Thursday, August 29, 2013
Twenty years ago Summerville was still quite rural and its hospital was the old county hospital on Cedar and Main.
Since then Summerville has grown ten-fold and that old hospital is now the county office building.
But 20 years ago, when the idea was broached to build a new hospital, some naysayers thought it was silly.
“It was in the middle of the woods,” said one long-time resident, saying that folks thought it wouldn’t work.
But community leaders and the leadership of the Hospital Corporation of American – the parent company of Trident Health Care and largest private hospital system in the Country – had the wisdom and foresight to see the need.
“I think,” says Caputo, “community leaders saw the need for closing the old hospital and embraced the new vision.”
HCA came to the Charleston area in the 1970s, says Summerville Medical Center CEO Louis Caputo, to see what opportunities were here for health care in the area. They met with community leaders and, says Caputo, what came from that was a strategy to bring advanced health care off the peninsula to North Charleston, Berkeley and Dorchester counties as well as consolidate services into one tertiary hospital – Trident Medical Center.
“Forty years ago the plan was to bring hospital services to Berkeley and Dorchester counties,” says Caputo.
So 20 years ago, HCA began fulfilling that vision in Summerville.
It built a stand-alone emergency room. In the middle of the woods. And people came.
“We had tremendous support,” says Deb Campeau of Trident Health. “Not just from the residents but from the elected officials of both the town and county. The chamber supported it too.
Campeau has been involved with SMC for all of its 20 years.
“I was working at the Presbyterian Home when I was recruited,” she says, and she became community relations for SMC. She is currently the assistant vice president for business development and the linking agent between hospital and [Trident] health care system and the facilities it serves.
“There were dirt roads to the middle of the woods for the groundbreaking,” she recalls, laughing. “I thought they were crazy. The next year I was working there!”
“It was amazing how close the community was to the hospital from the beginning,” she says. “It cared for so many from the community and knew its patients.”
It also hired from the community, says Campeau.
She recalls an open house prior to patients being accepted that included food and drink stations throughout even in operating theaters. A community extravaganza picnic, too, with the Charleston Symphony Orchestra all wearing scrubs and playing. “There was a huge turnout,” she says.
Campeau says in 1989 there was a freestanding ER with some diagnostic abilities and some doctor’s offices.
“But we quickly realized beds were needed to we built the tower.”
“We became a hospital when we built the tower,” she says.
“It began with a free-standing ER,” says Caputo, “similar to what Moncks Corner has. The plan was always to add beds and become full service. The ER gave us a slower approach in order to gauge demand. We quickly saw there was a big demand.”
“So,” he says, “in 1993 the tower was built. (A tower, in hospital vernacular, simply means anything with more than one story.)
The three-story structure initially offered 82 beds, Caputo says.
Also offered were outpatient services and a 12-bed skilled nursing rehab unit.
“But, because of the demand for medical and surgical services, the 12 beds were converted and patients in need of rehab were referred to other community facilities.”
Then, in 2006, the first major expansion occurred. The ER added 12 new emergency room bays that, with the 14 original bays, brought its capacity to 26.
“We are a really busy ER,” says Caputo, “we have 45,000 ER visits a year.
“Come in around 4 p.m.,” he says, “and on a typical day, every one of those ER bays will be filled.”
“Our goal is that patients don’t wait. Our average wait time is 15 minutes.”
Patients, on arrival at the ER, are triaged with the highest emergency patients being seen first. This is true for both ambulatory self-arriving patients as well as those brought in by ambulance.
“Probably one of our biggest successes at HCA is the efficiency of our ERs…nationwide,” says Caputo.
Determined to get far away from the stereotypical and historical hours long wait of many urban ERs, HCA focused on its ER efficiency.
“Over the past five years we have held ourselves accountable by publicly posting ER wait times on digital billboards along the roadsides, online on our website and on TV.”
In 2009, says Caputo, SMC expanded again, moving its Sleep Center to an outpatient facility for better patient access.
In 2011, it opened an advanced wound care center.
“This was so needed,” says Caputo. “There was one in Walterboro and one at Roper but nothing closer than a 45-minute drive. Some patients need to go two to three times a week and this was very difficult for patients in upper Dorchester and upper Berkeley counties.”
SMC also has two hyperbaric chambers at the wound care center.
Then, in the spring of 2011, it added bariatric surgery to its list of services. This is surgical intervention for obesity and, says Caputo, is a very detailed program that includes nutrition, psychological components, all part of medical weight loss.
