Parkview Medical Center, Pueblo, Colorado
Culture changes prompt renewal…Working cooperatively with medical and clinical staffs, QHR helped create a quality-focused environment…earning staff and patient loyalty, financial success and a leading market share.
A Stabilizing Force
Caring for the industrial city of Pueblo and southeast Colorado for three quarters of a century, Parkview Medical Center had proven its dedication. Local competition from a billion dollar hospital chain, however, began to erode its market share. Financials declined; viability was threatened.
Selecting QHR to provide management advisory services, the board worked closely with QHR and the management team to address the challenges.
“QHR brought us excellent leadership,” comments Board Chair Sherry Nash, “and with deep resources, built a stable base.”
With QHR’s support, the management team began the process of restoring the hospital’s financial health.
“QHR’s advisors played a significant role in improving operations throughout the facility,” describes CEO C.W. Smith. “And they continue to help us improve.”
Over QHR’s twenty years of support, the hospital has more than stabilized; it has prospered:
- Cash reserves grew from $1.4 million to $72 million.
- Operating margin increased from 1 percent to 6.4 percent.
- Overall margin rose from 2 percent to 8.8 percent.
“We started with barely investment grade security,” according to CFO Bill Patterson. “Now our bonds are moving into Moody’s ‘A’ category.”
Quality Drives Success
The veteran team knew that real improvement goes beyond financials. As the second hospital in a two hospital community, Parkview had work to do to gain physician and market confidence.
“Before QHR’s arrival, this was not the hospital of choice for physicians,” admits Vice President of Medical Affairs Dr. Nick Alsever. “But it is now.”
Years of sincere commitment to quality improvement have changed the way the hospital functions… and raised it to status of market leader.
- Obstetrical business grew from one third of the market to 56 percent.
- Surgical services climbed from 40 to 55 percent market share.
- Medical services increased from 35 percent to 50 percent.
“CQI put us there,” explains CEO Smith. “With a constancy of purpose, and guidance from QHR’s experts, we changed our organization’s culture to one of constant search for improvement.”
Looking closely at systems - not people - to identify problems, the management and staff work together with mutual respect.“We deal with physicians, nurses and managers in a collegial manner,” Smith adds, “to improveour policies and procedures… and deliver better care.”
Excellence in Staffing Yields Results
Hand-in-hand with efficiency and quality goes staffing precision. Part of the leadership’s philosophy is to hire well and pay well, to keep a quality staff loyal.
“We run a higher nurse-to-patient ratio than our competitors,” explains CFO Patterson.“We consider it an investment in quality.”The hospital’s fixed payroll costs are higher, but its overall nursing cost per patient day is not…because it requires fewer registry nurses.
In fact, in direct contrast to its competitor, Parkview does not suffer from a nursing shortage. It runs a vacancy rate of three to five percent.With more nurses - well-trained, more satisfied, longer-term nurses - patient care is expedited.The physicians quickly perceived the improvement.“The word spread among the medical community that Parkview is a better place to practice,” remembers Dr. Alsever.
As Parkview gained a reputation for personal service and quality care, its medical staff increased in numbers from 180 to 280.The patients followed.
- Inpatient census climbed from an average of 119 to 191.
- Daily emergency department visits rose from 50 to 130.
- Cardiology and radiology volumes doubled.
Improved performance enabled Parkview to upgrade facilities, expand square footage, acquire properties and build a physician office building. And with its dedicated medical staff, it developed the premier cardiology service in southern Colorado.
Steadiness Supports Community
Parkview Medical Center’s stellar financial and operational achievements are even more impressive when seen in the context of its community.
“Demographically, we’re where the nation will be in ten years,” points out Patterson, “with 24 percent of the population over age 41, and 16 percent over 65. But with a 23.5 percent poverty level, Pueblo has even more challenges.”
QHR’s direction has not only strengthened Parkview; it has provided vision for the future.“We’re on our toes…always looking for the next improvement,” Nash adds. “In fact, our emergency department recently achieved a level II Trauma designation.”
The Secret to Success
Leaders comment on Parkview Medical Center’s rise to market dominance…
“Our financial stability allows us to offer programs Pueblo needs,” points out CFO Bill Patterson, “whether they generate revenue or not. Our school nurse, diabetes management and asthma programs don’t help the bottom line… but they help the community’s health.”
“QHR stabilized healthcare in this community,” describes VP of Medical Affairs Dr. Nick Alsever,” by stabilizing Parkview, and giving it a new focus.”
“Our successes come directly from our quality improvement culture,” reflects Board Chair Sherry Nash. “It was difficult to establish, but with QHR’s guidance, we did it. Now we’re more responsive to community needs.”
“A commitment to quality drives everything we do. With QHR’s help, we earned JCAHO certification with commendation three times. Our standards are high.”
