Facing an overflowing emergency department with wait times reaching up to 12 hours and people leaving without being seen, John Haupert took action.
Haupert — currently chief operating officer at Parkland Health & Hospital System in Dallas but expected to become CEO of Atlanta’s Grady Memorial Hospital — helped guide the complete revamping of the massive safety-net hospital’s emergency room system.
The number of people leaving without getting help dropped from about 15 percent to 3 percent; doctors began seeing patients within roughly 30 minutes, Parkland CEO Ron Anderson said.
“That may be one of the greatest things that have been done here,” Anderson said.
From improving ER operations to overseeing the construction of a $1.3 billion, 862-bed replacement hospital, Haupert’s experience at Parkland — one of the nation’s largest public hospitals — would be a big advantage in taking over as head of Grady this fall, experts say.
While the head of Grady has to be politically savvy in dealing with government, community and business leaders, he also faces an array of financial hurdles and must guide the hospital through uncertain times as the new federal health care law rolls out.
“The safety-net hospitals are the most complicated hospitals in America,” said Bruce Siegel, CEO of the National Association of Public Hospitals and Health Systems.
A Grady search committee chose Haupert, a 50-year-old native of Arkansas, out of hundreds of applicants to replace Michael Young, who resigned as the hospital’s CEO on March 31. Slated to start in early October if approved by the hospital corporate board Aug. 8, Haupert would come at a crucial time for Grady.
Finding ways to grow revenue to run day-to-day operations would be a top priority, Haupert said. “I really hope to lead the hospital toward a more stable financial future,” he said.
Grady saw an $18 million shortfall in the first half of 2011, following a drop of roughly $20 million in federal and local funding to care for the uninsured. That gap could climb to $25 million by year’s end, board Chairman Pete Correll said. At the same time, ER visits are up 15 percent as the number of uninsured people grows.
At Parkland, which is roughly 20 percent larger than Grady, Haupert dealt with many of the same issues, Correll said. The Texas health system provided nearly $600 million in uncompensated care in fiscal 2010 and saw ER visits jump 21 percent in the past year to more than 170,000.
Parkland is known across the country as a major success story of urban public hospitals, said William Custer, a health care expert at Georgia State University.
The health system began using data to track quality of care and improve decision making long before other hospitals did, Custer said. That’s a big advantage as the way hospitals are paid shifts away from reimbursing for every procedure and visit to a model based on quality and outcomes, he said.
Improving quality and patient satisfaction will become increasingly vital under the new health care law, Haupert said. How exactly payments will work remains foggy, but one thing is clear — the federal government will reward institutions for high-quality outcomes, he said.
Still, Siegel said, it’s a slow process that requires culture change.
Hospitals need leaders who are advocates in Washington, at state capitols and with major employers who are passionate about changing the model, he said. “They’re like battleships,” he said, “and changing course is very hard.”
In the future, the focus also will be on wellness, prevention and the whole patient, Siegel said. That means making sure people know how to care for themselves when they leave the hospital and aren’t readmitted a month later, as well as actively reaching out to the community, he said.
Parkland has one of the first and best primary care networks in the world and has done groundbreaking work on reducing hospital readmissions, Siegel said. Grady also has taken an important step in moving toward a more patient-centered model of care with its newest neighborhood clinic, he said. Keeping people healthy by intervening early on can greatly lower health care overall, Haupert said, adding that he plans to look closely at Grady’s clinic system.
The health care law also will be a positive for public hospitals such as Grady because millions more Americans will have access to insurance, experts say.
If reimbursements remain low, private hospitals may not take those patients. But if payments are adequate, that means people who may have typically gone to Grady for care will have more choices, Haupert said.
“Public hospitals nationwide have to closely look at themselves and determine if they can be more competitive in the market,” he said.
Grady’s challenge is to show it’s more than just a safety net, said Kevin Bloye, a spokesman for the Georgia Hospital Association. It has made strides in improving its reputation and becoming more competitive in recent years, and it would be up to Haupert to keep that momentum going, Bloye said.
Broadening its patient mix to include more insured people also means more consistent revenue, Fulton County Commission Chairman John Eaves said. “For the hospital to grow, to remain stable,” he said, “it’s just got to have a balance.”
Building a better dialogue with the Fulton and DeKalb county commissions that partly fund Grady would be crucial for Haupert, Eaves said.
“County budgets are heavily strapped,” Bloye said, “and getting those funds is a challenge in these economic times.”
Haupert has experience in building strong relationships with political and business leaders, as well as his own employees, said Howard Chase, a former CEO of the Methodist Health System, where Haupert worked before Parkland.
“His style is such, he’s working with you and you’re not working for him,” Chase said.
He’s a strong leader, said Brad Simmons, Parkland’s senior vice president of trauma and surgical services.
When the emergency department was experiencing problems, Haupert took control, he said. “When he sees a problem,” Simmons said, “he will take it head-on.”
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John Haupert
Age: 50
Hometown: Fort Smith, Ark.
Current position: Executive vice president and chief operating officer, Parkland Health & Hospital System in Dallas
Education: Master’s in health care administration and bachelor’s degree in business administration from Trinity University in San Antonio
Career: He began his career in health care management at Methodist Dallas Medical Center in 1992 as an administrative resident. He eventually became executive vice president for corporate services and business development for Methodist Health System before leaving for Parkland in 2006.
Community: Serves as regent for North and East Texas for the American College of Healthcare Executives and has served as board chairman of the Dallas-Fort Worth Hospital Council, among other positions
Family: Married with no children
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