Ellis Medicine: Unified Mission
Hospitals
Written by Eric Slack   
Thursday, 01 October 2009
Ellis Medicine: Unified Mission
After the state mandated the restructuring of the hospital system in Schenectady, three hospitals came together into a single organization in seven months, improving operations and reversing the system’s financial fortunes.
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Healthcare reform at the national level may still be in its infancy, but in Schenectady, NY, effective reforms are already under way at Ellis Medicine. The genesis of Ellis Medicine came about after the state’s 2006 Berger Commission report on healthcare reform mandated that Bellevue Woman’s Hospital should close and St. Clare’s Hospital and Ellis Hospital should unify.

“The commission’s findings said the three hospitals could no longer exist as separate institutions and remain viable,” said Jim Connolly, president and CEO.

Each hospital had its own unique history. Ellis Hospital was the oldest, dating back to 1885 when its predecessor, the Schenectady Free Dispensary, opened. Bellevue Woman’s Center began as Bellevue Woman’s Hospital in 1931, while St. Clare’s opened in September 1949. But market realities caught up with the healthcare continuum in Schenectady, to the point where the three hospitals had collective losses of $7 million in 2007.

Ellis Medicine: Unified Mission
Jim Connolly, president and CEO
In November 2007, Bellevue gave up its license, followed by St. Clare’s in June 2008, to the state Department of Health in return for funding that removed debt from their balance sheets, allowing the hospitals to cease operations with their remaining assets. Ellis Hospital took over the services provided by each, and the unification process was under way.

The campuses of Bellevue and St. Clare’s were turned over to Ellis Hospital in their entirety. The biggest obstacle was capital. Ellis received some money from the Department of Health to reconfigure services and link the three campuses together, and it has begun working for bonding, started making plans for a capital campaign, and is focused on generating margins to increase earnings. In addition, the organization has received grants from the state to help move the process forward.

Outside of financial concerns, an early stumbling block was a natural resistance to change. Although Ellis eventually employed virtually everyone from each hospital, there was a transition period that wasn’t unexpected. Services had to be moved to make operations as efficient as possible, but in the end, the transition among employees and physicians went more smoothly than anyone could have hoped for.

“Everyone realized we all had to be on board to make care for people in this community better and more affordable,” Connolly said. “We took about 1,100 employees from the two institutions, brought them over to Ellis at the highest salary scale with full benefits and no waiting period, let them join our pension plan at day one, and gave them full credit for all their years of service. It was important for us to respect and honor the service they had given to this community.”

In fact, the speed at which the process moved was a far bigger challenge than getting people to accept change. The first merger between Ellis and Bellevue took place in only three months, and after seven months, all three hospitals were combined. The first effort was overseen by a steering committee made up of administrative staff from both Ellis and Bellevue. There was no physician group, as Bellevue was a single practice OB hospital, which helped make the transition relatively smooth. After that, the organization was better prepared to go through the more complex unification with St. Clare’s.  

“There were multiple specialties, so we had to form a separate physician steering committee to oversee medical staff issues, but we had learned a lot from the first transition,” said Connolly.

Necessary changes
Of course, it took more than just connecting people to a single mission. Technology and services needed to be aligned as well. All three hospitals had different IT platforms, and moving to a common platform was a must. Bellevue and St. Clare’s needed to shift to Ellis’ IT platform, a process that wrapped up in July.

In addition, facility changes were required. When the hospitals were combined, the organization decertified about 168 beds. It is licensed for 455 beds, but currently operates only about 380. Making up for that bed shortfall required renovating the old St. Clare’s campus to accommodate Ellis’ nursing home. The Ellis Residential & Rehabilitation Center is an 82-bed nursing home inside Ellis Hospital. In March, the facilities will be ready at St. Clare’s (now known as the Ellis Health Center campus), and the nursing home will move, allowing the 82 beds to be recovered by next summer for medical/surgical purposes.

The emergency department is another issue to be tackled. Both Ellis and St. Clare’s have EDs, which are about a mile and a half apart, each seeing roughly 40,000 visits a year. Both were built to accommodate only half that amount. The plan is to consolidate the two EDs into a new, larger one at the Ellis Hospital campus, converting the other into an urgent care center.

Of the 80,000 annual visits between the two hospitals, the organization anticipates roughly 60,000 ED visits a year will go to Ellis Hospital with the remaining 20,000 going to the new urgent care center. However, that still requires a major expansion of the ED at Ellis Hospital. The organization is currently proceeding with a plan to renovate Ellis Hospital and build an ED capable of handling 80,000 visits a year. The organization hopes to have this project completed within three years.

As for Bellevue’s women’s services, the original plan was to shift those services to a newly built wing at the Ellis Hospital campus. The tightening of the economy forced the organization to change its thinking. The Bellevue campus is being upgraded and renovated to allow the facility to stay open. During the next two years, it will gain a one-and-a-half story addition at a cost of about $15 million to give it all-private rooms, more labor/delivery/recovery space, and more nursery space, enough to allow the facility to stay open for another 10 to 15 years.

Now the organization is going forward as Ellis Medicine, a unified system serving Schenectady and surrounding communities. The new brand identity will help people understand what is done on each campus, letting them know that an improved healthcare system is in town while taking advantage of the brand equity Ellis Hospital built over more than 120 years.

The signs that unification will succeed are there. The organization already provided exceptional care, ranking in the top 5% according to HealthGrades in both clinical excellence and patient safety, the only hospital in New York to achieve that double ranking in 2009. In 2008, its financial picture turned around, posting gains of $8.6 million only a year after the $7 million collective loss. Going forward, the goal is to get even better as one big, happy family.

“It is relatively easy to combine three hospitals compared to taking an organization that provides quality care and raise it to another level,” said Connolly. “That takes ongoing relentless attention to detail and a commitment to adequately provide a safety network for the people in the community, integrating with providers of social and supportive services here so all people have access to a high quality of care.”
 
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