St. Michael’s leadership: Getting an ‘A’ in Leapfrog is just the first jump for hospital

Newark-based Saint Michael’s Medical Center’s A grade in The Leapfrog Group’s Fall 2018 safety report is just the latest validation the hospital has received for its efforts since being taken over by California-based for-profit Prime Healthcare.

The hospital received an A, up from a C, just this past spring.

Robert Iannaccone, the CEO of SMMC, told ROI-NJ that as a result of the access to capital — from Prime — to improve the hospital, the medical community is taking notice.

The proof?

Doctors are bringing their patients back to the hospital, he said.

“One of the reasons why we are doing well is because the word is out in the community that this is a good hospital to come to,” Iannaccone said.

Since Prime Healthcare took over in May 2016, SMMC has spent $31.6 million on capital investments, a spokesperson said.

Planned in the near future are further investments, including two new catheterization labs estimated at about $4 million, a new clean pharmacy room in the cancer center and renovating of one of the hospital’s buildings.

Iannaccone said it’s all part of the transition.

Since the takeover, the hospital has had to battle a number of issues, including its poor fiscal state, a negative perception it had as a for-profit hospital and competition in the region.

On top of all that, the previous owners did not submit surveys to Leapfrog Group, which resulted in the failing grade, Iannaccone said.

“You have to put Leapfrog in the context of how it relates to patient safety,” he said. “We don’t just focus on the criteria from Leapfrog.

“Under the (staff) leadership, we really have been working on various quality initiatives. And working to be the best hospital we can be.”

According to Chief Nursing Officer Nancy Bisco-Flora, the hospital has upped its game. Many of the metrics of Leapfrog don’t cover what’s happening today in the facility, she said.

“We’re still being judged on some old data, so it doesn’t even truly reflect many of the things we have put into place in the last year,” Bisco-Flora said.

Iannaccone said this also can be credited to Prime.

“With Prime, we measure everything,” he said. “We track our quality measures, we track our financial measures. We’re not just benchmarked against local hospitals, but also against the national framework of Prime.”

That includes sharing best practices and catching up to national standards.

For example, when the hospital implemented a computerized physician order entry system in 2016, it jumped from receiving zero points in the Spring Leapfrog report to 100 in the Fall. Similarly, the hospital had low points for ICU staffing, but by Fall was at 100 points because they hired an intensivist.

Other metrics have lagged, though, Iannaccone said.

“Many of the improvements had an immediate impact on patient safety, but because there is such a lag in reporting, our Leapfrog grades did not fully take into account the changes that were put in place and didn’t reflect the high quality of care we provided to our patients,” he said. “It took a few years for our Hospital Safety Grade to catch up to where we should have been all along. Now our grade truly reflects the high quality of care patients receive at Saint Michael’s.”

Iannaccone said the hospital also has created a more appealing environment for general physicians.

“Saint Michaels, justly so, had a strong reputation for specialty care,” he said. “But we were not a hospital that was viewed as primary care-friendly.

“So, what we did, was we clearly put a focus on the doctors in the community doing primary care, supporting those doctors in the growth of their practices, and (focus on) the ease of access of their patients to our hospital and to the specialists.”

And this is just the beginning, he said.

Even for a for-profit.

“We do not do anything different,” Iannaccone said. “We don’t operate differently than a not-for-profit hospital. We are still subject to the same rules and regulations in the state of New Jersey.”

In fact, the hospital knows it still faces the traditional struggles of an urban hospital. But it has embraced that.

“Financially, are we ever going to perform like a suburban hospital? Probably not,” Iannaccone said. “The reality at the end of the day is we serve our community. The hospital is still heavily (reliant on revenue from) Medicaid. We’ve created a delivery structure that you can financially survive with Medicaid. That has been crucial for our community.”

ROI Leapfrog Safety Ratings Fall 2018 by ROI-NJ on Scribd