COLUMN: Keefer Scores Biggest Win Yet As DCH's Safety Grade Outperforms UAB, Others

*This is an opinion column*

TUSCALOOSA, AL —DCH Health System CEO Katrina Keefer has been on the job less than two years but recently scored her biggest win to date as the Tuscaloosa-based hospital system saw its Leapfrog safety grades for DCH Regional Medical Center, Northport Medical Center and Fayette Medical Center improve to a "B" grade for the spring of 2024.

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DCH's safety grades from the prestigious Leapfrog Group also outperformed other nearby hospitals with historically better reputations, including Brookwood Medical Center (C), Princeton Baptist Medical Center (C) and UAB Hospital (C).

The news was no doubt cause for celebration not just for DCH Health System, but the community it serves. However, many will be quick to point out that this degree of pride and optimism has not always been the case.

Indeed, a running joke I've heard for as long as I can remember growing up in Tuscaloosa was that DCH, originally Druid City Hospital, stood for "Don't Come Here."

I'm in no way disparaging the wonderful, hard-working nurses, physicians and staffers making the rounds every day. After all, I was born at DCH Regional Medical Center and truly value the fact that we have a community-owned hospital system in Tuscaloosa County.

The longstanding negative perception of the hospital system, though, was further solidified after celebrated Alabama wide receiver Tyrone Prothro suffered a career-ending open comminuted fracture of his left tibia and fibula in a blowout win over Florida on Oct. 1, 2005.

For the sake of this op-ed, what stands out the most years later was the fact Prothro spent a month in the hospital after his initial surgery resulted in a pretty serious infection. DCH doctors and medical staff for the University of Alabama claimed Prothro did not develop a staph infection and, at the time, insisted he would make a full recovery and return to action.

Instead, the once-promising wideout would never play another down and has had nearly a dozen surgeries since the traumatic injury. He's one of the greatest what-ifs in Crimson Tide history and, if you ask a lot of townies similar to your narrator, blame will somehow always be placed on DCH's handling of his surgery.

In an age before social media grew to the massive influence it wields today, speculation ran wild through our community as dinner-table conversations lamented a promising career cut so short.

Rumors ranged from one end of the spectrum to the other, with some claiming there were still blades of Bryant-Denny Stadium grass around the site of his injury at the time of the surgery to expressing anger over the possibility that a surgery at DCH cost him his career, which likely could have been avoided had orthopedic surgeon Dr. James Andrews conducted the procedure in Birmingham.

Regardless of where the truth can be found in this anecdote, Prothro's botched surgery dealt a black eye to the hospital's standing with the community, which improved very little, if at all, in the years before the COVID-19 pandemic.

The deadly pandemic, which resulted in over 800 deaths in Tuscaloosa County during its peak, laid bare many of the hospital system's carefully concealed shortcomings while also seeing its leaders' relationships with the local media deteriorate to an almost adversarial one.

Apart from acknowledging a nursing labor shortage that was being faced by every hospital system in America at the time, the watered-down propaganda offered up by the hospital's administration seemed to be working harder to preserve what was left of DCH's reputation than to provide the local media and the community it serves with any semblance of transparency amid the maddening uncertainty and misinformation that dominated the news cycles.

Nowhere is this lack of transparency more readily available than in the hospital's dire financial situation, with local officials outside of the hospital for years insisting that its finite reserves will be exhausted sooner rather than later if drastic measures aren't taken. This also comes at a time when rural hospitals, even across DCH's service area in places like Pickens County, are closing at an alarming rate, resulting in the hospital system taking on more patients requiring indigent care.

At the absolute deadliest height of the pandemic, all of these issues in the aggregate compounded to paint a more negative public image of DCH Health System than ever before as the healthcare provider's beleaguered administration struggled to gain any meaningful ground.

I recall a certain caginess on the part of the hospital's administration when it came to answering the difficult questions and many of my colleagues in the local media began to openly talk about their own concerns with DCH leadership.

Enter Katrina Keefer.

