Questions & Answers with CEO Doug Cropper

Q: How is this investment part of Genesis’ goal to be a national leader in quality and patient safety?

“This major project is designed with several goals: improved patient safety, quality and service, the use of technology and innovation for excellent patient outcomes, and efficient delivery of care. When the project is completed in late 2017, Genesis will be positioned to be a leader in a rapidly changing health care industry.”

Q: Inpatient volumes are decreasing nationwide while outpatient services have grown. Why do this now?

“First, it’s important to remember we’re not launching this project to build a bigger hospital; we’re doing it to build a better and more efficient hospital. Why? To better control escalating acute care costs at a time when inpatient census has declined and demand for outpatient care has grown nationwide. Most people may be surprised to know that 70 percent of our business is outpatient.

“Emerging health care trends point to fewer, but significantly sicker, inpatients; more complex patients with short hospital stays; and declining government reimbursements due to health care reform. These trends, and our strategic focus on population health, challenged us to question the feasibility of sustaining a 330-bed hospital split between two campuses, located 2 1/2-miles apart. This led to our decision to consolidate our surgery, shorter-term acute care and medical services on the East Campus and focus our longer-term care and outpatient services on the West Campus.

“The end result will improve quality and service to the community, with state-of-the art operating rooms and other inpatient services, and bring more operational efficiencies to Genesis Medical Center, Davenport, our flagship hospital and health system’s key economic engine. This is crucial to preserving the Quad Cities’ only locally owned health care system and maintaining Genesis’ legacy of nearly 150 years of local governance.”

Q: An impetus for this project is the need to address the aging operating rooms at both campuses, correct?

“Yes. It’s imperative that our operating rooms be modernized to meet future standards and appropriately sized to accommodate the technology and staff needed for complex surgeries. East and West Campus operating rooms are reaching the end of their useful lives. They were built to 1980s size and standards and not for the complexity of the current surgical caseload we now see. Today’s newly built operating rooms are larger and have much of the technology coming out of the ceiling. Our current operating rooms, with 12-foot ceilings, do not have the height needed to support this.

“We studied many options. We could have spent far less to extend the lives of our current operating rooms, but this multi-million dollar expenditure still would not have corrected size deficiencies and physical plant issues. Nor would this have addressed the duplication of services and the fact we often face a shortage of operating rooms at one campus and unused operating rooms at the other.

“Our forward-thinking Genesis Health System Board of Directors decided that making the added investment now was important to create a hospital for the next 30 years. We will reduce travel time between campuses, staff time and eliminate duplication of equipment, supplies and many services.”

Q: What is the future of the West Campus?

“Our West Campus has a very bright future. Although most of the construction will occur on East Campus, we now have an exciting opportunity to explore the growth potential of our West Campus-based services, including physical rehabilitation, behavioral health and oncology, among others.

"Our Genesis Cancer Care Institute, with its patient-centered care and the latest cancer-fighting technology, is vitally important to the region, and our commitment to advance cancer care close to home will continue. Our Physical Medicine & Rehabilitation program, the largest and busiest in Iowa, is centered on West Campus and plays an integral role in the continuum of care for our patients, even as we grow our outpatient rehabilitation clinics. Meanwhile, the region’s behavioral health needs remain staggering, and offering more services for this patient population at our West Campus Behavioral Health Unit and Emergency Department is under study.”

Q: Why centralize surgery and short-term acute care and medical services on East?

“We already have a preponderance of interventional and acute care services on the East Campus, including cardiac surgery and catheterization, trauma services, birthing and neonatal intensive care services. Under the plan, orthopedics, medical surgical and neurosurgical units will move from West to East Campus. All Intensive Care Unit services will also be on the East Campus.

Locating all surgical and interventional services on one campus will decrease duplication between East and West and create improved service and efficiency.

“Over the years, each campus has developed its own distinct inpatient focus. It is a natural evolution for East Campus to be the site of more short-term, critical care services averaging four-day stays while the West Campus will focus on outpatient and longer-term health care services averaging 10 plus-day stays, such as physical medicine and rehabilitation and behavioral health.”

Q: What will this mean for patients?

Construction and renovation on East Campus offers us the opportunity to improve the patient experience and wayfinding. During fiscal year 2013, we had 1,062 patient transfers between campuses - most of the time for specialized services not available where the patient was located. Patient privacy will improve. With the current East Campus layout, our patients are currently transported along the first-floor public corridors to and from Radiology and the Emergency Department. There are many ways this project will improve patient care now and into the future and bring us closer to our vision of national leadership in quality and patient safety.”

Q: What other trends drive this need to consolidate these services onto one campus?

“First, inpatient volumes and average length of stay have declined across the nation, reducing the need for inpatient beds. At the time of the 1994 consolidation, Genesis Medical Center, Davenport needed 500 beds; today the current need is around 300 beds.

“Second, the increasing complexity of our patients’ health care needs requires many specialists to consult and coordinate care, which is much more difficult when these services are located on two campuses.

“And third, more patients today are admitted for short-stay procedures or testing and their time in the hospital is often measured in hours vs. days. Our ability to admit and discharge patients efficiently depends on timely access to physicians, consultants and diagnostics. This plan strategically positions Genesis Medical Center for a future where fewer beds will be needed, but for much sicker patients.“

Q: Why not build a new hospital?

“It is true that GMC-Davenport’s West and East campuses are surrounded by residential areas and are not in ideal locations. We did evaluate the option to build a brand-new hospital on a highly visible highway or main thoroughfare, with better access. Unfortunately, the cost to build a new, 330-bed hospital would be approximately $500 million, so this was never a really serious option. Instead of our current $121 million bond issue to do this project, it would have required a $400-$500 million bond issue. That level of debt is just unaffordable.”

Q: How can Genesis afford a $138.5 million project?

“We borrowed $121 million in November. First, let me say we wouldn’t be able to afford this project without the financial strength of the entire health system, including our campuses in DeWitt, Silvis and Aledo. To prepare for our changing industry, Genesis has taken aggressive steps over the last two years to improve operational efficiencies, financial strength and growth through outreach and new business relationships.

“This effort of the last two years has resulted in a $30 million cost-savings that gave us the confidence to pursue this initiative, and we continue to work toward realizing an additional $30 million in cost-savings. Our strong bond rating and history of responsible financial stewardship made it possible to borrow $121 million. We’re very confident our strong financial position makes this affordable.”

Q: How does this hospital project fit into Genesis’ overall vision for the future?

“This project will help us improve the quality, safety and service of hospital care. It will also give us more resources to grow our outpatient services and transition to more population health efforts. Rapid change in health care is forcing organizations like Genesis to change their business model from a fee-for-service to a population health model -- one in which we get paid by how well we achieve prevention, wellness and improved management of overall health care cost for our patients. That’s a monumental change.

"We relish this challenge to keep people healthy and well, and we already have a track record for success in reducing risk factors for disease in our own employees. We’re leading the way in this population health journey with innovations like having “medical homes” in all of our Genesis Health Group primary care physician offices, which is improving prevention efforts for our patients with the help of health coaches and navigators. We’ve given thousands of free flu shots to elementary students, and launched an effort to offer 1,000 free, low-dose CT scans for individuals at risk for lung cancer – to name a few population health initiatives.

“In the future, we will also be centering many of our outpatient services at HealthPlexes like the one we recently opened at 3900 28th Ave. Dr. in Moline.

“It’s truly a transformational time in health care. This exciting project for Genesis Health System is all part of our much larger strategy to meet changes in health care delivery for this region.”