Grafton hospital to model BayCare center

Milwaukee Business Journal, Oct. 12, 2007

By Elizabeth Sanders

Family-friendly spaces, pet visitors and private patient corridors are a few of the elements found at Aurora BayCare Medical Center in Green Bay that could have an impact on planning the Aurora Health Care and Advanced Healthcare regional medical center in Grafton.

While it is early in the planning process for the 480,000-square-foot hospital located on a 105-acre site at the intersection of Port Washington Road and Highway 60, several potential members of the construction team from Advanced Healthcare have toured BayCare Medical Center to get an idea of what happens when physicians take part in the hospital planning process.

The Green Bay hospital was built to be as efficient as possible for physicians, said Dr. Thomas Koehler, an internist at the BayCare Medical Center and president of Aurora's northern region.

"There is a very deep sense of ownership here amongst the physicians. We feel like this is our hospital, we want to make this work," he said. "There are a lot of physicians who are eager to roll up their sleeves to help out to make this hospital home."

The hospital was started as a joint effort between BayCare Clinic's 75 physicians and Aurora Health Care after the health care system continued to expand its clinical presence in Green Bay. Discussions to built the tertiary medical center started in 1999, five years after Aurora entered the Green Bay area with a primary care clinic.

"It was basically my goal to link up with a system that was successful and had the same sort of philosophy as I did," Koehler said, adding that he had always seen Green Bay as a potential destination spot for health care.

In the six years that BayCare has been serving patients, it has had six major additions including an inpatient rehabilitation unit, a neonatal intensive care unit, a bed tower expansion, outpatient surgery center and the most recent project of a free-standing building to house orthopedics, sports medicine and a conference center, which started in August. The additions have increased the hospital's bed count from 108 when it opened in September 2001 to 167 beds now. The average amount of patients per day has also grown, from about 50 in 2002 to just under 100 in 2006. The center has nearly 140,000 outpatient visits in 2006 compared with nearly 70,000 in 2002 and has also grown in emergency department visits, births and surgeries. The number of employees at the center has risen from 757 in 2002 to 1,432 in 2006.

Before partnering with Aurora, Koehler said he had little input on planning hospitals where he has worked.

"I even was a significant donor to a hospital in the past to do some construction, it was basically unveiled after we had all donated to it," he said.

Though that was typically the way construction projects were done, Aurora changed that, Koehler said.

"That appeals to physicians to feel like we're truly partners and our expertise was used," he said.

BayCare Medical Center is unlike any hospital he had been in, said Dr. Bill Ebinger, an internal medicine physician in Grafton and a member of the Advanced Healthcare board of directors.

"The design of this facility was decidedly different," he said, describing the lobby as more like a hotel than a hospital. "It's a product we have not been introduced to in this area, it's just a style and a level of care that we were not familiar with."

Having physicians involved in planning a hospital can benefit employees and patients, Ebinger said.

"The physicians can tell you a lot about how things ought to work in terms of flow," he said. "Physicians can also provide some additional insight into patient care."

The center is designed by specialty, locating departments on the same floor as the specialists' offices so physicians can minimize steps and improve efficiency.

Visitors are allowed at all times, all patient rooms are private with separate thermostats, bathrooms and showers, and, when appropriate, families are allowed to bring food to cook in kitchen areas.

When plans for BayCare were announced, local competitors raised concerns about the potential impact on local health care costs. Would the cost of services and care increase with a new provider in the market?

"There was a lot of gloom and doom from our competitors, prior to us building this hospital, that competition was not good in health care and the cry that duplication of services is expensive -- and that proved not to be true," Koehler said.

Other area hospitals have started to expand their services as well, he said.

About 50 percent of the hospital's patients are from out of town, Koehler said.

The Grafton hospital plans to serve patients living in the immediate area. About 45.9 percent of Ozaukee County residents seek inpatient and outpatient services outside the county, Ebinger said.

"We're hopeful that this hospital is really starting to fill that gap and provide quality care close to home," he said.

Leo Brideau, president of Columbia St. Mary's Inc., which operates a hospital in Mequon about four miles from the Grafton site, has expressed concern that the new Aurora-Advanced hospital will result in an unnecessary duplication of medical services in Ozaukee County. Columbia St. Mary's Ozaukee County campus recently opened a $72 million bed tower, expanding its beds from 92 to 159 with room for expansion up to 223 beds.

"It's a complete waste of money and it drives up health care costs," Brideau has said of the Aurora-Advanced Grafton hospital.

"We certainly don't mind competition, we welcome competition," said Karol Marciano, executive vice president of business development of Columbia St. Mary's. "There's a difference between competition and duplication of services."