The Norwegian American Hospital has more than 350 physicians as part of its network, and services include everything from emergency, acute care, surgery, outpatient clinics and internal medicine to cardiology, respiratory, imaging, behavioral medicine, family medicine and pediatrics, detox and substance abuse, physical therapy and corporate health services. Norwegian American Hospital also has a women’s center of excellence, a GI lab and endoscopy services, and a wound healing center. President and Chief Executive Officer of Norwegian American Hospital José R. Sánchez provides insight into his role, his previous career experience and the challenges of providing healthcare in his region.
Please can you give us with an insight into your role and responsibilities as a CEO?
My role and responsibility is to set the strategic vision for the hospital, to improve quality, financial stability, best practices, human capital development and improve the health of the community, creating a coordinated care environment to support the hospital’ s mission. In addition, leveraging technology as a tool to promote efficiency and to prevent harm to patients has become an important strategic focus.
What is your previous experience and how do you draw on this in your current role?
I am Chicago’s only Latino hospital CEO, a senior health care executive with 30 years’ experience in the operational, strategic and fiscal management of healthcare and multi-hospital systems. I began my career as a clinical social worker before advancing through the ranks of the New York City Health and Hospitals Corporation (HHC), the largest public health system in the nation. I ultimately served as Senior Vice President and Chief Executive of the Generations /Northern Manhattan Health Network, comprised of three acute care hospitals, three diagnostic and treatment centres, and 20 community based health centres in Manhattan and the Bronx.
What is your overall mission for the hospital? How did you come to decide on this? How do you ensure this mission is upheld?
Norwegian American Hospital provides high quality and compassionate health care services by partnering with patients and their families, our employees, physicians and the communities we serve. We recognize that healthcare should not just be addressed within the walls of our hospital. As a steward of our community’s health, it is necessary for Norwegian American Hospital to take our mission to improve the health of our community into the community. We believe that effective leadership in healthcare transformation means inviting and promoting collaboration that will positively influence the overall health and wellbeing of our community. We are focused on major issues such as health disparities, diabetes, congestive heart failure, and high risk pregnancies, as examples.
When providing a service as vital as healthcare, what steps do you take to ensure that every client receives the best possible care?
The recent success of Norwegian American Hospital has been largely driven by a relentless focus on measurable improvements in clinical care and patient safety. Our strategy for improving quality begins with a hospital-wide culture of safety and a fundamental understanding that avoiding patient harm is everyone’s top priority.
Critical to Norwegian’s success has been our ability to leverage investments in technology to “hard-wire” clinical best practices, reducing human error and supporting our care givers. We have demonstrated our cultural commitment to patient safety through our participation in numerous voluntary quality reporting programs, including Leapfrog, The Joint Commission and Healthgrades, in addition to mandatory state and federal quality programs. Our results have been exemplary, setting us apart from our peers for the level of care and safety we provide. Every service line has trackable clinical measures which keep the pulse performance on gaining quality improvements.
How do you balance between the need for profitability and the needs of your patients?
Sound financial performance and growth are vital to ensuring our longterm success and ability to meet our mission of service to the community. Fiscal year 2015 was a banner year for NAH with significant growth in operating revenue, cash flow, and operating margin. We managed costs effectively and efficiently, implementing a cost reduction plan to offset lower Medicaid payments without reducing staff or eliminating jobs. The hospital saw improvements in our billing and collection processes, reducing insurance denials and ensuring we were appropriately paid for the clinical care we provided. What this means for our patients is we have the ability to fund improvements to patient care which have previously not been possible. $3.1 million was invested in development capital in 2015, aimed at space renovation and acquisition of new technologies. These investments included projects for new ultrasound units, ventilator replacements, “smart” medication pumps, EKG and EEG machines, bone densitometry suite, new surgical lights and tables, a modern infant abduction system, 52 new parking lot spaces, campus lighting upgrades, and cardiology growth with a new intraortic balloon pump.
The financial health of our institution has never been stronger, and will be the foundation for strategic planning and growth in the coming years. These results are significant for our quest toward measurable quality improvements and have helped us gain the confidence of our physicians and our patients.
When working in an industry that is constantly changing, what does your firm do to ensure that they are at the forefront of any emerging developments?
We have made a significant investment in technology and have developed a spirit of creativity and innovation as an important component of our organizational culture. Innovation has become a part of the soul of our hospital, ushering us into an era of excellence and pointing us toward a future of even greater care.
