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Erlanger honors Sen. Bob Corker, Drs. Cofer and Brown at annual Dinner of Distinction event

The Erlanger Health System Foundations will honor Drs. Hugh Brown and Joseph B. Cofer, and award U.S. Senator Bob Corker with the first “Gordon Street Distinguished Leadership Award” during Erlanger’s annual Dinner of Distinction Friday, February 27, at the Chattanoogan.

The 2015 honorees are being recognized for their enduring commitment to foster quality medical services to this community, as well as demonstrating unquestionable character and human compassion.

DrBrown

Dr. Hugh Brown

Dr. Hugh Brown, board certified orthopedic surgeon, taught future surgeons while serving as associate professor with the UT Department of Orthopedic Surgeons and was director of Pediatric Orthopedic Services from 1997 to 2008.   He has been honored on numerous occasions for his teaching skills and recognized with the “Outstanding Teacher Award” on three separate occasions from the Orthopedic Surgery Residency Program.  For 28 years, Dr. Brown served as Director of the Scoliosis Clinic, and orthopedic consultant to the Walter Boehm Spina Bifida Clinic, in addition to running a private practice for 28 years.  Dr. Brown’s influence will be felt within the walls of Erlanger for decades to come.

Dr. Joseph B. Cofer

Dr. Joseph B. Cofer

Board-certified general surgeon Dr. Joseph B. Cofer is a professor of surgery and serves as surgery residency program director for the Department of Surgery at the University of Tennessee College of Medicine Chattanooga. He has been recognized on numerous occasions as a champion for Project Access, a program based on donated services and medical care for those in need.

This year, the Distinguished Community Leadership Award will be posthumously awarded to Gordon Street and henceforth known as the Gordon Street Distinguished Leadership Award.  Senator Bob Corker is being honored as the first recipient of the Gordon Street Distinguished Leadership Award.

Gordon Street

Gordon Street

“Gordon Street was a devoted and longtime supporter of Erlanger, serving both as a member and chairman of the Erlanger Baroness Foundation,” said Erlanger Foundations President Julie Taylor. “Since his untimely death last March, Mr. Street left a void that will always be felt by the Erlanger family. We wanted to recognize his impact on Erlanger and his advocacy for improving health of our community,” she said.   According to Ms. Taylor, it was the wish of the Erlanger Health System Foundations that Gordon Street’s legacy will continue to live through those recognized in his name.

Senator Bob Corker

Senator Bob Corker

Senator Bob Corker has been a long-time advocate for improving the health of our region.  During his tenure as mayor of Chattanooga, Senator Corker supported numerous wellness initiatives within the city.  He has also sponsored several bills to improve healthcare in our nation and help empower all Americans to have access to medical services.

The February 27 event begins with a reception at 6 p.m., followed by dinner and program at 6:30 p.m. Table sponsorships are currently available at $1,500 per table.  Individual tickets will be available on February 9, at $85 per person.  For more information or to purchase tickets, contact Christian Orth at the Erlanger Health System Foundations at 423-778-9298 or Christian.Orth@erlanger.org.

Erlanger doctors, executives ‘tear down the wall’ for new orthopedic center

(as seen in the Saturday, January 24th, 2015 edition of the Chattanooga Times Free Press)

by Will Healey

Physicians and executives at Erlanger hospital traded their scalpels and pens for sledgehammers Friday as they tore down a wall in a ceremony to begin construction of the new Center for Orthopedic Surgery.

The new orthopedic area, set to open later this year, will feature four new operating rooms, 12 in-patient beds, pre- and post-operation areas, a family waiting room and rehabilitation and common areas. The $9.5 million project is the first phase of a planned expansion at Erlanger made possible by a $71 million bond investment.

Kevin Spiegel, president and chief executive officer of the hospital, addressed the gathering of executives in dark suits, doctors in white coats and nurses in blue scrubs.

“This is a wonderful occasion,” Spiegel said. “This marks a new phase of Erlanger’s future that will meet the hospital’s infrastructure needs with world-class facilities unparalleled in the region, and will help our patients achieve their goals to return to normal, more active states.”

