Saint Francis CEO talks about award, hospital's future

Saint Francis Medical Center president and CEO Steve Bjelich recently was named one of 25 health-care leaders to receive a 2014 Leadership Award from Becker's Hospital Review.

Other recipients of the national award include Dr. Toby Cosgrove, president and CEO of the Cleveland Clinic; Dr. John Noseworthy, president and CEO of the Mayo Clinic; and Richard Bracken, chairman of the Hospital Corporation of America.

Bjelich has led the hospital's health-care system since 1999 and has more than 36 years in the field.

The hospital is in the middle of a $127 million Building on Excellence construction project that will be completed in 2016. Plans include building a north and south tower that involves new construction and renovating existing space, and transitioning the hospital to all private rooms. The North Tower will house a women's and children's pavilion, and the South Tower will house orthopedics, neurosciences and medical services.

The first phase, an Expanded Level III Neonatal Intensive Care Unit, was finished in December.

Bjelich sat down last week to comment on his honor and explain how Saint Francis stays competitive in the world of health care. Parts of this transcript have been condensed.

Q: What does it mean for you to have won this award?

A: I feel I just have the opportunity, the privilege, to represent Saint Francis. This is not about any one individual's effort. The number of new programs, new services, the employees' commitment, the physicians' commitment -- all of those factors go into creating the success that we've enjoyed as a health-care system that ultimately will better serve the entire community, so the community benefits as a result of all this coordinated hard work that has evolved over the last 15 years.

Q: What does that award mean for the hospital?

A: Well, I believe it further validates our demonstrated results. We've had demonstrated results in employee and physician engagement. It's been further supported by a very focused strategic plan. We've also been successful in creating a cultural shift to one of a marketing and customer service climate. I think it's also reflective of the patient and employee satisfaction that has been earned at Saint Francis. We've been identified as one of the best places to work in all of health care for all six years that award has been available through Modern Healthcare. There's only six of us in the country that can make that statement. You look at our patient satisfaction; we are consistently in the mid-95th percentile. That is huge. This has been consistent for a number of years, and that's a direct attribute to our employees, our physicians, the environment that we've created for our patients to have the best possible patient experience.

I think third, the expansion of services here has been absolutely incredible. Think about it. When you look at an organization that reinstitutes obstetrics after a 36-year absence -- this is back in 2001 -- to become the market leader in women and children services is huge. We did 1,030 deliveries in 2013. We opened the very first Health and Wellness Center in the region -- Fitness Plus. We've stepped up to create the only trauma service in Southeast Missouri. We expanded and created the Heart Hospital and Cancer Institute to better serve this entire region, because the No. 1 and No. 2 leading cause of death in this region is cancer and heart disease. And we've also been recognized nationally through our clinical affiliations with the MD Anderson Physicians Network for cancer care, and then most recently, with the Cleveland Clinic, with their Heart and Vascular Institute. Those are major national recognitions. These are organizations that are not there to contract with an organization or a service program like this that needs assistance. They're here to work with the best to take it to an even higher level.

Q: What kind of major projects and changes that you've been a part of during your 15 years here? Are there any more that you want to add?

A: I think the biggest one is the Building on Excellence project that is underway. $127 million building project, which when the board approved this project, it was the largest private construction project in the history of Cape Girardeau. A few years later, it was surpassed by the casino.

Q: How is that construction project coming along? Still on schedule?

A: Absolutely. We are doing very, very well. There's a great team that is coordinating this under the leadership of Marilyn Curtis. I'm extremely proud of how we've maintained not only the time tables, but we've also been able to ensure that we, as we have every project that we've done here, we've completed on time and on budget.

And I think the other thing to keep in mind with the Building on Excellence [project]: It really has also been incentivized under the health-care reform.

Q: How are you tackling that ever-changing landscape, especially over the recent years with the ACA and Medicaid expansion? How are you keeping up with that?

A: Well I firmly believe, as an executive team and as a board of directors, I like to feel I'm a student of my profession. This is what I'm trained to do; this is what I've done for 35 years -- senior management in health care.

Saint Francis Healthcare System is well-positioned for the change that has been incentivized under the health-care reform, and we've been anticipated these changes and challenges with the Affordable Care Act for years. For example, baby boomers are approaching age 65. ... That's going to require the need for access to physicians, access to facilities, a convenience, and that's why we're a regional system. ... We cover western Kentucky, Southern Illinois, southern Missouri, northeast Arkansas and northwest Tennessee. If you were to look on the map and look at Cape Girardeau by itself, you would never imagine it would have a facility of this magnitude or the quality that's provided, that's been recognized nationally. And this award is another example of recognizing that.

Another way I think we have prepared successfully, we have successfully clinically integrated 170 physicians that are apart of Saint Francis medical partners. ... And this will ensure we have high-quality physicians that are integrated through expanded electronic medical records to a common vision, a common delivery system and a commitment to excellence that's second to none. ... One other key role we have prepared for, and it continues to be our guiding light, and that is a commitment to improve quality through clinical excellence and a commitment to improved health of the community and population through partnerships. ... And finally, continued ongoing exceptional patient experience.

