Five years in, hospital continues to grow

Health care: Doctors, administrators reflect on opening-day nerves, continuing growth

of the GatewayMarch 19, 2014 

Kurt Schley was at a Shell gas station off Wollochet Drive Northwest one day when a resident asked about his Tennessee license plates. Schley told the man he had interviewed for a job at St. Anthony Hospital.

“St. Anthony saved my life,” the man told him.

The conversation stuck with Schley as a reminder of how important the hospital is to the area it serves: Gig Harbor, Key Peninsula, south Kitsap County and North Mason County.

It’s been five years since the hospital opened on March 17, 2009. When Schley came on board as president in 2012, he replaced Carole Peet, the hospital’s first president.

Since St. Anthony opened, it’s continued to grow. One of the marks of success is the emergency room visits, Schley said. Since it opened, the hospital has seen 82,030 emergency patients.

“When you look at a hospital, the first thing that comes to mind is emergency room visits,” Schley said. “The emergency room is where (treatment) starts from.”

Dr. Thomas Minter directs the emergency department at St. Anthony. He spent 18 years at St. Joseph Medical Center in Tacoma, before he signed up to help open the new hospital in Gig Harbor.

Minter knows how important time is when it comes to a medical emergency. His department is known for its “door-to-doctor” time.

That means the department doesn’t use the waiting room unless it has to, Minter said. Patients go right in, and doctors are called immediately.

Most patients are seen within seven minutes. Often, he’s in a patient’s room early enough to help them take their jacket off, he said.

The quick movement doesn’t just save time, it saves lives. Schley quoted a phrase in the hospital industry: “Time is heart, and time is brain.”

When a person is faced with a crisis such as a heart attack or stroke, every second matters. The national benchmark is 90 minutes, and St. Anthony has been under that 100 percent of the time, Schley said.

HOSPITAL FOR PENINSULAS

Before the hospital opened, residents on the Gig Harbor side of the Tacoma Narrows Bridges faced long drives to St. Joseph or Tacoma General Hospital.

In 2007, the Gateway reported about 3,500 emergency cases were transported from the Gig Harbor area alone each year. Additionally, 4,000 Gig Harbor-area people were forced to leave the area for overnight care annually.

The “time is heart, and time is brain” aphorism was tested with longer drives. Citizens pushed for a place closer to home.

“It’s easy for folks to forget,” said Congressman Derek Kilmer, D-Gig Harbor. “We had one Narrows bridge, not two, and we had no hospital on our side of the bridge.”

During his time in the state Legislature, Kilmer helped to pass legislation for a Certificate of Need and a Hospital Benefit Zone in Gig Harbor.

The state doesn’t hand out Certificates of Need easily. It takes an involved process to prove a real, critical problem.

St. Anthony was the first hospital built in the state in 28 years.

“It’s a high hurdle,” Kilmer said of the process. “You have to demonstrate you’ve got an underserved population.”

Kilmer said he remembers standing on the porch of a Key Peninsula resident. The woman told him her husband died of a heart attack because the ambulance in which he was riding was stuck in traffic.

“The day the hospital opened was a really positive day for our community,” Kilmer said. “I’m thankful that we have it.”

Monica Starkweather, a clinical manager at St. Anthony, was on duty opening day. She remembers waiting intently for the first patient. Although some were pre-scheduled to arrive, there was no telling what else might come through the doors.

“We were fully staffed,” Starkweather said. “Were all just waiting.”

Starkweather worked at St. Joseph before the Gig Harbor location opened. She manages the 32-bed fourth floor, which is for medical patients. That’s where care focuses on comfort and procedure, rarely surgery. Opening day at St. Anthony is a special memory for the Port Orchard resident.

“It’s not every day you get to be part of opening up a hospital,” she said. “This has been a major highlight of my career.”

Minter said he remembers the excitement of opening day. No one on staff had ever done anything like it.

“In many people’s lifetime, there had not been a hospital built,” he said.

Going from 381 beds at St. Joseph to 80 beds at St. Anthony was an adjustment for Starkweather.

“You’d think a smaller hospital is slower,” she said. “It’s really not.”

Minter said that when he signed on at St. Anthony, he thought he would see cases like sore throats and sprained ankles in the emergency department. Not so much.

“We see incredibly sick people,” he said.

Cases of pneumonia, stroke, cardiac arrest and more have come through the emergency department, Minter said.

GATHERING PLACE

During his first week on the job, Schley encountered a woman in the hospital cafeteria who was having her birthday lunch. He apologized to her and said it must be hard to be visiting someone in the hospital during her birthday.

