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Bill Klaproth: More western New York residents are choosing ECMC for exceptional patient care and patient experiences as people are experiencing the difference between healthcare and true care. Here to talk with us about the evolution of ECMC is Thomas Quatroche, president and chief executive officer of the Erie County Medical Center corporation. Tom, thanks so much for your time. We appreciate it. ECMC continues to see record patient growth for the third year in a row with a record number of patients in 2017. What’s behind this impressive trend?

Thomas J. Quatroche Jr., PhD: Well, I think obviously the people here at ECMC and the culture that we've developed over the years is a large part of it. Western New York is very much a word of mouth kind of town. I think the fact that we take such good care of everybody that comes to ECMC, whether you're the most vulnerable or the most influential in our community, everybody’s treated as a VIP. The quality of the care. We’re the level one trauma center for western New York obviously is a large part of that. We started out on a journey many years ago when we became a public benefit corporation back in 2004. Really from a county entity to a freestanding hospital system. That journey, obviously we had a lot of growth over that time. Really professionalized the organization and began to tell the community about all the great things going on here. It was one of the best kept secrets in the community. So, we’ve been on a journey over the years to grow, become the hospital of choice for physicians, but also educate the community on the great care that’s delivered every single day.

Bill: Well speaking of that care and growth, ECMC has evolved as a hospital of choice for patients and clinicians and often being referred to as the region’s community hospital. Can you talk a little bit more about that evolution?

Dr. Quatroche: Sure. So ECMC, again, has been always known for trauma. The only level one trauma center for eight counties of western New York as well as burn. But we began to also become the hospital of choice for physicians to do elective surgeries here. So, we've grown significantly over the years bringing new services to Erie County Medical Center. Most notably, our orthopedic department has grown probably by 100%. We brought a bariatric program here. A head and neck cancer program, dental, oncology. So, we really worked hard to become the place of choice for physicians and really treated physicians as strategic business partners, not as employees as sometimes is the case. So, they were partners with us at the table every step of the way.

I think that open door policy that we've had here, our ability to treat the physicians as business partners, involve them in lots of decisions that are made here really was a differentiator for us in bringing them here. As a result, we’ve grown significantly. Probably in every single area anywhere from 20 to 30% we’ve grown. Inpatients and outpatients and ER visits and elective surgery, you name it. So that’s a significantly amount of growth in any institution. But it’s been one in which the existing folks that were here welcomed these new services on. So, there’s a culture piece to this too, and really saw the greater good of the organization and being able to take care of the community.

Bill: Well, you don’t grow without doing a good job. The physicians are so critical in improving patient satisfaction. Let’s talk about that a little bit. Speaking of becoming hospital of choice, can you share with us some of the improvements in quality and patient experience scores which are so important?

Dr. Quatroche: Sure. The physicians are a very integral part of that, obviously, but obviously the nurses are by the bedside each and every day. So, we really lead with nursing. The physicians really help us to do that by really being partners with the nurses. One the physicians here, who is head of the medical staff, coined it an egoless environment. That’s very important for communication and for improving quality in making sure that the physicians and the nurses and other healthcare providers can communicate very seamlessly with each other. We start with yes. They always want to know more information and rely on each there for the patients care. Nobody is more important than the other. I like to say actually I'm the least important person in the organization to the patient. All the people that touch the patient from the environmental services staff to the physician to the nurses. Everybody matters in the care of patients.

So, we’ve had some great successes in quality. We’re obviously American College of Surgeon’s level one trauma accredited, verified center. We did achieve Leapfrog A at one point, which is really somewhat unheard of for a large public teaching hospital. Our patients experience scores have improved significantly. And, again, patient experience scores are not adjusted for the type of hospital you are. So, we compete with elective hospitals were people kind of expect to come and there is a more of a predictable stay. So, over the years, we’ve received accreditations for almost every single area and high praise, whether it be our transplant area, whether it be our rehabilitation area. Almost to a tee, every single outside body that comes in says to us, “You really have a unique culture here.” It’s something we all should be very proud of at the institution. It’s always nice to hear that affirmation from an outside agency. I think we know we do, and the people that come to work here stay for many, many years because of it, but it’s always nice to hear when an outside accrediting body says that.

In fact, for our trauma accreditation, the gentleman who did the verification—it’s called for American College of Surgeons—said he’s done probably 40 of those accreditations and also has been a trauma surgeon for about 30 years, and said he’s never seen a culture anywhere he’s been quite like ours. We had “lightning in a bottle”. So, we that piece of it really drives our quality piece. I think as a public safety net hospital for the community, we have a lot to be proud of.

Bill: Culture is so important. I like how you put that, an egoless environment. Start with yes. Now, as you mentioned, ECMC is a safety net hospital. You mentioned you're seeing more elective surgeries in areas such as orthopedics, bariatrics, transplantation, and head and neck oncology. Why the upward trend in elective surgeries?

Dr. Quatroche: I think part of it, again, is recruitment of physicians. So, we have, again, really been the place to bring new physicians on. We’re actually having a hard time keeping up with the amount of business that’s coming to the hospital in our emergency room, our operating room, and also our inpatient beds. I think as the population ages, I think that’s part of it too. Orthopedic surgery, for example, is supposed to increase, I think it’s 50% in the next 10 years. So, there’s a demographic change that’s going on. Frankly, more people have insurance. Whether that be from a government provider or an employer because the unemployment rate is very low. So that also obviously helps as more people have insurance, they're more likely to obviously not wait for care. We’ve seen an uptake in our emergency room and again with elective surgeries because people aren’t waiting to receive the needed care that they so desire. So, it’s I think a combination of a lot of factors, but for us, the only thing we can control is our ability to have a physician culture and make sure that we create the efficiency so that we can see more patients.

