By: M. Diane McCormick; Photography by Alan Wycheck
Mid-point in his career, Michael Young says he took the safety net hospital Erie County Medical Center in Buffalo, N.Y., from a struggling facility to a financially stable force in the community. A few years later, he took Atlanta’s Grady Health System – in Young’s words, “the neediest hospital in America,” also county-run – from losing money to a viable, healthy system.
“If you serve the patient better, the financial stuff will improve along with that,” he says. “There’s a lot of MBAs who try to run health systems like businesses. If you run them like the Mayo Clinic, you’ll make money. You’ve got to stay focused on the patient and the care you deliver, and the bottom line will follow.”
PinnacleHealth’s president and CEO since June 2011 summarizes his philosophy by pointing to a little plaque on his desk: “Rule No. 1, the patient is always right. If the patient’s ever wrong, reread rule No. 1.”
Young is a York County native and University of Pittsburgh graduate who earned his hospital-administration credentials in a sort of transformational role – helping to revamp Pittsburgh’s Shadyside Hospital, Lancaster General Hospital, Erie County and Grady before returning to central Pennsylvania.
“I didn’t really know that much about PinnacleHealth, and what I’ve found is overwhelmingly positive,” he says. “The clinical quality is spectacular. The doctors really want to stay on the cutting-edge. The nonphysician caregivers are spectacular. The ability to work together is atypical compared to other places where I’ve worked.”
Once again, Young leads a health system in transformation, as PinnacleHealth remakes its Harrisburg and Lower Paxton Community General campuses and builds a new, 100-bed hospital in Hampden Township.
What did you find when you got to PinnacleHealth?
At Lancaster General and Grady, we spent 85 percent of our time focusing on clinical outcomes and patient waiting times and infection rates (measuring the process of how care is delivered). The good news here is that PinnacleHealth was doing a lot of those things well before I arrived, although maybe just not fast enough. Our patient satisfaction scores are way up. Our infection rates are way down. Our re-admission rates, which were good before, are down, so all of our quality trends are at national standards.
Why is PinnacleHealth growing?
The foundation for the plan is called Vision 2017. It’s about patient-centered care. When you buy a car, you don’t buy tires at Goodyear, and go to Toyota and get an engine, and call GM for a frame. Isn’t that what health care is like right now, where everything is disjointed? That’s not a good service model. When we form our plans, we talk about serving the patient and are moving forward with patient-centered care. Vision 2017 is really about integrating care delivery. The systems that are integrated have much better outcomes and much higher patient satisfaction, and they can attract the best clinicians in the world.
“If you take the $100 million and depreciate it over 25 years, that’s $4 million a year.”
What goes into integration?
We were named a most-wired hospital in Hospitals & Health Networks magazine because of the comprehensiveness of our electronic medical records. Say your pharmacist sees your drug interactions and calls the doctor to say they could cause a reaction. In our new system, that would happen automatically. In the old system, your pharmacist would find out after your family member has called saying you’ve passed out. We’ve also partnered with Heritage Medical Group to come into the system, to build this integrated system of primary-care physicians, because they’re the ones who are the patient facilitators, and we didn’t have enough primary-care doctors or enough sites. We brought in Tristan Associates, a well-known imaging provider, for the same reason. In order to be patient-centric, the physical structures need to be built for the patients. You need to have access to a primary-care facility within 10 minutes of where you work or live, or you won’t go. You need to be within 20 minutes of testing facilities. To truly integrate care, we need to make sure the patients in our system stay in our system, so we need to have acute inpatient capacity within 30 minutes of everybody.
But why build more facilities?
We need more bed capacity. Most people have forgotten that we’ve already taken 550 beds out of service over 15 years. Remember Seidle hospital? It’s gone. Polyclinic, it’s not inpatient acute anymore. Harrisburg Hospital, we’ve taken about 80 beds out of there. Now, our capacity is full. I could build the new hospital in downtown Harrisburg, but it’s $550 a square foot. Or I can do it at the new hospital for $280 a square foot.
The patients want the convenience. It’s half as expensive. We’re running out of capacity downtown, so downtown we’re keeping the tertiary high-end services that people will drive for, and spending less money getting close to the patients. If you take the $100 million and depreciate it over 25 years, that’s $4 million a year.
Can “convenience” be overblown, when we can hop in a car and drive anywhere in 10 or 15 minutes?
Not really. I went to a major hospital to visit a golf partner, and it was an 18-minute walk from the parking garage to the hospital. I’m 56. I’m healthy. I was glad to do that, except it was 101 degrees, and it was 22 minutes back because it was uphill. My mother-in-law, who was staying at my house, wouldn’t have been able to visit a friend under those conditions. Where you don’t have an integrated system, you have what we have today, which is the disintegrated system, with the high costs, the re-admissions and the expensive retesting.
The value to the patient is that the new hospital is being built from a green field. We’re not compromising on the number of elevators. We’re not compromising on space. We’re not compromising on layout. A new hospital is way better, way cheaper, more patient-centric and better clinically because you don’t have all the compromises.
Will the new facility be easier to navigate than Fredricksen Outpatient Center?
It will be a lot easier than Fredricksen. The signage at Fredricksen is being improved. I don’t disagree with you. It’s a little complex.
Do the system additions put PinnacleHealth in direct competition with Holy Spirit and Carlisle?
We’re not focused on competing; we’re focused on the community and the patients. Staring at your competitors takes your eyes off your patients. It’s not a good way to do business. If you focus on your customer – in our case, patients – competition works itself out. We deliver our clinical services and meet patients’ expectations.
But isn’t that a factor in calculating demand?
There’s very little duplication. It’s meeting community expectations at a slightly different site. When we built the health campus at Lancaster General Hospital in 1989, there was a lot of discussion about competition, but at the end of the day, it was really about a new way to deliver service. The doctors’ offices that used to be in little-converted houses with no parking were replaced by doctors’ offices that were laid out the way they wanted, so the doctors became 25 percent more efficient. That made patient care more efficient. That’s what Vision 2017 will do on the East Shore, West Shore, and downtown. It’s a pretty comprehensive plan – once again, built around the patient.
I hate to sound redundant, but that’s what we talk about all the time.