The new chief executive officer of Meritus Health fielded a wide range of questions Wednesday about emergency-room capacity, nursing shortages and the future of health care during a breakfast hosted by the Hagerstown-Washington County Chamber of Commerce.
"You cannot build emergency rooms big enough," said Joseph P. Ross, who took the reins of the health system last month, in response to a question about Meritus Medical Center's ability to accommodate emergency patients.
Ross, formerly president and CEO of Shore Health System of Maryland in Easton, said he built three emergency rooms in 16 years there and saw all of them full.
Some health systems have found a solution by constructing additional emergency departments at separate locations from their hospitals, Ross said.
"I think you're going to see a lot of that creative kind of thing play out in the coming years, because ... as the population grows, we just can't keep building hospitals," he said.
With 48 the average age of nurses at Meritus, Ross said it will be important to collaborate not only with area colleges but with the public school system to expose young people to the field of nursing. He said he would like to have passionate male and female nurses speak to seventh- and eighth-graders about the changing profession.
"I've always wanted to reinvent the name of the 'nurse,' because I think in some ways ... it's kind of a feminine word, and yet one of the fastest growing segments of nursing are men," he said.
He said he also plans to get the Meritus nursing staff involved in a national nursing-recognition program called Magnet to promote and reward quality patient care.
Discussing the future, Ross said the broad reforms in the federal health care bill have left health systems "inventing it as we go."
"There's no playbook here," he said. "We really are being asked to think about things radically differently in the coming years."
He predicted that rising health care costs and the growing population on Medicare and Medicaid will contribute to a gradual constriction of the health care system over the next 10 to 15 years.
"I think you'll see pressure on hospitals to find more efficiencies, and one of those ways is going to be consolidation of hospitals," Ross said.
Already in Maryland, three major health systems represent 75 percent of the hospitals, Ross said.
At Meritus — which is part of the remaining 25 percent — one of Ross's goals is to "work some more with organizational design that reduces duplicate functions and delivers services seamlessly," he said, adding that much of that work would be related to information technology.
The health system will also focus on improving patient satisfaction scores and other measurable data that accountability demands in what Ross called the "show-me era in health care."
Ross also spoke about Meritus Medical Center's participation in an experimental revenue system called "total patient revenue," or TPR, which he said will encourage the hospital to do more to prevent released patients from having to be readmitted.
For example, many congestive heart-failure patients are readmitted to the hospital for reasons that could be prevented with more attention to their diets, medications and weights, he said.
"Under TPR ... whether we admit that patient one time in a year or 10 times in a year, our revenue is the same, so (it is) a very dramatic shift, and one that I think over time will result in more independence for the elderly, more knowledge for the elderly, more support in the home for these kinds of patients," Ross said.
Meritus is one of 10 hospitals in the state using the TPR system, he said.
Wednesday's "Eggs and Issues" breakfast, held at the Academy Theater Banquet and Conference Center, was sponsored by First United Bank.