Bill: Well that makes sense. Tom, you currently serve on the statewide executive committee for the Healthcare Association of New York state as board secretary and are the board chair for the Western New York Healthcare Association. You're also a member of the board of Directors of America’s Essential Hospitals as well other boards. How does that help you shape your mission? And how does your overall involvement in these various boards and committees benefit ECMC?

Dr. Quatroche: Well, I think it’s a give and take. So, we do have some national quality statistics and we have better statistics then most well-known institutions in the United States. Some of these things that we’re doing here—and we, again, hearing this from our accrediting bodies—is best in class and world class care. So, part of the goal is to make sure that ECMC’s talked in the same light as some of these larger institutions that are known nationally. The first step to doing that is obviously to raise our awareness nationally. So that’s part of, and statewide, is part of our goal.

The second part of it, obviously, is you learn a tremendous amount from others who are like you. So obviously in New York state, we all face many of the same issues when it comes to reimbursement and other things that happen to go on in the state legislature. So, we advocate together, but we also learn from each other with regard to clinical care and quality. Same on the federal level. The America’s Essential Hospital system used to be called the National Association of Public Hospitals, but now has expanded their scope. All the institutions that we interact with in that organization are very much like us. They're safety net hospitals. They're large, academic teaching hospitals, and they’re taking care of everybody in the community. So, as we interact with that group and also as we actually present at many of the conferences and kind of teach others what we do as well as learn from others, the practices and experiences, it just makes us richer as an organization and obviously gives us contacts for things that we need to do. Again, as I mentioned at the beginning of this piece of our interview, it obviously gives us an opportunity to highlight and really take pride in some of the great initiatives going on here.

Bill: Well it’s easy to see where that type of exposure and interaction is very beneficial. So, Tom, ECMC is in the midst of a $55 million trauma center and emergency department capital campaign. Why the need for a new facility?

Dr. Quatroche: Well, our facility was built for 35,000 individuals. We grew it a little bit in the ‘90s so we could see 45,000, and today sees over 75,000 visits. Obviously, we’re going to be continuing to grow. So, the existing space is not adequate for the amount of volume that we see. On any given Monday—it’s usually our heaviest day—you’ll see patients in the hallway. That’s just not a healing environment. So obviously having been built 40 years ago from a physical standpoint, it was not built for families. Families are a big part of the care that’s delivered these days and we want the families to be engages in patient’s care. So just the size of the rooms, the size of our trauma rooms, on and on and on to accommodate the type of care that’s delivered today and the technology that’s needed to take care of patients has all changed.

So, it’s going to be also on the ground level. Right now, we’re actually on the first floor, which is a level up from ground. It has a ramp that goes up to it. We are the disaster preparedness center for western New York. If, God forbid, anything happened, many people would be coming there. That ramp in and of itself up to the next level would be a disaster if we had 50 ambulances coming to us at once. So, it’s going to help us with our ability to serve in the unfortunate situation that we may have a mass casualty or a disaster in western New York.

So, there’s many components to it and reasons that we’re building it, but obviously the first and foremost is centered on the patients in the community. We’ve also got a capital campaign for the project. It’s the first time we’ve really gone to the community and asked them for significant help. We had a foundation that does a very, very good job at events and raising lots of money, probably more than any other organization in western Ney York with their events. We’ve never really asked from a capital perspective. So, some of the larger institutions in town have large staffs to do that. We do not. We’ve been kind of a small shop going out to do that. We’ve raised almost $10 million. So just a testament to the care that’s delivered here and people’s experience with the trauma center and the many lives that have been saved as a result of the caregivers here.

So, we’re very proud of the fact that the community’s stepped up to help us. We’re continuing to raise dollars hoping to reach a $15 million goal. We’re confident that by the time the trauma center and ER is built, we will reach that goal. All in all, a very positive project for the community. It will save lives. Not trying to be melodramatic, but it will the way it’s designed. Also, again, and opportunity for the community to kind of be there for us since we’ve been there for the community for so many years.

Bill: Well, that certainly is a lot of growth and sounds like a great facility for the community. Lastly Tom, thank you so much for your time today, if you could wrap it up for us. From your chair, from what you see, what makes ECMC so special?

Dr. Quatroche: It’s the people. It’s the culture. It really distinguishes our ECMC. I think it’s the trauma culture. We’re available 24/7 and many, many specialties to take care of patients. So, the people here really understand the mission of what they do, of taking care of the most vulnerable in our community as well as the most influential and treating everybody the same. They live that mission. They live the mission of making sure we provide the very best quality of care for our communities. So, it does make it special. It’s sometimes hard for us to articulate unless you're a part of it, but I think from the trauma center to behavioral health, which is a large part of what we do here at ECMC in taking care of the most vulnerable in our community. It’s just a place where a lot of special people work, and a lot of special work is done on behalf of western New York and the community.

Bill: People taking care of people. What a great message. Tom thank you so much for your time today. We appreciate it. For more information on ECMC, visit ecmc.edu. That’s ecmc.edu. This is the True Care Healthcast from Erie County Medical Center. I'm Bill Klaproth, thanks for listening.