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Westerly - Last Wednesday, Christopher Lehrach's primary work uniform became a suit and tie, but he hasn't given up his stethoscope and scrubs.
Lehrach is now The Westerly Hospital's chief transformation officer for interim operations, a newly created title he describes as "awkward and meaningless" but nonetheless reflects the transitional status of the 125-bed nonprofit institution.
The 44-year-old resident of Charlestown, R.I., has been an emergency physician at Westerly Hospital since 1998 and chief of its emergency department since 2005, as well as chief executive officer of the hospital's affiliated physicians organization, the Atlantic Medical Group, for the past two years.
Now, as the hospital moves out of receivership and toward acquisition by Lawrence & Memorial Hospital, a process expected to be completed in January, Lehrach will help guide the smaller institution over the bridge of the next 2½ months and beyond. He was the mutual choice of attorney Mark Russo, the court-appointed special master for the receivership, and L&M.
"We anticipate having him continue to be the site administrator once we achieve closing," L&M spokesman Mike O'Farrell said. "It's good to have somebody in place there now as we complete the transition. He's somebody who already has a relationship with Westerly Hospital and with L&M, and who understands what Westerly Hospital can be."
Lehrach cautions that his new role is not equivalent to that of either the former president and chief executive officer of Westerly Hospital, who retired in July, or the chief financial officer, who recently resigned.
"I'm not Charles Kinney or Jean LeChance," he said. "I'm going to be the eyes and ears at Westerly Hospital for the folks at L&M as we bring about this assimilation. We have to view ourselves as one of the campuses of L&M, along with Pequot Health Center (in Groton), the new Dana-Farber cancer center and the main hospital (in New London). Early in the new year, we will have a substantial partner that is well-capitalized and extremely well-run."
For patients and the community, he said, the transition "should appear to be seamless," even as the hospital works to win back their loyalty. While the community has long been supportive, he noted, there has been a dropoff in patient volume since Westerly Hospital entered receivership last December. He could not quantify the dropoff.
"We need to earn that faith and trust back," he said. "We need the community to recommit to us."
Lehrach said that in becoming a hospital administrator - a career move for which he positioned himself by obtaining a master's degree in business administration from Yale University - he didn't want to give up being a doctor. As part of his agreement with L&M and the special master, he'll continue caring for patients in the Emergency Department two nights a month, on Fridays and Saturdays.
"It was important to me, for my professional satisfaction and because it gives you a legitimacy factor with the rest of the medical staff," he said.
One of his first actions was hiring his own successor as director of Westerly's emergency department. He tapped Dr. Kevin Torres, who worked there before taking a job as an emergency department physician at Pequot.
Lehrach also has begun what he views as one of his main responsibilities - getting out of his third-floor office for several hours each day and into the patient care areas to help prepare the 700-member staff for what's ahead.
"I want to be visible, talking to folks and hearing from them, and continuing to send a theme about embracing change and achieving efficiencies," he said. "I can guarantee and predict that the people who are going to be unhappy here in the future are those unwilling and unable to change."
The problems that led to the receivership, he said, were purely financial and did not impact the foundation of high-quality care.
"We've already got what we need at the bedside," he said, praising the loyalty and commitment of the nurses, technicians and doctors. "We've done an extremely good job with our mission, but when you run out of cash, you can't keep the doors open."
When L&M takes over, he said, it will import the financial practices and revenue cycle management techniques that have kept it consistently in the black. L&M has set a goal of Westerly Hospital achieving a 3 percent operating margin.
Already since the receivership, he said, debt restructuring has enabled Westerly Hospital to go from losing $1 million per month at the start of the process to breaking even for the last four months "and even making a little money."
Ultimately, he said, the joining of the two hospitals represents a promising opportunity for both institutions, even though it came out of a difficult situation. The two hospitals already serve overlapping communities and can help fill one another's needs - Westerly Hospital for financial stability, and L&M for additional space to add services. Under consideration is a geriatric psychiatric program and a subacute care area.
"They are landlocked (in New London). We have the space, and they need capacity," Lehrach said. "This is an incredibly good thing for the greater community."