Anne Arundel Medical Center, a 380-bed hospital in Annapolis, Md., is staying on the cutting-edge of healthcare during a turbulent time in the industry. AAMC prides itself on being environmentally friendly: in 2011, it opened a LEED-Gold certified patient tower, the first LEED-certified acute-care hospital in the state. Also, the hospital is positioning itself to succeed under healthcare reform by participating in an accountable care organization through the Medicare Shared Savings Program.
Leading the advancements at AAMC is Victoria (Tori) Bayless, the hospital's president and CEO. Here, Ms. Bayless shares why AAMC strives to be green and what it takes to become an ACO. She also opens up about her goals for the rest of 2013 and how she uses humor as a leader.
Question: Anne Arundel Medical Center was recently named to Becker's Hospital Review's list of "50 of the Greenest Hospitals in America," and it has received other awards for being environmentally friendly. What is the drive behind the hospital's green efforts?
Victoria Bayless: AAMC always has been intensely mission-focused. The path toward achieving our 
mission — to "improve the health of the people we serve" — naturally takes us to concerns about the environment in which people live. By taking whatever steps we can to improve the health of our environment, we also help protect the health of our patients, staff and community.
Q: What have been some of the most successful environmentally friendly programs or initiatives at AAMC?
VB: There have been several, but perhaps none more stunning than the design and construction of our newest patient tower. Opened in 2011, our Hospital Pavilion South is the first LEED-certified acute-care hospital in Maryland and has earned a gold rating from the U.S. Green Building Council. Many of the materials and resources used to create our building came from re-used or renewable resources. A solid 87 percent of the steel in our beams and columns is pure scrap. Given that we are located near a Chesapeake Bay tributary, it was important to design the building to be as ecologically kind as possible. It uses 33 percent less water and uses material that emits less greenhouse emissions. We also installed a chemical-free water treatment system, and we are close to public transportation to [reduce] fossil fuel use.
Since implementing our "green team" a few years ago, we have managed to significantly impact our waste management performance. To date, the hospital has cut incineration rates from 50 percent to 16 percent of our total waste to help improve the quality of Maryland air. Recycling has grown from 1 percent to 24 percent of our total waste, reducing landfill burden while supporting jobs and new manufacturing.
Q: I understand AAMC is participating in a Medicare ACO. What drove participation in the Shared Savings Program?
VB: Anne Arundel Medical Center's Collaborative Care Network is participating in the Medicare Shared Savings Program. While this is very much an evolving process, we strongly believe that we can improve individual patient care as well as the health of our community while reducing costs — and the only way to achieve this is with a committed partnership with our primary care physicians.
Several investments over the past few years make it possible for us to attempt this. These include:
(1) a large group of affiliated primary care physicians who are organized around a patient-centered medical home model; (2) a $40 million investment in a robust electronic medical record that connects the primary care physicians with both the inpatient hospital and the ambulatory environment; (3) growing partnerships with area [skilled nursing facilities], home care and hospice organizations to better coordinate care — prior to and post-hospitalization. In keeping with healthcare reform, we are becoming less hospital-focused, more patient-focused and more centered on care beyond the hospital setting.
Q: How, if at all, have things changed at AAMC since becoming a Medicare Shared Savings ACO?
VB: Perhaps more than ever before, our aim now is very focused on improving access to care while maintaining high quality and reducing cost. One of the biggest changes is the assumption of risk. Under the ACO, we are responsible for the care of a defined Medicare population. We are now compelled to consider which patients in our community are the most vulnerable and how we can ensure a strong primary care physician relationship. How can we provide care in the community and prevent unnecessary emergency room visits? To this end, we are establishing a series of community-based clinics to serve people where they live.
Readmissions and infections rates both continue to decline. At the same time, we are proud to sustain among the highest HCAHPS scores in the state. We have access to even more data on our patient population that allows us to better target those requiring additional assistance such as care management or disease management programs. Physicians are engaged in the process and interested in utilizing the information to improve care and outcomes. It's also paying off in reducing costs. As one of the busiest hospitals in Maryland with more than 30,000 admissions annually, we are bending the hospital's cost curve by more than 4 percent and [currently] maintain a lower cost structure than the majority of Maryland hospitals.
Q: What issue will be top-of-mind for you for the rest of 2013?
VB: Clearly, it's focusing on three things: how to achieve improved access, sustain higher quality and reduce cost. One aspect that we are tracking very carefully is the upcoming changes to Maryland's unique rate-setting system and the impact this will have not just on our hospital, but on healthcare overall in Maryland. Through participation in a regional grant, specially trained staff are helping to enroll individuals in the state's new health exchange, offering many people health insurance coverage for the very first time.
We look forward to cutting the ribbon on a new community clinic — this time as part of a Maryland Health Enterprise Zone grant in partnership with the local housing authority — in an area senior citizen high rise building. This is yet one more testament to our belief that people need better access to primary care. We remain firm in our commitment to improving the health of our community by providing high-quality, low-cost care.
Q: How would others describe your leadership style?
VB: In healthcare today, it's easy to give lip service to such terms as "teamwork," and "trust" and "compassion." But at AAMC, these are a few of our values that guide us every day. Staff know our patients and families come first, but they also know a spirit of collegiality and openness to new ideas — fresh ways of looking at old ways, to encouraging innovation and giving opportunities to test new programs — is what will continue to advance AAMC.
Many would likely describe my leadership style in these terms, perhaps with just one other characteristic: a sense of humor. What our teams do every day is frequently stressful, demanding long hours and, sometimes, nothing short of miraculous. If I can help lighten a staff member's day, or we can share a laugh together, it improves everyone's health. And our patients and families are the better for it.