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2/28/2013 2:23:00 PM Email this articlePrint this article 
Hospital makes strides in expanding care, cutting costs

Bud Hufnagel, CEO
Three Rivers Hospital

In the course of closing our fiscal year, it made sense to look back at the last 12 months and objectively assess what we've accomplished in 2012.

As this process goes, it is often difficult to separate the nice from the necessary when you have this overwhelming sense that you haven't accomplished near what you would have liked. That's the beauty of this kind of process; it imposes patience on the impatient and forces you to take the time to think about what's really happened over the past year. This process also adds context, puts things into perspective and lets the district know what we are doing to improve their hospital.

While we still have a lot to do, this is a very positive story that demonstrates progress that we can build on. Here are the highlights:

• Began developing a culture of staff inclusion and accountability that is open and relies on personal responsibility.

• Opened affiliation discussions with Lake Chelan Community Hospital and Wenatchee Valley Medical Center to engage more specialists, gain operating leverage, and formalize patient referrals. This expansion of services includes obstetrics, gynecology, cardiac and rehabilitation services so far with other possible additions in family medicine, ophthalmology, radiology, and occupational medicine.

• We needed to make a lot of changes in our leadership team, hiring a new chief nursing officer, information technology director, manager of dietary services, manager of radiology, emergency department supervisor. We reorganized surgery services and did not fill the chief operating officer position, relying instead on existing administrative staff.

• Reduced our overall cost structure in excess of $1 million annually.

• Instituted continuing education programs for hospital staff and our board.

• Achieved a net operating profit three months in a row.

• Reduced total Accounts Receivable (AR) by $1.2 million.

• Reduced AR days from 81 to 59 days; this is the first time on record that the hospital has been below 60 days.

• Reduced our outstanding warrants with the county from a high of $3.2 million to $2.6 million.

• Developed new wage scales for all positions in the hospital to make Three Rivers Hospital (TRH) more competitive in the marketplace.

• Completely redesigned and began rebuilding the technology infrastructure of TRH; telephones, TV, wired and wireless networks, making our infrastructure faster and more efficient.

• Completed the implementation of a new electronic medical records system that gives us the ability to share patient specific data with regional referral centers.

• Developed maternity specific menus with an emphasis on continuing our program as a "Baby Friendly Hospital," the only Baby Friendly Hospital in Eastern Washington and one of only four in the state.

• Reduced our overall staffing levels without affecting service delivery.

• Initiated an "in-house" repair and maintenance program to minimize our reliance on outside contractors.

In summary, we've made great progress in finding operating stability for TRH and reestablishing credibility and trust in the organization. However, there's still much to do.

What has made the past year all the more challenging is while we've had some success, real progress has been slowed as we've lost four primary care physicians and three mid-level providers from the medical community. We are working to recruit new physicians to our area, but this is not a quick process. Coupled with changes to reimbursement and health care reform legislation, these are seriously challenging times. However, I remain optimistic that we will find a way to achieve a stable business model and keep care local for the communities we serve.

Lastly, I want to assure the district that the rumors of the hospital's demise are greatly exaggerated. While we face a variety of challenges, we fully expect to be here for a very long time and we thank you for the trust and support that you have shown Three Rivers Hospital.



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