Richard Thomas is the executive director of the Center for Health at OSF Saint Francis Medical Center, responsible for planning and directing the short -and long-term development and operation of the OSF Center for Health—the organization’s newly constructed $36 million ambulatory care center. It is composed of a six-suite ambulatory surgery center, a diagnostic center, a PromptCare, a women’s center, and a 68,000-square-foot medical office building.
Thomas has more than 30 years of experience in business administration and nursing, with specific involvement in capital and operational budget, project and systems development, membership, facility licensure, accreditation, medical practice management, capitation, physician recruitment, personnel management, and outcomes measurement.
He first became involved in medicine at the University of Pittsburgh, Penn., where he majored in liberal arts/ pre-med from 1971 to 1973. From there he went on to receive his bachelor’s of science in nursing from Widener University in 1975.
He worked as a staff nurse as the team leader on a 60-bed surgical floor of the 750-bed teaching hospital at Mount Sinai Medical Center, Fla., from 1975 through 1976. Thomas then became first the charge nurse, and then supervisor of the mobile intensive care units at Crozer-Chester Medical Center, Penn., until 1979.
Next moving to California, he worked as the special project officer, manager of the occupational health program, house supervisor, and staff nurse at the Doctors Medical Center until 1986. In 1986 and 1987 Thomas was the assistant administrator at the Doctors Hospital of Manteca, and promoted to vice president and administrator of Memorial Hospital Ceres for the Memorial Hospitals Association from 1987 through 1992. From 1992 through 1998 Thomas served as the associate director at the American Academy of Pain Management.
Prior to coming to Peoria, Thomas served as the associate executive director at the Guardian Rehabilitation Hospital, Calif., where he was responsible for all nursing services, respiratory therapy, radiology, laboratory, pharmacy, dietary, housekeeping, plant operations, security, materials management, and staff education in the 100-bed rehabilitation hospital.
Tell us about your background, schools attended, family, etc.
I grew up in Bradford, Penn., which is south of Buffalo, N.Y., so I have some experience with snow and cold weather (at least I thought so until this past Winter in Peoria). I have two younger siblings; a brother and a sister. My brother lives in Ohio, and my sister lives in North Carolina.
I went to the University of Pittsburgh for two years as an undergraduate and then transferred to Widener University to complete a bachelors degree in nursing in 1975.
After completing nursing school, I moved to Miami Beach, Fla., and worked at Mt. Sinai Medical Center on a medical surgical unit for a year. I then moved to Chester, Penn., a suburb of Philadelphia, Penn., where I worked on a mobile intensive care unit for three years. In 1979, I moved to Modesto, Calif., where I worked as an ICU nurse and then took a position as a nursing supervisor while I went back to school to get my MBA.
You came to Peoria one year ago to become executive director for OSF’s new Center for Health. Why were you attracted to the position? What do you bring to the job that will make the project a success?
I was attracted to the position in Peoria for a couple of reasons: I like being involved in new construction and start-up projects—where you get to build the team and start from scratch with a new facility. It’s very exciting—and fun—to build your own team and see months of planning turn into reality.
It’s often difficult to see the fruits of your labor in health care. This type of project does it for me. Also, the Peoria area has a lot to offer in terms of what I was missing in California. Having grown up in Pennsylvania, with the four seasons and opportunities for hunting and fishing, I was hungry to return to that type of setting.
You have published several articles on pain management. Why is this area of interest to you? What changes in pain management will we see in the next decade?
Pain management has been an interest of mine for probably 10 years. My first exposure to pain management was through accepting a position as hospital administrator at a hospital where comprehensive pain management was offered. Through that process I came to learn pain is not well managed in this country. Nursing schools and medical schools focus primarily on acute pain management.
Chronic pain, on the other hand, involves the psychological, social and physical well-being of the patient. It is very poorly understood, and thus, managed in this country. Treatment tends to be sequential when what is needed is a collaborative approach that involves all disciplines simultaneously. Consequently, resources are drained, rather than being pooled to affect a positive outcome. My efforts in this area have been focused on getting the whole patient treated rather than just a portion of the problem, and focusing energies early in the process while there are still resources and energy. This appeals to my MBA side as well because I think resources are often wasted in the pain management efforts in this country.
With respect to changes in pain management over the next decade, the joint commission has already focused the spotlight on pain management. Despite the fact that the spotlight is on acute pain, the intensity of focus will help with the overall problem.
My concern about pain management is that unless we, as health care providers, understand and manage chronic pain better, payers will deem chronic pain a social ill and will quit funding it. I’m convinced that comprehensive care that includes social, physical and intervention is key to affecting positive outcomes in pain management. If those programs are offered as a stop-loss to payers, I think we’ll see continued funding. Otherwise, funding will largely dissolve. I am enthusiastic about lending my talents in this area to the already existing OSF Saint Francis Pain Management Program.
How have you spent the past year preparing for the opening of the center? Describe your responsibilities as executive director for the Center for Health—both during the past year, and after it opens.
I spent the last year facilitating communication between the various work teams that are designing the operational processes for the new center. Part of that process included hiring some of the managers for departments at the Center for Health. I have also overseen the development of the staffing plan and the hiring process for the Center.
As we approach the opening of the center, a large portion of my time is spent designing the training processes for the new staff, and coordinating our move as the construction company wraps up its efforts.
