Role Player – BFMC’s Bradley Embraces a Demanding New Challenge

Steve Bradley’s commute to what might still be considered his new job — he’s been at it about nine months now — is roughly the same, time and distance-wise, as the one to his old position.

But the destinations, not to mention the job descriptions, are worlds apart.

Indeed, from his home in Pelham he used to travel south and slightly west to Springfield, population 160,000, and the administrative offices of Baystate Health, one of the state’s largest health systems, which he served as vice president for Government, Community & Public Relations. Now, he travels north and west, to Greenfield (population roughly 18,000), and Baystate Franklin Medical Center (BFMC), part of the Baystate system and one of the state’s smallest hospitals with only 90 licensed beds. There, his name badge reads ‘president.’

“It’s a huge change,” said Bradley. “I went from one of the largest urban centers in the state to the most rural area in the Commonwealth; all of Franklin County only has about 80,000 people.”

But when one gets past the differences in population, demographics, and compass points, the challenges inherent with both jobs — and both healthcare providers — are quite similar, Bradley told HCN.

“These areas are very different, except in a few very important regards,” he explained, starting with the overriding common denominator. “Poverty drives everything challenging in Springfield and in Hampden County, and poverty drives everything challenging in Franklin County.

“The poverty looks different, though,” he went on. “In Franklin County, it’s rural poverty, so a lot of it’s hidden; this is the poorest county in Massachusetts.”

Meanwhile, the issues that create such poverty are similar as well, said Bradley, adding that educational attainment is an issue in both regions, limiting access to many technology-driven jobs, and, at the same time, many of the manufacturing jobs that would be described as low-skilled or moderate-skilled, have left both areas, leaving fewer alternatives.

But Franklin County has some additional and unique challenges, he went on, adding that the biggest are its remoteness and small population. Public transportation exists but it is quite limited, he said, and this impacts many aspects of everyday life, including healthcare.

Meanwhile, the rural nature of the county makes recruiting and retaining doctors — already a stern test statewide because of the high cost of doing business here — an especially daunting task for BFMC.

Improving access to healthcare, improving the overall quality of the services available at BFMC and its community health centers, and putting the hospital back in the black after years of operating in the red (something that was accomplished last year for the first time in many years), constitute Bradley’s unofficial mission since he succeeded Chuck Gijanto last July — and he credits his predecessor with creating considerable momentum in each area.

The official mission, or goal, is to move the medical center into the top 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of community hospitals nationwide within five years.

This will occur through the addition of new facilities, such as the 50,000-square-foot surgical center now taking shape on the BFMC campus, said Bradley, who set that goal the day he arrived and knows he now has four years and three months to realize it, and also through new initiatives, such as ongoing efforts to integrate programs at BFMC with those at Baystate Medical Center and other facilities in the system (more on those later).

But mostly, it will come through what he considers a somewhat new attitude, or a renewed and heightened commitment to the people of Franklin County — and all areas served by community hospitals within the system — on the part of Baystate Health and its president and CEO, Dr. Mark Keroack.

“Baystate Health and our new CEO are making it clear that for the first time in a very long time, community hospitals are as important to Baystate Health as any other entity,” he explained. “And he’s backed up those words with resources, not only financial resources, but clinical resources as well. As a result, we’re living our mission in a more authentic way.

“Our mission for years has been to improve the health of the people of our communities every day with quality and compassion, but I don’t think you could really say that this is the way the people of Franklin County felt that Baystate Health was behaving,” he went on. “But under this leadership team, we’re talking the talk and walking the walk.”

For this issue, HCN talked at length with Bradley about this intriguing change in his career path and also about his ambitious plans for this rural hospital.

While Franklin County represents a new mailing address for Bradley, it’s a region he’s already quite familiar with, through his work at Baystate Health as well as career stops before that.

Indeed, Bradley spent more than four years as chief of staff for state Sen. Stanley Rosenberg, currently president of that body.

While his district includes Hampshire County’s major population centers, especially Northampton and Amherst, it also covers most of eastern Franklin County, including Greenfield and Deerfield.