Dr. Mark G. Freeman, who trained at Erlanger and has been pushing for the project for more than five years, said it has been a long time coming.

“The quality of care at Erlanger has always been the best, but unfortunately the infrastructure has lagged behind,” Freeman said. “It’s a great day for me and my colleagues, but most importantly for Erlanger and its patients in the region.”

Photo by Tim Barber/Times Free Press.

Freeman said Erlanger has long been the region’s go-to destination for sports medicine, not only treating athletes from UTC and the area’s high schools, but patients in North Georgia, Alabama, North Carolina and South Carolina as well. He said the project will help the hospital provide the best orthopedic care around, and he borrowed a racing analogy to express its impact.

“You can have the best car in the world, or the best driver in the world, but you need both to be successful,” Freeman said. “We’ve had the best drivers for a long time, and now we’ll have the best car, too.”

Four doctors, Spiegel and Erlanger Executive Vice President and Chief Operating Officer Rob Brooks all donned blue hard hats, safety glasses and gloves and wielded gilded sledgehammers made specially for the event. Spiegel took the ceremonial first whack, with others following suit with three or four swings. Freeman, attacking the wall as if it cheated him at cards, took eight. He called it a release.

“I’ve been waiting to do that a long time,” Freeman said, smiling through the air, thick with dust from the bludgeoned wallboard.

Contact Will Healey at whealey@timesfreepress.com, 423-757-6731, or on Twitter at @wfhealey.

Erlanger leaders and physicians “tear down the wall” for new orthopedic suites

Group Shot TDWErlanger executives and physicians celebrated today by “tearing down the wall” with sledgehammers in hand at the future location of Erlanger’s new Orthopedic Services area.

“Our orthopedic and sports medicine specialists were so anxious to see this construction begin, they wanted to personally kick off this first phase of Erlanger’s expansion efforts by making their own mark on the re-build,” said Erlanger President and CEO Kevin Spiegel.

This demolition effort represents the first phase of Erlanger’s ambitious expansion plans made possible by $71 million in bond sales last November to be used for capital improvements throughout the Erlanger Health System.  More than $9.5 million of those funds have been allocated for Erlanger’s operating room expansion for orthopedics, vascular and cardiac surgery.

The new orthopedic area, which will open later this year, will feature four new operating rooms, 12 in patient beds, pre and post operating areas and support services, such as a family waiting room, rehabilitation and other common areas.  From patient arrival, surgery, post operative care and discharge, each area will be specifically designed for orthopedic care.

Close Up TDW

Dr. Bill Moore Smith TDW

Erlanger reports ‘unprecedented’ $12.7 million profit after three years of losses

(From the January 20, 2015 Chattanooga Times Free Press) There are usually plenty of empty seats at Erlanger Health System’s budget and finance committee meetings.

But as physicians and administrators crammed into the hospital boardroom Monday evening, several rows of extra chairs had to be dragged in. The crowd had been invited to the session by Erlanger executives to celebrate good news for the hospital, which has been beleaguered by financial tumult for several years.

As the hospital’s chief financial officer Britt Tabor took to the podium to outline the hospital’s quarterly earnings, he told the packed room that “this is unprecedented, what I’ve got to say tonight.”

He then reported that the hospital has posted a $12.7 million profit for its second quarter and $20 million for the year so far — already outpacing its performance for all of last year.

Tabor and other hospital officials say the latest report is proof that the hospital’s financial recovery is not “just a flash in the pan,” said CEO Kevin Spiegel.

This time last year, the hospital was posting a $1.5 million deficit. The hospital had previously suffered from three years of financial losses before posting a profit at the end of fiscal year 2014.

But while Erlanger saw a dramatic financial turnaround by the end of its last fiscal year in July — when it posted an $18 million profit — skepticism has persisted about the hospital’s ability to show that kind of long-term performance.

Hamilton County lawmakers, outraged at the Erlanger board’s decision to grant the hospital’s executives $1.7 million in bonuses in December, said that it was too early for such incentives considering the recent financial tumult. While Erlanger may have posted the profit they emphasized, the hospital relied on $19 million in new funding from a federal pool to reach it.

