MVH History – William Thornton, MVH President and CEO, 1998-2005

 

Bill Thornton began his career at MVH as chief operating officer in 1988 after holding several administrative positions at Grandview Hospital in Dayton. He sat for an interview Dec. 19, 2012, in the Health Information Center of the southeast patient tower.

What were some of your proudest accomplishments as an executive at Miami Valley Hospital?

Well, that's hard to answer because so much happened in my 18 years here. I want to stress, though, that whatever was accomplished was accomplished by a team, not by any one individual. It was accomplished by everybody working together to provide the quality of care we thought the people in this community deserved.

That said, there are a number of things I’m really proud of. We were a city hospital that served most of the indigent in the area, we provided the highest quality care of any local hospital and we had the best financial balance sheet. It’s rare for a hospital to have all three of those traits, because taking care of the uninsured is so expensive. But we did it and it really set us apart, and still does today.

Another was looking out for our employees, trying to do right by them. We really strived to provide our employees and medical staff with a high-quality environment, one that had the best facilities and technology available, so they could practice high-quality medicine.

I’m also proud that we continued the hospital’s tradition of being involved in the community and serving the poor. From the year we started in 1890, that’s been our cornerstone.

The Shaw Emergency & Trauma Center opened in 2000 under your watch. Why was that project necessary?

The old emergency department had become totally inadequate. We had become probably the largest ER in the state of Ohio in terms of number of visits. The old ER was built to handle maybe 40,000 visits a year and we were pushing upward to around 90,000 to 100,000 visits a year. So in order to provide the quality care the Valley was known to provide, we needed a state-of-the-art facility.

The project was physician-led, with a lot of involvement from nurses and other employees. And all through construction we didn't miss a beat, we really didn’t even slow down. Again, it’s a tribute to the physicians and employees who continued to provide outstanding care while building a new ER. And when we finished, it was the state-of-the-art facility in Ohio and probably one of the best facilities in the country.

It also was fortuitous that we expanded the ER when we did, because Franciscan Medical Center (the former St. Elizabeth Hospital west of MVH) closed that fall, creating a void for the indigent population it served. We felt that impact immediately.

What were your biggest challenges?

One of the hardest parts of our job was negotiating fair and equitable reimbursement rates with third party carriers, such as Anthem Blue Cross and Blue Shield, Aetna, United Health Care and others. They were very tough negotiators and we had to make some very hard decisions in terms of how we spent that revenue.

The budgeting process was probably always the most difficult thing we faced, deciding where to allocate our resources so we could maintain the long-term viability of the organization. There’s always that tension between needs and resources.

Moving to the electronic medical records system, known as EPIC, started during your tenure. Talk about that endeavor and why it was important.

We had to do it to provide a better, safer environment for patients and physicians. The amount of information that goes into a person's chart is vast and complicated, making it difficult and time consuming to manage on paper alone. There’s a potential for mistakes and conflict between different types of orders and medications and so on. So what the electronic medical record did was help provide information right at the time it was happening. It allowed for continuity and better communication for physicians and staff and it had built-in safety alerts for possible drug interactions or dosing questions.

The challenge was taking individuals who had been used to writing things down and having them stop and electronically enter this kind of data. For some individuals it's very time-consuming. It caused some pain, but the output is better and safer patient care.

The hospitalist program here started in 2005 with the opening of The Miami Valley Hospitalist Group. How did this added dimension to patient care benefit the patient and hospital?

The hospitalist program started mainly because a lot of primary care physicians were finding it very difficult to be in their practices and to also come here and make rounds in the hospital. The time was just not there, and neither was the reimbursement. So in order for the family physicians and the internists to make a living, they had to spend most of their time in their office seeing patients. But that left a void in the hospital. When the patient came in they needed someone to help monitor and coordinate their care and that's where the hospitalist came in.

It started out of the ER, where unassigned patients would be assigned to a hospitalist, who was really a family physician or internal medicine specialist. The hospitalist would then take over the inpatient care of that patient, determine what the problem was, how to treat it, what specialists and lab tests were needed, etc.

It's worked out fairly well. There is some concern there’s a loss of continuity between the patient and his family physician, but you work around that by making sure the hospitalist and family physician talk and communicate closely together.

Did you visit patients when you were CEO?

