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Saratoga Hospital CEO Discusses Newsweek "Best Hospital" Ranking, Pandemic Impacts

Saratoga Hospital President and CEO Angelo Calbone
Photo provided by Saratoga Hospital

Newsweek has named Saratoga Hospital one of “The World’s Best Hospitals” in its ranking of 2,000 facilities across more than 25 countries. The 171-bed hospital ranked 162nd in the U.S. with a score of 66.7 percent. Strong Memorial Hospital in Rochester, Baystate Medical Center in Springfield, Massachusetts, UMass Memorial Medical Center in Worcester, Massachusetts and St. Francis Hospital & Medical Center in Hartford, Connecticut also made the cut.

WAMC's Jim Levulis spoke with Angelo Calbone, President and CEO of Saratoga Hospital, about the ranking and how the hospital industry has weathered the COVID-19 pandemic.

Calbone: Well, first of all, I’m incredibly proud of our organization and staff for doing the great work that they do every day that gets such a ranking in the first place. You know, as to what drove this, there's a number of components. To kind of give you the general high- level sense of that. It's public feedback, sourced from patient satisfaction surveys, from physician recommendation. And that's fairly heavily weighted. And to give you a little bit more of an insight into that physician recommendation, there's actually a survey process that they went through asking questions like, if you had a patient that couldn't go to the hospital that you typically work at, what would be your preferred institution? You know, very happy and proud to say, the Saratoga Hospital ranked very high in that around the region. Those components of feedback didn't just come from physicians, they were nurses and other healthcare professionals. And like I said, the other one was patient satisfaction, patient feedback, was another heavily weighted component. The third actually relates to objective metrics. Things that we track inside the institution that measure a lot of outcomes: mortality rates, safety measures, readmission rates, infection rates, as examples. So those are the three, you know, groupings of information that go into picking this. The comment I'd like to make, and this really gets back to why I think this is even more special in this moment, is that the heaviest weighted components relate to how our patients and community experienced us over this last year. Put that in context that we experienced a pandemic over that same period of time. Our staff was challenged, pushed, stressed. And I think the remarkable outcome here is that while we were experiencing that as an institution, our patients and community experienced their customary level of service, compassion, and attention from our staff so that that stress didn't translate through to the patient experience. And I think that's probably what I'm most proud about with this recognition.

Levulis: And you mentioned that external interaction over the past year during the pandemic, did the pandemic alter at all the internal approach that Saratoga Hospital had to take?

Calbone: Well, yeah I think I can say that there's not a single hospital in the country that didn't have to alter their approach. Visitor restrictions were in place. You know COVID patients were managed in particular parts of the building. Staff that had to manage those patients had to adopt very strict protocol, masking and gowning. So, the organization did feel different over this last year, and we’re winding out of that. Thank goodness, to an extent. But yeah, we, and when I say we I mean every institution, had to manage its approach a little differently this last year.

Levulis: And of course, health care facilities across the country faced shortages of that personal protective equipment that you mentioned over the past year-plus. Has that experience changed your approach for Saratoga Hospital in terms of, you know, stocking supplies, stocking materials for such emergency that we did experience?

Calbone: Yes. Again, some of it was imposed through department of health expectations about, you know, managing certain levels of inventory, which is a good idea if it's available. We experienced times when it wasn't available. But we're very aware of our inventory levels of personal protective equipment and work very hard to keep those at an adequate level with a safety margin. So yeah, that's something maybe we didn't think as much about the years past but we do now.

Levulis: Is the staff at Saratoga hospital vaccinated against COVID-19?

Calbone: We are a little above 80% vaccinated. So that's where we stand now, we hope that increases a bit. But the majority of our staff is vaccinated.

Levulis: Will you mandate that all staff get vaccinated eventually?

Calbone: We're not having that conversation at this point. I think you know, it's being used under an emergency use category. So, at this point, no, we're not mandating it. And if we think that ever makes sense, and we would have that conversation, but that's not in our plans right now.

Levulis: Have you yourself been vaccinated?

Calbone: Yes, yes, I have.

Levulis: Has Saratoga Hospital seen staff leaving the medical field because of the pandemic and the rigors that have come with it?

Calbone: Unfortunately, yes. I would characterize our turnover, meaning staff leaving, was remarkably low during the heaviest part of the pandemic management, which was last year into early part of this year. Our staff, you know, we're here for the patients and colleagues, but now that things are lightening up and I'm speaking as an industry also, we're seeing staff reevaluate their life, how they want to spend their time and what they want to do, and are looking around and making some changes in their life. I think that's probably could have been expected. So we're seeing that happen now. The good news was, during the pandemic, we saw very little of that. Which, you know, thank goodness that that turned out to be the case, because we all needed our staff here in doing during the great work that they do.

