Deborah Proctor is big on what she calls “systemness.”
The new chief executive of Orange-based St. Joseph Health System, which runs 14 hospitals,including three of the 10 largest in the county,said she hopes to use size to get better prices on equipment and supplies and improve care at its facilities.
“I bring some experience in ‘systemness’ and the value that can be delivered by having hospitals work as a system, and not simply as independent entities,” Proctor said.
Proctor comes from St. Louis-based Ascension Health, the largest Catholic hospital operator. St. Joseph also is a nonprofit Catholic operator with hospitals in California, Texas and New Mexico.
Locally, St. Joseph runs its flagship hospital in Orange, the county’s third largest by patient revenue after Newport Beach’s Hoag Memorial Hospital Presbyterian and UCI Medical Center in Orange. St. Jude Medical Center in Fullerton is No. 4 in the county, while Mission Hospital in Mission Viejo is No. 6.
Proctor takes over for longtime St. Joseph leader Richard Statuto, who’d been with the hospital operator since 1990.
In February, Statuto is set to become chief executive of Bon Secours Health System, a 24-hospital Catholic operator based in Marriottsville, Md. He left St. Joseph in October to join his wife and children in Gettysburg, Pa., where his wife has family.
Proctor is familiar with St. Joseph. She worked there from 1976 to 1990, starting as a critical care instructor and working her way up to assistant vice president of leadership development.
At Ascension, Proctor was chief administrative officer.
Beside the advantages of bulk buying, a “systemness” approach could help spread medical advances across St. Joseph’s hospitals, according to Proctor.
“If we learn a way of improving care in one of our facilities, we can rapidly disseminate that to our other facilities,” she said. “They don’t have to go through the same learning process.”
Proctor will have to straddle a line in pushing for more coordination among St. Joseph’s hospitals here. Each has its own distinct character and local ties.
“Clearly, the organizations have to be very tied in with their local community,” she said. “But the fact that they are aligned with other hospitals can offer a leveraged set of advantages.”
Another of Proctor’s goals, she said, is to make sure St. Joseph keeps its focus on patients.
“One of the things that I bring to the job is that I was a nurse,” she said. “As such, I believe I understand patient care, which is at the heart of everything St. Joseph Health System does. That’s the business we’re in,the business of delivering care and improving health of communities.”
In her first two months on the job, Proctor said she’s been visiting cities that are home to St. Joseph hospitals. Robert Fraschetti, chief executive of St. Jude Medical Center in Fullerton, gives her good marks so far.
Proctor’s “commitment to quality and service is clear,” he said. “She is extremely supportive of each hospital’s local ministries and understands that our mission is delivered in the communities we serve.”
When asked about challenges, Proctor took a wider view:
“We need national healthcare reform. In Orange County alone, nearly 12% of the adults and 9% of children are uninsured,that means their access to care is severely limited. That’s a huge issue for us and we think it’s a huge issue in the community.”
But Proctor doesn’t come across as a fan of all government regulation. In particular, she takes issue with two big California mandates on hospitals.
One is the state’s earthquake law, which requires all major acute-care hospitals to be self-sustaining for 72 hours following a major earthquake. That’s led hospitals to spend billions on new buildings designed to withstand earthquakes.
“Not only do I think this is a unique burden, I’m not sure if it’s a carefully examined burden,” Proctor said.
The issue for Proctor seems to be one of the state forcing hospitals to expand, rather than leaving it to them to determine how and when to grow.
Take St. Jude, she said. St. Joseph is spending some $60 million there to meet the law, she said.
But Proctor said she worries that expanding to meet a state mandate now could leave buildings that are outdated in a few years time.
“We, as a system, will be required to invest that $60 million in facilities that we know we will need to replace five years after that investment,” she said.
Proctor also is critical of another California mandate: the state’s nursing law.
Hospitals recently got a three-year reprieve from meeting the law, which dictates a ratio of one registered nurse for every five patients in medical and surgical units. The law originally was set to take effect Jan. 1.
“Clearly, we believe in safe care for patients,” Proctor said. “That does not necessarily equate to standardized staffing ratios. The reality is there will be a shortage of nursing that will be quite severe across the country.”
In the early 1990s, St. Joseph was at the center of another industry issue. Back then, it broke off ties with Cypress-based managed care plan provider PacifiCare Health Systems Inc. over how much St. Joseph was paid for treating PacifiCare patients.
The two since have resumed doing business together.
Proctor said she sees it as a matter of paying for quality service, “Where we’re not just driving toward the lowest-cost product.”
The system’s Catholic mission of community service isn’t at odds with pursuing financial stability, she said.
“If we do that well, success follows, operational success follows,” she said.
St. Joseph has its roots in the 1920s, when the Sisters of St. Joseph of Orange started a 28-bed hospital in Northern California. The health system as it’s known today was formed in 1982.
As a Catholic hospital, none of St. Joseph’s facilities perform abortions or voluntary sterilizations.
“There are many facilities in the community that provide these services and we focus our attention on other services,” Proctor said.
St. Joseph reported $3 billion in revenue and spent $310.6 million on community service, including care for the poor, in its fiscal 2004.
The system employs 17,880 people, including 9,100 in OC. It operates 14 hospitals and three home care facilities in California, New Mexico and Texas.
