Doctors leave Denver Health
New leadership cuts sta≠ and invests in a computer system.
Denver Health Medical Center has shed top officials and doctors, including its chiefs of medicine and surgery, under the leadership of a new chief executive.
The former city hospital, known for providing excellent care to the indigent and trauma care for all, also is undertaking a big investment in a new computer system while staff positions have been cut elsewhere.
Arthur Gonzalez, who took over the hospital’s helm in 2012, said the new Epic computer system is under budget at $170 million and is expected to start up in April. He also defended the hospital’s staffing, which included a reduction of 122 full-time nurses in 2013.
The hospital has appointed interim directors to replace its chiefs of medicine and surgery and hopes to conclude a nationwide search this year to fill those vacancies, he said.
Denver Health has “6,500 fulltime employees,” he said. “In an organization of that size, there is a normal course of turnover.”
Bill Sonn, a Colorado health care communication consultant not involved with Denver Health, said the departure of top-flight talent from any hospital could be a sign of trouble.
“For any organization, turnover like that is a red flag,” he said. “Given the physician shortage, moreover, keeping physicians engaged is a priority for most provider organizations. Having talent leave often indicates some sort of dysfunction in communication, compensation or shared decisionmaking.”
In interviews, The Denver Post learned that at least five hospital leaders have departed since Gonzalez arrived. He succeeded Dr. Patricia Gabow, the longtime hospital leader who helped transform Denver Health from a city hospital into a semi-public entity with more financial flexibility.
Dr. Richard Albert, chief of medicine, retired from the hospital but teaches and serves as vice chair for clinical affairs for the Department of Medicine on the University of Colorado’s Anschutz campus.
Dr. Gregory Jurkovich, chief of surgery, and Dr. David Brody, head of managed care, both resigned.
Stephanie Thomas, chief operating officer, also retired, and Gregory Veltri, chief information and technology officer, departed after a disagreement concerning the hospital’s change of computer systems.
Thomas was “highly regarded” and gave advance notice of her retirement plans, Gonzalez said, but he could not discuss the departures of Jurkovich and Brody. They declined to comment, and Albert did not return messages.
Veltri praised Denver Health and its doctors. “They saved my life two or three times,” he said.
But he questioned the size of the hospital’s investment in a new computer system, saying the costs could total $300 million, including a $70 million payoff to the current contractor and a doubling of the information technology staff.
He said he warned that the cost could bankrupt a hospital operating on thin financial margins.
“My estimates weren’t flattering,” he said.
Gonzalez responded that Veltri was “held in good regard,” but “he’s severely mistaken.”
He said he could not divulge how much it cost the hospital to get out of its current computer contract, citing a confidentiality clause.
Denver Health records show it chose Epic as an electronic medical record system provider partly to share resources and research with other hospitals. Epic now serves about 65 percent of hospital beds across the Front Range.
The investment is vast already. According to the hospital’s January 2015 board minutes, it completed a temporary building to house the Epic team and hired “the required 125 person staff.” And while Gonzalez reported record cash collections in 2014, he told the board “that much of this cash-on-hand is already spoken for with projects such as Epic.”
The hospital’s finances have been helped somewhat by Medicaid expansion under the Affordable Care Act, which enables it to seek reimbursement for newly qualified patients.
In September, the hospital board increased Gonzalez’ base salary from $760,000 to $800,000, which the hospital calls the midpoint for comparable institutions. In addition, he was paid $180,706 last year for achieving organizational goals in 2014 ranging from patient safety to finances.
Gonzalez was rewarded at a time when some hospital employees were complaining of staff reductions, particularly among nurses.
In response to a records request from The Post, the hospital said in October that four nurses had been laid off since Gonzalez was hired, and 71 staff nurses had been “dismissed/termi- nated” for reasons that “are typically performance related.”
Minutes of the hospital’s April 2015 board meeting, however, refer to “the recent staff reduction of 122 FTE (full-time equivalent) nursing positions.”
Gonzalez noted that the April report found no link between an increase in atrisk events, which can be anything from infections to falls, and the reduced nursing staff.
A hospital spokeswoman said the report “was actually a discussion about the workforce reduction in 2013, which was a combination of leaving positions unfilled, reassigning staff and job elimination, and how, two years later, there was not an increase in ‘at risk’ events because of this change.”
In 2013, Denver Health spent $2 million for an efficiency consultant named Envigorate to help install a computer-based productivity system. “This organization-wide system drives our ability to align our staffing with our patient census,” the hospital said.
Gonzalez said the hospital achieved “about $32 million worth of improvements” in return, in part by right-sizing departments.
“We are just as concerned about departments that are overstaffed as departments that are understaffed,” he said.
Gonzalez also raised eyebrows at the hospital by setting aside space on campus for his staff band.
But he said it amounts to a 10-foot-square space in a previously vacant room on campus converted to office space, so the band rehearsal area didn’t cost the hospital anything.
It’s “an all-volunteer staff band” that rehearses after hours and performs at hospital events such as the employee picnic, he said.
He plays rhythm guitar.