UCH eyes challenges Memorial will pose

It takes more than just doctors and patients to build a successful hospital system. It requires creating new relationships and new partnerships.

That’s University of Colorado Hospital CEO Bruce Schroffel’s operating philosophy. He’s the one leading negotiations to lease Colorado Springs’ Memorial Health System.

“This is about building something that’s human, that’s real,” he said. “It’s about building trust and transparency — really that’s what we’re all about. If I’ve done anything while I’ve been here, it’s build those relationships between doctors, patients and the community at large. I think making an institution human, that’s one of my abilities.”

He’ll need those abilities if he takes over Memorial.

In the two years since the city began exploring options for divesting itself of hospital ownership, the hospital’s community relationship has become so strained that patient volumes have fallen month after month and financial figures have plummeted as well.

“It’s a concern for us,” Schroffel said. “That’s why we have to get through these negotiations as soon as possible. We need to restore the trust and faith of the community — and that includes physicians as well. That relationship has been strained throughout the process.”

Schroffel has navigated these waters before. He just finished a joint partnership agreement with Poudre Valley Health System that created an entire new entity called University of Colorado Health. Adding Memorial to the stable of four hospitals — the arrangement also includes Childrens’ Hospital in Denver and the Medical Center of the Rockies in Loveland — will extend the hospital’s reach across the Front Range.

That reach will allow the system to attract more doctors and more patients — but it could take a while. The negotiations haven’t yet started, although Schroffel says he is encouraging a quick resolution. Then the lease package has to be approved by voters.

“We are very concerned about Memorial’s patient volumes,” he said. “All this uncertainty is unhealthy for the physicians and for the patients. We want this to be completed soon, for the good of everyone.”

Community

So, assuming that the lease negotiations are completed and voters approve the lease arrangements — what sort of partner will University of Colorado Health be for the city and for Memorial?

“They’ve been an excellent partner here,” said Kevin Hougan, president and CEO of the Aurora Chamber of Commerce. The Anschutz Medical Campus is located in Aurora, where it employs about 5,500 people. “They are a major economic driver for us.”

The hospital is in the middle of an unprecedented building boom, creating local construction jobs. They are building a new 760,000-square-foot, 12 story patient tower and adding 2,500 parking spaces. They’re also adding a new cancer center, with 650 new parking spaces.

“We’re spending about $400 million on new construction,” Schroffel said. “We’re building a new emergency department, because our volume is double what the current department can handle. We’re building a 44,000-square-foot cancer center.”

All the growth creates jobs, he said, construction jobs in the short term and high-paying health care jobs over time. He expects the hospital will add 1,400 people once the projects are completed.

That’s good news for Aurora.

“Our only real complaint is that it takes some time for them to get going,” Hougan said. “But they do things right, and the community benefits.”

That’s because of the high salaries paid at University — average wages are around $80,000, not including physician pay — and those jobs support others in the community.

“But it goes beyond the economic,” Hougan said. “When they first moved here, most people commuted (from Denver). But now, they are living here, they’re involved in the community. For instance, the hospital staff encourages kids to go into medicine, as early as third grade. They can attend programs at the hospital. It took a while for people to really get involved, but they are a solid part of Aurora now.”

Hougan believes the good news in Aurora could spread to Colorado Springs.

“This can only be a good thing for the city,” he said. “As the hospital grows and expands — it’ll create jobs and community there as well.”

Outcomes

The construction boom at the Anshutz campus isn’t due to the medical education that goes on there — the school gets very little state funding and the hospital doesn’t receive any. Instead, it’s a part of the high patient volumes seen at UCH.

“Our reputation is growing and patients are choosing us,” Schroffel said. “We’re running out of beds, basically.”

The hospital was named the top academic hospital in the nation by University Health System Consortium, a group of the nation’s 114 medical-training hospitals. It also is designated as a stroke specialty center by the Joint Commission, the accreditation body for hospitals.

The success hasn’t come easily, Schroffel said.

“We’ve gotten very disciplined,” he said. “Our outcomes are much better — and that’s because of a lot of effort with doctors, nurses and staff. It’s something we put a tremendous focus on, and it works.”

Still, the hospital isn’t perfect.

“I wish we could say that we were,” he said. “But we still make mistakes.”

HealthGrades, a Denver-based nonprofit that ranks the nation’s 5,000 hospitals based on outcomes reported to the Center for Medicare and Medicaid Services, reflects UCH’s efforts.

In 2011, the hospital receive HealthGrades pulmonary care excellence award and received the stroke care excellence award in 2012, 2011 and 2010.

HealthGrades also ranks hospitals based on patient safety and complications during surgery. UCH’s outcomes are good; in most cases, they are better than Memorial’s.

For instance, the hospital has a better outcome than other hospitals on the number of pressure or bed sores obtained during hospital stays. Its outcomes are better for hip fractures after surgery and respiratory failure following surgery. Its ratings are average for deaths following serious complications after surgery and for fluid imbalances after surgery.

The outcomes are important because as a teaching and research hospital, UCH doctors treat some of the most complicated cases in the state. They have the highest volumes of transplant patients, for example. The hospital also employs subspecialty doctors — those who specialize in treating a certain organ — in order to provide care for complicated cancer cases.

But, as Schroffel notes, the hospital’s staff isn’t yet perfect. And that’s reflected in its outcomes as well. HealthGrades ranks it worse for death in procedures where mortality is usually low, in infections acquired from a catheter and in bloodstream infections after surgery.

HealthGrades also reviewed the hospital’s outcomes for complications during common procedures. For the majority of surgeries, the hospital performed as well as expected — or better. For instance, the hospital’s complications levels for sepsis, pneumonia, neurosurgery, aorta replacement and stroke treatment all ranked higher than other hospitals.

But it ranked lower in gynecologic surgery, maternal care and back-and-neck surgeries.

Schroffel says he is aware of some of the quality issues at Memorial — higher infection rates and more hip fractures after surgery, for example.

“I know issues have been raised,” he said. “And we plan to work on those issues. It takes a level of discipline, really focusing on quality. And that’s what we’ll do. “

Health care prices

While Colorado Springs will see greater cooperation between the hospitals, better quality of care and more access to care — what they won’t see is a big culture change or higher prices.

“We don’t want to change what Memorial is — a community hospital,” Schroffel said. “It’s important that we maintain that community focus.”

And that’s why UCH administrators have already visited the Springs in the weeks since the City Council chose them to lease Memorial. They’ve met with physician groups and with health care providers to make sure they can be a good community partner.

“We won’t change Memorial’s staff, “Schroffel said. “And we won’t raise prices. We believe we can do this without costing people more when they go to Memorial.”

That will involve being more efficient and more disciplined in the way dollars are spent. It will also mean increasing patient volume, adding more doctors and extending the hospital’s reach beyond Colorado Springs.

“We will focus first on improving quality and on increasing patients — getting the financials in order,” he said. “Then we’ll look at expanding the reach. But about raising prices — nothing could be farther from the truth.”

Shroeffel believes UCH can become a valued partner in the Springs. He’s willing to do the work to get there.

“This is about culture and values,” he said. “Those are incredibly important to building relationships with people. I think hospitals are their own family and they have to make themselves as human as possible. It’s not about bureaucracy. It’s about people.”