Thomas J. Quatroche Jr. said he wouldn’t have started working at Erie County Medical Center 11 years ago if his father-in-law hadn’t been taken there one year earlier for neurological rehabilitation following a brain hemorrhage.
The exceptional care that Courtney Johnston received from the nurses and doctors at ECMC defied the expectations that Quatroche and his in-laws had about the public hospital, Quatroche said.
That’s why, one year later, when Roger Kaiser, then the chief executive officer of ECMC, contacted Quatroche and asked for his help in developing a new brand for ECMC, which had been converted from a county department to a public benefit corporation, Quatroche agreed to leave the world of higher education to join ECMC as a senior vice president.
“I knew that we could make a promise to the community and could keep it. Had I not had that experience, I probably wouldn’t have taken the job,” Quatroche said, “because I had the same perception that many others did.”
In May, after 10 years as senior vice president for marketing, planning and business development, Quatroche was named president of ECMC.
Three months ago, he was named acting CEO, replacing Richard C. Cleland after the ECMC board of directors abruptly terminated Cleland. And on Jan. 26 the board voted to name Quatroche, 46, the permanent president and CEO without conducting a search or interviewing any other candidates.
Quatroche’s employment contract with ECMC has not yet been finalized, according to the hospital. Cleland, at the time he lost his job, was earning $600,000 per year as CEO.
But Quatroche hasn’t waited until to get the CEO’s job on a permanent basis to make his mark. He has been visiting with employees, overseeing plans for an expanded emergency room and guiding the 3,300-employee, 602-bed hospital through the end of its busiest year yet in terms of patient volume. And he put in place a plan to bring in house much of the legal work that for more than a decade has been assigned to outside counsel, including to the firm of Anthony Colucci III, ECMC’s general counsel.
The Hamburg native, who lives in Amherst now, is a SUNY Fredonia graduate who earned a master’s degree in student personnel administration from SUNY Buffalo State and a doctorate in higher education from the University at Buffalo.
He previously worked at Erie Community College, Niagara County Community College and Canisius High School before joining ECMC.
He said he learned valuable communication, political and negotiation skills while serving as a Hamburg Town Board member, and he was the youngest person ever elected to that body when he was first voted into office at 22.
Q: ECMC’s two previous CEOs were insiders. Tell me why another insider candidate is again the right person for the job.
A: I would sum it up in one word, and that’s ‘trust.’ I think it’s very important as we’re growing the organization, bringing new people from the community, whether they be new service lines, or growing existing service lines, that there’s a high level of trust in the organization. Because when we do that, we change the organization, and we have to be careful not to focus our priorities always on the new. We have to make sure we’re taking care of our existing clinicians in the building. And also in the community, as we’re collaborating with other community partners, they have to know and trust the individual that they’re working with.
Q: What do you need to do to help the hospital recover from the turmoil since Rich Cleland’s ouster as CEO?
A: I would say, internally, it’s business as usual. I think — and I’ve said this before — to the patients that walk in this building, and to the employees, they want good leadership. But, again, I’m the least important person in the building. The patient cares about the housekeeper, cares about the nurse by their bed, cares about the physician. At the end of the day, they probably don’t even know who the CEO is. The employees, I think it’s not one person, it’s the leadership team. They’re interacting with our executive team on a regular basis. It’s my job to make sure that team performs, make sure that team behaves in a way that’s supportive of the organization. So I think internally the only work to do is to continue to build the trust with the executive team, and I think we’ve established and I have and I’m a known entity to the employees.
Q: What about externally?
A: Externally, I think in the business community, again, I have good relationships, known entity. So I think we’re fine there. And I think in the government community, there’s always a healthy dose of skepticism. And so it’s my job just to get back to relationships and trust and that we continue to use my relationships to explain to them that the institution’s on good footing and that we’re stable, that we’re good from a business perspective, and at the end of the day our focus has to be taking care of patients and growing the business and most importantly preparing the business for what’s coming at us from health care reform. Because we’re kind of on two water skis. We’re growing the business and continuing to grow surgeries, have new physicians come to the table. So that’s good, but we’re also preparing on the medical side to make sure patients are treated at the right place at the right time and receive the right care, and that may not necessarily be in the hospital. So we’re actually doing things consciously to have patients treated outside of the hospital in other settings. So that’s a little counterintuitive to the way we’ve typically operated, which is volume, volume, volume. Now it’s about managing patients and managing their continuum of care. That’s a different thought process for a hospital.
Q: Can the growth in patient volume from the last five years be sustained? And what are your goals for the next five years?
A: We’re going to continue to grow our business. We’re going to reach a point where we don’t have the physical plant for the patients that we’re going to be serving. So we’re opening a 16th operating room this year. I’ve already, since probably over the past couple weeks, I have that filled by the time it’s going to be opened. So filling the operating rooms has not been an issue for us. So my goals will be growth, will be collaboration and will be looking to strategize around businesses and health care organizations we haven’t been a part of that are in the community. An example, you just saw Kaleida partner with Western New York Urology and Cancer Care. We partnered with MASH Urgent Care.
Q: The vast majority of patients come to ECMC through the emergency room. What are you doing to make ECMC a hospital of choice?
A: We obviously educate people with advertising and those kinds of things, about the care we deliver. But I think the word of mouth in the community, is significant, amongst clinicians, physicians, in the community, as well as patients. I used to go talk to physicians in the community, and they would say, ‘My patients would say, I’m not going to ECMC. All right, if you practice there.’ Now they’re saying, ‘OK, I’ll go to ECMC.’ So there’s that image change that’s happened. I think from our standpoint, while we have great clinical care, culture of care, we can always improve patient experience. So all those things I’ll call the quote, “hoteling experiences,” in the institution – food, making sure people are comfortable, making sure there are amenities for patients – all those things that you would expect from a customer service standpoint. And now the federal government’s actually reimbursing us based on our patient experience.
Q: The hospital brought in $550 million last year, but your profit margin was just $485,000. How concerned are you about ECMC’s financial position?
A: So I think if you look at safety-net hospitals across the state, the fact that we’re in the positive territory is an accomplishment, considering the mix of patients that we have, either non-paying patients or Medicaid patients, which is about a third of our business. To your point, we’re happy that we’ve been able to be in positive territory, But long term, and the reason that we’re collaborating and working with those in the community, is because we understand that we need to spin off more margin to be able to invest back in our facilities and invest in the future. We have to collaborate. So that’s why we’re working hard to look for as many efficiencies as we can.
Q: Does Western New York continue to have too many hospital beds?
A: The overall picture, I can’t answer that question because each hospital has to answer that for themselves, I think, each hospital system needs to answer that themselves. But I know at ECMC from a hospital bed perspective, we’re appropriately sized.
Q: What is ECMC’s relationship with Erie County today? The county executive has warned of looming financial obligations to the hospital, related to federal matching Medicaid funding, that could cost the county tens of millions of dollars annually in the future.
A: We have always, and I continue to have, a good relationship with the county. And Mark Poloncarz and I have a good relationship. We’re taxpayers, and we want to make sure the county doesn’t have any financial issues. And Mark and his team, I think, are equally as concerned that they want to make sure that ECMC’s being reimbursed for the care it’s delivering. We haven’t figured something out yet with the county, but we’re working towards that goal. I’ve had a few conversations with the county executive, and they’ve all been positive. And I’m confident that we’ll come to a resolution.