Located in the central New Jersey communities of New Brunswick and Somerville, Robert Wood Johnson University Hospital is a 965-bed academic medical center that offers the highest quality medical services and a wide array of innovative therapies. Robert Wood Johnson University Hospital is part of the Robert Wood Johnson Health System, a 1,733-bed, $1.5 billion organization that employs more than 11,000. In 2010, Robert Wood Johnson University Hospital opened the Ambulatory Surgical Pavilion at RWJ as the hospital’s first outpatient department (HOPD). The state-of-the-art, 13,000-square-foot facility featured four operating rooms, one procedure room, a 10-bed post-anesthesia care unit as well as a 13-bed, pre- and post-operative area. While the facility quickly established itself as a leading regional provider of outpatient surgical services, it experienced difficulties in recruiting the requisite specialists in the notoriously competitive New Jersey market—a key component to successfully executing its business plan. The HOPD also lacked the dedicated operational staff and financial professionals necessary to navigate the day-to-day challenges of running a busy outpatient facility.
Robert Wood Johnson University Hospital approached Regent Surgical Health because of its reputation for developing and managing joint venture ambulatory surgery center partnerships with physicians and hospitals. Regent’s specialization in helping nonprofit hospitals develop physician alignment and expansion strategies also was an important consideration for the hospital’s leadership. As a result, Regent provided the following initial recommendations:
- Restructuring: As an ambulatory surgery center, rather than a HOPD, the Ambulatory Surgical Pavilion at RWJ would have more autonomy, higher reimbursements and be better positioned to recruit leading specialists in the area. In addition to proposing the joint-venture ASC model, Regent also developed a complementary strategy for the academic facility to meet the complex legal conditions these institutions face when establishing for-profit entities.
- Physician recruitment: With a saturated ASC market, New Jersey is one of the most difficult physician recruitment environments in the United States. Surgical specialists in key areas are even more difficult to attract. Regent’s strategy included targeting in-demand physicians with mutually beneficial ownership opportunities in the newly reorganized facility.
- Facilities management: Outpatient facilities face unique day-to-day operational challenges that may look very different from the problems hospitals encounter—and require different solutions. For example, labor expenses are typically the No. 2 cost at ASCs; without the appropriate benchmarking data and personnel management systems, these expenses can quickly erode a HOPD’s profitability. As a full-service management company, Regent would oversee all day-to-day aspects of the business, including personnel, financial and compliance issues.
The hospital’s leadership formally engaged Regent to implement its recommended approach. And once in place, the Ambulatory Surgical Pavilion at RWJ experienced a rapid turnaround. Regent successfully recruited numerous specialists to the facility and quickly retooled and standardized the ASC’s daily operations. “They’ve done a great job of bringing doctors to the table and expanding partnerships,” said Dr. Susan Krum, vice president of ambulatory operations at Robert Wood Johnson University Hospital. “Regent also understands how to run ASCs: They know the regulations and standards, and they’re instrumental in making sure we have the right people.” Even more, since Regent was brought onboard in 2012, it also has worked closely with hospital leadership on its broader expansion strategy for the hospital system. In 2013, Regent and Robert Wood Johnson University Hospital announced its newest partnership: the Endosurgical Center of Central N.J.—a 6,800 square foot state-of-the-art ambulatory surgery center offering the highest quality of care with the most advanced medical technology and equipment.
The Robert Wood Johnson Endosurgical Center is a joint venture between Regent, local physicians and Robert Wood Johnson University Hospital. It offers fully equipped operating rooms, a recovery room, a post-recovery room, and a spacious waiting room. The ASC’s staff includes highly trained physicians, registered nurses, and medical endoscopy technicians who provide patients with the care and expertise found within a hospital or medical center setting. Today, Regent continues to work with hospital leadership in executing its ongoing expansion plans. “The hospital market is extremely competitive now,” Krum said. “With Regent as our partner, we can focus on the bigger picture.”