St. Michael Medical Center in Silverdale opened its doors in December 2020 — right in the middle of the worldwide COVID-19 pandemic.
In the one year the hospital has been open, it has served more than 138,000 patients, hosted numerous COVID vaccine clinics to expand access to COVID care in conjunction with local organizations, and graduated the inaugural class of its Northwest Family Medicine Residency Program, according to the hospital.
Chad Melton took the reins as St. Michael's president this October. With more than 17 years of executive health care and leadership experience, Melton most recently served as CEO of Fauquier Health System/LifePoint Health in Virginia before coming to St. Michael's.
In light of the one-year anniversary of the medical center, which is part of Virginia Mason Franciscan Health, we spoke with Melton about the challenges the hospital has faced in the midst of the pandemic, and about what's in store for the hospital's future.
The following interview has been lightly edited for clarity.
Obviously the COVID-19 pandemic has been a challenge for a lot of different industries and businesses. What challenges did the new medical center face opening in the middle of a pandemic, and how were you able to respond to those challenges?
As you mentioned, the pandemic has affected a lot of different businesses in a multitude of ways. Health care is just a little bit different considering we’re providing direct patient care. I’ve had the opportunity to be a part of opening up two new hospitals in my career and what I’ve learned from that experience, and being here for my first 90 days, is the biggest challenge is just the overall transition. So greenfield hospitals, where you’re opening up a new facility and an existing hospital was not present, creates challenges. But moving from an older facility to the brand-new hospital at St. Michael was a huge undertaking. I think there were 170 patients that were transferred over in December of 2020 and so that creates its own logistics in itself when you’re transferring acute patients.
But with COVID in general, we saw that staffing was a challenge and the pandemic has caused even greater challenges for health care in general. And so we saw that that was a big impact on the overall organizations. If you look at some of the national statistics, we were significantly short and going into the pandemic, it created an even larger gap for us.
And another piece of it is, from my understanding, the construction had to be paused during COVID. As you know, with the testing and all of the unknowns that were currently out there, and then also supply shortages for a lot of material for construction was another impact on the overall organization.
So those are some of the biggest things that we saw as far as impact. And a lot of the other things are more just day-to-day operational challenges. The volume is significantly higher than we originally anticipated, and so we saw during COVID with the shutdown — I came from Virginia, and then same thing here in Washington state — is that a lot of elective cases were paused for a period of time and we saw that patients were not receiving their care, their primary care, urgent care, offices, and so it had an impact on the overall acuity that we’re seeing here at St. Michael today with patients not seeking just preventative care.
At some point, you were still using the old hospital in Bremerton, weren't you? I know it wasn't necessarily useful if you couldn't staff it, but to what extent was having the old facility available useful for responding to COVID?
We’re still 100 percent committed to providing care in Bremerton, because that’s a huge part of why we’re here, to support the Kitsap and Olympic Peninsulas. And so we did use the facility up until July of 2021, where we ended up currently pausing operations at that facility and moving all inpatient and emergent care here to St. Michael.
A big piece of that was our ability to be able to staff two separate facilities, because when you’re running two locations, you end up duplicating a lot of resources, and so it’s just more cost effective for us to do that at one location.
The old facility in Bremerton was dated to the point where it wasn't practical to keep it running, correct?
Yeah, that’s part of it. There was just a big commitment made in order to invest here locally to support the entire Peninsula and aging facilities are extremely costly to be able to keep open. The Silverdale location was more centralized to the community that we serve. And so we had moved all services here even though we continued to actively recruit to potentially reopen the facility in Bremerton until we can come up with a longer term strategy about how and what care will be provided there.
With the new facility, were you able to expand services or equipment or introduce new technologies?
The facility was really designed with the patient and family experience in mind. When you come to the facility, it’s easy to navigate and we’ve got several different entrances for patients — our Ridgetop and our Mountain View entrances. So when you come into the facility, instantly you’re able to be with one of our patient advocates, our navigators, to get you where you need to be. And so it really is open, unlike the Bremerton facility where there were numerous access points and it was difficult to navigate.
The [new] facility was really meant for that overall experience as I mentioned, to be able to get the patient where they need to go, whether it be an inpatient or an outpatient procedure or access directly to the emergency room. So you will find there are very large waiting areas. The patient rooms are all private rooms with the latest and greatest technology around our nurse call system. A lot of our rooms, like our orthopedic rooms, are equipped with the list directly in the rooms so that you don’t have to move equipment in and out of the facility.
