Sparks Trims Staff, Builds on Strengths

The recent elimination of 170 positions at Sparks Regional Medical Center isn’t so much about losing money, but spending it where the community needs it most.

No patient services have been cut. In fact, Sparks is expanding in the areas of heart disease, cancer and stroke, and more. A $39.5 million expansion plan will provide 109,000 SF of new space dedicated to integrated services for heart, stroke and cancer patients, upgraded emergency room and intensive care services.

“We’re not hunkered down. We’re not hiding in a bunker. And we definitely have some progressive and aggressive plans,” said Michael D. Helm, president of Sparks Health System. “Our overriding directive in this entire process is patient care. Our level of bedside nursing has not changed.”

The staff cuts aren’t effective until July, giving department heads two months to work out shifts in the workload. Sparks had 2,862 employees as of June 30, 2002 — its last fiscal year.

Sparks cut 95 positions three years ago when Medicare cuts threatened $25 million of the system’s revenue over five years. Sixty of those positions were already vacant, and those cuts, like the recent cuts, didn’t include bedside nursing positions.

Sparks has actually hired nurses since the staffing cuts were announced in April. Helm said the hospital hired half the nursing graduates this spring from both the University of Arkansas at Fort Smith and Carl Albert State College in Poteau, Okla.

But some changes had to be made. Revenue for health care has been stagnant the last few years because of increased labor costs, insurance expenses and higher costs for patient services. Through February, the system had an 8.4 percent negative margin. Medicare cuts have also added to the hospital’s financial woes.

The plan to eliminate positions allows the medical center to more closely match its expenses with its operating income, Helm said.

“We needed to appropriately size ourselves within the revenue we are being paid,” he noted. “It actually makes us a stronger organization.”

Jeanne Parham, senior vice president of the Sparks Medical Foundation and communications, explained that Sparks is community owned and operated. It doesn’t have a religious organization or large health care corporation to lean on for added support.

“Profits generate our capital entirely,” Parham said.

But some forward thinking is paving the way for the plans Helm and his team have mapped out. The funding for the medical center’s expansion is in the bank and waiting to be spent. The $35.9 million comes from a 2001 bond issue of $70 million that also funded Sparks’ purchase of the Holt-Krock Clinic.

Helm has no regrets about the purchase. Calling it “an opportunity to act and operate as one health care system,” Helms said the purchase has eliminated the competitive nature of the hospital’s relationship with the clinic, allowing both to concentrate on health care.

In the Works

Two years ago, Sparks bought additional land surrounding of the medical center. This summer, eight commercial buildings and a house now on the site will be razed, paving the way for big expansion project and 300 new parking spaces. More than 40 physicians and other health care professionals had input on the best patient flow for the new emergency room, stroke and coronary care areas, and the architects were hired to build around that.

The changes will increase the emergency room’s capacity by 25 percent.

Parham explained that streamlining the process will help the hospital make sure patients are handled by the most appropriate unit, rather than being shuffled around.

And new services are coming for the area’s aging population. Three-million dollars in renovations has updated the women’s services unit and turned 23,000 SF of space into a new geriatric psychiatric unit. The SeniorCare Behavioral Health Unit will include everything from plant and aromatherapy to group counseling and nightly games. It has 23 beds and will open June 1.

The renovation of the labor and delivery, and morther-baby unit completed in April has brought newborns out from the display window and into cozy family-oriented rooms in their mother’s care. Some of the rooms include queen-size beds.

Attention to Care

A big part of the changes going on at Sparks started with surveys. Helm’s team polled its physicians, nurses, technicians — in fact, all its employees, to find out how they could improve efficiency and reduce costs.

They also set up a system of constant polling of patients to measure their level of satisfaction and compare that to similar patient satisfaction levels at other hospitals. They also have a set of goals for the patient satisfaction level. The Service Excellence Program hasn’t met its goal yet, but improvements have been made.

The September 2002 score was 55 percent. Inpatients surveyed from Oct. 1 through Dec. 31 rated Sparks at 71 percent, said Executive Vice President Bill Senneff.

But attention to patient care can mean more than candlelight dinners for new parents. It can also mean an integrated approach to emergency care, intensive care and heart care that puts the units together allowing them to serve the patients more efficiently when time and distance can mean the difference between life and death.

Sparks’ StrokeSense program is designed to raise public awareness about early stroke intervention. The hospital is bringing in a new director — Margaret Trimmell, M.D., PhD, a leading authority on early stroke intervention.

The hospital is also pushing public awareness about cardiac care for women and enhancing other women’s services. Services to cancer patients are also being emphasized as part of Helms’ plan to strengthen services in three big areas — cancer, heart disease and stroke — all of which will need more emphasis because of the aging population.

Sparks is also planning to bring a PET scanner in on a contractual basis one day every two weeks starting in June. The scanner allows intense screening of cancer patients to determine if cancer therapies are working. The hospital will save money by not purchasing the $3 million machine, Helm said.

Beyond the Hospital

The health system’s highest volume of patients come in through the emergency room and its clinics. So plans are also coming together for improvements in service to patients of some of the 40 clinics operated in the area by Sparks.

Five years ago, the system purchased 22 acres along Interstate 540 adjacent to the Air National Guard Base. Final plans are in the works for a new medical park that’s all about patient convenience.

“It will be a much more coordinated experience,” Parham said.

Sparks and St. Edward Mercy nearly split the health care market in Fort Smith. Sparks with 49 percent of the patient load and St. Edward with 51.