Editors' Note

Louis Shapiro assumed his current position as Hospital for Special Surgery (HSS) President and CEO in October 2006. Before this, he served as Executive Vice President and Chief Operating Officer of Geisinger Health System’s Clinical Enterprise for five years. He began his career at Allegheny General Hospital in Pittsburgh and then joined McKinsey & Company as a leader within their health care practice. He is a Fellow of the American College of Healthcare Executives and serves on the board of both the Greater New York Hospital Association and Crutches for Kids. Shapiro is also a member of the Young Presidents’ Organization.

Institutional Brief

A world leader in orthopedics and rheumatology, Hospital for Special Surgery (www.hss.edu) has been recognized since its inception in 1863 as a leading academic specialty hospital dedicated to musculoskeletal disorders and autoimmune diseases. The New York-based Hospital pioneered the modern-day total knee replacement, and today performs more than 25,000 surgical procedures per year and has one of the most sought after training programs in orthopedics. An elite group of professional sports teams utilize Hospital for Special Surgery and its physicians including the New York Knicks, the New York Mets, the New York Giants, and Nets Basketball, to name a few.

Over these past 24 months, did you see an impact on the way Hospital for Special Surgery was able to operate, and how is the hospital positioned going forward?

As an organization with a local, regional, national, and international market, we have a very large reach to individuals who want to seek out the best providers to help them regain their mobility. Since there’s no other institution like HSS, the demand for what we do has increased over the past 24 months.

We have worked hard at achieving extraordinary outcomes, maintaining an infection rate among the lowest, if not the lowest, and ensuring an exceptional patient experience.

We also effectively manage our expenses while at the same time improving productivity. As a result of all these elements working together, our financial performance has also remained strong.

You’re known as a great hospital for service, but many refer to you as a teaching institution. How do you define the brand?

At its core, HSS is a hospital that helps people who have had their mobility hindered or taken away as a result of an orthopedic-related problem or a rheumatologic condition, which includes autoimmune diseases like rheumatoid arthritis and lupus. We treat any condition dealing with the musculoskeletal system, whether due to injury, wear and tear, or disease.

Additionally, we offer specialists in pain management and physical rehabilitation to help patients get better, even if it requires nonsurgical intervention.

We’re also academically oriented, which means that we teach physicians and other health care professionals in our areas of expertise and conduct research that helps answer difficult questions about how to be even more effective with both diagnosis and treatment.

At HSS, how do you foster the patient relationship?

Patients who choose to come to HSS know this is where they’re going to get the best care, measured both by outcome and quality, as well as overall patient experience. The day we stop having that as a differentiator is the day patients will stop coming here.

So we pay personal attention to our patients, because they’re making a decision on whether they want to put their life in our hands or someone else’s hands. And it’s working, because we’re growing at a rate of 5 to 10 percent per year.

How have you led other institutions in maintaining a consistently low infection rate?

When patients select a hospital, a low infection rate should be one of the items at the top of their list. Because we’re so focused on orthopedics and we do such a high volume of procedures, we understand every process that is related to taking care of our patients. For example, we perform more joint replacements than anywhere else in the country, so we have become experts in that area.

We are well-versed in the most effective ways to prep the patient before surgery to avoid infections. Our surgeons are very efficient in the operating room, which decreases surgery times, and we know how to effectively prevent infection after surgery as well. We use highly sterile methods for cleaning patient rooms and the operating rooms.

Because we’re a specialty institution, we can orient our employees to infection prevention practices that specifically relate to orthopedic patients. From hand-washing to the environment in the operating room, everyone understands their role in infection prevention, and the end result is a low infection rate.

Part of our quality management efforts is measuring and monitoring everything related to this. So if anything deviates from what we expect, the responsible party will intervene and make whatever improvements are necessary to get things back in line.

Do you believe that the recent health care reforms will bring meaningful changes?

Some of the right dialogue is taking place. We have too many people in the United States who are uninsured or underinsured. Health care reform must increase access for those who don’t have it.

Also, insurance reform must prohibit companies from being able to cancel an individual’s policy because they were diagnosed with a problem.

However, we have not figured out a way to pay for increased access to health care, and we’re not going to know how big of a problem that is until we are further down the road with health care reform.

Will you broaden into other areas of medicine down the road?

Our reason for existence is to take care of patients with orthopedic or rheumatologic-related problems. We’re not going to change that.

Because we’re situated in one of the most populous parts of the world, there is a huge demand for our services and we find ourselves every three to four years needing to expand our physical capacity. We are in the final phases of our most recent major expansion project on this campus, and we’re in the beginning stages of planning for the next one.

We are also exploring whether or not we can replicate the HSS model in other geographic areas, internationally and within the U.S.

How critical has building a talented senior leadership team been to the success of HSS?

Given who we are, it’s expected that we come to the table being very talented in our areas of specialty. Beyond that, our employees are focused and aligned in their goals. That means that everyone, no matter what their job is, wakes up every day to come together as a team to accomplish whatever is needed. Everyone at HSS is working toward the same end point. Without this, no organization can achieve its highest potential.•