At least in terms of management of University of Louisville Hospital and the James Graham Brown Cancer Center.

On July 1, University Medical Center again took over as manager of the two facilities following four years of a joint operating agreement with KentuckyOne Health. Both companies agreed in December to dissolve the JOA.

“While it appears that it is the ‘good old days’ it truly is a new era,” said Ken Marshall, president and chief executive officer of UofL Hospital and the James Graham Brown Cancer Center. “In the coming years, we will be a leader in our region for providing the highest quality of care in a patient-centered way. All the while, UofL Hospital will continue be the primary adult teaching hospital for the UofL School of Medicine and provide care to all who come to our doors.”

Marshall and his team have accomplished in approximately six months what typically takes at least a year – stand up an entire organization. This includes creating the executive team, hiring an entire staff and putting into place everything necessary so that patients who need care have the best experience possible.

“We were fortunate in that every single person who had been working at UofL Hospital and the Brown Cancer Center accepted our offer to continue working there under UMC management,” said Shari Kretzschmer, chief nursing officer. “This eliminated a significant amount of time in recruiting and training staff. But we continue to bring on more, high-quality staff so that the care we provide is unsurpassed in its quality.”

Some services will be purchased from KentuckyOne Health on a short-term basis, lasting no longer than 18 months. These are services such as information technology and group purchasing.

“The effort of the entire team during the past six months has been Herculean,” Marshall said. “The collaboration with our physician leadership cannot be stressed enough. What we have seen is emblematic of the attitude all of us share – it’s about our patients.”

The award recognizes the hospital’s commitment to providing the most appropriate stroke treatment according to nationally-recognized, research-based guidelines based on the latest scientific evidence.

Hospitals must achieve 85 percent or higher adherence to all Get With The Guidelines-Stroke achievement indicators for two or more consecutive 12-month periods and achieve 75 percent or higher compliance with five of eight Get With The Guidelines-Stroke Quality measures to receive the Gold Plus Quality Achievement Award.

To qualify for the Target: Stroke Honor Roll Elite or Elite Plus, hospitals must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the Food and Drug Administration to treat ischemic stroke. If given intravenously in the first three hours after the start of stroke symptoms, tPA has been shown to significantly reduce the effects of stroke and lessen the chance of permanent disability.

These quality measures are designed to help hospital teams follow the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients.

“University of Louisville Hospital has been recognized with the Stroke Elite Plus award again as we continue to strive for excellence in the acute treatment of stroke patients,” said Kerri Remmel, MD, PhD, chair of UofL’s Department of Neurology and director of the UofL Hospital Stroke Center. “This recognition further reinforces the UofL stroke team’s hard work and commitment to caring for patients with stroke.”

UofL Hospital now has received the Get with the Guidelines Stroke Gold Plus Award for the past 12 years. In 2004, UofL Hospital became Kentucky’s first Joint Commission-certified Primary Stroke Center and in 2012, the hospital became Kentucky’s first Joint Commission-certified Comprehensive Stroke Center, the 20th in the nation.

“Stroke is 80-percent preventable. High blood pressure, diabetes, cigarette smoking, high cholesterol, atrial fibrillation and sedentary lifestyle are treatable and modifiable risk factors. If we could give the community one message for the prevention of stroke, it would be to know your own risk factors and be aggressive about controlling them,” Remmel said.

This decision was agreed upon by all parties as the most effective way to collaborate in care for the community, moving direct operations of the academic medical center to UMC and ensuring continuation of innovative and high-quality patient care and clinical training via KentuckyOne Health facilities.

“The dynamic nature of the health care landscape requires organizations to explore innovative approaches and relationships for the delivery of care,” said Gregory C. Postel, MD, interim executive vice president of health affairs at UofL. “Today, we are presented with a very different environment than when we signed the joint operating agreement and revised the academic affiliation agreement in 2012. We are pleased with our shared accomplishments yet understand that changes were necessary to address ongoing challenges and ensure we are able to respond nimbly to the unique needs of our care facilities, particularly the academic medical center.”

