Poudre Valley Hospital: Prepared for Change
Hospitals
Written by Eric Slack   
Sunday, 01 November 2009
Poudre Valley Hospital : Prepared for Change
After expanding its organizational footprint and successfully focusing on continuous improvement, this Colorado hospital and its health system are ready to handle anything.
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In the 80-plus years Poudre Valley Hospital (PVH) has been in Fort Collins, Colo., many aspects of the organization have changed. But the last few years have seen major changes to the organization that altered the regional healthcare landscape. Seven years ago, its parent company, Poudre Valley Health System (PVHS), began the process of resolving strains on the hospital’s capacity by planning to open a second hospital. In 2007, Medical Center of the Rockies (MCR) opened in Loveland, about 20 minutes away from Poudre Valley Hospital.

Between the two facilities, PVHS offers a full spectrum of healthcare services with the exception of transplants. It includes two trauma centers, Level II at MCR and Level III at PVH; bariatric surgery; and cardiovascular services. The system is a regional referral center for orthopedic and birthing and women’s services. Its service area doesn’t have an enormous population, but it is an expansive area, roughly 50,000 square miles including Northern Colorado and parts of Wyoming and Nebraska.

Poudre Valley Hospital : Prepared for Change
Kevin Unger, president and CEO
Stepping forward
However, the population has grown significantly since the hospital first opened, and in recent years, PVHS made a conscious decision to grow far beyond a community hospital. Poudre Valley Hospital’s journey has made it a regional tertiary center, and decisions like building Medical Center of the Rockies have helped that journey continue.

PVHS opened its Harmony Campus in 2000, which consists of physician offices, outpatient services, and an ambulatory surgery center that is a joint venture with numerous area physicians. A few years later, the organization added medical office space due to market demand. PVH itself has undergone a series of expansion and remodeling projects that resulted in nearly all private rooms and added two floors to portions of the campus.

“We decided to grow by bringing in specialties that a typical community hospital our size would not have,” said Kevin Unger, president and CEO of Poudre Valley Hospital. “We were early adopters in terms of joint ventures with physicians, and that built goodwill with physicians and began the process of developing successful joint venture relationships.”

The hospital has also focused on quality and satisfaction improvements, an effort that has not gone unnoticed. In 2000, Poudre Valley Hospital first earned distinction as a Magnet hospital for nursing excellence, a designation it earned again in 2004 and 2009. PVH also won the Magnet Prize in 2009 for its community case management program. From 2003 to 2007, Poudre Valley Hospital was named a Top 100 hospital by Thomson Reuters. In 2008 and 2009, Modern Healthcare named the system one of America’s 100 best places to work in healthcare. And in December, PVHS will be honored at a ceremony with President Obama as one of only three organizations in the US to receive the 2008 Malcolm Baldrige National Quality Award, and the only healthcare organization to do so.

Unger said these achievements illustrate the system’s commitment to quality improvement. “During the last decade, we have enhanced our quality and improved workforce morale by focusing on the issues that matter to them,” he said. “That has improved patient satisfaction scores because it sends a message that we are getting better by keeping our focus on quality improvement.”

He said that improvement effort helped reduce turnover, which reached as high as 24% in the late 1990s. It partnered with Colorado State University to develop an employee satisfaction survey. From there, the hospital learned that employees were unhappy with its staffing model. In response, the hospital came up with a fixed staffing model and implemented numerous other changes. Today, turnover is less than 5%.

Planning ahead
Since opening MCR, the system has attempted to focus certain specialties at each facility, carving out a niche in the market while avoiding duplication. MCR focuses on trauma and cardiac services, and PVH focuses on orthopedics, bariatrics, oncology, and women’s and children’s services, including a Level IIIA nursery. Both hospitals will likely see more significant changes in the future, as PVHS is currently in the midst of its master planning process.

“We are going through that right now with a healthcare consulting and design firm, and that will help us deal with our anticipated future needs, capacity issues, and growth opportunities,” said Unger. “One major part of the process is trying to figure out what the inpatient and outpatient markets will look like in the future. My sense is that acuity will continue to rise in the hospital, while anything that can be done in an outpatient setting will moved out of the hospital.”

PVHS has recently been working on integration strategies, an essential piece of preparing for whatever health reform brings. It has entered the world of direct physician employment and in the last year acquired three physician practices. The idea behind acquisitions and integration is keeping key strategic and safety net providers local.

“The first thing we thought of was, what are the key services we can’t live without and which providers are providing a lot of care to the uninsured and underinsured? By working with those groups, we can take some of the burden off our ED,” Unger said. “Entering these relationships is like walking a tightrope because there is generally competition among practices and specialties that approach us. Our goal is to broaden the volume and range of services available in the community so we can meet the medical needs of the region.”

With major changes expected to the inpatient and outpatient environments in the future, Unger said developing clinics in strategic locations is a central piece of Poudre Valley’s long-term growth strategy. As the industry continues its shift toward a focus on wellness and keeping people out of the hospital, running community health centers in underserved areas is likely to be a much bigger piece of the organization’s operations down the line. But the validation Poudre Valley Hospital and the larger Poudre Valley Health System have received for continuous improvement efforts and ambitious expansion plans leaves the impression that this organization will have little trouble adapting to any situation.
 
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