No longer a small-town hospital but now it's a regional medical center
ST. JOSEPH'S MEDICAL CENTER
If you think St. Joseph's Medical Center is the same small-town hospital you grew up with, think again.
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When St. Joseph's Medical Center integrated with Brainerd Medical Center to become Brainerd Lakes Health in 2007, the medical facility promised its patients and the community that it would grow, offering more physicians and specialties that its customers wanted.
During the last three years, Brainerd Lakes Health has recruited 54 physicians and advanced practice providers, an increase of more than 50 percent than what the medical community previously had. Brainerd Medical Center had about 50 physicians when BMC integrated with St. Joe's three years ago. Now there are about 111 physicians and specialists who are employed or practice at Brainerd Lakes Health.
This year two cardiologists, an oncologist, a radiologist, two family medicine physicians, a hospitalist, an ER doctor, a psychologist and an anesthesiology physician were added to the medical team. Seven more physicians have signed on to start later this year or next summer.
The regional health system, Brainerd Lakes Health, which includes St. Joseph's Medical Center, Brainerd Medical Center and six satellite clinics, has more than 1,200 employees.
Brainerd Dispatch/Kelly Humphrey
Bill Palmer, clinic administrator for Brainerd Medical Center and its seven regional clinics, said the Brainerd lakes area and Brainerd's medical community have a lot to offer, which is why physician recruitment has been so successful at Brainerd Lakes Health.
"I think they're really attracted to a medical community this size and they're able to really use their skills," Palmer explained. "The lakes area is really appealing and you put them together and it is an attractive recruitment opportunity."
Palmer said they have made an offer to a spine surgeon and they are actively recruiting additional primary care physicians and medical specialists. While other hospitals in the area are critical access hospitals, which operate 25 beds, St. Joseph's is a regional referral center licensed for 162 beds and operating 100 beds.
St. Joseph's Medical Center
$318,066,535, gross revenues from July 2009 to June 2010.
$82,617,191, salaries paid.
6,803, total hospital patient admissions.
3.2 days, average length of hospital stays.
363,316, outpatient visits at the hospital and clinics.
541 births.
"I think there is a misconception that we're similar to other critical access hospitals in the area and we are not," said Tom Prusak, president of Brainerd Lakes Health. "Our goal is to change the face of medicine in our service area."
For the past three years, St. Joseph's has developed its hospitalist program. A hospitalist is a physician who specializes in caring for patients in the hospital, rather than seeing patients in a clinic-type setting. The hospital has seven hospitalists who are scheduled 24 hours a day, seven days a week in the intensive care unit, monitoring critically ill patients, always ready in an emergency situation to adjust medications or consult with pulmonologists/intensivists, cardiologists and/or surgeons. They also will consult a patient's primary physician with a team approach to providing care.
In the ICU at St. Joe's, hospitalists are stationed within close proximity of the 10 ICU rooms so they can closely monitor critically ill patients. The rooms also feature large windows, making it easy to keep an eye on patients.
Dr. James Baumgartner, director of the hospitalist program, came from St. Cloud Hospital to start the hospitalist program at St. Joe's three years ago. Baumgartner said hospitals began starting hospitalist programs about 10 years ago as a way to offer more patient- and family-centered care.
Dr. Janelle Strom, an obstetrician/gynecologist, explained how she uses the da Vinci Surgical System for hysterectomies and other gynecological procedures at St. Joseph's Medical Center in Brainerd. Assisting in the demonstration by operating the robotic surgical device is surgical technologist Jamey Gadacz.
Brainerd Dispatch/Kelly Humphrey
"If there is an acute emergency, we're here 24/7," said Baumgartner. "We are changing the (hospital) culture, where the patient is the driver with a great emphasis on the family. It's a big move and it's permeating the culture here, from housekeeping to medical staff."
Every morning around 8-8:20 a.m., all ICU medical staff on duty, from the dietitian to respiratory therapist, pharmacist, hospitalists and charge nurses, go on multi-disciplinary rounds to become updated on the immediate needs of every patient in the ICU. This team approach is meant to ensure that each patient receives the care he or she needs, particularly during this critical period. The patient and family are invited to participate in these rounds as much as possible.
Last year the hospital hired intensivist Dr. Greg Davis, who is director of the ICU. He said in the past St. Joe's would send many of its critical patients to other larger hospitals. That is rarely the case anymore. Everything they need is right at St. Joe's.
"Two to three years ago that wasn't the case, but it's unusual if we have to send people away from here," Davis explained. "Those are rare exceptions, patients who need very specialized care."
If a patient is sent to another hospital, a hospitalist will coordinate that transition so it is as seamless as possible.
Hospital admissions were up 5.4 percent during the 2009-10 fiscal year, with 6,803 admissions.
Patrick Ballantine, registered nurse and cardiovascular technician who coordinates the invasive cardiology services at the new Brainerd Lakes Heart and Vascular Center at St. Joseph's Medical Center in Brainerd, explained the types of cardiac procedures, like angiograms and stent placements, that are performed in the catheterization lab at the center.
