Tomi Ryba has only been with El Camino Hospital for a year and a half, but she’s already made progress in shaking up the hospital and getting it prepared for the changes health care reform will bring. She talked with DOTmed Business News about her favorite projects and her hopes for the future of the hospital.

DMBN: Tell me a little about your background. How did you get to where you are today?
TR: My experience has been entirely in health care. I started my career at Riverside County Regional Medical Center, which is a public hospital in southern California.

DMBN: What have been some of the highlights of your time there so far?
TR: I would say the last year and a half has been focused on setting the context for health reform. That was a huge emphasis. Also in my first six months, I worked with the board to expand our governance structures. We are a district hospital, with an elected board and a hospital board as well. We expanded the hospital board by three members and we built a committee structure and invited 21 execs from Silicon Valley and the Bay Area to join our committee structure for our governance. That was remarkable work and very intensive.

From a programmatic standpoint, we’ve continued to expand heart and vascular services, women’s health, particularly robotics in respect to women’s health, while at the same time growing our men’s health program in Los Gatos which has become a national model.

DMBN: What is one challenge you have dealt with at your hospital, and how did you deal with it?
TR: I think one challenge was how would we integrate our health care reform aims, to bring quality and service and affordability, and to try to create the infrastructure that would support and reform all of those in a way that’s compatible. So we basically brought together our performance improvement resources, our quality resources, our service resources and our clinical decision support resources and have formed an integrated model that’s fairly uncommon around the country. What happens is these functions tend to be siloed. And they certainly talk together, but here was an opportunity to really link the resources and the planning in a much better integrated fashion.

DMBN: How is health care reform impacting your hospital?
TR: I think it has helped us sharpen our focus on ensuring that as we serve the community, we achieve these high standards. We achieved them last year and we fully intend to achieve them this coming year. I would say it’s a new set of requirements, even though we were doing the work before, it’s a new set of risk that’s associated with these efforts.

To the good though, I would say it has created a compelling case for change and the way we work with community providers. And I think to the community’s benefit it has helped us be less hospital centric and more community based. An example of that is how we’re working together with nursing facilities to see how they work, and how we can reduce the risk of patients being readmitted. We’ve done substantial work around this area and have lower rates of readmission than most in the area.



DMBN: What projects or expansions is the hospital working on?
TR: We continue to look at how we can help our independent physicians transition to some kind of group model, or help them if their preference is to remain independent. We have begun pilot projects, to improve quality and reduce cost of care for different patient cohorts. We have opened up a patient- centered medical home that has done quite well. The advantage is we have these wraparound services for the frail and elderly that allows us to treat their co-morbidities more effectively. We’re very excited about that and hope to expand. We’re expanding our palliative care program to be more outpatient instead of inpatient, of course. And, we’ve added a program called MOMS. There’s only a couple of programs like this in the country. It provides a setting for women who suffer from post-partum depression, and have the need for an acute level of care. It’s very rare to find these programs, and that has gone exceptionally well.

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