After the Center opens, my focus will be on the daily operations of the center—service to our patients, service to physicians, and service to the community. The goal is to create a health care "experience" for our patients, their families, our physicians and staff that is warm, friendly and unlike any other health care they have experienced.
Why was an additional health center needed in Peoria, and why a north-end location?
The Center for Health was needed for a number of reasons. Access to outpatient services is currently not easy given the size and complexity of the medical center, and there is not a single "one-stop shop" for all ambulatory services in this area.
The Susan G. Komen Breast Center is moving to the Center for Health. Are there any other facilities moving/closing because of the new building?
We will offer ambulatory surgery, diagnostic imaging, laboratory, promptcare, woman’s services, senior services, diabetic services, etc. and that’s just the start. We are only developing approximately 16 acres of a more than 200-acre campus.
What are the differences between a traditional hospital and the Center for Health?
In a traditional hospital, inpatient services are combined with outpatient services. By necessity, the needs of the inpatient population take precedence over outpatient needs. Consequently, as emergencies happen, outpatients may have to wait, and scheduled times may be delayed. Secondly, because outpatient services have been added onto existing inpatient services, the patient’s ability to find parking adjacent to their needed service, find their way to the service, obtain the services they need, and find their way back is pretty daunting. The Center for Health is quite the opposite.
Patient registration will be done by telephone, allowing the patient the convenience of completing that task in the comfort of their home. It will also save time once the patient is at the Center. Surface parking adjacent to the facility is available, rather than multi-story parking structures.
Once inside the Center for Health, patients will be greeted at the information desk, much like a large hotel, and escorted to your area of service. And lastly, one can expect their appointment time to be kept.
Are there any indications of the economic impact the Center for Health will have for the area? How many employees will the center have upon opening? Later?
The Center for Health will create approximately 130 jobs with a payroll somewhere between $2 and $2.5 million. Since the facility is within the city limits, property tax revenue will be generated for the City of Peoria. The future economic impact all depends on the rate and size of expansion.
How difficult was it to recruit nurses, surgeons, radiologists, as well as other staff to this facility? What, if any, recruitment packages are available?
In terms of recruitment, nurses are always difficult to find; however, this facility has facilitated that process. People want to work in a warm and inviting environment where they can provide the highest level of customer services.
Health care often doesn’t afford us that opportunity. Surgeons, radiologists, etc. are already on the existing medical staff. They will have the opportunity to practice in a new location.
What sort of "dry runs" will the Center go through before opening day?
The Center for Health will go through two process simulations. Each of those process simulations will be conducted over two days.
We will utilize a number of people from the community as patients and actually go through the registration process, taking the patient to the area of service, going through a mock run of patient care and then discharging the patient. This will give us an opportunity to test all computer systems, and our people processes, and fine-tune our systems before opening for service.
What surprised you the most during the construction/development of the Center?
I was surprised by the enthusiasm and dedication our staff has for expanding the Sisters’mission through this new Center. The mission—‘‘With the greatest care and love"—is the difference. My past employers talk mission, OSF staff, from top to bottom, live the mission. If you don’t believe me, come experience it for yourself.
During your career, what significant changes have you seen in health care and hospital administration? Are these changes positive or negative? Do you expect those trends to continue?
The most significant change I have seen is the shift from cost-based reimbursement (where the more services one rendered, the more one got paid) to the current situation (where one receives a fixed income for assuming the health care responsibility for a given population).
Under the latter scenario, the incentive is to provide no more care than necessary as it increases one’s cost and decreases the contribution margin.
Are the changes positive or negative? I would say it’s a double-edged sword. In one sense, it forced us, as health care providers, to trim the fat from our organizations and eliminate a lot of overhead.
On the other hand, patients often don’t receive the level of care they feel they should be offered. I expect the trend to continue. Managed care companies will continue to monitor to make sure they are not over-spending.
Patient’s needs will continue to increase as the baby boomers reach retirement age and increase their demands for health care services. The government will continue to view health care as an unfortunate necessity. The financial pressure will continue to focus us on finding more economical ways to deliver more and better care to larger and needier populations.
What is your vision for the Center for Health? How has it changed during your first year in Peoria?
My vision for the Center for Health is to create a new health care experience, one in which patients and families are treated much the same as they would in an elegant hotel.
My intent is for patients to have easy access to care, a warm and inviting environment, friendly customer service and competitive pricing. I can’t say my vision has changed in my first year in Peoria; I have always had this dream. Now, however, I have been blessed with the opportunity to see it become reality.
What do you hope to accomplish in the next five to 10 years at the Center for Health?
I hope to create a cost-effective, efficient and convenient health care system for outpatients with a customer service approach that is unparalleled. It will be a whole new health care experience for people in the central Illinois area.
I tend to like growth opportunities, and I get restless with routine operations, so I will look to be a part of any expansion opportunities at the new campus.
It is my plan to exceed the expectations of the community and the OSF administrative team and, thereby, ensure my future involvement in OSF developments.
What is your proudest professional accomplishment?
Prior to my involvement in the Center for Health, the development of an ambulatory surgery center and a diagnostic center in Modesto, Calif. Without a doubt, involvement with the Center for Health is my greatest professional accomplishment to date.
People skills are the key to operating a successful business. The way you interact with your management team, encourage your staff, lead by example, and treat customers and each other are all key to the experience people walk away with.
If people walk away with a good experience, they will naturally want to share it with others. Staff feel good about coming to work, and they feel good about being part of the organization. IBI