Pennsylvania Physician-Owned Hospital Experiences Transformative Year in 2013

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Chris-Doyle-thumbChris Doyle, Chief Executive Officer

Chris Doyle joined Physicians Care Surgical Hospital in Royersford, Penn., on March 25, 2013, after the organization partnered with the internationally renowned Rothman Institute. Physicians Care Surgical Hospital was originally founded by community surgeons, including Drs. Larry Feiner and Fred Liss, who were seeking to advance specialty care in the area.

The Rothman Institute itself is the largest orthopedics practice in the Philadelphia region and is highly regarded as the best in the world. Patients from every corner of the globe seek out the services of the Rothman Institute.

After opening its doors in October 2010, the hospital’s first few years were a building period, but with new leadership, 2013 was Physicians Care Surgical Hospital’s most productive time to date, especially in the area of HCAHPS scores.

“Traditional hospitals have other challenges, other focus areas, but we feel because we’re a surgical hospital, that our SCIP measures and our HCAHPS should really beat the top of the pack,” Doyle said.

Expanding its approach to delivering care

Doyle said the organization has numerous projects on its plate right now. For one, the Rothman Institute just opened a new medical building that features an urgent-care orthopedics center, a staff of newly hired physicians, and innovative and new approaches designed to complement the care already being provided.

“The idea is that if a patient arrived at the urgent-care center and needed care we would be able to provide surgery relatively quickly,” he said. “If not the same day, we would provide it in the next couple of days. So it would change our model just slightly. Currently, as a specialty hospital, we’re very scheduled. So we’re able to know our surgical cases in advance.”

Second, Physicians Care is dealing with an increase in volume. In 2013, it received 4,200 surgical cases, doubling the volume it had in 2012. With the new office building, the case volume in 2014 will climb even higher.

These changes have brought in new personnel and new positions, namely the development of a pre-admission testing department and the creation of a role for director of quality and accreditation.

For this position, Doyle promoted from within the hospital after identifying an accomplished nurse leader, Lisa Gill. He also hired a new director of nursing, Tom McLaughlin, and a new director of perioperative services, Michele Mayes. The new leadership team joined Jennifer Ryan, business office manager, who is the most veteran employee of the hospital and provides historical knowledge and continuity.

The hospital saw vast improvement with employee engagement throughout 2013, reaching among the top percentile in the nation.

“The culture has shifted not just with myself and new leadership, but also as a result of the volume and new ownership,” Doyle said. “With [2012’s] volume, there were a lot of inconsistencies with staff scheduling, staff expectations, and the staff feeling of productivity. With the volume we have now and how we’re streamlining a lot of our departments, we’re seeing an improvement in this area. We’re seeing staff that feel more satisfied, feel more productive, and feel more accomplished by the end of the day.”

Increasing volume and improving technology

Doyle would like to accomplish several goals in the next year. For one, he wants to increase orthopedic services by 45 to 50 percent of the current volume. He is also working to create more inpatient stays than outpatient.

He added that Physicians Surgical Care would like to bolster its existing EHR with improvements such as scanners for patient wristbands and an advanced platform that would allow them to integrate with local physician practices. He is exploring the possibility of bringing on a general surgery practice located to the southwest of the facility and would like to offer vascular surgical services.

Overall, though, he believes his first year has been marked by the financial success the hospital has experienced. Last year, Physicians Surgical Care was challenged financially and was desperately trying to be successful with outpatient cases. Coordinating with the Rothman Institute and the founding surgeons, 2013 proved to be a transformative year for Physicians Care Surgical Hospital.

“There was a lot of change that occurred last year and change is difficult for most people,” Doyle said. “The initial impact left some staff members wondering how the hospital would be impacted by these changes. When I and my leadership team arrived, we embraced a lot of those changes and when the staff were able to recognize the excitement behind bringing on new surgeons and learning new techniques and having brand-new instrumentation and the commitment basically that not only the leadership team, but also the new orthopedic surgeons have for the hospital, the staff themselves were very excited by this.”

Currently, physician-owned hospitals are not permitted to expand with additional operating rooms or in-patient beds. The problem here, he said, is legal with certain laws regulating the growth of physician-owned hospitals. More recent laws have favored other models in hopes of encouraging larger accountable-care organizations and preventing physicians from scheduling cases at hospitals that they own themselves.

In response to the current environment, Physicians Care Surgical Hospital is now eyeing potential expansion through the creation of a surgical center. In addition, other health systems have asked to tour Physicians Care Surgical Hospital after recognizing that better patient outcomes and satisfaction can be achieved using the specialty service model. Doyle sees partnerships as an opportunity in the future to approach the accountable-care organization model.

“I think the immediate political climate is probably not going to permit those laws to change,” he said. “I think that long-term, pendulums tend to swing, though. And when we look at the data, among the top five hospitals in the Philadelphia market are physician-owned hospitals. Our counterpart, Rothman Orthopaedic Specialty Hospital in Bensalem, is also affiliated with Rothman Institute and is among the top five. Also the Surgical Institute of Reading is physician-owned and near the top of scores.

“So we’re hoping that at some point we as a society see the value in physician-owned hospitals.”

by Pete Fernbaugh

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