In his presentation, Tabor outlined a long list of recent changes at the hospital that are creating “long-term,” “stabilizing” effects. The hospital has instituted a revised, decade-long agreement with the University of Tennessee for its academic program, and has also forged a five-year strategic partnership with BlueCross BlueShield of Tennessee that makes Erlanger the single provider in one of the insurer’s new exchange networks.

The hospital has gained about $47 million through savings because of new initiatives, Tabor said. That number includes the $19 million federal infusion — but it also includes the savings from new programs like discount drug sourcing,changing its food services contract and outsourcing housekeeping. Other initiatives, like shaving the average time a patient stays at the hospital by half a day, saved the hospital $3.1 million.

Other tightening has been much more personal and painful for hospital employees, like the decision to phase out pensions. That move has saved the hospital $4 million, while cutting retirees health benefits has saved $1.5 million. The hospital has also restricted overtime and increased employees’ responsibility for health insurance.

Photo by John Rawlston/Times Free Press.

But with the cuts has also come aggressive new spending. In the last 18 months, the hospital has purchased a new PET scanner, a new MRI, created a new breast resource center, renovated surgery centers and cath lab, among other upgrades. While seemingly contradictory to the belt-tightening, Erlanger leaders call these “important investments” to grow the hospital’s market share, to draw doctors and to “further the hospital’s mission,” Spiegel said. In the coming years, about $96 million will be funneled toward capital projects like expanding Erlanger East and building a new ambulatory center for the children’s hospital.

During the meeting, committee members also approved spending $8 million to relocate and expand its orthopedic surgery suites at its downtown campus, along with $1 million to build a new outpatient oncology clinic and infusion center at the Erlanger East campus.

Tabor said that such an aggressive stance pays off with investors looking to buy up Erlanger’s bonds, which went to market several weeks ago. Within 45 minutes, Erlanger had sold all of its bonds and by two hours, $650 million worth of orders had been put in for the hospital’s $149 million worth of bonds.

“It shows that investors really believe in the hospital’s future,” Spiegel said.

One of the most important turnaround efforts, Spiegel said, has been the work the hospital has done over the past 18 months to rebuild physician relationships which had soured under the previous administration of former Erlanger CEO Jim Brexler. Such relationships are key — physicians are the ones who bring business to Erlanger through referrals, and by choosing the hospital’s operating rooms to perform procedures.

Primary care physician Dr. Bill Moore Smith, who heads up Erlanger’s sports medicine services, said after Monday’s meeting that “doctors have come back to Erlanger because we believe in Erlanger.”

“We now have the leadership we all have confidence in,” he said. “We believe they have the right vision, and we want to be part of the success story. We believe we can take better care of patients and do it in a way that is sustainable.”

Those improved relations appear to be a large factor in the surge of patient admissions Erlanger saw its last quarter, up 10 percent from where it was this time last year. Meanwhile, the hospital also reported that its market share — how much business it gets compared with other hospitals in the region — had grown from nearly 31 percent to 32 percent.

“This is showing the sustainability,” Spiegel said. “We had one year of profitability, and now we have an additional six months of profitability and volume growth. We’re expecting next quarter to be significantly ahead of budget.”

Contact staff writer Kate Belz at kbelz@timesfreepress.com or 423-757-6673.

Erlanger posts $20.4 million earnings first six months; highest 2nd quarter earnings in 15 years

CHATTANOOGA, TN. – “Unprecedented in Erlanger’s history.” Those were the words used to describe Erlanger’s impressive financial results Monday by Chief Financial Officer Britt Tabor during his second quarter earnings report to the Chattanooga-Hamilton County Hospital Authority’s Budget and Finance Committee.

Tabor told board members that Erlanger posted $12.7 million in gains during its second quarter, bringing the health system’s year-to-date earnings to an unprecedented $20.4 million. “Although this is one of Erlanger’s most aggressive budgets, we have exceeded our year-to-date budget by $13.6 million and the prior year by $22 million for the first six months of this fiscal year,” Tabor announced.

