Healthcare today is changing at an unprecedented pace as institutions around the country grapple with economic difficulties, divisive politics, and a population that is sicker than ever. Record numbers of aging patients suffer from debilitating chronic disease, and epidemics of obesity, cardiovascular disease, and diabetes plague a younger-than-ever population. Healthcare executives struggle with these challenges, trying to fulfill their corporate mission while watching their bottom line.
Strategic planning increasingly requires a roundtable approach to understand the impact of development over time. The “health” of an institution is measured by the effectiveness of its organization and mission, and also by how well it plans for the future. Three institutions that offer a unique perspective into what drives their decision-making processes are Bayhealth Medical Center, motivated by its deep community roots; St. Christopher’s Hospital for Children, focusing on maximum flexibility; and Geisinger Medical Center, striving to change the culture of healthcare itself.
Terry Murphy, president and CEO, Bayhealth Medical Center, Dover, Delaware
“Improving the health status of the communities we serve is the driving force behind our mission,” says Terry Murphy, president and CEO of Bayhealth Medical Center, adding that it’s also a touchstone for measuring the facility’s success. “We trend very well against peer institutions, though doing what’s right for our patients and their families is what drives our bottom line.
Bayhealth is the largest healthcare system in central and south Delaware, with a main campus in Dover, Delaware (Kent General Hospital), another in Milford, Delaware (Milford Memorial Hospital), and numerous satellite facilities. It also is a member of Planetree, an organization that promotes a patient-focused model of care, centered on a holistic approach to healing. According to Murphy, this is only one aspect of a successful strategy.
Like many hospitals, Bayhealth’s growth has been accompanied by the need to realign services and upgrade facilities. “We strive to make our facilities flexible enough to accommodate changes in program and technology,” Murphy says. “At our Kent campus, we had to acknowledge that we’d outgrown the original campus plan. We needed to develop a long-term approach to site circulation and expansion.”
“Repositioning materials handling and the central utility plant to the perimeter of the site immediately clarified patient and service flow and allowed efficient program infill,” says Andy Jarvis, director of healthcare planning for EwingCole architects and engineers, which advised Bayhealth.
In 2010, Delaware declared itself an “innovation zone,” challenging institutions throughout the state to collaborate on innovative approaches to keeping people healthy, reducing readmissions, and lowering the overall cost of care. Among many initiatives underway, Bayhealth is working with other organizations to implement best practices in the care of patients with congestive heart failure. This effort has led to discussions about how to improve or expand programs. “In determining how to place resources, we look at what the community can support,” Murphy says, “and where we would get the most synergies for staff.”
For example, Bayhealth currently provides cardiac surgical services only at its Kent campus, because the total volume of cases is at a proper scale to the experience of its surgical team. “We can’t at this point justify having two separate programs, given the demographic of the Milford community,” Murphy says. “The last thing we want to do is provide a service for the sake of having it; we want to invest in services that can be properly integrated and sustained by the size of the community, with high-quality outcomes.”
Bayhealth places “much of its long-term strategic thinking and resources toward keeping people out of the hospital. Focusing on health not only is better for patients, but also is more efficient and has a larger impact on overall cost of care,” Murphy says.
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