10 Minutes with…
Barry H. Ostrowsky
President and Chief Executive Officer, RWJBarnabas Health
Gary S. Horan, FACHE
President and Chief Executive Officer, Trinitas Regional Medical Center
EDGE: As of January 1, Trinitas is now part of the RWJBarnabas Health system. What were some of the boxes that needed to be checked for this to happen?
Horan: Ensuring that we maintained our Catholic mission was of primary importance to us. It has been, and will continue to be, a core component of Trinitas, which remains a Catholic institution with continued oversight by the Sisters of Charity of Saint Elizabeth. We also looked to partner with an entity that could help us advance our mission of caring for our most vulnerable citizens.
To be successful in the future, we also knew that health systems would have to coordinate care more seamlessly among providers, hospitals and care settings. We believed that we needed to join with an organization that would enable us to continue providing care in our community for years to come—against a backdrop of healthcare trends that disproportionately affect safety-net providers like Trinitas. For instance, it is becoming increasingly difficult to recruit physicians and nurses as a standalone hospital; they are looking for more variety and better possibilities for advancement—which being part of a larger health system can provide. So, starting about five years ago, we began looking at a number of strategic partners in New York and New Jersey. When we engaged in more meaningful discussions with RWJBarnabas Health, it was evident that they were the partner that we wanted to continue to pursue.
Ostrowsky: There was complete alignment on our goals, and our mission statements are almost identical. That was a very important component of the merger. In our view, nothing needed to change in terms of the strategy and the commitment and the culture. We both focus on taking care of communities and Trinitas does a fabulous job of this. And of course, its clinical services are of the highest quality. We want to take care of more and more of the population of New Jersey in a culturally competent way and, thanks to the addition of Trinitas to the system, we shall.
EDGE: What changes might patients notice on their next visit to the hospital?
Horan: They will notice a branding change, with a new RWJBarnabas Health logo and, through advertising, they will see that they now have access to an entire system of specialists. Conversely, RWJBarnabas customers now have greater access to the things that Trinitas does especially well, such as wound healing.
Ostrowsky: When an organization like Trinitas joins another group of institutions—in our case an integrated system—it needs to get a real advantage. We were in a position to offer that. All of the presumed advantages in terms of clinical and social care are now available in a convenient, seamless way for Trinitas customers. For example, if you need a service that isn’t immediately available on-site at Trinitas, we have it in the system with an easy referral because that “seamlessness” is something that already exists within our system. Also, I should mention that we are an academic-based healthcare system and Trinitas was already teaching clinicians, which means we’ll be able to further expand our academic footprint. So patients may notice more teaching going on.
Horan: Barry mentioned social care. RWJBarnabas has a very significant behavioral health footprint, which made our behavioral program a particularly good fit with theirs.
Ostrowsky: Yes, Trinitas has definitely distinguished itself in this area. Its services are clearly accretive to our clinical success as an organization, which—together with our Rutgers partner—made us probably one of the top three in the United States in terms of the complexity and breadth of our commitment to behavioral health services. The merger adds to that in terms of scale, including the number of beds and clinicians, giving us a very wide and deep platform of social services. If individuals presenting for medical care at Trinitas are vulnerable because of food insecurity or any of the other social determinants, they now have access to a full suite of social programs. We, as a system, are able to mobilize significant resources—including financial, human capital and technology—that may have been outside the grasp of a standalone hospital, as Gary was saying earlier. I don’t like changing things that work. When you look at Trinitas—the results it has produced for the community, the culture of the institution and those who lead it—there is no reason to make any changes, other than ensuring Trinitas has the resources I mentioned to continue to do the job it has done. In terms of leadership at the management level and department-director level, it is such a great group of people. I call Gary Horan a dean of this industry and he is truly that.
Horan: I think Barry and I are both excited about what it means to have our School of Nursing folded into the RWJBarnabas Health system. We graduate 150 to 170 nurses a year at a time when there is a shortage of nursing personnel. Being part of a system offers those graduate nurses an opportunity to stay within the system instead of being scattered all over.
Ostrowsky: We currently have 900 openings in our system for nurses. No graduate from the Trinitas nursing program is going to go unemployed for more than three seconds—we have gotten graduates from this nursing school in the past and if I could do it legally I would insist that every graduate comes to work in our system! But yes, the nursing school is a great asset not just for us but for the entire industry, and we want to see that supported and hopefully expanded. In fact, I have actually discussed with the dean of the school, Roseminda Santee, what it would take to scale up.
EDGE: What other aspects of the merger stand out as “win-win” situations?
Ostrowsky: Trinitas has twelve Centers of Excellence that we will be able to learn from, including a specific focus on cardiac care, oncology, emergency services and, as we discussed earlier, wound care and behavioral health. That will help RWJBarnabas Health to scale several high-growth service lines, such as cardiology, oncology, neurology and orthopedics. I also see us benefiting from existing academic partnerships between Trinitas and Union County College, the College of St. Elizabeth and Kean University.
EDGE: This merger was finalized during a global pandemic. Did COVID impact the process?
Horan: The actual merger process, even during the COVID pandemic, went very smoothly. Obviously, meetings that normally would have taken place in a face-to-face setting were done virtually. But that was not as great an obstacle as it has been in other industries. Also, remember that Trinitas had been through this before, in 2000, when Elizabeth General and St. Elizabeth’s merged to form Trinitas Regional Medical Center. That was very tricky, but it became a model for consolidating a Catholic and non-sectarian hospital. That experience prepared us in some important ways for the merger with RWJBarnabas Health.
Ostrowsky: I think the way the teams came together to plan and execute our merger is a case study that’s worthy of being written up. There was incredible cooperation—a total of around 300 meetings between our staffs—and it shows in the results. Our alignment on the goals and the mission led to effective integration planning and execution. For me, this is a picture of what it looks like when you undertake a transaction like this and do it right.