12-7-2001 Health & Fitness – A Conversation With David Gitch of Harrison Hospital Harrison Hospital’s chief executive talks about problems facing the health care industry in general and Harrison in particular By Lary Coppola KBJ: What is the best thing about Harrison in comparison to other hospitals? Gitch: “It’s our staff, the people that are here. They’re dedicated to what they do and have learned how to rise to the occasion. We’ve been extremely busy with both our new opening in Silverdale and with an increased patient load and our staff continues to rise to the occasion at every opportunity.” KBJ: What could you do better? Gitch: “One of the things is to reduce the waiting times in our emergency room — especially here in Bremerton. Our folks are dedicated to improving that. We’re seeing just under 40,000 visits a year here at the Bremerton campus. We’re also seeing and dealing with some of the problems that are prevalent in big-city emergency rooms.” KBJ: Such as? Gitch: “The traffic connected with meth and meth labs. Also, the people who elect to use the emergency room as their primary health care. When we opened the Port Orchard campus, we thought we would see about 8,000 visits a year less, but the traffic hasn’t really slowed down at all. In Silverdale, we thought we would see about 10,000 visits a year, and that would decrease the Bremerton visits. The fact is, we’ve only seen Bremerton decrease by a couple thousand. We had about 17,000 visits in Silverdale last year. Our staff is having to work especially hard to keep up with the demand.” KBJ: With out of the area health care organizations looking at Kitsap. how do you plan to maintain and grow market share? Gitch: “Market share is certainly a term used in the health care world. We look at the numbers, but don’t really think in terms of market share. Rather, we look at what services are needed, study the demographics of the population and plan based on those factors.” KBJ: Besides being local, what do you offer that out of the area health care organizations don’t? Gitch: “You use an interesting term in ‘health care organizations.” In today’s world, there are a lot of single point types of services available in an office-type setting. What we offer is that we are a more full-service organization. Whereas the single service points are less inclined to do that. Being local is an important asset as well. Also our home health care agency has as many patients as we have in-patients here at the hospital on some days. It is a major health care organization in itself. We also have over 1,500 employees and they tend to know many of the people who come here, understand their needs and offer them what they need in human terms. That’s something other organizations from out of the area may not be able to do.” KBJ: Is there something similar to either what Harrison has done in Port Orchard or Silverdale planned for the north end of Kitsap County? Gitch: “We don’t have any plans for that. When we developed the Silverdale campus we looked very carefully at the entire area. We studied the transportation system and the highways between here and there and sited the Silverdale campus accordingly. We have no plans for doing anything north at this time,. KBJ: Currently, 55 percent of Kitsap’s population is over 50 years old. Are there any expansion plans based on that demographic and the county’s projected population increases in the next 20 years? Gitch: “In the service category would be the implementation of a cardiac surgery program. We had applied to the Dept. of Health earlier this year and we were just recently awarded the required Certificate of Need. Our cardiac program will be done in conjunction with the University of Washington. We estimate it will be somewhere between 12 and 14 months before we are able to implement the program here. There is significant training of appropriate staff and it will take us some time to ramp up and be able to do that. We are also planning on an expansion of the emergency room facilities here in Bremerton to deal with the increased number of visits we’re experiencing.” KBJ: There is a nationwide shortage of healthcare personnel, especially radiology and lab technicians, but particularly nurses. The current average age of nurses is about 45, and less than nine percent are under age 30. To compound the problem, enrollment in nursing and other health care related schools has been steadily dropping. How does Harrison plan to deal with that, especially in light of the aging population of the county? Gitch: “We’ve had a number of initiatives here. One thing we’ve done is focus on the recruitment and retention of nursing personnel. We’ve implemented a nursing recruiter who is a former nurse who has worked the floors and understands the needs and problems of the profession. The second is to make sure we are competitive from a compensation standpoint. The third is to work with other health care organizations in our community like Olympic College which has an outstanding two-year nursing program which is very well thought of. We are also working with the Regional Workforce Development Council which sees health care as a high priority and has put a great deal of effort into dealing with the problem. We’re just delighted with that. The other things we’re working on include participating in input with the Washington Hospital Association and National Hospital Association. Several of our staff members are serving on their panels that are looking at possible solutions to the problem. In spite of the shortage, Harrison has been able to recruit and retain somewhat better than the area in general. It’s something you just have to keep working on all the time. Our admissions are up by 10 percent and our staff certainly has been working very hard. We have wrap up all these initiatives in a program we started earlier this year called ‘It’s a great place to work.’ Because our number of patients is continuing to increase, it’s something we have to keep looking at constantly.” KBJ: What’s the biggest problem in healthcare today at the national level? Gitch: “There’s a constant problem, which is not new, and that is adequate payment for what you do. Medicare is a significant payer to Harrison - over 50 percent. As hospitals go, it’s a higher percentage for us than many other hospitals. So any change in Medicare is a concern to us. The other problem centers around regulations. The amount of paperwork to comply with the various rules and regulations is growing all the time. One of the big frustrations of health care workers is the amount paperwork required. For every patient in the emergency room, it generates an hour of paperwork for an employee. And, by the way, nurses are not the only skill in short supply. Radiology technicians, pharmacists, medical record coders, licensed practical nurses, lab technicians are all needed. Health care is the place to be.” KBJ: Is it any different at the local level? Gitch: “No. A concern we see over the horizon is people’s access to care. We’re hearing more about patients having difficulty getting appointments on a timely basis. With the economic situation, we also see a coming problem with insurance and with compensation to physicians being compensated in their offices at a level that allows them to stay in business. There’s a big concern there will be limited access. We have a large private physician community here in Kitsap so it’s a concern to the hospital that there be an adequate number of physicians in the community.” KBJ: What should I be asking you that I haven’t? Gitch: One thing you might want to know is that we are proud of being a very cost-effective hospital. When you get your hospital bill, you might not think so, but when compared to others in the state, we’re at the low end of the spectrum. Also, we’re pleased to be collaborating with the other emergency organizations here in the county. In the event of some natural disaster or something like the bio-terrorism scare the country is experiencing, Kitsap residents can be assured there is excellent cooperation between agencies. We also have a great public health system and excellent EMS personnel. We’re ready.”.