Q: How's the hospital faring through the changes? You're still undergoing construction ... How are you balancing that?

A: But we're expanding and not missing a beat on any of growth. ... We've grown from, 15 years ago, about 340,000 square feet to now we'll be about 1.4 million square feet when this project is done. So we've quintupled ... the size of the campus. I think it's the success, the way we organize our construction projects. because we develop these projects with the folks that will actually be utilizing that space. The doctors, the nurses, the environmental services staff, the materials management staff, patients, all have had input with the architects that design the space. ... We tripled the size of the emergency department. ... We have a separate expanded geriatric and pediatric emergency department wings that are committed just to pediatrics and senior citizens because there's different needs. We already incorporated that into the design of the emergency department. There's private bathrooms in each of the rooms. That's not typical ... We have separate rooms where your loved ones are with you. Those are all key, and that's all part of that physical plan that we provide with the excellent care that our physicians and staff are here to provide. We provide that environment because they were involved with the design of that environment up front. You do not want your CEO or administration designing the space for a department, because they're not the ones that work there every day. But we can create the environment where everyone has input and they design it and eliminate the need for change orders later on that are very expensive.

Q: As you and your team work together for the overall vision and strategy of the hospital, [could you touch a little bit on] working with insurance companies and negotiations [and] cost control?

A: I think it has to be a partnership. And that partnership, whether it be with Coventry or Blue Cross or any other insurer, Saint Francis wants to partner with them. Because it's really become more of an integrated delivery system as we recognize still the largest payer and source of patients, if you will, for all hospitals still remains the government -- Medicare patients and Medicaid patients. It's over 60 percent of our patients. So we'll look to continue to find ways to partner with insurers that will have mutually beneficial, high-quality clinical outcomes at an affordable cost.

Unfortunately there's a tremendous cost-shift that takes place in health care, because Medicare and Medicaid dictate what they will pay all providers. It's been cost-shifted onto local businesses through these various insurers. There has to be a better balance than that. And we as health-care providers need to continue to strive to reduce our costs through improved quality in patient safety and better clinical coordination of care across a population.

We're hoping our electronic medical records will provide some assistance, so that tests are not duplicated. ... And we started our investment when we opened the Health and Wellness Center in 2004, because we recognize the importance of wellness. Of the least-healthiest counties in the state of Missouri, we serve seven of those. The bottom five are all located here. ... We have to be able to take care of those patients, preferably before they become patients. ... We do multiple screening programs. They're not a financial incentive for us, but it will down the road if it prevents having admissions that could be avoided or other diagnostic tests or greater complication through the disease management process.

The most expensive place to seek care is in the emergency department. We have six urgent care centers. ... Those all provide not only access points, but access points that are less expensive than an emergency department. Approximately 23 percent of all patients that present themselves to our emergency department are admitted because they have major clinical indications [and] they need to have an acute care bed, which means there's a large population that may have been treated elsewhere for primary care. The other advantage of our urgent care centers, if they don't have a local doctor, we can hook them up with a local doctor and work on that prevention we've talked about.

Q: Following up on the Cleveland Clinic affiliation and, like you said, expansions and being able to offer higher technology and that kind of thing, how does that work to your advantage whenever you're going against hospitals in St. Louis, for example?

A: ... First of all, I have the data to support that fact there's more market share, more people are staying in Cape for their care today than they did 15 years ago, which is better care because they have their support mechanisms here. And secondly, I don't think you would be seeing their billboards creeping down I-55. They're feeling it.

We are blessed here. And we've worked hard to have the high-quality care so the community realizes they don't have to go to St. Louis.

Q: You said a lot of market share here is in Cape, in our area, with Saint Francis. How important is that, to keep that here?

A: Two reasons it's important. First, I think it's important from a community health population, or population health management. The community gets their support here. We also support the community. When you're a patient, it's nice to have your loved ones there. That's the advantage of our level three NICU. We transfer very, very, very few babies. We have all the full services that can be provided for our level three NICU. And that baby may be here for months, but the family of support is all here.

[The] second component of that, as we've grown, we've been extremely integral into the success of the local economy. ... We've calculated there's an impact of 450 jobs that have been created as a result of this construction project, and we had 95.1 percent of all the vendors and contractors and supplies and everything is bought locally.

And I think the other important reason to keep the importance of our dominant market share is it affects our credit rating. We have an exceptional credit rating, and it's independently judged.

Q: What do you see for the future of Saint Francis [Medical Center]? This can be in terms of you and the whole hospital itself.

A: It's actually the Saint Francis Healthcare System, because we really are an integrated, regional, health-care delivery system with a huge geographic presence in five states with access with 170 physicians that make up Saint Francis Medical partners. All [have] a common commitment to continue to provide high quality care, high level of patient safety, to take care of a not only community health, but our population ... at an affordable cost. To do that, we need to truly manage a delivery system that is partnered with other health-care providers, insurers and doctors. And we stand ready to partner with those other health-care providers. We have to be able to improve the health of the community and population through these partnerships. That probably sums it up best.

ashedd@semissourian.com

388-3632