2015-may-june

dialogue

MAY / JUN 2015

Healthcare Journal of new orleans

oscillate between us and Baton Rouge in

supporting veterans in the region.

Instead of being a referral hospital we refer

our care in the community. We run proba-

bly about an 80 to 85 average daily census

for inpatient care in community hospitals.

We have an agreement with Tulane for a set

of beds that we always have with them so

we can admit veterans when they need to

be admitted. For VA referrals we refer to the

VA inAlexandria. A lot of our acute cases go

to the VA in Houston, and of course Shreve-

port, Jackson, Biloxi, Gulfport.

The goal is to return to that vision of being

a referral center for the region and to do it in

a way that is in partnership with the medi-

cal schools. We’ve always been in partner-

ship with Xavier for pharmacy, Dillard for

nursing, LSU for nursing. We are now talk-

ingwithUNO to establish some sort of pipe-

line for MBAstudents, engineering students,

andwe already have an agreement withDel-

gado for Vo-tech.The idea is to partner with

the educational institutions to be able to sus-

tain a labor force that will allow us to man-

age this large referral destination hospital

for the region.

What is this hospital going to look like in

terms of size and services?

It’s roughly 1.6 million square feet and

200 beds. It’s a combination of medicine/

surgery beds, mental health beds, rehabili-

tation beds. It’s not a long-termstay hospital.

It’s a “I need to have a procedure done, I’m

not good enough to be home,”kind of hospi-

tal.We want to, down the road, evolve it into

a transplant center and establish a transplant

program for kidneys, which would make it

a quaternary medical center instead of a

tertiary care medical center. A lot of that is

dependent on our ability to stand up those

programs with the appropriate staff.

But right now, the hospital looks like a

bunch of steel and sheet rock. It’s starting

to come together. It’s something I’ma little bit

familiar with because I have a civil engineer-

ing degree; I actually startedworking across

the street managing construction projects. So

it’s actually a lot of fun for me to watch the

construction and be part of the team that’s

overseeing the activation of the hospital. It’s a

fairly complex process, though. Building the

building and getting the lights to come on,

and for everything to work, in itself is com-

plex enough. And then delivering furniture,

equipment, getting everything operational

and putting in the infrastructure for an infor-

mation system—that’s the next layer that on

its own is complex enough, but compounded

by this mammoth construction project.

But that’s not the end of the story. Before

we can see patients we have to have the

processes in place, the right people with

the right skill sets, we have to test our pro-

cesses, and we have to do it in a way that

meets the sequence for patient care. The

contractor builds the facility in a way that

fits the blueprints and design of the facility.

Their turnover of different buildings is based

on that sequence. But that’s not the turnover

sequence that allows us to see patients. For

example, they will turn over the inpatient

tower to us before they turnover diagnostic

services. We can’t see patients on the inpa-

tient side if we don’t have radiology, phar-

macy, lab, and so on. So for us it’s about that

alignment and preparing ourselves in a way

that will allow us to see patients in the saf-

est environment.

There’s a challenge to that outside of the

bricks and mortar stuff, building the infra-

structure, building for information systems

and technology, and then of course all of the

policies, processes, quality assurance, com-

pliance—we also have to have a workforce

that is prepared to operate in a 24-7 envi-

ronment. That hospital I described to you at

the very beginning that was a referral center

destination hospital for this region, that was

ten years ago. The folks that work here now

have not worked in that environment for at

least ten years and in some cases, have never

worked in that environment. So we have to

Greek physician Hippocrates promotes observation and the use

of the senses in making diagnoses, but also conducts diagnostic

tests on urine, sometimes by tasting it. He believes that disease

is related to imbalances in the body’s fluids or humors.

c. 1050 BC

Esagil-kin-apli pens the Diagnostic Handbook, a Babylonian

medical textbook that utilizes diagnostic techniques along

with observation of symptoms when treating illness.

c. 300 BC