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Jefferson Regional Medical Center's blueprint for progress

With new heart and cancer centers, an expanded ICU and an extensive strategic plan, the complex aims to be the country's leading community hospital

Wednesday, March 06, 2002

By James DeWeese, Post-Gazette Staff Writer

Against a backdrop of heart-shaped fireworks bursting outside the wall-size windows of the newest addition to Jefferson Regional Medical Center, a host of doctors, administrators and staff cut the ribbon to officially open the Jefferson Hospital Heart Institute.

 
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Milestones along the way

 
 

That ceremony two weeks ago marked not only a new arena of care for the community hospital, but also the latest chapter in the 25-year-old institution's history of expanding health care in the South Hills.

The new facility, which houses two fully equipped operating rooms for cardiothoracic and vascular procedures, will allow doctors at Jefferson to perform open-heart surgery for the first time since the hospital's construction in 1977.

Starting in April, with the completion of two new cardiac catheterization labs, doctors also will be able to carry out higher-risk cardiac interventions such as stents and angioplasties which, under state law, could not be performed without open-heart backup.

Before, patients who entered Jefferson's emergency room with more serious heart ailments had to be "shipped off across the river" to larger facilities in Pittsburgh, said Dr. Stanley Wetschler, medical staff president.

Long-term plans

The Heart Institute forms the cornerstone of a three-year strategic development plan already under way that calls for continued improvements to the hospital's Coal Valley Road campus, rigorous medical staff recruitment, better marketing and fiscal responsibility, chief executive officer Jan R. Jennings said.

Kurt Weber, director of planning, marketing and communications, said the goal is to make Jefferson "the best community hospital in the country."

With that in mind, the hospital opened the Jefferson Hospital Cancer Center in November 2001. The center concentrates all the necessary specialists in one location, eliminating the need for patients to trek back and forth between doctors, Weber said.

And in January, the hospital opened an expanded intensive-care unit on the second floor of the two-story football-shaped addition that houses the Heart Institute.

"The Mayo Clinic and Cleveland Clinic have nothing that we don't have," said Terry Riffner, the institute's administrative director.

Riffner added that the institute already has attracted two of the Pittsburgh area's premier cardiovascular surgical teams, led by Dr. Sang Park, formerly of St. Francis Hospital, and Dr. V.R. Machiraju, medical director of the Heart Institute. Machiraju noted the teams represent more than 5,000 man hours of cardiovascular surgical experience.

The opening of the Heart Institute and ICU closes the book on major construction for the time being, Jennings said. "We've addressed the intricacies of cardiovascular technology, but we're short on parking," he joked.

Balancing the budget

Even without any major physical expansion, Jefferson cuts a large economic swath in the South Hills.

With more than 2,000 employees, nearly double what it started with in 1977, the hospital is one of the largest employers in the area.

In Jefferson Hills, where the 353-bed hospital is located, the other seven top employers combined employ about 1,315. The U.S. Steel Clairton Coke Works in nearby Clairton has about 1,600 employees.

The hospital budgeted $123 million in operating expenditures for the fiscal year ending in June. Projected revenue is $124 million for the year, although increased patient volume and rising pharmaceutical costs will likely mean another $5 million in operating expenses, chief financial officer Tom Timcho said. But he expects revenue to keep pace, and hospital planners are optimistic the books will more than balance at the end of this year.

Nevertheless, the hospital has faced tough economic decisions.

Jefferson closed its Homestead campus in December 2000 despite outcry from some officials in Munhall and Homestead. Jennings said the Homestead facilities -- The Emergency and Family Medical Center, the Willis Skilled Nursing Center and The Homestead, an assisted-living facility for the elderly -- created $8 million in annual losses.

Over the past two years, the hospital has posted operating losses of about $14 million a year. Despite those shortfalls, Timcho believes the hospital has weathered the economic downturn well, thanks in part to its assets and investments that were made during the '70s and '80s.

Partnering option

Bucking a health-care consolidation trend that has absorbed other hospitals such as McKeesport and Shadyside, Jefferson has remained independent, preferring to partner rather than merge with other institutions. Last year, Jefferson joined forces with the University of Pittsburgh Medical Center to cooperatively operate its home health-care service, which has more than 400 employees.

Thanks to good planning in the past, Jennings said, any merger down the road would represent a decision, not an obligation. "We're not in a position where we'd have to crawl into any relationship because we're on our knees financially."

Marketing is another concern for Jennings, who said, "We've been the best-kept secret in southern Allegheny County." That's about to change, he said.

In January, Jefferson Hospital, its parent corporation, the South Hills Health System, and its satellite operations adopted the name Jefferson Regional Medical Center to eliminate market confusion.

And with the scheduled opening of the Mon-Fayette Expressway, Jefferson's relative isolation will be a thing of the past, Jennings said. The hospital, from its perch overlooking the Route 51 corridor, will be strategically located along the new artery linking Fayette, Washington and Allegheny counties.

In addition to helping Jefferson secure some of the untapped cardiac care market in Fayette and Washington counties, the Heart Institute will attract a greater variety and abundance of cases to the hospital's emergency room, Timcho said.

Last fiscal year, 175,491 people received outpatient care at Jefferson, and 15,613 who received inpatient care. Of those treated in the hospital, more than 27,500 received emergency medical care.

Community council

Nurses, doctors and administrators remain active outside the hospital's walls as well. Volunteers from Jefferson help organize the Mall Walkers Program at Century III Mall on Thursday mornings, providing on-site blood pressure screening and medical advice to participants.

Jefferson also collaborates with the Community Health Council, its 60-member advisory body, on other outreach programs.

Council members are appointed by elected officials from 30 South communities ranging from Mount Oliver in the north to Belle Vernon in the south. It coordinates speakers for schools, local government leaders and civic organizations interested in learning about health care. And it organizes a health-themed poster contest for elementary school students, which generated about 2,800 entries last year.

Board Chairman John Echement, a 40-year resident of the South Hills, said he remembers a time when Jefferson didn't exist. With "everything ... basically across the river," any time one of his seven children required a trip to the hospital, "it was always an experience," he said.

St. Joseph's Hospital, South Side, and Homestead Hospital joined in 1973 to form the South Hills Health System, a rare pairing of Catholic and non-sectarian hospitals.

To this day, Jefferson does not perform abortions, vasectomies or tubal ligations in accordance with church law. The hospital does not have an obstetrics division or maternity department, which Weber attributes, in part, to the other restrictions on reproductive medicine. A nun from the Order of St. Joseph continues to sit on the board as well.

A rocky start

After getting off to a rocky start -- several months of 50 percent bed occupancy and across-the-board pay cuts -- the system began to gain momentum. By the mid-'80s, the hospital had added an ambulatory surgery center and a professional medical building and was operating one of the largest home-care nursing programs in the area.

Caroline Atkinson, the longest- standing CHC member with 25 years on the council, described a spirit of collaboration between the hospital and community that she said continues to this day.

"[We're] not just here to pat the hospital on the back," said Atkinson, pointing out that she has had opportunity to address everything from parking fees and valet service to hospital billing practices and emergency room configuration. "[But] the big thing is, they're always willing to listen."

In fact, Echement said, the new Heart Institute and ICU are in direct response to requests from the community for cardiac services. "We exist for the community. We are an asset of the community. Our only reason for being is the community."

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