In citing this quarter’s earnings as truly unprecedented, Mr. Tabor said that Erlanger has posted negative second quarter earnings 10 times in the past 15 years and the next highest second quarter earnings was $5.7 million in fiscal year 2007-08, $7 million less than this quarter. And as a reminder, Tabor told trustees “we had a $26 million improvement comparing fiscal year 2013 to fiscal year 2014.”

“There is no question we have achieved this by focusing on two key areas: top line growth and bottom line cost management,” Tabor said. “This huge accomplishment represents a lot of hard work and reflects the impact of strategic business growth and cost management initiatives over the past twelve months,” he stressed. “The numbers for our second quarter clearly demonstrate the upward trend with growth in volumes and sustained positive financial performance at Erlanger. The strategic plan put in place during the last year will help Erlanger for the foreseeable future and provide the platform for Erlanger to invest in this community unlike any other time,” he noted.

Erlanger’s CFO reminded trustees that Erlanger’s earnings are even more noteworthy since the Chattanooga health system has “already provided over $43 million in uncompensated care to this community during the first six months of our fiscal year.” Erlanger’s indigent/self pay utilization was 6.6% over budget this quarter, and bad debt and charity care as a percentage of gross patient revenue was 8.23%.

Across the board growth

Tabor reported that Erlanger’s admissions the past three months were 10.4% over budget and 10.5% greater than last year. Days of cash-on-hand at the end of December 2014 was 94 days. By comparison, that number stood at 65 days cash-in-hand one year ago, he told the board. “This is the direct result of a continued focus on operating efficiencies, physician relations, top-line growth, and our cash collections,” Tabor said.

“Keep in mind it wasn’t just one area of operations that led to these impressive results,” the CFO said. “Erlanger is exceeding its projections in virtually every key area – from ER visits to admissions to inpatient and outpatient surgical procedures and air ambulance flights. Our business is up across the board. This means we are serving more residents in this community and demonstrating sustained positive financial performance,” Tabor explained.

  • Surgical inpatient volume was 4.1% over budget and 8.7% higher than last year. Surgical outpatient volume was 5.8% over budget and 1.8% greater than last year.
  • Emergency room visits were 11% over budget and 9.7% higher than last year.
  • Tabor also drew attention to two cardiac areas that showed “astounding growth” during this reporting period. “Erlanger’s cath lab procedures were 36.7% over budget and 32% higher than last year,” he said, and “our inpatient heart/thoracic surgeries were almost 32% over budget and 19.1% greater than last year.” These huge increases “are a direct reflection on Erlanger’s strategic growth plans surrounding the health system’s cardiac center of excellence this fiscal year,” he said.
  • Also impressive were volume growth figures in orthopedic and neurosurgery over the past three months. “Erlanger’s orthopedic inpatient surgeries were 15.3% over budget and almost 33% greater than last year, and our neurosurgery inpatient surgeries were 25% higher and more than 17% over budget,” Erlanger’s CFO reported.
  • Air ambulance patients were 4% higher than the same period last year and 1.7% over budget.
  • Tabor also reported that commercial insurance utilization was 2.4% over last year and .3% over budget this second quarter.
  • An ongoing focus on cost management initiatives also paid off during Erlanger’s second quarter. “Our cost per adjusted admission was $7,530 compared to a budgeted $7,758,” Tabor pointed out.

“A Successful Journey”

Also at tonight’s meeting, Erlanger President and CEO Kevin M. Spiegel, FACHE and Tabor presented a report to trustees, outlining “A Successful Journey Leading to a Strategic Capital Plan.” In the report, the executives described their focus on both cost management and strategic growth initiatives this fiscal year, which was the cornerstone of subsequent meetings with major investors and Wall Street in November.

This focus on sustainable growth led to an infusion of $71 million in new money from bond sales, created $35 million of cash flow savings over 10 years, and enabled Erlanger to move forward with key strategic projects this year. Those expansion efforts include: $50 million in bond proceeds to fund a major expansion of the Erlanger East Hospital expansion to a 107 bed hospital; $11.5 million funding towards a new Children’s and Women’s Ambulatory Center; and $9.5 million for the construction of new vascular operating rooms and construction of a dedicated orthopedic center with inpatient beds.

