West’s Wings

One day, Warren West looked around his high-flying, cherry-veneered New Jersey office with the leather seats and wondered where the patients were he had come to serve. He's found them at Copley Health Systems.

by Portland Helmich

His office might be simpler than the fancy one he had in New Jersey, but Warren West is in his element running Morrisville's Copley Health Systems.

If Dr. Sam Labow, medical adviser at Morrisville's Copley Hospital, had been given the power to create the ideal president and CEO of Copley Health Systems Inc., Warren West would have been his manifestation. "From the point of view of what this institution needs," Labow says, "if something could be a perfect fit, Copley Health Systems and Warren are it."

Labow's statement is hard to dispute. Running a not-for-profit health care system as complex as Copley's (the hospital is only one of 11 subsidiaries) demands more than a thorough understanding of the pecuniary bottom line nowadays.

With medicine's financial well-being on shaky ground, an upbeat and affable personality is more than an added benefit for any president and CEO it's almost a necessity. Such a position also calls for an unwavering commitment to quality patient care and the rural environment where Copley is located. Warren West doesn't just fulfill these requirements; he embodies them.

Raised in Westfield, N.J., West has worked in hospital administration his entire professional life. "You're going to love this," he says with a hard-to-resist grin. "My very first job was sweeping the floors of the local hospital when I was in high school."

West is speaking of Children's Specialized Hospital in Mountainside, N.J., where he worked in various departments (dietary, purchasing, security) to make extra money throughout college and graduate school.

After he obtained a bachelor's in public service administration from Pennsylvania's Waynesburg College in 1982 and a master's in public administration with a concentration in health care from Seton Hall University in 1985, Children's Specialized Hospital hired West as its assistant administrator.

Four years into his job, West felt the need to bolster his financial prowess, so continued working at the hospital while studying for a master's in corporate finance at Fairleigh-Dickinsen University, where he graduated with an MBA in 1991. By the time he left the non-profit children's hospital 18 years after sweeping his first floor, West had risen to vice president of administration, but couldn't move any higher.

"There's nothing better than the mission of children," he says. "I loved my job. In some areas of life, though, I'm an aggressive son-of-a-gun. I had a young boss who wasn't going anywhere, and I knew I needed to find a new place if I wanted to be number one."

The for-profit health care world beckoned. West moved his wife and two children to Scottsdale, Ariz., to become CEO/administrator of one of HealthSouth's small rehabilitation hospitals. "I thought it was good to get for-profit health care experience," he explains. "That's where I learned to manage by the numbers."

West describes his stint at HealthSouth as a "great education," but he moved on from the position after less than two years because of philosophical differences. "Really," he says, "I don't believe health care should be for profit. Quality of care should rate

higher than stockholder dividends. Of course, you need a bottom line to support your mission, but any bottom line should be turned back into providing services to the community."

With more tools in his toolbox, West moved back east to work at Saint Barnabus Health Care System, a massive non-profit in Livingston, N.J., that operated nine hospitals and 10 nursing homes.

While working in corporate headquarters, overseeing what he describes as "four product lines (neurosciences, occupational health, rehabilitative services, and alternative medicine)," West eventually felt disconnected from the reason he'd chosen his profession.

"One day," he recalls, "I looked around my cherry-veneered office with the leather seats, and I asked myself where the patients were I was trying to serve. That's when I started looking for another job."

Warren West (left) shares a moment of humor with volunteer George Spears, receptionist Sue Alexander, Joyce Tenney, LNA (licensed nurse assistant), nurse practitioner Katherine Wilde and Linda Shaw, nurse manager.

After responding to a recruiter's call about a position as president of a 53-bed facility called Copley Hospital in central Vermont, West was given the opportunity to fulfill a dream in 1999.

"It was always my intention to be the administrator of a small, rural hospital," the 41-year-old says. "Rural is my lifestyle, and small means I'll know folks' first names."

Know them he does. "You should seem him in the hallway," says Nancy Sweeney, West's executive assistant. "The man can't go to the bathroom or get a drink of water without stopping to speak to someone. He has a relationship with everybody."

That's quite a statement. Three hundred and fifty people work at Copley Hospital; another 250 are scattered among Copley Health Systems' other spokes like Copley Manor, the 87-bed nursing home across the street; Copley Terrace, a HUD-subsidized senior citizen apartment complex; Copley Woodlands, a retirement community offering home ownership; three physician practices (Morrisville Family Health Care, Stowe Family Practice and The Women's Center at Copley); Lamoille County Mental Health; and the Lifeline Foundation of Vermont, a phone-based intercom device connecting medically frail individuals living at home to an immediate-response system that not only contacts emergency personnel, but loved ones and neighbors, as well.

West spent two years at Copley Hospital before becoming president and CEO of Copley Health Systems in October 2001, but he still has a few more names to learn. This is a leader who places a high premium on the value of human interaction. "You can't manage people until you understand who they are," he says, pointing out that he spent a full day working in several hospital departments during his first few months as president.

"I cleaned toilets and made beds in housekeeping," he remembers. "I shoveled sidewalks with maintenance; I did prep work in dietary; and I learned how to be a licensed nursing assistant one day. I think it showed people that I'm interested in what they do, and it gave them a chance to know who I am."

In West's eyes, staff satisfaction is where it all begins. "I have a mantra," he notes. "Staff satisfaction is number one. If the staff are happy and satisfied, they'll ensure patient satisfaction. If the patients are happy and satisfied, they'll come back. If they come back, we'll have financial viability. It's a circle, and everything I do ties to that concept."