“I have no one in the hospital,” she responded. “This is some of the best food in town.”

Schley said he enjoys the made-from-scratch food as well. He and his daughters have Sunday lunch after Chapel Hill church services at the cafeteria.

Minter is a big fan of the café, too. He recommends the soup.

Since it opened, the hospital has become something of a community in itself. Minter said he sees people in the healing garden, women knitting in the lobby and others visiting for lunch.

With fewer staff members and patients, the community is tighter-knit, Starkweather said. Faces are recognizable, coworkers are consistent. The difference is not in the pace but in the people.

Schley said what makes St. Anthony special is an “associate-driven culture.” Teams are set up in the hospital to make sure it’s working in the best interest of each patient, he said.

Health care is undergoing changes in the United States, and that means teamwork is crucial for success, Schley said. It’s about keeping patients at the center of care.

“When we say teamwork, we actually mean it,” Minter said.

Teamwork has bred success. Minter proudly shows off HealthStream awards for overall emergency satisfaction in 2009, 2010 and 2011. The hospital just missed the patient satisfaction mark of excellence last year, but in the scheme of things, it ranked pretty high.

Minter said the awards are special because they result from patient surveys. The high marks are tangible evidence for a community hospital, one that citizens fought for and now support.

Minter points to the strong sense of community fostered in the greater Gig Harbor area. People are proud of where they’re from, he said, and, in turn, they are proud of their hospital.

“The community loves us, which is really, really satisfying,” he said.

“It’s gratifying to be a provider (here).”

THE FUTURE

Schley said the next few years will be about finding waste and eliminating it. A lot of that has to do with changes in the health care system, he said.

“The future of medicine is shaking,” Minter said. “Nobody knows where it’s going to go.”

Kilmer said the most significant conversation around health care is how to handle escalating costs.

Historically, the system has been a pay-for-procedure model, he said.

That contrasts a pay-for-performance model. It’s a complicated, but important, conversation, Kilmer said. Ideally, the system should center around both wellness and efficiency, he said.

There have been changes at the hospital and a few growing pains in the past five years. For example, the hospital would see large swings in its census, Schley said.

That’s not unusual, however.

“These are normal growing pains for a new hospital,” Schley said.

One sign of growth is the cancer center on site. Schley said that, for a cancer patient who is ill due to chemotherapy, having a local center means a lot. It means less driving and less time traveling for someone who is weak.

The hospital recently acquired a Da Vinci robot for surgical procedures. In the past, certain types of surgery would require an incision from navel to groin. That means greater blood loss and longer healing times.

The robot changes that, Schley said. It makes a much smaller incision and decreases recovery time.

“For a community to have a robot, that’s really special,” Schley said.

Last summer, Franciscan Health Systems rolled out electronic charting in all five of its hospitals, as well as its clinics. The electronic records mean better access to patient records for health care professionals, Starkweather said.

There’s also the possibility of expansion, but that may require another Certificate of Need.

Patients ask when the fifth floor will be opened. There’s an elevator button for floor five, but there’s no access to the level. Starkweather said there is no flooring and no walls. It’s actually just a shell.

Minter hopes those rooms will one day be finished and occupied.

“That’s the future,” Minter said. “Some day.”

Five Years of Growth

 • March 17, 2009 – St. Anthony Hospital opens with 48-bed capacity.

 • May 2009 – Hospital opens additional 16 beds to bring capacity to 64.

 • June 2009 - $16 million capital campaign completed. Funds help purchase MRI equipment.

 • July 2009 – Hospital opens additional 16 beds to bring capacity to 80.

 • July 2009 – Oliver Hunt Welch is the first and only baby delivered in emergency department.

 • December 2009 – Hospital designated a Level IV trauma facility.

 • June 2011 – GPS for the Body Technology introduced for the treatment of prostate cancer.

 • July 2011 – Designated Stroke Level II facility.

 • September 2011 – Designated Level I cardiac facility.

 • May 2013 - daVinci surgical robot introduced at hospital.

 • August 2013 – Joint Camp for orthopedic patients reopens in remodeled rooms.

 • December 2013 - Awarded Silver Quality Achievement Award from the American Heart Association and American Stroke Association. BY THE NUMBERS

St. Anthony Hospital, 2009-13:

 • 14,861 surgeries

 • 82,030 emergency patients

 • 19,820 inpatients

 • 199,353 outpatient visits (not including emergency patients)

Reporter Karen Miller can be reached at 253-358-4155 or by email at karen.miller@gateline.com. Follow her on Twitter, @gateway_karen. Source: Franciscan Health Systems

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