Enloe Medical Center

Source: Healthcare Digital

Date :8/1/2007 9:02:20 AM

Enloe Medical Center has avoided merging with larger healthcare organizations in order to maintain its history of strong and community focused care.

Written and produced by James Buchanan & Thomas Venturo

Though they have long been considered to be in a unique industry, healthcare providers have not been immune to the trend in other industries of larger companies gobbling up smaller ones.

In the world of healthcare, says Jim Hauenstein, CIO of Enloe Medical Center located in Chico, Calif., there are only a few unaligned community hospitals remaining.

“There are not a whole lot of not-for-profit hospitals that have not merged with the large hospital systems, and we are one of the few remaining stand - alone community-based hospitals,” says Hauenstein. “Large systems such as the Kaiser Foundation Hospitals and Catholic Healthcare West have purchased a number of hospitals over the years, and have since become very large hospital systems.”

Enloe Medical Center was founded in 1913 by Dr. N.T. Enloe, when he opened the original hospital for North Valley residents. According to Enloe’s website, the first operation conducted at the site was to pin a broken hip with a two-penny nail.

In 1937, the hospital moved to its current location on The Esplanade in Chico, where today it is the region’s most comprehensive medical center, with 391 licenses beds serving 400,000 residents in six adjacent counties.

“We are the only hospital in Chico, and we are growing as a result of the growth of the community,” says Hauenstein. “We are also the largest employer in the community.”

According to Hauenstein, the fact that the hospital proudly remains locally - governed is an important asset to the quality of care it provides.

“Since we have not merged into one of these other systems, we have a number of advantages because we are not controlled by a large system,” he says. “We can design our programs to fit specific needs in the community we serve, rather than have a larger and more distant group make the decision that a service isn’t needed.

“You can control and manage the quality of care you are providing. As an independent hospital we are still governed by Federal and State government regulations such as Joint Commission, OSHA (Occupational Safety & Health Administration) and OSHPD (Office of Statewide Health Planning & Development) plus CMS (the Centers for Medicare and Medicaid Services). Health care is not like being a bank where the standards can be the same across an industry. In a hospital, the needs of patients are not always the same. The key to delivering quality patient care is meeting and exceeding the standards for delivering quality care. The standards are the same; it is the processes that an organization implements that make the difference in the delivery of quality care.”

Hauenstein adds that as healthcare becomes far more complex, as regulations governing the industry evolve, developing the policies to meet those regulations can more easily be done in a standalone environment.

Further, good executives need to build a strong clinical team that includes physicians and nurses and has the support of local community leadership. An independent hospital that is rich in these kinds of resources is well positioned to create a strong, quality-driven health care provider that is immune to acquisition by a larger health care system.

However, there are challenges that come with independence directly related to the need to integrate the latest technology iterations, and to meet the growth in population in the surrounding community.

To grow the facility, Enloe is in the process of an expansion to its facility titled the Enloe Century Project. The project is expected to add 130 new beds, 14 new operating rooms, a new emergency center with 34 exam/treatment bays, a new maternity center, more spacious lobby areas, and a new 800 space parking center. The project is expected to take at least three years to complete.

“We haven’t broken ground yet, as we are just finishing the planning and pre-work phase,” says Hauenstein. “We expect to break ground in July of this year, though.”

The reason for the expansion, he says, is due directly to population growth and the increased number of elderly residents.

“There are many times when people will sit in the emergency room for hours waiting for a bed to open up because we are so full,” says Hauenstein. “To be able to respond to the growing needs of the community we have to increase the size of our overall facility.”

Enloe is also going to expand its technology base as well under the Enloe Century Project, which includes patient rooms designed for advanced medical capabilities and technologies.

In fact, the hospital has just installed a Picture Archiving and Communication System (PACS), which is already reaping benefits.

“In the old days x-rays and any other images were taken on film, but now everybody is going to digitized systems,” says Hauenstein. “So instead of having to carry film up to the ICU or one of the other care units, the physician can look at images electronically. In surgery, surgeons can look at the monitors to see the images.”

However, all of these improvements are not cheap and require a considerable capital investment by the medical center and its community supporters.

“The trick is having enough capital dollars to meet the demand for these new information technologies and expanding our facility,” says Hauenstein. “So how do you put that together with limited resources in terms of staff and dollars? Also, how do you balance all of these while remaining a standalone operation?”

There is also the parallel issue that many of the physicians that rely on the hospital are not necessarily members of the hospital’s staff.

“Many of the physicians are separate entities with their own practices out in the community, and they may or may not accept these new systems, so you have to make adopting them enticing to the physicians.” says Hauenstein.

One of the ways to get them to buy into these changes, he says, is to highlight how new technologies enhance the quality of care while also reducing - or at least increasing - the amount of time it takes to provide care.

On the capital side of the equation, growing income is a relatively simple concept to understand, but can be challenging to implement.

“The best way you can grow capitol is by maximizing reimbursements, reduce the length of time a patient is in the hospital, and control your staffing,” says Hauenstein.

On the latter point, he says the ebb and flow of patients on a per - day basis through the hospital provides a staffing challenge because the medical center has to have enough staff one day, and not too many the next.

To maximize reimbursements, says Hauenstein, it is important to negotiate good contracts. Reimbursements should meet the actual cost of care, he adds, which is not always the case.

Hauenstein goes on to say, “Healthcare is a unique business because there is so much that is driven by quality of care, but there is so much information that is needed to provide that quality care. The information has to be there.”

To raise funds for its Enloe Century Project, which is expected to cost $110 million, the medical center is seeking operational savings, loans, and a fundraising campaign. Enloe is also selling a vacant property it owns.