“Franklin County was a big part of his district, and we were up here quite often,” he said. “I got to know a lot of people, and became familiar with the individual communities and their issues.”

Those years with Rosenberg were wedged between two decidedly different stints within the broad spectrum of healthcare.

Prior to that assignment, Bradley served as the first director of the Western Mass. region of the State Department of Mental Retardation. In that role, he established the department’s first Regional Competency and Diversity Initiative, helped lead the closing of the region’s only institution for people with developmental disabilities, and created a nationally recognized community-based system of services and programs for those individuals.

At Baystate, Bradley saw his role expand and evolve over 15 years. He started as vice president for Government Relations, and eventually added community relations and public relations to his job description.

Over the years, he was involved in a number of high-profile initiatives both within the system and in the community.

Regarding the former, he led the team that gained state approval for Baystate Medical Center’s Hospital of the Future; he helped write the application for the what turned out to be the second-largest determination of need (DON) grant in the state’s history. He also helped lead efforts to get Baystate Medical Center added to the state Medicaid waiver.

As for the latter, he was involved with everything from Springfield Technical Community College (he was chairman of its Board of Trustees) to DevelopSpringfield, which he also served as a trustee.

But perhaps the work he’s most proud of has come with making Baystate a major player in an initiative called the Undoing Racism Organizing Collective, which he serves as a member of its steering committee.

Launched by Irene E. and George A. Davis Foundation President John Davis, UROC, as it’s called, stages two-day workshops and other initiatives to meet its mission to ‘organize, communicate, and provide resources to undo racism in our families, communities, and institutions.’

“It has a very narrow focus, which is to provide two days of high-quality education centered around understanding the effects of institutionalized white privilege on communities of color,” Bradley explained, adding that Baystate set aside $200,000 from its community benefits budget to help fund the work, which he considers critical to the region’s future.

“There’s a direct link between 400 years of institutionalized racism and economic status,” he went on, adding that since he arrived at Baystate he’s been working in various ways to stem this tide and its many effects on the health of individuals and a community, and the Davis initiative provided a way to take these efforts to a higher plane.

“Our goal is to help people who are not of color to understand what the differences are in day-to-day living,” he told HCN. “White people don’t ever think about walking into a store and being followed, or being turned down for an apartment, or being stopped while they’re driving just because the police officer thinks he can stop you — and they need to think about these things.”

Bradley told HCN that he greatly enjoyed the sum of all the parts that went into his job, and wasn’t exactly looking for another career challenge, especially the one he eventually accepted, when Gijanto approached him about succeeding him.

“I like to joke with my friends and associates that becoming president of a community hospital was not high on my professional bucket list,” he explained. “I loved the job I was doing, I’d been doing it for 14 years; but I will say that you can’t do the same job forever.

“I was asked by Chuck Gijanto to seriously consider the position; I was surprised and really honored, but I hadn’t given it any consideration,” he went on, adding that other administrators at Baystate encouraged him to apply. “Twenty-seven interviews later — well, I interviewed with 27 people, let’s put it that way — here I am.”

‘Here’ is a place far removed from Springfield and other Hampden County population centers in many ways.

Indeed, Franklin County is a mostly agricultural region, where the communities are very small, population-wise, with many of them home to fewer than 1,000 residents. BFMC is the only hospital in the county, and there is only one college — Greenfield Community College — as well. And there are only three major employers: GCC, BFMC, and Yankee Candle.

Since formally arriving in Franklin County, Bradley said he’s come to understand even more about the individuals who live and work there.

“This is a very individualistic county — people here don’t like to be told what to do,” he said, adding that he was speaking in generalities, obviously. “It’s also a very self-sustaining community; this county has taken the lead in addressing the opiod-addiction crisis, for example.

“That came out of grass-roots, community organizing, a very tight network of community leaders, political leaders, social service leaders, religious leaders, and healthcare leaders who identified the problem long before anyone else did,” he went on. “And rather than fighting over who was going to lead this effort, they came together in a coalition that has been extremely effective.”

Bradley is already getting involved with the Franklin County community. Indeed, he’s a member of the chamber’s board of directors, and he’s annual campaign co-chair for the United Way of Franklin County.

