Kris Gose
Q & A with Kris Gose, president of OU Medical Center
March 06, 2020
by Sean Ruck, Contributing Editor
Oklahoma’s OU Medical Center is bucking the trends seen elsewhere in the country of decentralization of larger hospitals and consolidation of smaller facilities. The organization became a freestanding system just two years ago and is also getting set to open a new patient tower this year, but the project was first discussed more than a decade ago. While it’s been some time in the making, that was a positive, as it gave an opportunity for deep assessment of needs and ultimately led to a more innovative building that is set to better serve both patients and healthcare team members. OU Medical Center president, Kris Gose, played a big role in the reassessment and the tower has been a major focus for her. HealthCare Business News spoke with her to find out more.
HCB News: How long have you been with OU Medical Center?
Kris Gose: I’ve been on this campus since 1995. I’ve been in my current role since 2013.
HCB News: What drew you to a career in healthcare?
KG: I really wanted to be a leader in changing the way healthcare is delivered and improve that to make a difference. I started as a pediatric nurse, so at the beginning, it was one patient family at a time. I moved into leadership, which was always my goal, but starting with the clinical side allowed me to better understand and facilitate care because as you lead, you try to help facilitate others to improve care. So, today I hope I affect many at a time through the individuals I work with and lead.
KG: I was chief nursing officer for the system in 2007 when the first conversations occurred. The first time I was involved in discussions regarding the proposal of building the tower was 2009. That had variations of the proposals over time, which had made it through different approval processes with our past parent company. But in February of 2018, we transitioned away from our parent company and became a locally-owned, free-standing, not-for-profit health system. As we went through that journey, it was decided that we would be moving forward with the patient tower that had been put on hold. So we got back to work, and at that time, we got to redesign the building. Up to that point, it had been sort of a square box. We sat back down with the architects and we had a lot of fun. We decided to have the design of the building reflect the innovative healthcare we planned on delivering to the public. It looks a lot different than a square box today, as I’m sure you can see.
HCB News: Many hospitals are trending toward smaller satellite buildings to offer services, what made this a better option?
KG: We are a rural state with a population centralized in several primary cities. Beyond that, however, it’s small communities that struggle with resources. We have seen hospitals shut doors and those communities have reached out to us to figure out how to deliver care across the state in the most effective ways.
We are the state’s only Level 1 trauma center and that unique status, along with the subspecialties and specialties we offer, created the need to build inpatient capacity here. As an organization, OU Medicine is looking at many different pieces. We have part ownership of a post-acute rehab facility and we continue to look at post-acute opportunities to ensure patients aren’t staying in the highest-cost delivery settings to achieve their healthcare goals. We’re looking at primary care, urgent care centers, and telemedicine. We’re continuing to look at things you see on the national trends, but we have this demand as well as the academic tertiary/quaternary system in the state.
Maybe it’s also, in part, because we didn’t build as much during the time that others did. Today, we’re over 100 percent occupancy every day. So some of the growth we had built into the business case of the patient tower we actually achieved in the current patient tower. We did this by creating unique settings for patients, creating new processes and making sure we had enough resources to bridge the time period until the new patient tower became available.
HCB News: Does the expansion also bring an expansion to any services or specialties offered?
KG: We have started geriatric and palliative care programs, and the new space will enable us to really expand the capabilities. We are beginning to develop a burn program. We didn’t have the room to do that in our ICU. Over the last year, we achieved NCI designation. One of the strengths in our services is our cancer program, which includes the only bone marrow transplant unit in the state. This new growth will allow us to expand our bone marrow transplant unit significantly to meet the needs and demands for the state. It will also allow us to include a surgical oncology floor, a medical liquid tumor floor and other services, so we’re going to be able to truly specialize our inpatient care to match our cancer center delivery.
Currently, we have one OR setting, so our elective cases are done in one location — the same location our Trauma Center utilizes. Our team does a phenomenal job, but it’s a challenge to deliver elective care and emergent care at the same location.
In the new facility, trauma will stay primarily in the current patient tower, so we can deliver trauma and emergent care all in that setting. And then we will have an entire separate new OR floor for scheduled and elective surgery, which will allow us to deliver more timely and efficient surgical care.
In the last couple of years, we built a new cardiac cath lab. The new patient tower will hold the prep and recovery to that unit. We will have an entire Cardiovascular Institute floor in the new patient tower. All the rooms in the new patient tower are set up to be acuity flexible. On the Cardiovascular Institute floor, we’re actually going to do some research on keeping the patient in the room and bringing the different levels of care to the patient. So if they come in as an ICU patient, they will have intensivists and ICU nurses seeing them, but as they get better and step down their medical status, they will stay in the room and we will bring their providers to them. There are thoughts that this will decrease the length of stay and improve communication among stakeholders to improve patient satisfaction. We’re collecting data now about this population and we will deliver care in the new method and see if we impact those areas. If we don’t, that won’t be the healthcare delivery future for us. But if we do, we’ll have found something positive, and being an academic healthcare facility with an important piece of our mission to look for innovative solutions, we’ll be fulfilling that role.