Levulis: On the flip side of that, from an industry perspective, are you seeing though an increased interest in entering the healthcare field? You know, over the past year-plus, during the pandemic, nurses, doctors, health care professionals, and rightly so were celebrated for what they were doing. So do you see, you know, a younger generation moving in?

Calbone: Honestly, not yet. But I hope that's the case. I hope that's the case, because we need them. We need more and more, you know, students to look at healthcare as a career. And, when I say you know, healthcare, it isn't just nursing. It's across the entire spectrum of healthcare professionals, and, frankly, even support staff. We need support staff throughout our organizations that can be challenging to attract at times. I hope that's the case as, you know, the schools begin to gear back up and get back to normal. We look forward to promoting health care careers out in the schools in the high schools and even some of the local community colleges. So we'd like to see that come true, what you described.

Levulis: And when it comes to staffing levels at hospitals, the New York State Legislature has passed a measure that would require minimum staffing levels for nurses and other health care workers at hospitals. What do you think of that legislation?

Calbone: I think I would characterize it is well intended, but probably problematic. And I think it has the ability to be very ineffective. You know, any hospitals that I've been involved in and I can speak Saratoga Hospital and I know all of our system-affiliated institutions, staff on a shift-to-shift basis driven by capacity, case severity, and the kind of talent that's needed on the floor. It can be a very fluid situation driven by real on the ground awareness of what's happening in your institution. I fear that overlaying a kind of strict guideline over that is going to cause some hospitals to miss allocate staff and maybe not do as good of a job as they can do in the present time.

Levulis: Do you think it could lead to staffing shortages?

Calbone: Well, we are in the middle of maybe the worst staffing shortage I've experienced in my career right now. If you were to check in with all the regional hospitals, you're going to find that we're all aggressively recruiting medical professionals, which include nurses and frankly, seeing challenges attracting staff, there just aren't as many out there as we all need.

Levulis: Do you think that there does need to be some sort of change in legislation when it comes to nurse to patient ratio in hospitals at all, though?

Calbone: At this moment, we are, you know, I would characterize aggressively regulated by the New York State Department of Health. Anything that is considered to be inappropriate in how we manage patients and care for patients is under the Department of Health oversight, and any concerns get reported into the Department of Health. I'm actually not a fan of imposed ratios. I just I think it's maybe well intentioned, but I don't believe it will be effective in the end. You know, back to the Newsweek article. We look forward to using that frankly in our recruitment, we're going to brag about that. And as we recruit medical professionals in the region and outside the region, you know, we're going to point that out that you know we'd like them to join an institution that gets this kind of recognition. We hope that helps.

Levulis: And now earlier this year, Saratoga Hospital offered some new designs for a medical office complex near its main campus in Saratoga Springs, the expansion efforts has faced pushback from area residents for several years. Why is this expansion needed?

Calbone: That is a medical office building that we look forward to bringing many of our employed specialty physicians to. We'd like them closer to the hospital. Right now we rent space all around the broad community to house those positions. We have a large employed medical group over 200 providers. We spend a great deal in lease amounts, frankly, enough to nearly pay for the building. And getting it closer to the hospital creates a lot of opportunity for us, for physicians moving back and forth from the hospital to their office. And, you know, actually to get a little bit into the weeds, it also provides an opportunity for us to be a lot more efficient as to how we run those practices. We don't need a waiting room, across, you know, 15 different offices, we can just be more efficient in how we operate these things. So it is important to our growth and stability.

Levulis: And now you've led Saratoga Hospital since 2006. And it's expanded during that time. Tt's added some affiliations as well, now as 171 beds. Does such an expansion or a continued growth, as you just mentioned, put at risk, the benefits sort of that we've been discussing of being a smaller community hospital?

Calbone: No, not at all. This has been a long focused process for us to develop Saratoga Hospital into a very sophisticated, competent community hospital that really has evolved into more of what I would describe as a regional medical center. We're in a growing community that has brought many people from outside the region who have brought with him experiences and expectations in many larger areas, urban areas. So we've worked hard to make sure we can meet those expectations. And that's driven a lot of our growth. So I think it is, you know, it's all been part of, you know, a direction that we've been undertaking for, you know, well over 15 years. So, no, I think it is all complimentary. And we need to do these things to ensure that this community has access to great care. And that we have an organization that can remain financially stable, because as you have witnessed, not just in this region, but in our industry, hospitals can become financially unstable in this very challenged environment. So now we see this is all part of contributing to the strength and quality and competency of the organization which our community I think has come to expect and appreciates. We don't see our community of service to be the city of Saratoga Springs. It really is the broader region to include much of the county.

Jim is WAMC’s Associate News Director and hosts WAMC's flagship news programs: Midday Magazine, Northeast Report and Northeast Report Late Edition. Email: jlevulis@wamc.org
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