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HEALTHCARE
- April 2002 by Claude Hammond Sidebar-
“I describe our mission as the three wheels on the tricycle,” Claypool said. “The big wheel is the clinical component. The other two are education and research.” Because of the two “little wheels” of Claypool’s description, there are many additional demands made of the administrators and staff of Kentucky’s two university-affiliated hospitals at UK and the University of Louisville. Both hospitals employ more than 2,200 people and have budgets in the hundreds of millions of dollars. As employers, they are an economic force, though the greatest value they provide to a community may be as a teaching facility. Both hospitals are integral parts of their respective healthcare community.
Because of the added scrutiny of the accreditation process and the demands of medical professionals for research opportunities, Kentucky’s research hospitals demand the best of their staff in providing good patient care. “You’ve got to provide a quality product,” Claypool said. “And, that’s probably more demanding today than what it’s been in the past. There are people who are critical of the healthcare services being delivered in all hospitals all across the country, so the industry is responding to this scrutiny. As a result, we’re seeing more and more agencies who evaluate the care that’s provided. Nowadays, particularly with the advent of the Internet, more of that information is disseminated, resulting in better-informed consumers.” In other words, the pressure’s on for university hospitals to perform well. For hospitals to perform well, it oftentimes takes a lot of money for new equipment for treatment and research. “Right now we’re building a molecular imaging resource center and a cyclotron,” said Kent Marshall, vice president of marketing at U of L HealthCare in Louisville. Marshall stated that, because Kentucky’s hospitals have limited funding, they have found productive partnerships with other area healthcare facilities. “From the top down, about six years ago, we started a partnership here in Louisville called the University Medical Center, or UMC,” Marshall said. “We partnered with Norton and Jewish hospitals and formed UMC to oversee it all.” The UMC partnership allows the educational and research components of U of L HealthCare to function at other healthcare sites throughout Louisville. It’s become a win-win situation, with students in healthcare professions getting the opportunity to learn using the newest technologies in the area and to work in a diversity of settings. “There is a very close relationship between UMC and the University of Louisville,” Marshall said. “How the management is arranged, a portion of our cash flow supports research in the School of Medicine. As a result, more than $53 million has been made for the support of medicine over the last six years. It’s real important for us and the University to go down this path hand-in-hand.” An extensive building program at U of L HealthCare will greatly enhance the teaching and research function at the facility. “There are classrooms, auditoriums and teaching spaces on every floor,” Marshall said. “This will really enhance our instructional ability.”
In Lexington, the University of Kentucky Hospital has also formed important partnerships. The benefits to both education and budget have proven to be very important to both UK and U of L’s hospitals. “We’re intending to do more partnering with local businesses,” Claypool said. “We have as an initiative at this time to develop corporate partnerships. One example is with General Electric, which has a big presence in this state. There’s a lot a company like GE, which is recognized as a leader in the services they provide and for its corporate leadership, can offer. We, being an academic center, can offer a lot to them as far as them working with our physicians, possibly in regard to new technology. Right now, we are talking with them about performance improvement initiatives.” New, emerging and experimental medical technologies associated with research and clinical treatments are expensive. But another huge challenge experienced by university hospitals is getting medical insurance companies to pay when those technologies are used to treat patients. “I’ve seen where some academic physicians say, ‘The heck with it,’” Claypool said. “Some very good academic physicians have left the academic arena and gone to the public sector because of the sheer frustration of dealing with payors who won’t authorize payment for new and experimental technologies for a patient. We as a society lose out when academic physicians cease to do research and instruction.” Among the demands made of Kentucky’s university hospitals are the specialized resources available to both. Sometimes that can put considerable stress on the hospital staff and budget. “For example, at our Level I Trauma Center, it’s typical to be at near capacity, in the number of beds, utilization of operation rooms and emergency department,” Claypool said. “Because of the scarcity of resources, we need to be sure we’re caring for patients truly needing care from a Level I Trauma Center.” Claypool’s example is very relevant. For example, a compound arm fracture, where the broken bone is protruding from the skin, can often be easily set and is rarely life-threatening. However, because of the broken arm’s alarming appearance, there is both the emotional inclination of the medical staff and pressure from the patient to admit such a patient into the Level I Trauma Center, even though the admission would be unnecessary. This stretches that valuable resource and increases insurance costs at the same time. “These are the stressors on the system,” Claypool said. “We’re clogging up the system with people who are better cared for in other parts of the hospital. Trauma is just one example. This is a problem nationwide and in every department of every hospital. The issue of the scarcity of resources and the utilization of them in an inappropriate way is industry-wide. “Some studies claim that 80 percent of the cost we’ll spend on healthcare in our lives is spent during the last few days or weeks of our lives. Until the American public is ready to lessen the medical expenditures at that time for irreversible conditions, healthcare and insurance costs will continue to rise. Fortunately, patients can give advance medical directives for dealing with that part of life.” Claypool speaks from personal experience in this matter. “My mother just died just a few weeks ago,” he said. “Her problem was 60 years of smoking – in other words, emphysema and heart disease. She wasn’t going to get better. Her advance medical directives were already filled out. Had she not filled those out, and the system had allowed it, she would have been placed on a ventilator and later put on dialysis as her kidneys failed. Her life would have been extended only a short time and the costs would have escalated considerably, with services being used to care for her that could have been used for someone needing them worse.” A goal that UK Hospital has set for itself is to be one of the top 20 academic hospitals in the U.S. “The top 20 challenge is exactly what it says it is,” Claypool said. “It’s going to be a significant challenge for us. I heard a national consultant say that there are 40 academic health centers that say they want to be in the top 20. Most of those in the top 20 want to be in the top 10. It’s obvious that not all of us can be that. Specifically, our goal is to be ‘recognized nationally as a top 20 academic medical center’ – a phrase that’s in our mission statement. This ranking should be the perception of the public and the people utilizing our services. We could probably bring 20 people in and get 20 different opinions on who’s number one. But again, our mission statement says ‘to be recognized.’ It could be the recognitions of a publication, the legislature or the patient. If the patient thinks we’re in the top 20, we’ve succeeded.”
Claude Hammond
is editorial director of The Lane Report. |
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Copyright 1996-2002, by Kentucky Business Online. All rights reserved. Editorial content
is copyright 2002, Lane Communications Group The Lane Report is a trademark of Lane Communications Group. All other trademarks are the property of their respective owners. |
According
to Joe Claypool, director of the University of Kentucky Hospital, the
role of the Commonwealth’s two university-affiliated hospitals
is both vital and challenging.
“The
challenge is we’ve got to maintain the very highest standards that
are demanded from us from the accrediting agencies for education,”
Claypool said. “You can see how that affects the clinical component.
The clinical piece is the gateway for the majority of the patients entering
the academic health system.” 
Both
UK and U of L hospitals have medical, nursing and dental schools. UK
boasts a respected college of pharmacy and both institutions train other
future professionals in numerous health-related majors such as radiology.