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News Room: ENQUIRER: St. Elizabeth healthy after hospital merger

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By: Amanda VanBenschoten

EDGEWOOD — When St. Elizabeth Healthcare took over rival St. Luke Hospitals in October 2008, many Northern Kentuckians viewed the merger with skepticism.

Would the quality of care suffer with one company in charge?

Would we have fewer options? Would services be cut?

Would people lose their jobs?

The fear of the unknown ran high. Five years later, however, those concerns have largely been put to rest.

“For the first couple years, the word ‘monopoly’ was bandied around a lot,” said St. Elizabeth CEO John Dubis. “We don’t hear that anymore.”

The old St. Luke facilities in Fort Thomas and Florence remain, with new names on the buildings and tens of millions of dollars in upgrades and improvements inside.

The quality of care has vastly improved, and new services have been added.

St. Elizabeth has actually hired hundreds of new employees over the past five years.

Much emphasis has been placed upon making the two facilities more community-oriented, from moving outpatient procedures and testing labs closer to the entrances, to hiring chief operating officers with deep ties to the surrounding communities.

“I have heard nothing but positive comments from everyone: that the care is excellent, the people are good. I can’t say anything but good things that have happened since the merger,” said Fort Thomas Mayor Mary Brown, who volunteers at St. Elizabeth Fort Thomas twice weekly.

Merger brings changes to hospital network
In the five years since the merger, St. Elizabeth has sunk $250 million into improving and upgrading its entire network, including $30 million apiece in technological and facility improvements at Fort Thomas and Florence. (St. Elizabeth also operates hospitals in Edgewood, Williamstown and Falmouth, and an outpatient-only hospital in Covington.)

“We’re trying to build upon what was here and just take it and expand it in every aspect that we can,” said Chris Carle, chief operating officer of St. Elizabeth Florence since the merger.

Both look like entirely different hospitals now: They’re airier, more modern and much more user-friendly than in the past. But the changes aren’t just cosmetic.

A $1 million tele-ICU system was added at Florence and Edgewood to provide around-the-clock care from nationally trained critical care doctors.

Three $1.5 million da Vinci robots were added at Fort Thomas and Edgewood to help perform delicate surgeries.

St. Elizabeth also spent $80 million to implement an electronic medical records system across all of its facilities and doctor’s offices, a network that spans eight counties in Kentucky, Ohio and Indiana.

Not all the changes were positive: Catholic-run St. Elizabeth stopped offering reproductive services such as tubal ligations, which were provided by St. Luke.

Other services were consolidated. The birthing centers at Florence and Fort Thomas closed, a move that saved $7 million a year.

But St. Elizabeth also added services, including a bariatric weight loss center and a spine center in Florence; a heart valve center in Edgewood; and a women’s wellness center in Fort Thomas.

It also plans to open Northern Kentucky’s first Level 3 neonatal intensive care unit in Edgewood.

“We’ve done a lot, and we’ve invested a lot, and the community has responded to that,” Dubis said. “And it’s not just me saying that; it’s shown by their coming to us. The out-migration that’s happened from Kentucky to Cincinnati for a number of years has slowed very much, and we’re very proud of that.”

Patient care scores have dramatically improved
Florence and Fort Thomas have seen double-digit growth in patient volume over the past five years, indicating that more Northern Kentuckians are choosing St. Elizabeth rather than traveling north to competing hospitals in Cincinnati. (Christ Hospital and the University of Cincinnati Medical Center are now moving south, though, with new offices in Fort Wright and Florence.)

Most important, patient care scores have dramatically improved.

The nationally accepted measure of a hospital’s performance is called a “core measure” score.

Calculated by the Joint Commission and the Centers for Medicare & Medicaid Services (CMS), the score reflects the percentage of patients who receive the nationally recommended quality of care.

Florence’s core measures improved from 85.2 percent in 2008 to 99.8 percent in 2013, and Fort Thomas’ score improved from 83.9 percent in 2008 to 99.8 percent in 2013. (Edgewood continues to rank in the 99th percentile.)

U.S. News & World Report recently ranked St. Elizabeth Edgewood top among Kentucky’s 130 hospitals.

St. Elizabeth Florence and St. Elizabeth Fort Thomas were both ranked eighth.

Among the 38 hospitals in Greater Cincinnati, Edgewood ranked fourth and Florence, and Fort Thomas tied for eighth.

Strategic move positions St. Elizabeth for the future
While care and services have improved, the merger was also part of a bigger plan to position St. Elizabeth for growth in the changing health care industry.

As federal health care reform takes effect across the nation, Dubis expects to see the old fee-for-services model, by which unnecessary tests and procedures were often prescribed, replaced instead by a system in which more emphasis is placed upon preventative care and chronic disease management.

Instead of heading to the hospital for an expensive test when disaster strikes, for example, more attention will be paid to avoiding that disaster in the first place.

St. Elizabeth has spent years preparing for that shift.

In addition to the merger, it has also acquired practices and facilities across an eight-county region in Kentucky, Ohio and Indiana, including a diagnostic imaging center in Maysville and new partnerships with hospitals in Owen and Dearborn counties.

And in 2010, it created St. Elizabeth Physicians, a 350-doctor group that provides the vast majority of the region’s primary care.

Founded 152 years ago as a hospital for the poor, St. Elizabeth is now the largest employer in Northern Kentucky and provides the vast majority of the region’s health care.

Its 7,400-person staff, which includes 1,100 employees in the physicians’ group, is larger than major employers such as the Internal Revenue Service, Citigroup, Fidelity and Northern Kentucky University.

“We’ve got all the pieces in place,” Dubis said. “We’ve got a broad, integrated health system throughout eight counties: We have hospital facilities, ambulatory facilities, diagnostic facilities, surgery centers, physician offices. ... We’re set. We’re ready to go.”

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