PinnacleHealth West Shore Hospital Opens in Record Time Thanks to Engaged Team

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Michael-Young-thumbMichael A. Young, President and Chief Executive Officer

by Pete Fernbaugh

Building a new hospital is often fraught with complications, delays, and management woes. However, PinnacleHealth System, based in Harrisburg, Penn., managed to avoid many of these pitfalls with the construction of its West Shore Hospital in Mechanicsburg, Penn.

HCE interviewed Michael A. Young, president and chief executive officer of PinnacleHealth, on May 30, 2014. At that point, the West Shore Hospital had only been open for a week and already its emergency department had achieved its 24-month projection in seven days and the 108-bed, $120-million, 188,000 sq.-ft. facility’s inpatient utilization was at the six-month projection level.

This is an even greater feat considering the entire building—from planning to construction to opening—took 12 months.

Filling four service holes

Young has been with PinnacleHealth for three years. A native of central Pennsylvania, he brought with him an acute awareness of the healthcare needs in the region.

Prior to opening West Shore Hospital, PinnacleHealth already had three campuses and more than 50 additional locations, and the non-profit system had earned a historically solid reputation for high-quality healthcare at a low cost. It led the region in low infection rates, low readmission rates, and high clinical outcomes.

But, Young said, our leadership “knew the day of taking economic risks was around the corner, so a big piece of that was finding the holes in the puzzle where we needed PinnacleHealth services that were focused on quality and cost.”

The management team delineated four service holes that needed filling: its primary-care network, its hospital network, getting its ACO approved by Medicare, and establishing a primary-care center in Perry County, a traditionally underserved rural region north of Harrisburg.

The freestanding West Shore Hospital helped the team fill the first two holes and solved an access problem for patients who used PinnacleHealth’s ambulatory site off the East-West highway.

“Patients who used to come to our tertiary hub from an hour away could now make it to this new hub in 35 or 40 minutes,” Young said.

With the location secured, the management team zeroed in on the timeframe with aggressive targets. Young knew the team’s biggest challenge would be the budget, and PinnacleHealth’s payers were putting tremendous pressure on them to bring the project in at a certain pricing level.

Rigorous negotiations began, and the guaranteed maximum price model was employed. Young remained involved in the contract negotiation process to personally ensure PinnacleHealth secured the ideal contract. The team collaborated with physicians on setting up the operating rooms and catheterization labs. They consulted every location within the system to ensure service lines weren’t being unnecessarily duplicated, and only one set of architectural plans was drawn up, not the usual three or four.

“Our management team really did a spectacular job at bringing in the latest programs in technology at a fraction of the cost of what we’re seeing around the country,” Young said.

Of course, unexpected challenges arose to test the team’s resolve. First, when the project was 70 percent completed, PinnacleHealth realized that operations had to be moved up by 90 days. Without wincing, the team managed to move it up 85 days, having already absorbed the costs.

And second, after purchasing the best patient monitors GE had to offer, the IT team discovered this particular model would create compatibility issues with PinnacleHealth’s other patient-monitoring platforms. By rapidly upgrading the system’s platforms, the IT team swiftly resolved this complication.

The new hospital’s IT infrastructure is now so advanced, West Shore is preparing to introduce Google Glass into its Emergency Department within months, Young said.

In both cases, Young thought the nightmares were going to be longer and scarier. “But it came together in the end. It shows that when you work as a team, you can really make spectacular results happen.”

Taking a hands-on approach

The final two holes in PinnacleHealth’s four-part strategic plan are now almost filled. Its ACO was approved and started operation in partnership with Susquehanna Health in Williamsport, Penn., on January 1. Between the two systems, 38,000 covered lives are in the ACO.

In the fall, PinnacleHealth will be opening a full-service primary-care center, Medical Professional Center, in Perry County, looking to reach an underserved population that routinely ranks 64th out of 67 counties in Pennsylvania for mortality, smoking, obesity, diabetes, and childbirth and cardiac challenges.

Young credits the organization’s rapid progress to an involved and active leadership team.

“We’ve made tremendous strides in three years by being hands-on,” he said.

He also credits an institutional philosophy code-named “Just Ask” for empowering his team to lower costs while maintaining quality.

“Our purchasing people and our facilities people asked contractors, IT companies, and steel companies to provide extraordinary pricing, service, and delivery items. We found out, if you don’t ask, you don’t get it, and people are afraid to ask. But we believe every dollar you save is a dollar you can spend somewhere else.”

The West Shore Hospital came in at a fraction of the price tag usually attached to projects of this magnitude. The $30 million dollars PinnacleHealth saved can now be invested in other projects, such as the new cancer center it will be opening at the West Shore campus in August.

“It’s the philosophy of getting people engaged and getting very clear understanding upfront,” Young said. “It saves a lot of distraction, time-wasting, and confusion down the road by getting the clarity upfront. It saved us hundreds of thousands of dollars on architects and saved us millions on change orders. It got everybody on the same page. And at the end of the process, we opened, and the hospital is almost full.”

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