Tonight’s Resolutions

Erlanger Oncology Service Line Administrator Tony Dotson presented a resolution authorizing the construction of an outpatient infusion center and medical oncology clinic at the Erlanger East Hospital campus. In keeping with strategic growth plans surrounding the Erlanger East expansion, Dotson told trustees that this project will “foster improved access to care for oncology patients within Erlanger’s entire service area, particularly those living in East Hamilton County, Bradley County and North Georgia.”

“This project represents a commitment to expand the oncology service line throughout the Erlanger Health System and to meet the needs of an increasing patient base,” Dotson said, followed by supportive comments from oncologist Dr. Larry Schlabach, with University Oncology and Hematology Associates. This plan is also consistent with Erlanger’s larger strategic initiative to develop the Erlanger East Hospital campus into a full-service community hospital with a comprehensive cancer treatment program.

The budgeted cost for this project is $1.02 million, which will be funded out of Erlanger’s current fiscal year budget.

Trustees voted unanimously to move forward with this vital recapitalization project.

Rob Brooks, Erlanger’s Executive VP and COO, sought board approval for the construction of elective orthopedic surgery suites on the hospital’s 6th floor. Brooks told trustees that this project represents the initial phase of Erlanger’s orthopedic growth strategy “addressing the needs of this patient population in an efficient, cost effective, high quality and customer friendly manner.”

“Our data research supports that the elective orthopedic and sports medicine population will continue to grow in this region for years to come,” Mr. Brooks said. “This effort allows Erlanger to continue to grow our orthopedic footprint by placing the correct technology and services at the correct location,” he added.

The project would build out 4 OR suites and supporting areas on Erlanger’s 6th floor dedicated to elective and sports medicine customers who require surgical intervention. Total cost of the expansion effort is $8 million, which will be funded through capital approved for FY 2015.

Erlanger’s Budget and Finance Committee members also voted to move forward with this $8 million recapitalization project, and will vote on the resolution during Thursday’s board meeting.

Times Free Press story describes Erlanger Stroke Center as the frontier of U.S. stroke treatment

The Erlanger Stroke Center is on the cutting edge of stroke care and treatments. Click here to read the Sunday, January 11 article in the Chattanooga Times Free Press about some of the clinical trials and research that make Erlanger one of the best hospitals in the nation for stroke care.

Erlanger First U.S. Hospital to Launch AlarmNavigator System

Erlanger Health System has taken a national leadership position by becoming the first hospital in the United States to implement the AlarmNavigator solution from Excel Medical Electronics. Erlanger is a key contributor to the development and continuing field testing of this innovative software tool.

AlarmNavigator enables the hospital to analyze the occurrences of physiological alarms generated by GE patient monitoring systems, such as monitors that measure high and low heart rate, high and low blood pressure, low oxygen saturation, and cardiac arrhythmia.

“AlarmNavigator offers tremendous power as we work to improve patient safety by reducing the audible and visual alarm burden on our clinical staff for events that do not require clinical intervention. It will also play a key role in our efforts during 2015 to comply with the Joint Commission National Patient Safety Goal on Alarm Management,” explained Spears McAllester, Erlanger Director of Clinical Engineering.

With a thorough understanding of the total number of alarms, the different kinds of alarms, how long each alarm lasts, and in which specific care unit alarms occur, Erlanger can customize alarm activation settings and identify potential changes to patient management processes that will enhance patient care and safety. These customized settings and process changes also will help Erlanger to comply with the objectives of the Alarm Safety National Patient Safety Goal established by The Joint Commission.

“As a unique web-based application, AlarmNavigator is fully scalable, allowing hospitals to identify and quantify alarm conditions and to generate meaningful reports that enable evidence-based decision making when approaching the clinical alarm challenge,” said John Hoffman, President of EME. “The hospital can harvest already available alarm data from patient monitoring systems by utilizing a software-only solution that leverages the existing hospital IT infrastructure.”

“We are excited to integrate the AlarmNavigator program into the Erlanger Health System,” said Kevin M. Spiegel, FACHE, Erlanger President & CEO. “The safety of our patients is our top priority, and I am confident this new program will enhance the safety aspect of care for all of our patients.”

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