We were able to expand our robotics program [with the] Da Vinci XI. We are one of 10 facilities, I think, across the country where we do almost all of our general surgery cases robotically. We are a show site for Intuitive [the company that manufactures the Da Vinci XI robot]. That’s something that we’re able to add to the community.
We expanded our cardiac catheterization program with something that we call our radial lounge, where patients can get a procedure, which is not always the most comfortable, so it’s set up so that they have lounge chairs, refreshments, and they’re able to use their electronic devices through web access here in the facility.
We also have our rooms in our new tower where family members, when we have visitation, are able to stay in the patient’s room in a comfortable manner. We were able to add a new medical pavilion here to our campus where patients can come here in more of a one-stop shop. So if they come to see the vascular surgeon, or a cardiac, they can get all their services here on campus, where before they may have had to drive to various locations; they can receive their care here locally.
And so those are just a few of the highlights. I think that you’ll see as well a continual expansion to meet the community needs: the population 65 and older has grown at about 125 percent; we want to be able to meet the needs of the community, provide the latest and greatest technology, but also do that in a cost-effective manner for our patients.
Can you talk about the Northwest Family Medicine Residency program?
We talked a little bit about the staffing challenges that we’ve seen for nurses and techs and other ancillary and support positions. It’s no different when you’re talking about physician recruitment and meeting the need of a growing community.
So if you look at our overall residency program, it is primary care. And we have a location off of Kitsap Way. It’s in the shopping center over there, so easy access. The big piece of it is that to meet the overall needs of the community, especially when you’ve got an underserved population, growing population, we want to make sure that we are able to provide primary care. Primary care is needed in order to prevent patients from getting into a sometimes acute condition where they need to come to the hospital, and so the program has really grown.
Even through COVID, we were able to graduate our first graduates through the program and I think six of those seven stayed here locally, which is one of the huge benefits of having the residency program, is to be able to fill our need for primary care physicians. Two of those providers through our first class joined our hospitalist program — hospitalists are those that just do inpatient work. They stayed on to provide that overall inpatient care. So the program is a benefit to us and we have a full complement of 24 physicians that are currently in the residency program and are providing anywhere between 25 to 30 thousand visits on an annual basis. And so that, again, keeps patients here local, allows us to provide access to care. I think a big benefit of our programs in general is that we see all patients, which is a significant benefit.
What does the future holds for the medical center, both in terms of responding to the ongoing pandemic, but also more longterm?
If you’ve been around health care, people constantly talked about not recreating the wheel but aligning best practices and others, and we will continue to do that. But I think part of the pandemic has made us look at things a little bit differently than we had previously, and so we’ve been talking to our team members regarding, how do we continue to provide care knowing that it may be endemic, it may not go away, very similar to the flu? How do we continue to provide the care in the communities that we serve? And so we are reevaluating what that looks like, but I think that what you will see is hopefully in the next couple of months we’ll be able to announce some of the plans that we have going on in regards to inpatient expansion, growing programs in a variety of communities. But the thing that we’re focused on right now is adding another Da Vinci [robot] here on campus.
A big piece that you will see here shortly is that we’ve done over 4,300 cancer center visits, and we’re actively working on expanding our cancer center to meet the growing needs of the community. As I mentioned earlier, the hospital's [patient] volume has been much higher than we anticipated, so we’re actively constructing the expansion of our parking areas to meet that overall demand that we’re seeing here today. And then I can’t really talk about it just yet, about expanding certain services in Bremerton and other parts of the Peninsula.
Anything else you’d like to add?
I think it’s always good to highlight our quality results. So even though we’ve been through the pandemic and we’ve moved to a new facility, we’ve been able to maintain our Leapfrog base score [the hospital has maintained an "A" grade since the fall of 2018]. We continue to grow the majority of our programs — we’re a stroke center, level III trauma center, we’re certified with the Joint Commission for total joints, we’ve been able to maintain our quality.
Even though we’re talking about the facility, at the end of the day our biggest assets are our team members, those who are providing care and ancillary support services to our facility. We want to thank them for the work they do each and every day, and for the community’s patience as we continue to grow with them and meet the overall demands.