All the time. Probably the best part of my day was getting out of the office and visiting not only patients but employees and seeing them working in their environment, seeing some of their issues and how they addressed those issues. I would visit patients or meet people out in public who had been here and sometimes we had unpleasant conversations, but 98 percent of the time it was, “What a wonderful experience we had,” or “What a nice place.” It makes you feel good, it make you appreciate all the hard work of all the people here who produce that kind of result.

Can you think of an occasion or moment at Miami Valley that sticks with you to this day?

There are so many, but what comes back to me is Project Holiday Baskets, where employees in different departments would raise money all year long to provide a nice Christmas for needy families in the area. This was a volunteer project, we didn’t mandate it. Employees would donate toys, clothing and household items to fill the baskets and we would also include a gift card. We would deliver these gifts to families who were identified by our employees. I think when I left we were up to 127 families that were adopted. It just tells you a lot about the caring nature of the people who work here — they're very busy, they work hard, but they're willing to take extra time out of their day to do this.

I also remember watching the videotaped vignettes of patients and their families during my annual State of the Hospital address. It might be of a daughter explaining how her mother was here dying of cancer and how the nurses and staff were so solicitous of her, how it made the final days of their mother’s life and their life with her so much better because of the people who work here.

Talk about the early days of the hospital’s Palliative Care Program and why that initiative was important.

The idea of the Palliative Care Program was to have a support system for terminally ill patients and their family members and loved ones. Maybe the patient had suffered critical injuries in a car accident or they were fighting an illness and suddenly took a turn for the worse. You can imagine how shocking that might be for family members. They’re just not prepared for that kind of news, and these circumstances require delicate, expert communication and time.

The doctor who has 50 patients may not have the time to sit with these families, walk them through the dying process, tell them what to expect next and help them through their grief. With the Palliative Care Program, we had an interdisciplinary team of doctors, nurses, counselors and others to do that. They would spend time with these families and loved ones during the patient's last days and hours, just listening and talking to them, trying to explain what was going to happen and helping them figure out what type of arrangements needed to be made once the patient succumbed.

Our program was modeled after several programs nationally, including Cleveland Clinic, and it was initiated by Beth Delaney, one of our advanced practice nurses. Under the leadership of Jayne Gmeiner, one of our nursing directors, Beth, Dr. James Murphy, and Dr. Basil Yanes worked tirelessly to get the program up and running and make it what it is today. I also can’t give enough credit to the Miami Valley Hospital Foundation for their role in this. Beth went to the Foundation to help fund the program because it was a fairly expensive and untested proposition, and the Foundation really stepped up.

The program made an immediate impact. You cannot imagine the amount of letters we received from patients’ families saying, “What a difference you made in our lives.” Those things stick with you. It’s really one of the bright spots in my 18 years at the hospital.

Any regrets?

No, not really. In the 18 years I worked here, I'm sure there were a couple of days I didn’t want to come to work, but I enjoyed the job. I thought it was important. I worked with a bunch of great people, a great medical staff, and I worked at a hospital that was well thought of in the community. I was very fortunate and privileged to work here, just to be a part of this organization.

Patient Satisfaction

Bill talks about an initiative in the early 1990s that focused on patient satisfaction. 

Click play to watch the video or read video transcript.

“…When people come to a hospital it’s a new experience, they’re scared. They’re not usually here for a happy occasion — it could be an accident, it could be a loved one facing a major surgery, it could be something terminal. It's not some place they choose to go, it's not Disneyland. It's not a happy experience for most people and what you realize as an employee is that all of us, in order to set those people's minds at rest, you got to treat them like you want to be treated. You have to realize they're scared, you have to realize they don’t understand our jargon, you have to realize that they're not happy to be here. So treat them like you want to be treated and if you do that we will be successful as a hospital and we will continue to thrive and we have.

Thornton is a native Daytonian and a graduate of the University of Dayton.
He was also employed at Inland Manufacturing Division of General Motors Corporation and served in the U.S. Army as a combat engineer specialist.
A diplomate of the American College of Healthcare Executives, Thornton received a master’s degree in Hospital Administration from Xavier University, Cincinnati. He has served on several community boards, including the Greater Dayton Area Hospital Association, the United Way of the Greater Dayton Area, Big Brothers/Big Sisters and the Miami Valley Child Development Council.

He and his wife Carla live in Kettering.

 

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