Brainerd Dispatch/Kelly Humphrey
For the upcoming year, the hospital projected a 2.66 percent growth in hospital inpatient admissions and a 1 percent growth in clinic visits. During the past fiscal year, which ended in June, BMC had 177,032 outpatient visits, the hospital outpatient visits were 139,710, including emergency visits of 24,590; and 46,574 visits to its regional clinics last year in Crosslake, Hackensack, Pequot Lakes, Pillager, Pierz, Pine River and ConvenientCare in Baxter Cub Foods. The ICU admissions are 618 annually. There also are hospital-based clinics, which include the new Brainerd Lakes Heart and Vascular Clinic, the Cancer Center and Lakeland Psychiatry.
Brainerd Lakes Health has about 1,200 employees. The average employee salary is $74,000, including physicians.
Tom Prusak, Brainerd Lakes Health president, said another promise the health care system made to the community three years ago was to improve access to care. As part of that promise, Brainerd Lakes Health is growing, building a new 42,000 square-foot medical clinic in Baxter. They hope to break ground on the new facility in October and open the new clinic a year later, in 2011.
There are many other improvements and investments planned for Brainerd Lakes Health during the next few years. Projected growth areas include family medicine, cardiology, cancer care, and obstetrics. Family medicine added two new doctors this summer and several more next year.
The Cancer Center, based on the fifth floor, is now fully staffed with four practitioners in oncology, including Dr. Laura Joque, oncologist/hematologist, who recently started. The Cancer Center is a "one-stop shop" for all cancer treatments. Cancer patients are even greeted with valet service at the hospital, since they often are fatigued due to their treatments.
"We have a very stable cancer program and we're proud of that," said Marian Foehrenbacher, Cancer Center manager. "We get to know them, they become almost like family. We try to keep it an upbeat place to receive your cancer care."
"It's a very busy unit," said oncology nurse practitioner Jessica Nybakken. "We have over 600 treatments a month here and service the whole Brainerd lakes area."
The Cancer Center is the only cancer center in north central Minnesota accredited by the American College of Surgeons Commission on Cancer. Only 25 percent of hospitals in the country have this accreditation, said Foehrenbacher.
The Cancer Center, starting in November, will offer patients the option of taking part in National Cancer Institute-sponsored clinical trials through the North Central Cancer Treatment Group, a research group based out of Mayo Clinic. They will be able to participate in cutting edge cancer treatments.
Nybakken said the Cancer Center is exploring the possibility of offering genetic cancer counseling through a partnership with St. Mary's in Duluth.
"It's really an exciting time for growth," said Nybakken. "We're really providing quality cancer care to this region of Minnesota."
The Brainerd Lakes Heart and Vascular Center opened in February. Cardiologist Dr. Mark Johnson joined the heart center staff a few months ago while Dr. Michael Rich, also a full-time cardiologist, joined the staff Sept. 1.
Dr. Greg Davis (left), an intensivist in the intensive care unit at St. Joseph's Medical Center, was updated on the unit's critically ill patients by Dr. James Baumgartner, director of the hospitalist program in the ICU. St. Joseph's now has seven hospitalists, hospital-based general physicians who assume and coordinate the care of hospitalized patients. St. Joseph's began the program three years ago to create an environment of patient- and family-centered care.
Brainerd Dispatch/Kelly Humphrey
Patrick Ballantine, registered nurse and cardiovascular technician who coordinates the invasive cardiology services at the heart and vascular center, started last year.
"It's new for everybody here but we're not new at this," Ballantine said of treating heart patients. Ballantine mentioned that Dr. Johnson has performed thousands of cath lab procedures in his career.
Ballantine's department has been ramping up the number of angiograms and now interventions performed since February, along with many other procedures. The heart and vascular center is a five-bed cardiac procedure recovery unit.
"We've had a really good response from our patients and our families," said Ballantine. "I tell my nurses, if the patients want to give you a hug when they leave, you did the right thing."
St. Joseph's also has the latest in robotic surgery technology. The daVinci Surgical System is a state-of-the-art, minimally invasive surgical robotics system that is used by St. Joe's general surgeons, urologists and gynecologists for a variety of procedures. Specifically for women's health surgeries, St. Joe's performed its first robotic-assisted laparoscopic hysterectomy in Sept. 2008. Gynecologists have now performed 100 such robotic-assisted surgeries, according to Dr. Janelle Strom, OB/GYN physician. Patients are in the hospital an average of one night, instead of three nights, and suffer less pain and have smaller incisions.
Strom said St. Joe's is the smallest hospital in the state that owns a daVinci Surgical System. She said St. Joe's is performing the most female pelvic surgeries north of the Twin Cities using the daVinci Surgical System, just behind the Mayo Clinic and Twin Cities hospitals.
"We're very proud of that," Strom said with a smile.