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A conversation with Tom Kruse

Tom Kruse, Vice President of Business Development, Harrison Medical CenterLike many health care organizations, Harrison Medical Center has not been untouched by the economy. The nonprofit has postponed plans to expand its Silverdale hospital, while forging ahead with a new cancer care center in Poulsbo. And it wasn’t immune to layoffs this year, which was a trend seen across the public and government sectors.

With health care issues being at the forefront of discussions at home and nationwide, the Kitsap Peninsula Business Journal visited with Harrison’s Tom Kruse to talk about current developments and challenges.

Kruse is vice president of business development and his role is to shepherd the future business model of the organization, from facilities and new locations to the addition of new services and physicians. With Harrison since 2007, Kruse started his career in health care administration as an analyst in strategic planning in Eastern Iowa in 1990, and has been in the senior executive level since 2003.

KPBJ: What is happening currently at Harrison with regards to facility development?

Kruse: We’re continuing to develop our plans for Port Orchard, and would still like to bring part-time specialty services to the campus. The Belfair campus is growing and successful. The Poulsbo campus is being developed and we’ll likely start rough-grading in October, with more detailed grading in spring. We’re ready to move forward as soon as we find a developer willing to work with us, and we’ll be submitting for permits in a couple of months.

In Bremerton, we started demolition for the heart and cardiovascular center, which will give us a front door for cardiac services. People still leave for Seattle for cardiac care, and they’re leaving the best care in the region — we’re as good if not better than anyone in the region. National standards for “door-to-balloon” is 90 minutes or less, and for three years in a row we were at under 65 minutes, and are at 58 minutes this year and shooting for 55.

KPBJ: Are the plans to expand Silverdale permanently shelved?

Kruse: We are looking at our timeline, because due to the economy, a lot of our volume has tailed off. Our growth projections have changed. So we’re looking at the Silverdale investment to figure out what’s the right time, and what the phases should be. When we build is just as important as what we build. The other huge variable is health care reform. When you put the variables together, no one has seen this amount of uncertainty in a long time. It’s not the right time to spend $150 million, but we think some of those issues will play out by the end of the year and we plan to do reforecasting.

KPBJ: What does reforcasting entail?

Kruse: We use a five-year horizon for our vision. We’re in the process of completing Vision 2015. That will yield the 2010-11 forecast and budget plus a long-range financial plan, IT strategy, facilities master plan, human resources strategy and physician recruitment targets.

KPBJ: What’s next for Harrison?

Kruse: Vision 2015 is a really involved process because we don’t think of the limitations but ask where do we need to be and how do we get there from here. But we don’t have to worry about what happens in Tacoma or Seattle, only what our population needs and how to provide for those needs.

We don’t do everything but for the things we do, we’re second to no one. The $14 million investment into the cardiac center is an example. The goal is to plan for the next 10 years of heart care but also to shave even more time (during “door-to-balloon”). We’re not planning to be best at everything, that’s not our goal. But we don’t see a reason we can’t be the best community hospital in the United States. Why not?

KPBJ: What continuous challenges do you face?

Kruse: The economy, first and foremost. It’s changed the world we live in. When the economy stopped, everything stalled, but it was a little bit like throwing the emergency brake at 80 mph. One of the other big challenges is end of life care, something Americans as a culture haven’t dealt with. Eighty percent of health-care resources spent on a person are spent in the last two years of life — we still have societal expectations that we have to cure everything.

Health care reform is another challenge. We can’t guess what’s coming and we can’t adapt overnight. This could be an innovative time in our industry that changes what it takes to be successful. Right now we just need to know what the answer is.

KPBJ: What themes are you seeing in the health care reform discussions?

Kruse: Obama’s not wrong — it has to change. But if it changes too much, or too fast, it can be problematic. What has to be dealt with is the issue of utilization — Americans use more resources than needed, getting procedures they don’t need, all because of the legal system. Tort reform has to happen and utilization has to change, and part of that has to come down to individual liability and lifestyle choices… For the first time in my lifetime, there is good, candid conversation about what we need and can sustain.

 
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