Staff satisfaction is so important at Copley that a committee designs and distributes a survey measuring it. West maintains an open-door policy; he's also created "It's Your Turn" meetings, which allow staff to share concerns and make suggestions on a quarterly basis.

Since West has come on the scene, he's done two market basket adjustments to ensure that Copley pays competitively across the board. "One of our long-term goals is to be the employer of choice in Lamoille County," he says, "and you can only do that through competitive salaries and benefits and a pleasant work environment."

Staff must be fairly content. For the last two years, Copley has consistently been rated number one in the state in patient satisfaction by Press Ganey, a national company measuring patient satisfaction at 600 hospitals throughout the country (12 of Vermont's 14 hospitals subscribe to the service).

"Most people don't want to come to hospitals," says West. "Aside from childbirth, it means there's something wrong. We need to make sure that people have a good experience when they're here because this is usually not where they want to be."

Lab technician Deb Austin is one of 350 people working at Copley Hospital. Another 250 work in Copley Health Systems' 10 other subsidiaries, including an 87-bed nursing home, retirement community, physician practices and Lamoille County Mental Health.

West says a good experience means patients see friendly faces, don't have to answer the same questions as they move through hospital departments and get home as soon as possible.

To find out if Copley is meeting customers' expectations, West meanders into patient rooms to chat. "If they ask me who I am, I say I work for the hospital," he says. "Normally, I find out that people are happy with our services. This is a very good hospital."

Nevertheless, Copley has discovered through a recent public perception study that while it's viewed as a good primary-care hospital, the community doesn't think the institution is as technologically advanced as it actually is. "We need to educate people about that," West asserts.

Seventy years after Copley Hospital was founded by Alexander Hamilton Copley, the Lamoille County institution boasts a modern radiology department, a brand-new nuclear medicine camera, a mobile MRI and CT Scanning.

The hospital's full spectrum of services includes general, orthopedic and gynecological surgery; rehabilitative care; occupational, speech and physical therapy; audiology; and an around-the-clock, physician-staffed emergency department.

There's also the Birthing Center, which tailors the birth experience to women's individual needs and desires. Both nurse-midwives and obstetrician-gynecologists are on staff. Women looking for less stressful deliveries might take advantage of Copley's hypnobirthing classes or its labor tub, where water births routinely take place.

There are few specialists at Copley; still, Labow feels the hospital's level of care cannot be beat. "We'll never do neurosurgery or heart surgery here," he admits, "but in the context of what we can do, it's as good as what you'll find at the Mayo Clinic or we wouldn't be doing it."

Copley Health Systems has an overall operating budget of $43.5 million for FY 2002. One hundred percent of its revenue is generated from fees for service. According to West, about 60 percent comes from federal entitlement programs like Medicaid and Medicare; 39 percent comes from commercial insurance companies; and 1 percent is generated through private pay.

West's long-term financial goal is that Copley Health Systems be a solid presence in the community 50 years from now. "We can only do that," he says, "if we offer quality services and maintain our bottom line."

The difficulty of attracting qualified staff to Copley's rural setting can pose a threat to the system's viability. West emphasizes that Copley has been successful despite the challenge, but concedes that his bottom line is vulnerable to minor changes.

"We lost an orthopedic surgeon," he explains, "and 10 percent of our bottom line went with him. It took us a year to find a good replacement, but we did it."

In addition to enhancing Copley Health Systems' financial strength, West and his board are committed to developing a strategic plan to understand the community's needs even better. "Copley's latest community needs assessment revealed that people still want more prevention and wellness activities from us," says West. "They also want more behavioral health and substance-abuse programs."

West should be pleased, as these results harmonize with Copley's vision, which begins with "a community with wellness at its core." Like every other health care system in the country, Copley is working to figure out how to move its system from one that treats diseases to one that prevents them. Education, of course, is critical, so Copley's outreach programs, which feature classes like managing anxiety and stress, smoking cessation and heart support, should be on the rise.

Copley's vision, however, is not just a community with wellness at its core, but a community with "clear access to a comprehensive continuum of quality care." In order for that to happen, West says Copley needs to improve the coordination of care, so, for instance, when patients are transferred from the hospital to the nursing home, all their documents go with them.

"For the last 10 years," West explains, "we've been in expansion mode. Now we need to focus on operations, which are our finances and quality of care. We need to get back to basics and concentrate on why we're here."

Russel Page is a physician in Copley Hospital's around-the-clock emergency center.

Copley was in a constant state of transition over the last two years, as West was promoted from hospital head to system head and as Copley's 11 boards were unified into one. "We've stabilized," West says, "and the system is clearly headed in the right direction."

Labow attributes this direction to West. "I'd retired," says the former surgeon. "I don't have to be here. I'm here because I see a guy who is so totally devoted to making this the best small community hospital in the country."

What Linda Shaw, nurse manager of Copley's Ambulatory Care Unit and Outreach, appreciates about West is his absence of airs. "He still parks back in the employee parking lot," she says with a chuckle. "As they move up, they usually move closer to the front door but not him. He's one of us."

Undoubtedly, West would accept Shaw's comment as the highest of compliments, as this is a man who refuses to separate himself from the people who make Copley thrive. People are what Warren West is all about. Fortunately for him and the thousands of patients who rely on its services, Copley Health Systems is, too.

Originally published in January 2002 Business People-Vermont