El Camino rebuilding to become ‘shopping mall’ of health-care services
El Camino Hospital’s soft-spoken, yet driven, leader, CEO Lee Domanico, conveys enthusiasm as he describes ambitious goals to make this 42-year-old institution the hospital of Silicon Valley.
“We really want to create the health-care campus of the future,” said the Stanford graduate who was hired in October 2000 to turn the hospital around.
Envision El Camino’s Hospital of the future: approximately 300 rooms, surrounded by numerous supplemental services, from alternative medicine to ambulatory services. Domanico pictures a veritable shopping mall concept for one-stop health care.
Feeding into the hospital’s longstanding reputation for customer service, the new hospital has pager and Internet services in waiting rooms for patients’ families who want to do more than wait. Nurses carry miniature phones attached to their collars, allowing patients to call directly, rather than ring the nurses’ stations, which in turn must ring for the nurses. Picture El Camino on the cutting edge of all things high-tech, such as the stenotactic linear accelerator targeted for use later this year using radiation therapy to kill brain tumors inaccessible through traditional surgery.
El Camino plans to take advantage of a state-mandated requirement for seismic upgrades to completely rebuild its main tower by 2008, bringing its facilities up-to-date to complement changing medical technologies. Domanico and other hospital officials held their first meeting, March 8, with Kaplan McLaughlin Diaz Architects, to begin design-development. The predesign phase is expected to last six months. Domanico predicts 18 months of planning, 18 months of public process and three years of construction.
To get hospital leaders to think “outside the box,” El Camino earlier this year employed consultants from Strategos of Menlo Park to conduct workshops and help the hospital team look at all aspects of health care; and as a recent El Camino press release put it, include “what might happen if traditional beliefs and sacred cows were overturned and not included in future plans for the hospital.”
“Before you begin building, you need to redefine yourself,” said retired physician Richard Gilman, a member of the hospital team. “Medicine is not what it was. The same old model won’t work. Even if we were not forced to build a new hospital, this has given us an opportunity to see where we are and where we want to go. By doing this, the hospital can provide appropriate care to the next couple of generations.”
The present and future appear bright, from where Domanico sits. Hired away from Philadelphia, where he oversaw the unprecedented $1.5 billion bankruptcy recovery of a large hospital chain, the CEO has seen the Mountain View hospital recover from a $13 million loss in operations two years ago, to a projected $6 million profit this year and nearly $20 million overall the past two years. Domanico reports surgical services growing and outpatient services increasing rapidly.
Not bad for a hospital that was nearly given up for dead in 1996. Back then, the hospital had just regained its public, non-profit status after an ill-fated attempt at an integrated delivery system that drained hospital funding and created employee dissension. The settlement, even now, is still under scrutiny in some quarters, with the charge that a handful of principals involved in the transition made off with a large amount of money. Details of that agreement, involving a host of lawyers, are sealed and might never be publicly revealed.
But like a phoenix rising from the ashes, El Camino persevered. Former CEO Richard Warren began the recovery. Surveys continue to rank the hospital near or at the top in not only customer satisfaction, but also in satisfaction among hospital employees. The hospital was recently ranked No. 1 in employee satisfaction. El Camino physicians were ranked in the top 5 percent among 150 hospitals in a recent patient survey, with nursing care ranked No. 1 and cleanliness and overall quality of care ranked in the top 10.
“We have a very solid work force with a very high patient-care ethic,” Domanico said.
Domanico also pointed to two recent studies regarding cardiovascular surgery and heart attacks that showed El Camino one of few hospitals that had lower actual mortality rate than predicted mortality rate.
Translation? “If you come here, you’ll get a better outcome or do as well as expected,” Domanico said.
When asked about the hospital’s biggest challenge, Domanico didn’t hesitate.
“It’s hard for hospitals to attract and retain physicians, nurses and other health-care professionals in this area,” he said. “We believe that our reputation helps us attract physicians.”
He added that El Camino hires more employees than other hospitals, making it more attractive to physicians who like to see their surroundings well-staffed.
One idea the hospital is implementing is providing mortgage support for physicians who are first-time homeowners. The hospital faces a big challenge with the area’s high cost of living, an area where a family of four making $70,000 a year can qualify for moderate affordable housing.
Even Domanico himself is not an area homeowner. He commutes every weekend to Los Angeles to be with his wife, living in a Mountain View apartment during the week.
El Camino’s hospital of the future likely will include larger, more private patient rooms to allow families to sit and congregate. He called it “individualizing the patient-customer experience.”
Domanico also sees a hospital “more sensitive to ethnic differences.”
He cited subtle changes to this end already – an Indian vegetarian dish recently added to the cafeteria menu.
In this hospital of the future, where El Camino is the Macy’s in this shopping mall of health-care choices, Domanico made it clear he wants the complex to attract the healthy and well as the ill and injured.
To do that, he sees the creation of a “smart hospital” and a destination hospital for all of Silicon Valley by utilizing the high-tech innovations that distinguish the area.
He noted with pride that El Camino was the first hospital “in the world” to implement a computerized information system, some 20 years ago, that would allow physicians to choose from pre-programmed diagnoses and select treatments. This eliminated confusion over hand written notes that could lead to mistakes. Domanico is looking to enhance this system with the eventual goal of eliminating paperwork altogether while providing better information security.
A number of factors have to align to accomplish the hospital’s ambitions. The public must buy into the plans, literally and figuratively, with the most obvious example being a possible bond proposal for the new hospital.
According to facilities manager Ken King, costs could range from $120 million to $200 million. Other possible sources could include cash reserves, borrowing the money and philanthropy.
The venerable institution must continue its reputation of excellence to draw business and justify not only existence, but its expansion.
Competition is fierce in the health care industry, but El Camino is improving with Domanico at the helm.
“He’s great for El Camino,” King said.
Hospital leaders are working toward a future bereft of the contentious climate that marked the hospital’s Camino Healthcare period.
As for Domanico, a calming presence with an offhand sense of humor, the hospital has a gentle – but firm and experienced – guiding hand. He described both the hospital and himself as “a work in progress.”