HCB News: With your background as a pediatric nurse, when it came time to design the new tower, were there things you were able to suggest that would make it easier for the staff having daily interaction with patients?
KG: It’s something I’ve been incredibly passionate about for a long time. Part of that rationale and reason are basically because of what your question touched on. Obviously the architects and all the other team members had input and their fingerprints on the project, but I’d like to think I had impact from being a pediatric nurse, being a face in front of patients and family. You’ll see all our rooms are over 300 square feet and they’re divided into a healthcare team, patient area and family area. In our current space, we get a lot of feedback from family members that when the academic healthcare team comes into the room, families don’t feel like they have anywhere to be. They feel like they aren’t supposed to be there because we crowd them out. So the goal was to create a space that would be very friendly and supportive of their presence regardless of the resources coming into the room. On top of that, you’ll see from the exterior that all the patient rooms are on the outside-facing walls with windows going floor to ceiling to provide plenty of natural light and a healing environment
We also had surprising feedback regarding even things like door choices. We thought patients would prefer full steel doors. As we talked to patients though, they said that was actually scary to them. They wanted for us, the healthcare team members, to be able to see them, but also wanted to have the ability to shut that view off if they needed to. So we have blinds built into the windows in the doors.
Conference rooms will be located on the first floor to help us communicate as teams. Being an academic medical center, the planning for that area was actually driven by what I think is the big connection to our community. As a Level 1 trauma center, we take our responsibility in disaster preparedness and treatment very seriously. Our community comes to us when tornados hit, or any other disaster. So, those educational conference rooms all have walls that go up, allowing us to provide a space for hundreds of people in the case that we ever experience a large disaster. We can convene, communicate and coordinate disaster response in this area.
HCB News: Will the staffing for the new tower be from existing staff or new hires?
KG: We have significant recruitment plans already initiated and have hired additional recruiters. We already hired some perioperative staff before Christmas so they can be appropriately trained before we open. There will be a cascade of new staff — ICU nurses have to be hired by spring, medical surgical by summer, housekeeping by August. We’re not planning for every piece of the new facility to be 100 percent staffed on day one, but we’re looking for 100 to 200 new hires initially, and when the facility is complete and fully staffed, it will take somewhere between 400 and 500 additional new full-time employees.
HCB News: How do you think healthcare will or should change over the next five to 10 years to make it sustainable?
KG: I think healthcare cannot stand alone in different aspects of delivery of care. We have to join together to create that continuum for two reasons. The first is that it increases the quality of care for patients because it forces communications between providers that sometimes is otherwise siloed. Separately, at least in Oklahoma, not from the delivery side, but resource side, Medicaid expansion is something that’s necessary. The second is because it’s cost-effective; it maximizes utilization of resources.
HCB News: How long have you been with OU Medical Center?
Kris Gose: I’ve been on this campus since 1995. I’ve been in my current role since 2013.
HCB News: What drew you to a career in healthcare?
KG: I really wanted to be a leader in changing the way healthcare is delivered and improve that to make a difference. I started as a pediatric nurse, so at the beginning, it was one patient family at a time. I moved into leadership, which was always my goal, but starting with the clinical side allowed me to better understand and facilitate care because as you lead, you try to help facilitate others to improve care. So, today I hope I affect many at a time through the individuals I work with and lead.
OU Medical Center, Renderings provided by Perkins and Will
KG: I was chief nursing officer for the system in 2007 when the first conversations occurred. The first time I was involved in discussions regarding the proposal of building the tower was 2009. That had variations of the proposals over time, which had made it through different approval processes with our past parent company. But in February of 2018, we transitioned away from our parent company and became a locally-owned, free-standing, not-for-profit health system. As we went through that journey, it was decided that we would be moving forward with the patient tower that had been put on hold. So we got back to work, and at that time, we got to redesign the building. Up to that point, it had been sort of a square box. We sat back down with the architects and we had a lot of fun. We decided to have the design of the building reflect the innovative healthcare we planned on delivering to the public. It looks a lot different than a square box today, as I’m sure you can see.
HCB News: Many hospitals are trending toward smaller satellite buildings to offer services, what made this a better option?
KG: We are a rural state with a population centralized in several primary cities. Beyond that, however, it’s small communities that struggle with resources. We have seen hospitals shut doors and those communities have reached out to us to figure out how to deliver care across the state in the most effective ways.
