. It experienced tremendous growth from 1973 until 2000, becoming known as the “country club” hospital in its community. But after 2000, the hospital began to see key operational metrics flatten or decline.

“This hospital was viewed as the legacy facility, so the system invested $120 million into facility renovations,” said Robert Fulbright, senior vice president and administrator of the hospital. “We began construction on a new emergency department, operating rooms, and inpatient rooms.”

In 2006, Florida Hospital Altamonte unveiled a beautiful new emergency department, with private rooms and bathrooms. The new facility was gorgeous, pulling in the latest patient- and family-centered care elements and using evidence-based design.

During the first three months after the new ED was opened, however, numbers were less than the same three months the previous year.

“Seeing the numbers decline after opening was a kick in the gut to my team and me,” Fulbright said. “We realized that our community wants more than bricks and mortar. They want a different experience. So we returned to our mission statement and began to rebuild our operations.”

Florida Hospital Altamonte is a faith-based organization whose mission is to “extend the healing ministry of Christ.” Fulbright said that focusing on the hospital’s mission creates a different way of looking at the patient experience. Rather than being concerned about regulations, databases, and percentages, staff are focused on making sure patients are receiving the highest quality care to meet their needs.

“When we put that mission statement on the wall, I think that’s all the pressure we need,” Fulbright said. “It doesn’t matter what anyone else tells us we should be doing. There’s no room for mediocrity in a faith-based organization.”

Fulbright and his team chose to reform the newly renovated ED first. They discovered that what patients really wanted was door-to-doctor times under one hour.

At the time, Fulbright said, nowhere in Central Florida could you find wait times under three hours. In February of 2007, Fulbright told the staff that on May 1 the hospital would run ads and billboards promising door-to-doctor times under one hour.

“The staff asked me how we are going to do that, and I said, ‘Don’t know,’” he recalled. “’But you live this every day. You know what needs to be done. My job is to break down barriers that prevent you from delivering great care.’”

On May 1 the hospital hit its numbers and ran the ads. Growth was in double digits, and the hospital experienced double-digit growth for the ensuing three years. The hospital continued to transform the culture, moving into the operating rooms, employee engagement, and patient satisfaction.

Key operating metrics for surgery are now in the top quartile nationally, employee engagement is in the top 15 percent nationally according to the Gallup database, and HCAHPS are in the top quartile nationally and on the rise.

Creating a future of alignment and relationships

The hospital continues to see tremendous growth, and Fulbright said the challenge in the future will be determining how to spend capital dollars as the organization learns what the Affordable Care Act will mean for them locally. Florida Hospital Altamonte is at capacity in the ED, OR, and inpatient beds.

“We are having to spend money to expand, while we stand at the threshold of reform, which I am not sure is going to provide the same volume,” he said. “As a tax-exempt organization, the dollars we make get reinvested back into the community through our facility. It truly is the community’s dollars, and we have to make sure we are being good stewards of the resources we are given.”

Although there is uncertainty with reform, Fulbright is looking forward to changes in the health-care system and feels they are necessary.

“The regulations and the fact that we have politicians now telling us how to deliver health care are a reflection on our industry and what we’ve been in the past,” he said. “We haven’t been good at policing ourselves; we haven’t owned up to our performance.”

But all of that is changing throughout the industry. Florida Hospital’s strategic plan for the coming years has three main components: determining the health disparities in the community and alleviating or meeting those needs; promoting health and wellness; and aligning with physicians and health plans.

Fulbright said in the future, he thinks hospitals will be more like health campuses with a hospital component. The current system doesn’t reimburse hospitals to keep people healthy, but “our mission calls us to do that.” In addition, he said improving alignment with physicians and improving relationships is key to providing better care for patients and the community as a whole.

“We have to take ownership of our industry and our work,” Fulbright said. “We should have the best health care in the world, and it should be cost effective. We can create cultures in our hospitals that develop high-performing teams that will allow us to bend the cost curve and deliver high-quality care.”

-by Patricia Chaney

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