“For a hospital this size to have a bariatric program,” says Caputo, “is huge.”
All these expansions and additional services “means a lot to people to know they don’t have to go downtown for specialty care,” Caputo explains.
“And we find people in this community prefer to come here as opposed to a larger hospital.”
“Patients who come here a lot, tell us they know everyone and like coming here,” adds Bob Behanian, public information officer for Trident.
“We are really a very friendly community hospital,” says Mary Linder, a board certified medical surgical nurse, who has been with SMC since the beginning. She is currently the director of Advanced Clinicals and trains physicians to use computer systems for patient charting and orders. “We’ll have 80 percent of our doctors using computer-based systems in a couple of weeks.”
Linder says, “The patients love the very congenial, family-oriented environment at SMC.”
“So do our staff who enjoy each other, socialize outside of work and love creating a friendly, warm environment.”
“We are very focused on quality, on a safe environment,” Linder continues, “and customer service is huge. We will continue to grow…I can’t imagine us going anywhere but up!”
Another thing unique to SMC, says Caputo, is that the Cardiac Rehab Unit is at SMC. There is not one at Trident Medical Center.
“We see 17,000 patients a year,” says Caputo.
The unit cares for strokes, heart attacks and COPD issues.
“The unique thing,” continues Caputo, “is that patients can stay and continue to use the facilities like a gym membership. They have built relationships with the staff and they feel more comfortable being near medical help…just in case.”
SMC also offers 24/7 Ob/Gyn services. Initiated in 2012, the Ob/Gyn Hospitalist Program ensures that there is obstetrics and gynecology coverage around the clock, 365 days a year, making those services immediately available to patients.
SMC also teamed up with General Electric Healthcare on a high-tech pilot program. The program measured hand hygiene success by hospital staff every time an employee interacts with a patient.
Using radio frequency identification technology and infrared light sensors, the system tracks every time a badged employee goes in and out of a patient’s room. It also records every time a badged employee pumps the hand sanitizer gel dispenser outside the patient’s door. The system was introduced in 2012 in the intensive care unit and has been expanded to all patient rooms throughout the hospital.
Also introduced in 2012 was a da Vinci surgical robot, which enables the surgeon to perform surgery in a less invasive manner (usually through a very small incision) with greater precision. It also increases recovery time.
More to come
The next expansion planned, says Caputo, is an advanced pediatric unit and ER.
“We’ve always cared for kids,” he says, “and last year we took a significant step to formalize how we care for them. In response to the community and its need we established a pediatric unit, which was the first step in committing resources. The next step is the construction project for an advanced pediatric unit, pediatric ER and pediatric support services such as labs, respiratory services and radiology. We will have specialized pediatric equipment and staff.”
“Our goal is to meet the needs of the local growing community so they won’t have to go so far.”
Caputo noted that his career has taken him through large tertiary hospitals such as medical centers in Nashville, Orlando and Tampa to Summerville, where he became CEO four years ago.
“What makes SMC really special is the advanced capabilities it has for a community hospital this size. Capabilities and services you would not typically find in a 94-bed community hospital – such as a certified chest pain center, an accredited stroke center or a da Vinci surgical robot.
So what are SMC’s plans for the next 20 years?
“A medical office building,” says Caputo, “we are breaking ground in six to nine months. This gives us the ability to recruit other physician specialties to the community.”
“Also, a 30-bed tower expansion for which the timing for construction is to be announced. We are in the planning process right now,” he says, “we would like to break ground on the expansion in six to 12 months.”
In addition to the medical care the community has access to, SMC also benefits the community in many other ways.
As a private hospital, it pays taxes. A lot of taxes. In 2012, according to its annual report, Trident Health (which includes SMC, TMC and Mocks Corner) paid $9.3 million in federal taxes, $17.6 million in state and local taxes, $2 million in property taxes and $6.5 million in sales tax.
In the same year it spent $39.2 million in charitable and uncompensated care ($7 million of that at SMC), $145.7 million in salaries and benefits, $29.5 million in local vendor support and $18.7 million in capital investment.
The three have saved 2,676,800 gallons of water and 6,501 trees, by recycling paper instead of throwing it in the trash. It has spared 1,147 cubic yards of landfill space through recycling.
Locally, SMC employs 450, has 250 active physicians and 200 volunteers.
“It’s [SMC] a great group of people,” says Linder.