Rising to the challenge Featured

11:47am EDT November 20, 2003
Every day, OhioHealth President and CEO David Blom prepares for battle. The foes he faces are many -- a rapidly changing health care industry, increasing costs and the threat of for-profit surgical centers entering the Columbus market.

But it's all in a day's work for Blom, who's worked for OhioHealth since 1982 and has risen through its ranks to its top spot.

"The rate of change in the industry and the sheer complexity of it all is a huge challenge," he says. "Medical technology is changing, but unfortunately, reimbursement systems haven't kept up."

Blom's job -- to accomplish OhioHealth's mission to be the place where people want to work, doctors want to practice and patients want health care -- isn't an easy one, considering the complex and unpredictable future of the health care industry. And, because the organization is no-for-profit, it depends on government resources to make ends meet.

"More than 50 percent of our funding comes from the government," says Blom. "There's no negotiation, and increases are small and unpredictable."

Add to that an intensifying shortage of medical workers, rising malpractice costs for physicians and hospitals, and increasing labor costs largely due to a labor shortage, and one might find it a battle not worth fighting.

But Blom and the OhioHealth network appear to be winning not just each battle, but also the war.

The system, which admits more than 100,000 patients each year and averages more than $2 billion in gross patient revenue, operates a well-planned combination of inpatient and ambulatory (outpatient) services, including the McConnell Heart Health Center, Grant Health and Fitness Center, and the Senior Health Center.

And expansion plans are in the works to meet community needs well into the future.

"We have a very sophisticated plan in process," Blom says. "We are doing our best to meet the needs of a growing elderly population and be good stewards of the community's resources."

Putting on the gloves

At the heart of OhioHealth's fight to provide high-quality care despite rising costs are its employees and physicians. Blom says it's essential to attract the best possible doctors and staff members then keep them happy for the continued success of the network.

"We work hard at recruitment," Blom says. "And we offer competitive compensation."

The awards and recognition the organization has received, with two of its hospitals -- Riverside Methodist and Grant -- ranking nationally in U.S. News and World Report's Top 100 lists, help attract high-quality physicians and health care workers.

"But what's more important is how the teams interact with each other," says Blom. "To keep morale high takes a positive work environment and processes that run smoothly and are well-managed."

Blom points to improving turnover rates and decreasing number of absences as indicators that OhioHealth is doing well in both areas.

"You can feel when morale is slipping by absences and turnover," he says. "And I can feel it when I'm walking down the hall in one of our facilities."

The organization measures employee satisfaction with an annual survey, and the results indicate that OhioHealth workers are increasingly satisfied with their work life.

"We make sure that employees have a voice in how the organization operates," Blom says proudly. "We have a formal, frequent communication program used by managers and vice presidents. Patient care is definitely a team effort."

To keep staff and patients happy, as well as to reduce costs, OhioHealth has applied Six Sigma and lean principals to streamline its processes. One outcome was the decision to route all high-volume laboratory work through one lab.

"We were able to reduce the square footage we needed for lab work and our labor costs; and we increased the turnaround time for lab results," Blom says,which resulted in increased patient and physician satisfaction. "We reduced costs and are still delivering great quality care."

Another example of how the organization is making the most of its resources is the laundry facility OhioHealth is building in conjunction with Mt. Carmel Hospitals, which will open in spring 2004. Sharing the facility will keep costs down for both organizations.

Beyond that, expansion plans are designed to prepare OhioHealth to meet the needs of the aging baby boomer population. While it's clear that there will be a need for an increasing number of health care facilities, whether those will be inpatient or outpatient remains to be seen, Blom says.

Because of medical technology that allows physicians to treat patients less invasively, outpatient care is becoming increasingly more popular.

"There are a lot of disparate opinions as far as whether hospitals will need more inpatient beds or how many," Blom says. "The trend we're seeing is that the acuity of inpatient care is rising. And more patients are being treated at outpatient facilities.".

OhioHealth is playing it safe, expanding both its inpatient and outpatient facilities. With Riverside Hospital's new heart treatment tower, Grant's emergency room expansion, and surgical center and cardiology floor expansion at Doctors Hospital, Blom expects the system to be in a position to meet the needs of a larger geriatric population.

"We also have ambulatory facilities all over the city so patients can be treated where it is convenient for them," Blom says. "Those are diagnostic, therapeutic and some surgical offices that are close to where people live."

And it's not just about treatment, but also prevention.

"We have the McConnell Heart Center and the Gerlach Center that offer preventive services," he says, adding that each facility relies heavily on nurses to staff them. "We hired 575 nurses last year. That's more than we've ever hired."

For-profit vs. OhioHealth

The new enemy facing OhioHealth -- which delivered $85.6 million in charity care, uncompensated services and bad debt in 2001 -- threatens the organization's financial security. Throughout the country, for-profit surgical centers are thriving, offering physicians an easier lifestyle.

"There are no regulatory hurdles that prevent these for-profit niche hospitals," Blom says. "They are an investment opportunity for physicians," a way to replace income lost in part due to rising malpractice costs.

To combat these rising costs, physicians are both investing in the centers and working for them. And, for-profit hospitals can choose the cases they treat, picking the most profitable ones that present the least chance for complications.

Columbus will experience this firsthand when a for-profit surgery center opens by year's end in New Albany.

"Community hospitals rely on those cases to fund the departments that do not make money," says Blom. "It is the high-end general surgery cases like heart surgery and orthopedics that pay for the trauma centers and indigent care."

Blom, who serves on the Ohio Hospital Association's board of directors, is working with others in the state to change legislation so that these for-profit centers have a few more regulatory hoops to jump through.

Currently, physicians are legally forbidden to refer patients to nursing homes and similar facilities in which they have ownership. Blom and others want for-profit surgical centers to be added to that list.

But he knows that legal remedies are not the only answer.

"Part of the popularity of these centers for physicians is how easy they make life," he says. "We are partnering with physicians to make things here as efficient and effective as possible."

When the smoke clears, Blom wants to keep offering services that the community needs.

"I just want us to be able to continue serving this community," he says. "Just as we've done for over 100 years." How to reach: OhioHealth, (614) 566-5000 or www.ohiohealth.com


The Blom file

Born: Aug. 13, 1954

Education: B.S., The Ohio State University, M.S. in health care administration, The George Washington University, Washington, D.C.

First job: Dusting caskets and washing windows in a funeral home in Lisbon, Ohio

Career moves: Joined OhioHealth in 1982, worked his way up through the ranks

What was your greatest challenge in business, and how did you overcome it?

My biggest challenges come when we decide to close a hospital. We've had to do it three times, and each time it is a gut-wrenching decision. But each time, the hospitals remaining in the community become stronger, so there have been long-term benefits.

Past or present, whom do you admire most in business and why?

I can't single out any one person. I feel that you learn from everyone you work with -- colleagues, board members -- everyone.

What is the greatest lesson you've learned in business?

You need to have a strong set of values that are unwavering, because it is that value system that will see you through the challenges as well as the successes.

By the numbers

* 11,074 babies were born at Riverside, Grant and Doctors last year.

* 195,877 patients were treated in the Riverside, Grant and Doctors Hospitals emergency rooms.

* 16,255 people are employed systemwide.

* 111,783 patients were admitted.

* 43,682 outpatient surgeries were performed in Central Ohio.

* 500-plus research trials are going on at any given time at the three Columbus hospitals.

* 15,316 cardiac surgeries, diagnostic heart catheterizations and angioplasties at were performed at Riverside, Grant and Doctors, more than all other adult hospitals in Columbus combined.