“We are pleased to move into the next phase of our relationship with University of Louisville. Our longstanding partnership at Jewish Hospital dates back several decades prior to KentuckyOne Health. Since the formation of KentuckyOne Health, we have partnered in many areas and will continue to do so for many years to come, including working together on our innovations to meet the health needs of our community,” said Ruth W. Brinkley, president and CEO of KentuckyOne Health. “During the past four years of our partnership, we have implemented significant improvements to enhance the health of our patients and the communities we serve. This includes the installation of an electronic health record system, and many other updates and enhancements to the University of Louisville Hospital.”

“It is important to emphasize that the transition of care will be seamless for our patients, physicians, employees and community partners,” said Joan Coleman, interim CEO of University Medical Center. “We are committed to continuing the facility improvements and staffing initiatives that began during our partnership and look forward to seeing them through to completion. We will be active with focused transition teams working closely with current leaders, physicians and employees across the Downtown Louisville campus to ensure continued high-quality care, support our employees and shape the future of health and wellness.”

The agreement, effective Dec. 14, 2016, establishes the framework for future partnerships between the organizations and resolves all disputes previously raised. Key aspects of the agreement include the following:

• KentuckyOne Health, UMC, and UofL, working together, will continue to implement projects involving up to $44.8 million in capital investments at ULH by July 1, 2017;
• KentuckyOne Health has agreed to complete the funding of the joint investment proposals as set forth in the Academic Affiliation Agreement;
• The University of Louisville will release its rights to three seats on the KentuckyOne Health Board of Directors; and
• The University Medical Center is expected to take over the management of the University of Louisville Hospital on July 1, 2017.

The University Medical Center, University of Louisville and KentuckyOne Health will work together over the next six months to facilitate a successful transition for both the management of ULH and JGBCC, and the Academic Affiliation Agreement between the organizations for programs at other locations. Ongoing information and details on the transition will be provided to patients, community partners, employees and physicians as the process evolves. Transition teams focused on key areas of patient care, employee engagement and infrastructure are being assembled, drawing from the shared expertise currently in place at ULH, JGBCC, KentuckyOne Health, UMC and UofL. These teams will guide the continuation of initiatives underway, including patient care quality and safety programs and recruitment and retention of top nursing talent, while also shaping the future operations and leadership structure.

Partner profiles

University Medical Center (UMC): Comprised of the University of Louisville Hospital (ULH), the James Graham Brown Cancer Center (JGBCC), and the Center for Women and Infants (CWI), UMC is an integral part of the University of Louisville’s academic health center. Its first priority and concern is the welfare of patients and therefore provides, without regard to economic status, the highest quality patient and family centered inpatient and outpatient hospital-based services; supports the educational and research missions of the University of Louisville’s Health Sciences Center; and initiates outreach to meet community needs.

The University of Louisville Health Sciences Center is the city’s only academic medical center. Approximately 1,000 faculty members are involved in education, research and clinical care. The UofL HSC is home to more than 650 medical and dental residents, 3,000 students pursuing degrees in health-related fields within the Schools of Dentistry, Medicine, Nursing and Public Health and Information Sciences, as well as 14 interdisciplinary centers and institutes. Approximately $140 million in extramural funding enables researchers to uncover the causes of disease and better ways to prevent, treat and cure those diseases. Patients are seen at the Ambulatory Care Building, the James Graham Brown Cancer Center, the UofL Health Care Outpatient Center and University Hospital, which is the primary adult teaching hospital for the School of Medicine. University Hospital’s public mission is steeped in history and now is most clearly visible through its provision of nearly $90 million of health care to the uninsured annually.

KentuckyOne Health, the largest and most comprehensive health system in the Commonwealth, has more than 200 locations, including hospitals, physician groups, clinics, primary care centers, specialty institutes and home health agencies in Kentucky and southern Indiana. KentuckyOne Health is dedicated to bringing wellness, healing and hope to all, including the underserved.  The system is made up of the former Jewish Hospital & St. Mary’s HealthCare and Saint Joseph Health System, along with the University of Louisville Hospital and James Graham Brown Cancer Center. KentuckyOne Health is proud of and strengthened by its Catholic, Jewish and academic heritages.