01/12/11 — Wayne Memorial Hospital looking ahead at 2011

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Wayne Memorial Hospital looking ahead at 2011

By Phyllis Moore
Published in News on January 12, 2011 1:46 PM

For Wayne Memorial Hospital this past year, the biggest issues beyond national health care reform continue to be physician recruitment and maintaining quality care and services.

Hospital President and CEO William Paugh said Wayne Memorial is positioning itself for the expected changes on the horizon.

"I think we're still all trying to get our arms around what that's going to be," he said. "No one has the complete answer.

"What we're trying to do is make sure that we have our house in order, that we're working with our physicians and medical staff here to try to be sure that we have a model that's in place, a contemporary model that will allow us to have access to the appropriate manpower and really, health care reform has changed a good bit of that."

Despite the uncertainty of the exhaustive plan, the hospital continues to respond to the changing medical profession.

One way is by readying for the pending needs of the community -- particularly in cases of physicians considering retirement in the next four or five years. There is a medical staff placement plan in place, Paugh said, which the hospital studies as it prepares for the next generation of doctors.

Gone are the days of house calls and long hours in a single-doctor private practice. With the new pool of medical school graduates, quality of life and carving out time for their own families is important.

"Many of them don't want to have the job hassle, particularly in a time of significant uncertainty of what their future might look like," he said. "Now, as we move forward and try to recruit, the 'one-size-fits-all model' is not the only model that people have.

"We have an internist starting this year that still wants to hang a shingle and start on his own but that's rare."

A plastic surgeon also introduced his practice this past year, and the process has been "very active" to draw doctors in other areas, Paugh said.

"We have got four new physicians the last year and a half, they're building practices," he said. "We have got several internists, internal medicine specialists that have committed to come and we continue to recruit in that area. We have worked with the medical staff to identify critical needs in the future in terms of anticipated retirements. We have got a lot of those folks that will be working with us as we move forward."

The hospitalist program -- physicians whose practice is concentrated within the walls of the hospital -- also continues to thrive, Paugh said.

"I think our program here is growing, it's maturing. We constantly look at all the things that we do here -- how can we make it better, how can we make it more responsive?" he said. "Not only to the patients that we're serving but for the physicians that we're serving."

Hospitalists are actually a "huge piece" of the recruitment strategy, Paugh said. When patients become hospitalized, the hospitalist essentially becomes a specialist, able to focus his entire attention on the patient.

The role serves two purposes, he explained. First, he picks up the slack and handles the round-the-clock needs of the patient while in the hospital and secondly, it allows the primary care physician to maintain his practice.

Overall, Paugh said, 2010 was a decent year for the hospital, which maintains efforts on efficient ways to allocate resources.

"We feel fortunate as a community hospital that we were able to have a positive operating margin this year," he said. "Not all the hospitals in the state of North Carolina did, about one-third of the hospitals in North Carolina did not. It was a tough year economically for the entire region but we dealt with the issue and are still able to maintain a positive operating margin. ...

"The real paradigm, the real Rubik's cube if you will, is we're continuing to improve quality and safety here in the hospital and if we do that with limited resources, we'll continue to do that in the most efficient way that we can. You can't sacrifice quality, (and) it's working to enhance and improve the level of quality in the organization."

Looking at the bottom line, he said the focus at the hospital is on access to quality care.

"Staffing is not something that we look at every once in awhile around here. We look at it day to day," he said. "You just have to really stay on top of that, day by day, shift by shift. We look at it on a department-by-department basis and really determine what our activity levels are going to be, what they have been, and try to match that day's staffing level with the anticipated activity levels."

One of the main physical plant needs on the horizon for the hospital is in the area of the emergency department, which sees a high volume of patients throughout the year.

Plans are being made for the area to be expanded, with a certificate of need awarded this past year.

"We have right-sized the plans but we have done that in an efficient way," Paugh said. "The whole access to capital, we have spent a fair amount of time to figure out how to make that happen.

"We're at a point now that we have solicited bids on the project to determine exactly what the cost would be."

In all likelihood, the future will center around pending changes in health care requirements, Paugh said. But that does not necessarily have to translate to a pessimistic outlook.

"Our work has changed with health care reform, but we're all trying to figure out what that means," he said. "Nobody knows exactly.

"What we can do is make sure that what we're doing, we're doing as well, as effectively and as efficiently and safely as we can do it."