Following the resignation of former DCH Health System President Bryan Kindred a few months prior, I'd never heard of this woman from Monroeville coming into our community from some hospital system in Georgia when I received the press release announcing her hire in August 2022.

In roughly a year and a half, though, Keefer has done more to improve the reputation of DCH Health System than just about any other high-level administrator in my lifetime.

Maybe there was nowhere to go but up when she was hired, but you'd be hard-pressed to find anyone in this community today who hasn't noticed across-the-board improvements in everything from the public perception of the hospital system's quality of care to its community outreach and relations.

I say that in no way to denigrate Kindred's commendable legacy — a decades-long one that can be credited with opening the system’s first cancer center, building the hospital’s medical tower for outpatient services and physician clinics, and securing an affiliation with the MD Anderson Cancer Center.

Rather, this Tuscaloosa County native would argue that the time seemed right to bring in some new blood and some fresh ideas, especially when you consider the changes brought about by the pandemic, the myriad financial issues facing the system and the looming possibility of it being purchased by or merging with a larger system.

Indeed, I've written extensively over this time about the sweeping reforms Keefer promised from day one, which included addressing recruitment and retention, improving relationships with area elected bodies and providing more transparency than ever before. And she would accomplish all this, she said, while also forwarding noticeable improvements to the overall quality of care for DCH Health System patients.

Almost immediately, this commitment to make good on her promises could be seen in Keefer bringing in new leadership for some crucial administrative positions, while leaning on the tested experience of DCH's best and brightest for others. In her first months on the job, she referred to this as an "inside-out culture change."

And it didn't take long to see that this approach was working.

At the one-year mark of her tenure, Keefer touted what she referred to as "an elite recruiting class" consisting of new hires for the following departments: Emergency Department; Imaging; Cancer Center; Chief Clinical Informatics Office; Service Excellence; Women’s Services; Revenue Cycle; Finance; Medical Staff Services; Strategy Execution and a new manager of the Diabetes Center.

From there, the fresh ideas and renewed energy of the hospital system's administration and leadership team, along with the talent brought on by deliberate recruiting efforts, DCH Health System began to see the hard work pay real dividends.

When considering those positive results, the best place to look today can be found in DCH Health System's Leapfrog safety grade. The latest marks for DCH come after its facilities received a "D" safety grade for the last two years, with hospital officials pointing out that the improved score reflects a "continuous focus on improvements in quality and patient safety measures over the past few years."

In the years before Keefer was hired, DCH officials placed little to no premium on its regrettably low Leapfrog grades, while often providing flimsy explanations in an attempt to contextualize why the prestigious hospital safety group gave the system such low marks.

Keefer and the current administration, however, took the opposite approach and took a well-deserved public victory lap to tout its progress to a community that had shown an increasingly cynical view of how the hospital was being run.

“The trajectory of DCH’s rising grade is proof that our culture has changed," Keefer told Patch after the grades were released last week. "Over the past few years, DCH is fortunate to have recruited and retained talented caregivers, both administrative and clinical, which has helped elevate DCH’s quality and patient safety grades. Our community deserves nothing but our very best; every day and with every patient.”

While there's no crystal ball to predict what the future holds for DCH Health System, it's clear that Katrina Keefer is delivering on the promises she made when she first arrived in Tuscaloosa almost two years ago.

There have been much-needed employee pay raises given, a renewed emphasis placed on hiring the best leadership possible and, most importantly, a visible willingness to listen to community stakeholders in order to provide high-quality care.

Keefer is far and away the most transparent and accessible hospital CEO I've ever worked with in over a decade of journalism, which is the unifying theme when trying to make sense of how she has achieved so much in so little time.

And it's this energy and commitment to a vision for the future that is likely to see DCH stack up more wins as long as Keefer occupies the CEO's office.

Ryan Phillips is an award-winning journalist, editor and opinion columnist. He is also the founder and field editor of Tuscaloosa Patch. The opinions expressed in this column are in no way a reflection of our parent company or sponsors. Email news tips to ryan.phillips@patch.com.