But most of his time and energy is focused on the medical center and meeting that lofty goal he set upon his arrival. And there are obvious challenges to meeting it, he said, listing everything from the remoteness of the county to the difficulty BFMC faces in recruiting and retaining doctors and other healthcare professionals.

“I think there’s two buses that run between Springfield and Greenfield each day,” he noted. “I’ve talked to many people who’ve said that if they have to go to Springfield for care, they have to take the whole day off from work — they take a bus in the morning, and they take a bus back late in the afternoon. They don’t want to take the whole day off, their boss doesn’t want them to take the whole day off, and they can’t afford to take off the whole day. But they must.”

So in many respects, the evolving strategy is to bring healthcare to the people of Franklin County, rather than bring them to the care, and to improve the facilities on the BFMC campus so area residents won’t be tempted to drive past it to pursue care elsewhere, Bradley explained.

“We’re brining a lot of care up from Springfield and having it delivered inside Baystate Franklin Medical Center,” he said, adding that there are many facets to the broad strategy being deployed.

One of them has involved improvements to the emergency department, which actually led to a situation where there was a shortage of beds to accommodate those who required admission, a problem resolved by reopening a nursing unit that had been mothballed for eight years, when volume at BFMC had plummeted.

“It was mothballed because there just wasn’t the demand, and the hospital was losing between $2 million and $4 million annually, year after year,” Bradley explained, adding that the surge in emergency room volume was in some ways a good news, bad news situation.

Another step forward is the new surgery center, or the “surgery modernization project,” as it is also known, said Bradley, adding that the new facility rising on the campus is sorely needed to replace facilities that are half a century old and in most all ways antiquated.

“Our operating rooms are 48 years old,” he explained, “and when you’re out there nationally and internationally trying to recruit surgeons and skilled operating room nurses and technicians, and competing against brand new facilities such as the ones at Baystate Medical Center or Cooley Dickinson Hospital, that makes it much harder to compete.”

The new center will feature five operating rooms that are two or three times larger than the ones they’re replacing.  Construction is due to be completed in the summer of 2016, and the facility should be operating by December of that year.

In addition to building new facilities, BFMC is also moving forward aggressively with plans to integrate its services with those at Baystate Medical Center and other providers within the system, a step that will improve quality, add needed depth and flexibility, and enable more people to receive care close to home.

“Down the road 40 miles, we have one of the top academic medical centers in the United States,” he said, referring to BMC. “And in the parent company, Baystate Health, we have one of the top 15 health systems in America. Plus, we have one of the top-rated heart and vascular programs in the state in Springfield.

“When you have that kind of expertise 40 miles away, and you’re part of that system, you need to take full advantage of that,” he went on. “What we’re doing is fully integrating all of our clinical service lines with Baystate Medical Center.”

At present, roughly 95{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of surgical services are integrated, he continued, adding that rather than being an independent operation, as it has been historically, BFMC’s surgical services are now essentially part of a larger Baystate Health team, with day-to-day operations led by Baystate’s chairman of  surgery, with shared governance.

“This will create what amounts to a seamless surgical program,” Bradley explained. “And what that does is get more surgeons who are specialists to actually come up and provide surgery here, rather than forcing the patients to go to Springfield. And the new surgery center will make it even more desireable for folks to come here, because we’ll have a state-of-the-art facility.”

Other clinical service lines will follow, said Bradley, adding that this work in progress will yield a facility far more capable of adequately serving the people of Franklin County than the one operating the past several years.

And one that he expects will be in that top 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of community hospitals nationwide.

“That’s our only goal here,” he said of that benchmark. “I think it’s going to take us the better part of the next four years to get there, because every other hospital is getting better too.

“But we’re going to a be a great community hospital,” he went on, “and there’ll be no reason for anyone to have to leave Franklin County to receive high-quality care.”

Becoming the administrator charged with backing up that statement isn’t a career move that Bradley could have envisioned 18 months ago. But it’s a challenge he’s willing accepted.

Indeed, he believes he’s certainly in the right place at the right time.