July 01, 2007
BY TERENCE LOOSE
Children’s Hospital of Orange County (CHOC) President and CEO Kim Cripe’s dedication and skill was tested from her first day at the hospital. Thanks to its mission of turning no child away, regardless of the family’s ability to pay, and the intense pressure from managed healthcare, the non-profit CHOC had just posted a record operating loss. That was 15 years ago, and under the direction of Cripe, while the healthcare land- scape remains just as harsh, CHOC’s fortunes have definitely blossomed.
Under Cripe’s direction, CHOC is not only financially sound, it’s kept up with a staggering 90% increase in admissions over the last decade to become the nation’s 11th largest and 15th busiest children’s hospital, all without compromising its “no child left-behind” mission statement or cutting any of the special, “non-medical” programs that put smiles on sick kids’ faces.
And while she is quick to hand the credit off to both her dedicated staff and the generosity of the local community – for instance, the mother of a former CHOC Pediatric I.C.U. patient recently donated $1.5 million toward the hospital’s ongoing expansion – Cripe is widely regarded as the compassionate leader who used her years of for-profit healthcare business experience to ensure CHOC’s future. And most importantly, a lot of children’s futures, too.
How did you come to a career in healthcare?
I wanted to work in healthcare because I’ve always loved science. As a little girl I wanted to be a veterinarian and an astronaut. So in college I started out as a biology major, then changed to communications. Then I found I also loved business, so the [hospital] administrative route was the perfect blend of all those things. So I got a masters degree in public health and health care administration and have worked in hospitals ever since.
Sounds like it’s more than just a job.
Definitely. I like helping people and that’s part of what drew me into healthcare. Most people at CHOC really love children and want to help children and families. It’s always amazing to me how many doctors I speak to who knew they wanted to be pediatricians when they were young. It’s one of the things I really love about this hospital: that most of the people who work here see it as a calling.
I imagine there are a lot of personal reasons behind that.
Yes, a lot of our staff either had a serious childhood disease or ailment themselves or their brother or sister did. I think when people go through those experiences it either really compels them to enter the field to help others or it makes them really afraid [of hospitals]. Our staff is very dedicated.
Is it hard seeing kids in the hospital instead of on the playground?
It is heartbreaking sometimes. I spent the first part of my career working in adult hospitals and decided that I wanted to work in a mission-focused hospital. In an adult hospital it’s sad but you can kind of reconcile it in your mind, but when it’s kids, you just can’t. How do you [explain] a two-year-old with cancer? You can’t. So in the first couple of months I worked here it was very hard.
So how do you show up every day?
I’ve found the key is to focus on the successes. Most of our patients get better and return to a healthy and full life. In the I.C.U.s the majority of the patients get better and go home and are success stories. And over 80% of pediatric cancer cases are cured. So I find if you focus on the successes, it’s truly amazing. If you focus on the few who don’t make it, it can be overwhelming.
Counseling must be greater here than other hospitals.
Absolutely. We not only treat the child, we treat the entire family. We have our own pediatric psychology department, an integrated school program so kids who are here can keep up with their studies, a program called Child Life where trained professionals teach kids pain management and help them with their anxiety. We have a big social services department.
How else does the hospital differ from an “adult” hospital?
A lot of the basic medical care is similar, but in a children’s hospital you tend to have two to three times more I.C.U.s because a children’s hospital takes care of the sickest of the sick children. So half the beds are I.C.U. beds. That was also something I had to get used to. We also have rec rooms where kids can play Nintendo and rent videos and do arts and crafts. And a pet therapy program where dogs are trained to play with the kids – it’s amazing how much pets lift kids’ spirits. Basically, we try to do as much as we can to normalize a hospital stay. We say a kid’s job is to play.
Yes, and insurance and Medi-Cal doesn’t pay for any of the programs I spoke of, so fundraising is a really important aspect of what we do. And because our mission is to take care of all children regardless of their [family’s] ability to pay, we take care of children whether they have insurance or not. That alone makes it a real challenge and in fact if you look up and down the state, most children’s hospitals are losing money. We’re lucky that we don’t actually lose money from our hospital operations right now.
That wasn’t true when you came aboard.
No, when I was first the CEO we did, but we’ve worked really hard to get better contract rates and write for grants and of course fundraise. Currently, we raise $15 to $16 million a year from the community. We are really dependent on the community for those special programs so luckily, we have a really caring community.
And in fact, you’re growing. Why?
One of our biggest challenges is keeping up with [population growth] and the advancements in pediatric medicine. Our census has doubled in the last decade and our outpatient programs have nearly doubled as well. Then there’s the hiring, which is hard, because there are shortages of all staff positions.
But this area must be a draw, right?
Yes and no. The weather is absolutely a selling point, especially in the winter time. You can talk to people living in Chicago or New York and sell the weather all day long. And the lifestyle is another huge selling point. But then when people come here they discover the cost of living is really high. They try to find an affordable home and suddenly the area becomes more of a challenge than a selling point. It’s especially true with physicians, because a lot of times they have big student loans to pay off. People think doctors make a lot of money but it’s really hard for young physicians who are coming out of their training; they’re not making the kinds of salaries that historically they’ve made, because of managed care.
How big a factor is managed care?
We went through a six year period when we were losing quite a bit of money on the hospital operations. California is particularly harsh. The margins are really thin. Reimbursement rates are the lowest in the country, but the cost of living is toward the other end, so it’s really tough.
Was it ever an option to cut programs?
To make a turn around easy we could have cut programs, certainly, and not take all children regardless of their ability to pay. Tighten the belt so to speak. But we stuck to our mission. That’s one of the things I’m most proud of: We didn’t cut any programs.
What’s your favorite part of your job?
That our mission is to protect the health and wellbeing of children, so I feel like I’m doing something really important. It’s an honor for me to lead this organization and work with really talented, passionate, dedicated people. Then of course to see the children going home who were, say, in a bad car accident and we got them better. It’s a daily reminder of how fragile life is. I love being part of a team that saves children’s lives.
To learn more about CHOC, visit www.choc.org.
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