First Steps

The population of Franklin County hovers around 72,000, but it’s growing.

Staff at Franklin Medical Center in Greenfield see that growth firsthand, introducing about 400 babies to the region each year. That statistic sends a very clear message: Franklin County is changing, and its time for FMC, its largest employer and only hospital, to grow up a little.

The facility is currently in the midst of a comprehensive five-year plan drafted by FMC to address issues caused by increased admittance, aging technology, and an increasingly health care-savvy public, which includes three major expansion projects currently underway and a number of safety and quality-improvement initiatives.

But according to Michael Skinner, FMC’s president, the physical changes are paired with the ongoing challenges all community hospitals face, as well as those currently affecting all Massachusetts hospitals in the wake of sweeping health care reform. It’s a balancing act, Skinner said, that is centered on providing the most quality care to the largest amount of people, while still remaining true to the community hospital model.

“What we hear again and again is that people like the fact that they can turn a corner and be greeted by one staff member after another making sure they’re getting the attention they need,” he said. “We don’t want to lose that feel. We want to get better, not necessarily bigger.”

But some growth is inevitable, and currently the hospital is seeing more construction activity than it has in years, simultaneously completing those three major renovation projects totaling $16.3 million and working toward a $5.5 million capital fundraising goal through a campaign dubbed Second Century.

“There are a lot of changes happening at once,” said Skinner, “But I think it’s pretty clear that we’re meeting the vast needs of the community and that’s the goal that we are most focused on achieving.”

Big Fish

Indeed, FMC has a formidable presence in Franklin County. It’s the county’s largest employer, with a workforce of nearly 900 people and a $35 million payroll. Skinner said numbers like these necessitate a very keen sense of responsibility to the community from an economic perspective, as does the hospital’s affiliation with Baystate Health.

“All community hospitals typically have peaks and valleys in terms of patient flow, but being part of the Baystate health care system allows us to access resources that other small community hospitals cannot,” he said. “That’s huge for us, because in many ways our systems, such as those for critical, clinical information, mirror those at the large acute care hospitals like Baystate, and that in turn benefits the well-being of the community.”

Skinner did note that not all challenges of the community-sized hospital are eradicated by such affiliations, however, among them staffing issues.

“We still must work very hard to recruit top-notch, experienced, board-certified physicians, because physicians have a lot of choices,” he said. “So small community hospitals have to pull out all the stops to convince prospects that yes, we provide great care, but there are also advantages to living and working in the community.”

The visible role FMC plays in Franklin County also helps to shape answers to a number of health care delivery-related quandaries that are unique to community hospitals.

“We meet frequently with a lot of other community hospitals, and we do share a lot of the same challenges,” he explained. “There is a sort of fraternity of folks who share strategies; all community hospitals face issues due to our smaller size, and there is an overall change everywhere in how health care is delivered that smaller hospitals must work harder to keep up with.”

Skinner added that those variables led specifically to the current renovations and projects on tap at FMC, and in turn fine-tuning of the Second Century campaign.
Now underway are major improvements to FMC’s emergency department, radiology department, inpatient medical/surgical unit, and the intensive care unit. The project’s $16 million price tag will be offset in part by Second Century funding, and represents the largest expansion effort the hospital has ever undertaken.

“In terms of the emergency and radiology departments, we were at capacity,” said Skinner. “We are adding emergency treatment rooms, expanding from 14 rooms to 20, all of which will be private and allow patients to be seen more quickly and efficiently.

“Without an expansion to the radiology department, we would be hard pressed to get any more patients through the door,” he added, noting that the renovations will also include the installation of a permanent MRI – the hospital currently uses a mobile unit a few days a week – and a brand new CT scanner.

But Skinner also told BusinessWest that in addition to capacity issues, some aspects of the renovations are in response to feedback from the community in terms of comfortable, efficient health care service.

“The renovations to the inpatient rooms are the third component,” he said. “We have quite a few four-bed patient rooms, and in the past, they have created the most dissatisfaction, among both patients, and staff. Now, the rooms will be semi-private – the improvement is another type of rationale that leads to caring for more patients more effectively. With more comfortable facilities, people are more apt to choose us.”

Second Sight

He added further that Second Century is expected to serve as a starting point for continued renovation and expansion in the coming years. While he said it’s not a goal of the hospital to change its community-based model, capital projects will take on a brisk pace over the next few years in order to address immediate needs and those that will be necessitated by aging Baby Boomers.

“We only want to be as large as we need to be,” he said. “But we need to project to the future and how many patients are coming in.”

Skinner added that upgrades in response to a changing health care landscape and the needs of Baby Boomers are a particular challenge for smaller hospitals, because many are still emerging from a school of thought that had them scaling down and reducing beds.

“At one time not long ago people still thought community hospitals would disappear, but the Boomers change that,” he said. “Now, we’re faced with planning delayed expansions because of the old model. We’re rapidly trying to catch up with Boomers. There is a wide range of issues to be addressed over time, and we can’t solve all of them with these three projects. We also can’t tear down our walls and build a brand new, $100 million hospital, so we hope the Second Century campaign will sort of whet peoples’ appetites for more projects and attract their support.”

The public portion of the campaign was launched this April after a ‘quiet phase’ that lasted about a year and centered on garnering contributions from FMC employees, medical staff, and its board of trustees.

“We did that to show to the community how the staff supports the hospital, and why others should as well,” Skinner explained, adding that soon after the public campaign was launched, several pace-setting contributions were made by Franklin County employers and organizations, including Greenfield Savings Bank, Channing Bete, the Rice Family Foundation, Greenfield Cooperative Bank, and MassOne Insurance.

“We’re close to the $4.5 million mark already, Skinner remarked, adding quickly, however, that the homestretch has become the most pressing – and community-oriented – phase of the campaign. “The large givers have made their pledges, but that doesn’t mean that we don’t have a long way to go. The public campaign has shifted to be primarily focused on individual community members, and we’re asking people to play some strong leadership roles in the campaign.”

To that end, Skinner himself has taken to shaking the proverbial trees, through a series of public awareness events. The events are not large or flashy in nature, he explained, but they are frequent, and often effective. To raise that last million or more, Skinner, along with Dr. Jacques Blanchet, FMC’s director of emergency medicine, have been visiting homes to conduct information sessions hosted by residents, and often attended by 20 to 40 friends and neighbors.

Growth Factors

“We’ve done about a dozen of them,” he said, noting that while the presentations center on the ongoing renovations and the Second Century campaign, a give-and-take of thoughts and ideas has become the definitive aspect of the home visits.

“We go in and present the hospital in its best light, but we also ask to hear opinions – the good, the bad, and the ugly,” he said. “A pretty intense dialogue usually occurs, but we are also learning what are we doing well.

“The vast majority of people seem to really love this hospital,” he concluded, “and it’s important for us to hear that and respond to it. We’ve chosen not to get bigger, just better at whatever size we choose to be.”

Jaclyn Stevenson can be reached at[email protected]