Conway Regional encountering competition from new hospital has been a defining moment

Three years ago, when Matt Troup became CEO of Conway Regional Health System, the organization was facing major headwinds. Baptist was opening a new 111-bed hospital presenting significant competition. And 30 Conway Regional doctors were actively engaged in negotiations to join the staff at the new hospital. In addition, Conway Regional had entered into a management agreement with CHI St. Vincent. Some employees weren't sure what that would mean.

Troup said the competition was a defining moment for Conway Regional. Conventional wisdom might have been to institute a hiring freeze and take other economic measures. Instead, Conway Regional elected to expand its services. And instead of losing 30 doctors, they have hired 28 new doctors.

How is Conway Regional doing as a result?

"We're doing great," Troup said. "Our net revenue in 2018 will be the highest it has been ever. We've had a shift in the types of services we provide. We are more of an outpatient facility than before. Still, our revenue is higher than it has ever been, which is great."

Early on Troup instituted mandatory town hall meetings every 90 days.

"At those town halls, we talk about our progress and challenges," Troup said. "Everyone has the opportunity to hear where we are going and how we are doing. Every organization will have 15 percent of employees really engaged, and 15 percent not engaged. When you can engage the middle 70 percent, that is where you get a cultural shift. Keeping people informed about how we are trying to do the right thing has led to a lot of positive outcomes."

Initially at town hall meetings, people raised their hand to ask questions. But some people don't like asking questions in a large group. So, they went to a polling app (PollEverywhere) on phones where people could send in questions.

"It is such a cool tool," Troup said. "You can be in a meeting and use your cell phone to get feedback and ask survey questions anonymously." Feedback is also attained through a post-Town Hall survey. "A survey is conducted after each town hall. From that we know if different units are super engaged and if they doing well. If we know the challenges, we know where to focus our attention. Part of the effort with town halls is to try to tell our stories. Taking about revenues doesn't motivate people. What motivates people is feeling part of the community. Conway is one of the more proud communities in the state and we have really tried to leverage that."

Increasing services

Another effort is to treat people at Conway Regional rather than transferring them to Little Rock. One way they have done that it is to add services not presently offered in the community. Conway Regional has recruited an infectious disease specialist, a neurosurgeon and a vascular surgeon.

"We are not duplicating services, but hopefully retaining patients who might otherwise go to Little Rock," Troup said. "Any time someone goes to Little Rock, there is a stickiness factor. They go there for one doctor and then may get other treatment they need there."

Conway Regional has also opened clinics in Russellville and Pottsville, and expanded clinics in Greenbrier and Vilonia.

Best Places to Work

Another accomplishment has been being named as One of the Best Place to Work by Arkansas Business and by Modern Healthcare.

"That is a real source of pride for us," Troup said. "The bulk of their assessment comes from employee surveys."

Employee retention is a priority. Troup said one of the things he is most proud of is their focus on employee benefits and programs. They have doubled the amount paid for tuition reimbursement, and have a clinical ladder program which incentivizes staff to achieve higher certifications, do research, and get involved with different committees. Starting in 2019 they will offer paid parental leave for staff. And they instituted automatic enrollment for their 401(k) program driving up participation well over 90 percent - an incremental cost to the health system but a long term benefit to the employee.

"If you are an individual who wants to advance your career, this is the place to be," Troup said. "We also give employees eight hours to go work in the community. Again, that aligns with our values."

Shared governance is another way to engage employees and improve performance.

Conway Regional has seven functional councils under shared governance that review issues such as patient safety and satisfaction.

"Front line staff from different parts of the hospital serve on these councils to help us address the issues," Troup said. "They can raise concerns and advocate for things that are going to make the hospital better. We have a servant leadership philosophy. We are there to serve the community, people and our staff. The better we can serve them, the better off we are going to be."

Accountable Clinical Management

There is also a strong emphasis on Accountable Clinical Management (ACM), an initiative started in 2016 that is a model of shared governance to promote meaningful engagement of physician leaders in partnership with hospital administrative leadership.

"At Conway we are physician led and professionally managed," Troup said. "ACM has a financial metric to it. When we do well in the hospital, the physicians do well. It is co-management with the physicians. ACM creates alignment and buy-in. That has been immensely valuable in growing physician leaders at our hospital. It has been game changing. It gets physicians thinking as a team."

The future

For the future, Troup said they plan to continue to diversify the services provided to increase retention of patients in a way that continues to meet community needs.

"We are going to focus on services not traditionally provided in Conway and do that in a bigger and better way than before," Troup said. "We will become more and more a regional medical center. We face a lot of issues such as patients continuing to have access to healthcare through the Affordable Care Act and Arkansas Works. That is going to be huge. We face a lot of challenges in payments. We don't get reimbursed for all services. In this state, we are in the lower third nationally in payment for the services we provide. Continuing to protect payments for Arkansas hospitals is going to be an issue."

Troup grew up in Dallas, Texas, and went to Texas A&M where he received a BA in business management. He earned a Master of Science in Healthcare Administration from Trinity University. He chose going into medical management because he wanted a career where he could do good and make a difference.

He and his wife, Melissa, have been married for 26 years and have four sons ages 11 to 21. A lot of their time is spent being engaged in their children's activities. Troup runs four to five times a week, and enjoys reading, especially books on leadership. He is a Fellow in the American College of Healthcare Executives and has a Six Sigma Green Belt.

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Conway Regional Medical Center