McCullough-Hyde Memorial Hospital - The quality of wellness

Source: Exec Digital USA

Date :21/07/2008 11:52:26

Richard Daniels and Pam Collins tell Exec how McCullough-Hyde Memorial Hospital has realized the vision of its founders

Written by Ruari McCallion and Produced by Shaheen Mohammadipour

When the McCullough-Hyde Memorial Hospital (MHMH) opened its doors for the first time in 1957, it was as the result of a remarkable legacy of two sisters in the community of Oxford, located in southwest Ohio. Daisy McCullough and Elizabeth McCullough-Heath left sizeable amounts of money in their wills, to be used “…for the alleviation of human suffering, without distinction of race, color or creed …”

Specifically, they wanted the funds to be used to build a hospital, which would be named in their memory. Another local family, the Hydes of Indiana, committed an additional fortune to the hospital as part of Benjamin Hyde’s estate and the hospital duly changed its name to its current appellation. It has come a long way and is currently raising US$580,000 for the relocation and expansion of oncology facilities. “We’re up to around US$490,000 so far,” says Richard Daniels, president and CEO of MHMH.

The Oxford site remains the hospital’s main campus, with time-share office accommodations, as well as in-patient care, obstetrics, intensive care, emergency room, and a full service lab and imaging services. However, it is far from being the only location. “We lease a building in Brookville, Indiana, from an optometrist and sub-lease to physicians. Our facility at Hamilton, OH, houses physical therapy services. The Ross, Ohio location, about 10 miles south, covers 23-25,000 square feet and provides many ambulatory services.”

Business Evolution

MHMH is a business, and all decisions regarding expansion and patient services are based on commercial principles. When MHMH was established, hospital practice was based on in-patient care and stays were typically lengthy – a week or more was common. “The hospital was larger in the physical number of beds we had but covered about half the area we have now. Services were very different – the emergency room wasn’t open 24/7 for example,” says Daniels. “When I arrived, in 1980, 10-12 percent of revenues were generated by outpatients; it’s around 75 percent today.”

“Lengths of stay are significantly shortened – it’s now typically three days,” says Pamela Collins, vice president and chief patient services officer. “Medicine today is quick in-quick out, with physical therapy, aftercare and rehabilitation delivered at the patients’ homes or in outpatient facilities. What we now have is three full-time equivalent staff coordinating care at home. They find and schedule independent services, like respirator equipment, and source home support to those who need it.”

Tight ship

The hospital provides more than 80,000 individual patient episodes of care a year. A number are the same person coming back for a repeat visit, whether it is a follow-up examination or part of ongoing investigations, like blood tests, x-rays or returns after ER treatment. MHMH has 600 staff altogether, equivalent to 410 full-time personnel. Net revenues, after negotiated discounts for insurance companies, Medicare/Medicaid and charity cases total over US$52million, which means the hospital runs a pretty tight ship. With rising healthcare costs on one side and downward pressure on prices from the insurance companies and public agencies, cost control is very important.

“When I came here from a large medical center I saw people who spend money as if it was their own,” Collins says. “The directors and staff are very conscientious about the use of supplies – it’s in the culture. We were recently recognized on the Internet as a hospital with physicians who treat in a conservative manner. They are less aggressive in their interventions and there is no difference in outcomes. We demonstrate in action that less can be better.” Daniels sees this approach as being as much about philosophy and culture as practicalities and pressures.

“It is a bit of the midwest mindset, which drives it to a degree; the other part is the medical philosophy,” said Daniels. “On the coasts, east and west, they practice a more aggressive style, with more intervention. Doctors adopt the culture of where they live – ours tend to have trained nearby and have that more conservative approach. It’s not entirely that simple but the difference has been measured and noted for over 30 years by the Dartmouth Atlas program.”

Upgrades planned

MHMH is a member of the Greater Cincinnati Health Council, which provides a group purchasing organization that has helped the hospital to achieve significant economies in local sourcing supplies.

“We have not yet automated inventory, purchasing and ordering beyond some individual items, so we haven’t yet achieved just-in-time deliveries,” Collins said. “We are appointing a new director of materials in August and we’re also purchasing a new IT system, which we hope will be operational in nine months and will help us improve.” MHMH is also investing in medical technology. The Ross facility is getting a 64-slice CT scanner, and the whole hospital has had a picture archiving computer system (PACS) since 2005. X-rays are no longer kept on film. The physicians love the quick and easy access it provides. However, medicine is about people and their skills, and they are in short supply.

“There are worldwide shortages in various medical disciplines, especially nursing,” Collins continues. “Every year, we undertake an assessment of where we expect critical shortages. We ask the Trust, which helps with capital and special expenditures, to support us with our educational program. It is geared towards training for specific roles we will need in the future. We will help nursing students with fees and stipend support, for example. In return, we require they commit to work for us for two to four years.” That people stay longer is testament to the strong culture of community it espouses.

“A study we undertook found we have 60 per cent retention of these employees we support, which is well above average,” said Daniels. “People come back to us, and stay with us, because we have a commitment to quality. We’re constantly working to improve. Our people love what they do and care for patients as if they were family. Those who come here feel it; a personal, caring experience, on both sides – both in patient care and in the work environment.”

Alleviating suffering without distinction is what the founders wanted and that is what McCullough-Hyde Memorial Hospital is achieving.