Rita Mercieca, Forest Hills Hospital

Rita Mercieca

Changing a Culture

Editors’ Note

Rita Mercieca, RN, was named to her current post in January 2012. Prior to her promotion, Mercieca served as the hospital’s Chief Nurse and Associate Executive Director of Patient Care Services. She worked at North Shore-LIJ’s Franklin Hospital, first as a nurse manager in the Emergency Department (ED) then as director of ED and critical care before coming to Forest Hills Hospital in 2008 as Associate Executive Director, Nurse Executive. Previously, she worked for nearly 20 years at the former St. Vincent’s Hospital and Medical Center in Lower Manhattan in various nursing positions. Certified in emergency nursing, Mercieca has been honored with the North Shore-LIJ Nursing Leadership Award. Mercieca received a bachelor’s degree in nursing from Adelphi University and an M.B.A. from Regis University in Denver.

Hospital Brief

Forest Hills Hospital (www.northshorelij.com) is a proud member of the North Shore-LIJ Health System. As a 256-bed community hospital located in an ethnically diverse residential neighborhood in northern Queens, its mission is to provide the highest quality and most compassionate health care in the county, with sensitivity and respect for the cultural needs of patients and their families.

What makes Forest Hills Hospital so special and how have you provided such consistent quality care?

When it comes to changing a culture, which is what we had to do here, it’s about getting the right team together that is going to be innovative and wants to change, and has the skill to drive that change throughout the building.

It’s all about engaging the employees and helping them to build improved processes to provide the best possible care to our patients.

When we look at quality, we want to put processes in place that are going to be hardwired, revisit them often, and change them if they don’t work. We also always look for opportunity to improve.

Do you provide services across all areas or are you specialty focused?

We admit and treat any patient that comes into our ER. We provide orthopedics, general surgery, bariatrics, and GU and GYN procedures; we deliver 2,400 babies a year and see 50,000 patients in our emergency room. There have been closures of three hospitals within the past five years in the surrounding neighborhoods and that has resulted in an increase in our ER visits from 32,000 to 50,000. Managing that influx of patients while improving quality and service says a lot for the professionals that work in this building.

How tough is it to manage the growth?

The surge happens when a hospital closes and it’s almost like a disaster scenario. We have to manage the surge by increasing our staff and becoming much more efficient so we can handle increased patient capacity.

To accomplish that, we have to analyze our processes and look for inefficiencies at point of service in all departments. We do that routinely and have committees that look at flow and efficiency – a process that originated with the surge but continues today.

With all of the outside pressures, has there been a real toll on the doctor/patient relationship?

At this point, it’s more important than ever to develop partnerships with physicians, who are feeling a lot of pressure in delivering care. We want the physicians to spend time at the bedside with their patients; we want to support the patient and be their hospital of choice.

In order to do that, we have to develop relationships and partnerships. Partnerships are the key to success for any institution. More than ever before, those relationships need to exist within the walls of the hospital as well as outside the facility in the greater community. Patients need to partner with health care professionals to stay healthy at home so they can stay out of the hospital.

How much of a focus has technology been for Forest Hills Hospital?

Technology is a piece of the pie that will help us figure out how to improve care for patients and make the physicians’ jobs easier.

It also drives quality initiatives, providing a means of seeing how well we’re doing at certain things.

At Forest Hills, we are implementing an EMR (Electronic Medical Record) so that we can link patient information in the hospital back to a physician’s office, so the relay of information to the provider is seamless.

How critical to hospital culture is it to be engaged within the community?

We have nurse practitioners who are involved with heart failure and diabetes. One of my nurse practitioners for diabetes also speaks Russian, so she goes into the communities and teaches people to become advocates when it comes to diabetic care so that they can then pass on the information.

We are spreading knowledge quickly through our communities by helping people become experts at what they’re teaching and giving them the means to spread the word.

How beneficial is it to be a part of North Shore-LIJ?

Each hospital is responsible for the quality and the care they provide. However, we report to the North Shore-LIJ Health System, so protocols are put together not just for one hospital but for all hospitals and they’re rolled out to all of us. So we share best practices and standards of care that benefit all of the institutions and, ultimately, the patient.

How are you working to develop the young leaders who are entering medicine?

We have the advantage of having more nurses than we need right now so we can choose those who care the most about what they do.

North Shore-LIJ has also opened a new medical school in partnership with Hofstra University (Hofstra North Shore-LIJ School of Medicine) and we’re training physicians differently in the caring and the nurturing that are so important to providing effective health care. We believe it will lead to doctors spending more time at the bedside.

The next generation will be different than the physicians practicing today. We need to understand that for tomorrow’s physicians, technology has been with them forever. We have to capitalize on how they communicate, and we must recognize that they’re looking for a work/life balance that some of today’s physician leaders are not used to.•