Miami Herald Op-Ed: “Jackson’s reinvention in the making”

The Miami Herald

Wonders happen at Jackson Health System. The teenager saved after being shot through the head with a spear gun. The baby whose life-threatening tumor was removed before she was even born. The ailing Army veteran who received a kidney from her daughter just in time for Mother’s Day. The homeless man whose face is being put back together after a vicious attack on the MacArthur Causeway.In just the last month, these are some of the Jackson success stories that remind us of how limitless our abilities are when we focus talented professionals on even the most challenging of tasks. In a much quieter way, it is what we have been doing to transform Jackson.

A year ago, our taxpayer-owned system was on the verge of collapse. Despite medical marvels and the daily healthcare excellence provided to everyone in our community, Jackson was suffocating on outdated business practices and dysfunctional processes. The system had lost $419 million over three years and was poised to lose another $400 million in 2012.

The relationship with the University of Miami’s stellar medical school was archaic. Few doctors wanted to work here, and few patients wanted to come here. Facilities were decrepit, wait times too long and there was no strategy to recover. Jackson was dying.

Last spring, elected leaders traded the cumbersome 17-member Public Health Trust for a new and nimbler seven-member Financial Recovery Board, held to high ethical standards and empowered to make difficult decisions. A new executive team was put into place with a record of success and a commitment to accountability at every level. Our community put aside its skepticism and offered support.

We worked together to tear down generation-old ways of doing business, dramatically reducing unnecessary spending on contractors, supplies and overtime. We worked with our union partners to eliminate automatic raises through at least 2014 and, for the first time, required employees to pay into Jackson’s pension plan. We meticulously reviewed every department, looking at patient volumes and business plans to make sure staffing levels were appropriate for the actual work being done. After years of failing to keep pace with the seismic shifts in healthcare, Jackson embraced foundational change.

As a result, a system that was on pace to lose $400 million this year will come within a whisper of breaking even when the fiscal year ends in September. For three consecutive months, Jackson has earned more than it spent — all but unheard of in Jackson’s modern history. We still must replenish our working capital, catch up on payments to vendors and fund carefully planned strategic growth. But Jackson is escaping from the daily threat of financial collapse.

Unlike prior cost-cutting plans, which focused on muddling through for a little bit longer, this transformation laid the groundwork for a future of growth and success. We developed plans for Jackson’s next generation: primary-care centers and urgent-care clinics that bring Jackson’s unmatched reputation into more neighborhoods; renovated facilities that reflect Jackson’s clinical excellence; partnerships with hundreds of physicians, many of whom were trained at Jackson.

At the same time, we are reinventing a decades-old partnership with UM that enhances the best parts of our relationship while also allowing both institutions to grow. The stage is set for our signature shared services to remain at Jackson: the Miami Transplant Institute, the neonatal intensive care unit at Holtz Children’s Hospital, the groundbreaking rehabilitation programs, and the Ryder Trauma Center, which will celebrate its 20th anniversary in August.

Through it all, we insisted on improving the world-class level of healthcare for which Jackson is known. In key areas tracked by all hospitals — surgical-care measures, infection rates, patient satisfaction — Jackson is stronger today than it was a year ago. Moreover, we have never lost sight of our mission to deliver the same high standard of care to every resident of Miami-Dade. The work is far from finished. Executing these plans will require discipline, precision and expertise. We must reinvent emergency rooms and clinics to reduce wait times and attract patients who can choose where to receive care. We must integrate community doctors as well as the emerging program at Florida International University’s medical school. We must retain and recruit the best staff, mindful of our newly adopted bylaw to conduct an annual diversity audit. And we must adapt to healthcare reform, which could have dramatic impacts on Jackson.

Our confidence is rooted in the two unshakable qualities that differentiate Jackson: the world’s finest staff of doctors, nurses and other caregivers, and a community that has refused to give up. Your investment in Jackson honors us all. Jackson will continue to be the place where wonders happen.

Marcos José Lapciuc is chairman of the Public Health Trust Financial Recovery Board. Carlos A. Migoya is president and CEO of Jackson Health System.

© 2012 Miami Herald Media Company. All Rights Reserved.

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