Lobby Entry, Renderings provided by Perkins and Will
Maybe it’s also, in part, because we didn’t build as much during the time that others did. Today, we’re over 100 percent occupancy every day. So some of the growth we had built into the business case of the patient tower we actually achieved in the current patient tower. We did this by creating unique settings for patients, creating new processes and making sure we had enough resources to bridge the time period until the new patient tower became available.
Patient Corridor, Renderings provided by Perkins and Will
KG: We have started geriatric and palliative care programs, and the new space will enable us to really expand the capabilities. We are beginning to develop a burn program. We didn’t have the room to do that in our ICU. Over the last year, we achieved NCI designation. One of the strengths in our services is our cancer program, which includes the only bone marrow transplant unit in the state. This new growth will allow us to expand our bone marrow transplant unit significantly to meet the needs and demands for the state. It will also allow us to include a surgical oncology floor, a medical liquid tumor floor and other services, so we’re going to be able to truly specialize our inpatient care to match our cancer center delivery.
Currently, we have one OR setting, so our elective cases are done in one location — the same location our Trauma Center utilizes. Our team does a phenomenal job, but it’s a challenge to deliver elective care and emergent care at the same location.
In the new facility, trauma will stay primarily in the current patient tower, so we can deliver trauma and emergent care all in that setting. And then we will have an entire separate new OR floor for scheduled and elective surgery, which will allow us to deliver more timely and efficient surgical care.
In the last couple of years, we built a new cardiac cath lab. The new patient tower will hold the prep and recovery to that unit. We will have an entire Cardiovascular Institute floor in the new patient tower. All the rooms in the new patient tower are set up to be acuity flexible. On the Cardiovascular Institute floor, we’re actually going to do some research on keeping the patient in the room and bringing the different levels of care to the patient. So if they come in as an ICU patient, they will have intensivists and ICU nurses seeing them, but as they get better and step down their medical status, they will stay in the room and we will bring their providers to them. There are thoughts that this will decrease the length of stay and improve communication among stakeholders to improve patient satisfaction. We’re collecting data now about this population and we will deliver care in the new method and see if we impact those areas. If we don’t, that won’t be the healthcare delivery future for us. But if we do, we’ll have found something positive, and being an academic healthcare facility with an important piece of our mission to look for innovative solutions, we’ll be fulfilling that role.
Patient Waiting Room, Renderings provided by Perkins and Will
KG: It’s something I’ve been incredibly passionate about for a long time. Part of that rationale and reason are basically because of what your question touched on. Obviously the architects and all the other team members had input and their fingerprints on the project, but I’d like to think I had impact from being a pediatric nurse, being a face in front of patients and family. You’ll see all our rooms are over 300 square feet and they’re divided into a healthcare team, patient area and family area. In our current space, we get a lot of feedback from family members that when the academic healthcare team comes into the room, families don’t feel like they have anywhere to be. They feel like they aren’t supposed to be there because we crowd them out. So the goal was to create a space that would be very friendly and supportive of their presence regardless of the resources coming into the room. On top of that, you’ll see from the exterior that all the patient rooms are on the outside-facing walls with windows going floor to ceiling to provide plenty of natural light and a healing environment
We also had surprising feedback regarding even things like door choices. We thought patients would prefer full steel doors. As we talked to patients though, they said that was actually scary to them. They wanted for us, the healthcare team members, to be able to see them, but also wanted to have the ability to shut that view off if they needed to. So we have blinds built into the windows in the doors.
Conference rooms will be located on the first floor to help us communicate as teams. Being an academic medical center, the planning for that area was actually driven by what I think is the big connection to our community. As a Level 1 trauma center, we take our responsibility in disaster preparedness and treatment very seriously. Our community comes to us when tornados hit, or any other disaster. So, those educational conference rooms all have walls that go up, allowing us to provide a space for hundreds of people in the case that we ever experience a large disaster. We can convene, communicate and coordinate disaster response in this area.
Patient Room, Renderings provided by Perkins and Will
KG: We have significant recruitment plans already initiated and have hired additional recruiters. We already hired some perioperative staff before Christmas so they can be appropriately trained before we open. There will be a cascade of new staff — ICU nurses have to be hired by spring, medical surgical by summer, housekeeping by August. We’re not planning for every piece of the new facility to be 100 percent staffed on day one, but we’re looking for 100 to 200 new hires initially, and when the facility is complete and fully staffed, it will take somewhere between 400 and 500 additional new full-time employees.
HCB News: How do you think healthcare will or should change over the next five to 10 years to make it sustainable?
KG: I think healthcare cannot stand alone in different aspects of delivery of care. We have to join together to create that continuum for two reasons. The first is that it increases the quality of care for patients because it forces communications between providers that sometimes is otherwise siloed. Separately, at least in Oklahoma, not from the delivery side, but resource side, Medicaid expansion is something that’s necessary. The second is because it’s cost-effective; it maximizes utilization of resources.