Since 2010 the hospital invested over $7 million in our Electronic Health Record System, and we have made the highest use of our system to protect patients and improve care. We have taken significant measures to ensure the privacy and security of our patient data and health information, an initiative of vital importance in our current environment. A new video remote interpreting platform has made providing care to patients who require an interpreter, including the deaf, much more patient focused. The service provides immediate two-way video access to certified health care interpreters in a number of languages.
We debuted “smart” medication pumps which promote medication safety by connecting us to standardized drug libraries with information about hard dose limits and a lock function to prevent tampering by unauthorized users. This development puts us on the vanguard of medication safety among acute care hospitals. Technology has bridged many gaps for NAH. Our nurses, doctors, and other staff can now communicate more quickly and effectively than ever before, and they have greater, more immediate access to the most comprehensive medical data we’ve ever possessed.
How have recent changes in the American healthcare system, both in terms of regulation and funding, affected your business? How have you adapted around these changes?
Recent changes in the healthcare delivery system have had both a positive and negative impact on NAH. The Affordable Care Act (ACA) has increased access for patients in our community resulting in a higher level of Medicaid coverage versus uncompensated care. This has increased NAH operating revenues by $1.5 million per year. The State of Illinois’ recent shift of the Medicaid population into Managed Care has resulted in additional challenges to providing necessary care to NAH patients. This change has resulted in longer patient wait times for services, higher staffing costs related to meet new insurance requirements and a need to explain to patients what their insurance coverage and benefits are. In addition, the new Medicaid system has reduced NAH’s payments by more than $3.0 million per year.
NAH has responded with a redesign of its revenue cycle operations to add front line services and staffing to assist patients gain access to these new benefits. NAH works with each patient to qualify for Medicaid and or other available insurance coverage offered by the State exchange. These changes have produced a 25% increase in cash collections, year over year, and have brought in more than $5.0 million of additional collectible revenues. NAH continues to make changes to its billing and collection systems to maintain and increase the benefits achieved to date. NAH is reducing its cost structure by renegotiating many of its supplier contracts and vender relationships. Changes in operating services have been redesigned to place the patient in the right level of care and provide timely service. NAH has implemented labour management systems to ensure the right amount of staffing is available to meet patient care needs. These combined changes have reduced NAH costs by more than $1.2 million to date and will continue to identify opportunities to improve performance.
What makes your hospital unique and sets you apart from other healthcare providers?
One of the most remarkable aspects of Norwegian American Hospital’s turnaround and expansion is how it defies industry-wide trends. As large healthcare providers consolidate and grow and independents shrink and falter, we have found ways to increase our business and provide more care.
Our cardiology department is now more than three times the size it was in 2011, addressing prevalent heart conditions in the area. Our oncology services have grown by more than 275%, including a biweekly Tumour Board and an Oncology Patient Navigator system that helps guide patients through every stage of cancer care, from breast exams to chemotherapy.
Norwegian’s Surgical Services concluded its first year of providing stateof-the-art general surgery, minimally invasive surgery and surgical oncology services and our Women’s Health Associates and Midwife Health Associates each grew, allowing us to increase access to obstetrics and gynaecology services at the hospital and community locations. Sixty new physicians and allied health professionals were credentialed by our Medical Affairs staff in 2015 in key specialties including Vascular Surgery, Radiation Oncology, Minimally Invasive Surgery, Gastroenterology and Maternal-Fetal Medicine.
What does the future hold for your firm? Do you have any upcoming plans or projects you would be willing to share with us?
Norwegian American Hospital is planning to partner with a Federally Qualified Health Centre on the development of an Ambulatory Health and Wellness Centre with comprehensive health and wellness services including: Comprehensive Diabetes Centre; Primary Care; Exercise/ Wellness; Rehab; Day Care; Dental; Nutritional Education/Test Kitchen; Specialty Care; Alternative Medicine; Women’s Health; Pharmacy; and Commercial Space
We have innovative plans in place that will help us continue to grow and solidify our vision for the future. First is the full implementation of the expansion of our emergency department. The renovation includes a dramatic redesign of the facility’s footprint and will ensure that the residents of Humboldt Park have access to expert emergency care close to home.
The second initiative we are excited about is the plan for a full campus development, utilizing the resources of the hospital to bring economic prosperity, stability and growth to our community. We will be working with the community on a project that we can all be proud of.
To improve access to specialty services for our patients and community, our third area of focus is our clinical programs. We will be working toward meeting all requirements for a cancer centre and developing a comprehensive diabetes program to address this major health concern in the community by leveraging our natural resources for economic growth.
Company: Norwegian American Hospital
Name: José R. Sánchez
Email: [email protected]
Web Address: www.nahospital.org
Address: 1044 N. Francisco Ave., Chicago, IL 60622