He has also changed the name to Harrison Medical Center to better reflect the mission of the institution, and he is putting the finishing touches on both an expansion plan and mapping out the future for Kitsap County’s only hospital.

Scott Bosch is a likeable, engaging sort of fellow, who is quick to give credit to others — even when he has set the stage for their accomplishments — and minimize his own behind the scenes involvement. He presents business cases in a very direct and matter-of-fact style, and doesn’t hesitate to give a direct answer to a direct question.

We sat down with Scott Bosch late on a Wednesday afternoon a couple of weeks ago for a freewheeling interview. Here’s what he had to say.

KPBJ: You’ve been here about 18 months now, so what’s changed in that time?

Bosch: “It’s been remarkable to contemplate how the important things have begun to change. The most important thing is an enhanced and improved relationship with the medical staff here.

KPBJ: Improved and enhanced in exactly what ways?

Bosch: “The quality of care we give is directly related to the people here. An employee engagement survey we had done by the Gallup organization shortly after I came here, ranked us in the 27 percentile. A year later, we were rated in the 65 percentile. That’s the largest move in the last three and half years of any health care organization in the country. It’s the magnitude of change that’s important because it demonstrates the shift in thinking and attitude on the part of our people. We’re very proud of that. It validates the work our leadership team has done in creating a culture of excellence here.”

KPBJ: What is it about your style of leadership that has created the climate necessary for that magnitude of change?

Bosch: “I give people permission to excel.”

KPBJ: So exactly what specifically has changed?

Bosch: “We involve the physicians in the major decisions that impact their practices. Things like changes to our facilities and physical plant, IT upgrades and improvements. I think that was not happening nearly as much before, as it is now.

KPBJ: What kinds of changes to the facilities are you talking about?

Bosch: “One of our goals is to move to all private rooms.”

KPBJ: Won’t that drive up costs to patients and insurance companies? In this era of ever-escalating medical costs, is that really a smart move?

Bosch: Facility costs are not the largest cost item for health care providers like Harrison. Controlling internal conditions and situations such as infection control for example are much more of a concern in hospitals everywhere today. Private rooms will allow us to control infections much more readily, by being able to control the patient’s environment, as well as monitor their overall care much more accurately. Besides, private rooms in general are an amenity for patients. They provide confidentiality as well as more room for family. It’s just a more positive and controlled environment for the patient to recover in.”

KPBJ: With the growth of the community, it’s no secret Harrison will have to expand — especially if you go to private rooms, which will effectively cut the number of available beds in half. Since there is a very limited amount of land here at the East Bremerton facility, how will you accomplish that expansion?

Bosch: “We’ll do that by expanding the Silverdale campus. At first, we looked at either selling that facility or converting it into something else, and starting from scratch. What I’ve learned since then, is that there are very few 30 or 40 parcels of land available, and where they are available, cost is a major issue. And then there is an entire gamut of zoning, environmental, and other time-consuming processes to deal with.”

“Meanwhile, we have 32 acres there, and with the expansion of the freeway interchange, it will allow more convenient access for people coming from both directions.”

KPBJ: How will expanding in Silverdale impact South Kitsap — especially in light of Franciscan’s planned St. Anthony’s Hospital in Gig Harbor, as well as MultiCare’s clinic, which is currently under construction in Port Orchard? Are you surrendering that part of the market in favor of expansion to the north?

Bosch: “Not at all. We have absolutely no plans to “surrender’ anything. The Gig Harbor extension from Tacoma was inevitable. Our plans are to continue to have a strong presence in South Kitsap. We see that area growing and providing a lot of opportunity for Harrison.”

KPBJ: What are your biggest concerns from a business standpoint?

Bosch: “Physician recruiting. The one thing that keeps me awake at night is making sure we have an adequate supply of well-trained and accessible physicians. We’re specifically looking for people who because of their qualifications, could practice anywhere, but choose to live here. As physicians evaluate potential practice sites, the cost of the practice is naturally one of their main issues, so they always ask, what’s the malpractice environment in the state? We have to be honest, and it can be a mark against us in a head-to-head competition with other states. Somewhere around 29 states have enacted tort reform, so they are potentially more attractive.

KPBJ: We hear a lot about it, but how much of a real issue is the cost of malpractice insurance in recruiting doctors — especially OB-GYNs?

Bosch: “Except for OB-GYNs, it’s not an issue at this minute, but it’s lurking out there. Rates are holding at the moment, but we still don’t have tort reform, so huge claims are always a possibility. Insurance companies just can’t predict where that will go, and they base their rates on claims and damage awards.”

KPBJ: What about nurses? There is a major nursing shortage nationwide. How is that impacting Harrison?

Bosch: “The average age of a nurse at Harrison is 50. We believe in the next 10 years we’ll turn over 40 percent of our nursing staff. We’re very pleased OC got a baccalaureate program. Very pleased. We’re going to be the training ground for them.”

KPBJ: Any thoughts on the future of Harrison — or the past — and what brought things to the point they are today?

Bosch: “Dave Gitch came here in ‘91, and he added the new operating suites, the cancer center, the emergency facilities in Bremerton, the Silverdale campus and the open heart program. The business of healthcare is continually evolving. I appreciate the work Dave did. He positioned us well for future growth, and created a springboard for me to take Harrison in new and different directions to take advantage of new opportunities as they arise. I’m really looking forward to the future.”.