St. Elizabeth Healthcare

In January 1861, St. Elizabeth -- a hospital organized by the Sisters of the Poor in Cincinnati -- admitted its first patient. 

In January 2011, St. Elizabeth celebrated a milestone anniversary. After 150 years, it's the largest employer in Northern Kentucky and its regional economic impact is over a half-billion dollars a year. And it's got a new CEO to boot. John Dubis, former Chief Operating Officer, started on January 1 this year. 

"It's been a great 150 years," he says. "I'm looking forward to 150 more." 

Dubis is not a native of Greater Cincinnati, but the region's charms -- and the hospital's excellence -- attracted him here in 2008, after a recruiter lured him from his position as lead executive of the Children's Hospital in St. Louis. He didn't know anything about Covington, Kentucky and he wasn't looking for a job. 

"It was really just a coincidence," he says, "or fate. After you do this for a while, as soon as you walk into a hospital, you can sense the culture, the attitude, the flavor -- how things work. [And] on my very first visit, I could tell right away that this was an excellent organization."

St. Elizabeth's approach to health care is quality-centered and focused on innovation. For the past four years, St. E's has been named a Top 100 Hospital by Thompson Reuters and a Top 50 Hospital by Health Grades (which measures all 5,000 hospitals in the country). In addition, it was the first hospital in the region to receive Magnet status for nursing in 2006, and it was re-designated as a Magnet institution in 2010 -- recognition received by only 3.5% of the country's hospitals.

But St. Elizabeth's many accolades just confirm what this hospital is able to do, and the values that drive its high standard of care. And John Dubis sees plenty of room for improvement. St. Elizabeth is laying groundwork in 2011 to deliver more seamless care to more people in the region while cutting costs, streamlining services and reinvesting the savings into the hospital.

The more you do

As an example of St. Elizabeth's model of smart, streamlined growth, Dubis points to the consolidation of three obstetrics programs across three St. E. campuses into one efficient whole.

At St. E's Ft. Thomas facility, the OB program was delivering two babies a day and losing about $3.5 million a year; at Florence, three babies a day, and another $3.5 million annual loss. When all three programs were consolidated at Edgewood, St. Elizabeth used the savings to develop a high-risk OB program and create a natal intensive care unit -- neither of which previously existed in Northern Kentucky. The consolidated OB program delivers 5,000 babies a year.

The reason more volume leads to better results, Dubis says, is simple: "The more you do, the better you are." 

Another successful effort has been the implementation of an electronic medical records (EMR) system. All of the hospitals in St. Elizabeth's system were converted last year. EMR allows everyone on a care team -- including the patient -- common access to medical records and an easier way to communicate. It ensures that patients don't get the same tests more than once, allows care providers to collaborate efficiently, and integrates care at multiple levels, from physician to specialist to pharmacist. 

"We're really striving for seamless care," says Dubis, "and we're really on the right road to get there."

Community innovation

Throughout 2011 and over the next several years, St. Elizabeth plans to expand its reach and build partnerships with other physician groups and hospitals throughout Kentucky, Ohio and into Indiana. Whether it's implementing St. E's electronic records system at other hospitals and care centers, dispatching mobile diagnostic units to provide mammograms and cardiovascular screenings in rural areas, or sending specialists to small community medical centers, St. E believes in improving access to care on a regional scale.

St. E's dedication to technological innovation also gives it an edge in a competitive marketplace. In late November 2010, Ft. Thomas added a state-of-the-art da Vinci surgical robot for minimally invasive procedures; the robot will be integrated into the new Ft. Thomas Women's Health Center, one of several Centers of Exellence in the St. Elizabeth system. Another Center of Excellence, the cardiovascular program at Edgewood, is one of only 10 facilities worldwide with a 320-slice CT scanner -- the most powerful x-ray imaging device in existence.

The developments St. Elizabeth chooses to pursue don't happen in a vacuum -- they come from community.

"We don't make decisions in a closed conference room," says Dubis. "We do market research to find out what Northern Kentucky wants and what it needs."

St. Elizabeth already engages with the higher educational community in the region and enjoys a collaborative relationship with the informatics and nursing programs at Northern Kentucky University. And in Northern Kentucky's emerging life sciences and biotechnology cluster, St. Elizabeth could be poised for a productive partnership.

"We haven't had a lot of engagement yet, but I see that as an opportunity for the future. We are an innovative, creative organization. If you're not, you die." 

The bottom line always comes back to quality -- and the power of quality to impact the bottom line.

"We're striving to bring a new level of care to Northern Kentucky and Greater Cincinnati that has never been seen before," he says. "Given the caliber of what we're able to do -- in terms of our market position, financial position, and alignment of services -- in five or 10 years, we can create a level of service that will rival in reputation a Mayo or a Cleveland Clinic.

"That may sound a little ambitious, but Mayo didn't start on day one as Mayo. And we're not starting from day one."

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