June, 2011

Greetings. As I write this first issue of what will be a monthly electronic newsletter, I’m pleased to report that the Penn State Hershey Medical Center and College of Medicine are wrapping up another highly successful year.

Penn State College of Medicine recently held its 41st Commencement, adding 151 M.D.s, 5 M.D./Ph.Ds, 29 Ph.D.s and 31 master’s graduates to the ranks of our alumni. We’re already preparing for the next academic year, including the launch of new clerkships at our Regional Medical Campus at University Park. I look forward to sharing a more in-depth report on the Regional Medical Campus in a future edition of this newsletter.

In this issue, I’d like to focus on some of the state and federal budget challenges that are at the top of many people’s minds, as well as what we are doing to increase efficiency, enhance quality and improve access to care. Penn State Hershey Medical Center continues to experience strong financial performance, with high levels of clinical activity and a very positive bottom line. We’re fortunate that, eleven months through our fiscal year, we are well ahead of budget. Our success to date is a credit to our dedicated staff and faculty, as well as the vision and support of our Medical Center Board of Directors and University leadership.

Despite our success, we recognize that there are challenges looming on the horizon for which we must prepare. We are facing significant proposed cuts to federal and state budgets, and increased fiscal constraints. We are working with our legislative leaders to make a strong case for continued state and federal support for our missions of education, research, patient care, and community outreach. And we are doing our best to minimize the impact of potential cuts.

That said, given the economic situation in Pennsylvania and across the country, we must recognize that government budget deficits and a sluggish economy will make cuts inevitable. Rather than wait for fiscal cuts to come and accept changes that are determined for us, we are focused on working thoughtfully and intentionally to shape that change, improve efficiency, reduce costs, and improve the quality of care as well as access to that care. Like every other academic health center and hospital in the Commonwealth and nation, we must prepare for inevitable reductions in reimbursement and a world where financial rewards will come only with demonstrated improvements in quality, safety and patient satisfaction.

Growing to Better Serve Our Region

With the opening of nine new buildings and a number of new ambulatory care clinics in the region, we’ve experienced tremendous growth over the past five years. We’ve added major new facilities to our campus, including the Penn State Hershey Cancer Institute, which opened in July 2009, and the East Health Campus outpatient facility at 30 Hope Drive, to name a few. Construction is proceeding rapidly on the new, freestanding Penn State Hershey Children’s Hospital, slated to open in 2012. We have been truly fortunate that these projects have garnered tremendous support from individuals, businesses, our government officials, and groups throughout the community.

We are proud to have earned this confidence and support by our commitment to efficiency, quality, and access to care. Through the Penn State Hershey Medical Group, we are working to increase the efficiency of outpatient care, and we have increased access by adding and expanding clinic sites. Our newest practice sites include three new clinics in State College – part of the growth of our Regional Medical Campus – as well as locations in Camp Hill, Lancaster, and Reading. At the same time, our growing network of hospital affiliations through the Penn State Hershey Health System makes it easier for people throughout our region to access state-of-the-art care and the resources of an academic medical center, while receiving care close to home. St. Joseph Medical Center in Reading and Hanover Hospital in Hanover, York County, are just two of the recent additions to our expanding network of affiliates.

Creative Approaches to Improving Quality and Efficiency

But we've done more than get bigger, we have also created innovative ways to improve access to health care in our region. In partnership with PinnacleHealth, we formed the Pennsylvania Psychiatric Institute (PPI), consolidating our psychiatric services in a manner that increases the total number of psychiatric beds, creates additional training opportunities in psychiatry for medical and nursing students and residents, and locates inpatient psychiatric services closer to the highest concentration of at-risk populations, while freeing up space that has been converted into new operating rooms at the Medical Center. Similarly, our Penn State Hershey Rehabilitation Hospital, a partnership with Select Medical, combines our resources as an academic medical center with Select’s expertise in operating stand-alone rehabilitation hospitals.

On our Hershey campus, the innovative redesign of our Emergency Department illustrates how improving efficiency and increasing quality are connected. Like many Emergency Departments, our ED has experienced tremendous growth in patient volumes, which led to long waits, crowding, and dissatisfaction among patients and staff. Rather than simply increasing the size of the ED, our Emergency Medicine faculty worked with colleagues at Penn State’s College of Engineering and College of Information Sciences and Technology to re-engineer the ED, using computer simulation modeling and human engineering principles. The end result has been dramatic reductions in wait times and increases in patient satisfaction scores, all at less than half the cost of the original proposal to double the size of the ED.

Our recent initiative to reduce the incidence of venous thromboembolism (VTE), or blood clots, in patients, is another example of a successful quality improvement project. An interdisciplinary team developed a scoring system for determining which patients are at greatest risk for blood clots. This scoring system was then embedded in our electronic health record, so that the treating physician will see a patient’s risk score and is led to appropriate interventions. The project has resulted in a 62% reduction in blood clot-related mortality among our patients over the past two years.

Finding innovative ways to improve patient safety and clinical outcomes not only results in better care, but also reduces the costs associated with treating complications and infections. We are doing our part to address the escalating cost of health care. We’re finding other ways to enhance our efficiency, including a new energy efficiency program. The first phase of this program will save us $1.1 million in energy costs each year. Through smarter energy purchasing, we are also saving an additional $1.3 million over standard rates. We recently received $220,000 in rebates as a result of our efforts to improve energy efficiency. As an added bonus, we can also take pride in being better, “greener” stewards of our resources and environment.

As we look ahead, we are facing a rapidly changing system of health care that will require continued effort to enhance quality, improve access, and control costs. We are not alone in facing change. Health systems and academic medical centers throughout the country are confronting similar challenges.

Hard work is not enough to overcome the mounting challenges facing our health care system. We have to continue to innovate and collaborate. And I believe that with our strong track record of innovation, creativity, and collaboration, Penn State Hershey is ready to respond to the challenges ahead.

Patients expect care that is of excellent quality, accessible and affordable. They deserve those things. It's up to us to find ways to deliver on that promise. It is our responsibility as the only academic health center in the region to provide this, not only for our patients, but also for our students and residents. We must be a model of how care will be practiced by others in the future. Those 211 students who just graduated depend on it.

Harold L. Paz, M.D.
Chief Executive Officer, Penn State Hershey Medical Center
Senior Vice President for Health Affairs, Penn State
Dean, Penn State College of Medicine