Kent Hospital’s new president hasn’t taken long to initiate a program that could bring a cultural shift for the state’s second largest hospital.
Robert J. Haffey, who came to Kent in September from the Philadelphia area, recently introduced Relationship Based Care (RBC) to a 10-bed orthopedic unit. If adopted, Kent could become the first hospital in the state where nurses practice RBC.
Haffey gave a brief outline of RBC in an interview Tuesday where he described the condition of Kent as healthy and touched upon Care New England’s intent to be acquired by HealthCare Partners of Boston. Kent is a Care New England hospital. Present for the interview was CNE’s director of communications, James Beardsworth.
“We’re very optimistic this is going to happen,” Beardsworth said of the acquisition by Partners, which is still undergoing regulatory review. Assuming Kent becomes a Partners hospital, Haffey said it would remain a “community hospital” but would benefit from the “halo effect” of Partners cardiologists and other specialists.
Both Beardsworth and Haffey gave Kent and CNE a sound financial report, although an annual report, unusually released at this time, has not been finalized.
“Care New England is profitable as a whole,” said Bearsdworth.
He said the carryover losses from Memorial Hospital in Pawtucket would show a deficit but that CNE operations for the past fiscal year were in the black. CNE closed Memorial’s intensive care unit in December 2017 followed by the emergency room a month later to stem losses.
“We’re moving forward,” said Haffey.
He finds the hospital’s revenue streams dependable. He looks to build upon Kent’s cardiac care unit and its ability to perform emergency coronary angioplasty. Haffey said he has met with emergency management services in the area and has brought EMTs who have rushed patients to the hospital into the cardiac labs to follow the lifesaving procedure and witness the outcome. Emergency coronary angioplasty involves the introduction of stents to open a clogged artery and restore blood flow to the heart.
Kent has long performed the procedures on an elective basis and in May 2017 introduced the procedure on an emergency basis, thereby reducing the time to reach care for individuals suffering a cardiac arrest from near Kent and points south. Rhode Island and Miriam Hospitals in Providence continue to perform the majority of the emergency procedures.
“This hospital is now profitable,” Haffey said of Kent.
That was not the case for the 2017 fiscal year. That’s turned around.
The third quarter CNE report released in August showed its Obligated Group (CNE excluding Memorial Hospital) achieved income from operations of $4.6 million compared to a $6.5 million loss for the same April-June quarter last year. Overall, consolidated financial improvement (including Memorial Hospital wind-down) for the third quarter was $7.3 million better than the same quarter last year.
Beardsworth said Kent’s emergency department visits are a consistent 70,000 a year. The hospital has 359 beds and employs 2,417, of which 853 are medical staff. In 2017 it had 12,948 admissions, 744 births and 8,926 surgeries.
There are no immediate plans to further expand the Kent campus, but Beardsworth points out the hospital continually is looking to respond to the community. He said Kent is in the process of developing an older adults program in response to the state’s aging population. Planned is a united-based program with professional trained in issues such as dementia faced by the elderly.
While finances are critical, Haffey is motivated to build a system that delivers safe, quality care and is there to meet community needs. He is in the process of selecting his key directors and has introduced “Breakfast with Bob” as a means of getting to know the staff and learn of their ideas and concerns. Breakfasts are held by units and are informal where Haffey updates staff on developments as well.
“There’s a lot of work here,” says Haffey. He is confident he has the skill set to do the job.
Recruited as a candidate for the Kent job, Haffey was the president of Springfield, Pennsylvania-based Delaware County Memorial Hospital, Taylor Hospital and Crozer Keystone Health System Ambulatory Care Services. Haffey was associated with Crozer Keystone Health System since 2012, serving as chief nursing officer for the five-hospital system before moving to his current role in 2014.
According to a release at the time of his selection, Haffey’s efforts at Crozer resulted in financial stability, recruitment of key specialty physicians and an increased referral base. Haffey’s five years of bedside nursing experience also give him an important understanding of hospital operations.
Haffey is currently living in a summer rental in Narragansett and plans a more permanent residence in the area in the spring when his daughter completes school and wife makes the move. He earned his master’s of business administration in health care administration from Eastern University in St. Davids, Pa., and his master of science in nursing from LaSalle University in Philadelphia.
Haffey describes RBC as strengthening the relationships between those delivering the care and the patient, between those delivering the care and, finally, individually with themselves.
As described online, Relationship Based Care (RBC) is an operational blueprint for improving safety, quality, the patient experience, employee engagement, and financial performance. In a follow-up email to the interview, Haffey said the hospital started implementing the RBC model about six weeks ago. The nursing staff was provided the book Relationship Based Care: A Model for Transforming Practice by Mary Koloroutis, and Nurse Director Nicole Hebert, MSN, RN has been reviewing and discussing the book with the nursing staff. He said that the nursing staff on 2 North have already started implementing some of components of the care model.
“I meet with the staff and the manager periodically to see how things are going and to offer my insight and advice; however, it is truly a grassroots effort that the nursing staff on 2 North have embraced,” he said.
Haffey said Chelsea Defeo, RN and Kari Dimascio, R.N are mapping out every step of the care they provide to patients throughout the day and are “reviewing this and determining which areas can be improved through evidence-based practice and through keeping the focus on the patient and the patients’ experience.”
In the next step a Professional Practice coordinator, who starts in December, will help with the implementation of this model throughout the hospital.
“Staff from each individual unit will be included every step of the way,” he said.
Haffey implemented RBC at a hospital in Philadelphia.
“We saw great improvement in quality, safety, patient experience of care and staff satisfaction,” he said.