TheBakersfieldCalifornian.com

San Joaquin Community Hospital is celebrating its 100th anniversary this year, a testament to staying power that would make any business proud. Yet for most of its existence, it has operated in the shadows of its competitors as the underdog of area hospitals.

But then, just a few years ago, something happened at the once-sleepy Adventist hospital that turned it into a powerhouse eager to make up for lost time. Since 2007, the downtown institution has doubled its size, opened a nationally certified stroke care center and chest pain center, affiliated with the Grossman Burn Center and signed a coveted contract -- once held by Catholic Healthcare West -- with Kaiser Permanente, bringing thousands of new clients to its fold.

Chief Executive Officer Bob Beehler and others at San Joaquin claim that that "something" -- the catalyst responsible for the breath-taking burst of energy -- is "sacred work," a corporate philosophy rooted in spirituality they say has changed the culture at the hospital.

"Five years ago, (San Joaquin) was the worst performing in the (Adventist hospital) system," said Jarrod McNaughton, a hospital vice president, during recent interviews with administrators and staff. "The (staff) turnover rates and the vacancy rates for RNs were out of control. Employee satisfaction was mediocre. People in the community didn't know about us. We put a stake in the ground and things really began to turn around."

The "stake" -- sacred work -- was a public commitment made in 2007 to a values-driven work culture at San Joaquin Community Hospital.

"Sacred work means taking care of people -- patients and staff -- at every level," Beehler explained. "Before 2007, there was always 'good things' being done here. But we made a public commitment to the staff and the community to focus on these values always. When we made a commitment to sacred work, something happened. I can't explain it. There is just something tangibly different about the culture at the hospital."

Beehler came to San Joaquin as its chief executive officer in 2003, bringing decades of experience working at for-profit hospitals.

While the for-profit hospitals "provided good patient care, it was still about stock value and profits. At Adventist Health, the mission is primarily about values and doing the right thing for the right reason," said Beehler, an Adventist himself. "It is so incredible to be able to practice your profession and your faith openly."

Only about 6 percent of the hospital's staff is Adventist. The staff also includes Catholics, Jews, Muslims and many other religions.

"There is no effort to force the Adventist religion on patients or staff," Beehler said. "Sacred work does not apply to only one brand of religion. People who work here believe in a higher power. They respect patients. Their work is a calling, not just an economic transaction. It is 'sacred' to take care of patients' needs."

Growth spurt

In 2007, San Joaquin opened the 130,000-square-foot North Tower, which doubled the size of the hospital and expanded services. The following year, San Joaquin became the area's first nationally certified stroke care center.

"To Memorial's credit, they later put one in, too," said Beehler, explaining the community's aging population and increased incidents of strokes require a dedicated health care team and streamlined procedures. "When a person has a stroke, you have three hours from onset of the stroke (to get treatment and intervention) or results go dramatically down. You have to be pretty darn organized. We had to train 500 RNs" to create the stroke care center.

In 2009, San Joaquin created its chest pain center, which again required specialized staff training and streamlining of procedures. The hospital has a long history of pioneering heart treatment. It was one of the first hospitals in Kern County to perform heart surgery and angiograms in the 1970s.

Training and procedures were developed to quickly and appropriately diagnose chest pain and direct care.

"The hospital's record is 21 minutes from patient entering the emergency room door to being treated in the cath lab," Beehler said, explaining the national average is 90 minutes. Among the center's procedures is the posting of a nurse in the emergency waiting room. Within five minutes of a patient entering the emergency room complaining of chest pains, an EKG is administered to determine if the patient is having a heart attack. While the Heart Hospital was the first in Bakersfield to be certified as a chest pain center, San Joaquin received its certification a couple of weeks later.

Also in 2009, San Joaquin affiliated with the Grossman Burn Center and opened a four-bed burn center.

"This meets a longstanding community need and allows patients to remain in the community for this long-term, critical care," said Beehler. Many local groups helped raise funds to equip the burn center and offset start-up costs.

Next on the horizon is the establishment of a diabetes center at San Joaquin.

"It's another community need, particularly in light of the area's aging demographics and documented increases in cases of diabetes," Beehler said, noting San Joaquin already is involved in outpatient care, and diabetic and nutritional education. "We want to get better at it."

These improvements have not been lost on San Joaquin's customers, particularly one of its biggest -- Kaiser Permanente of Kern County. After a 15-year contractual arrangement with Catholic Healthcare West, Kaiser switched its contract to San Joaquin last year. And rather than the past three-year, renewable contracts with CHW, Kaiser committed to a 10-year renewable contract with San Joaquin.

"We felt we needed to make a longer commitment," said David Ameen, Kaiser's executive director. "We were looking for a partnership -- not in the sense of a financial partnership, but in working together to improve the quality of medical care for Kaiser patients."

The contract means that Kaiser members are directed to San Joaquin unless circumstances, such as emergencies, or specialty care sends patients to other hospitals. Kaiser physicians and staff are stationed in San Joaquin, where medical records can be shared.

"Certainly one big factor in awarding the contract was price. They gave us a good price for very good, quality service," said Ameen.

"San Joaquin had done a remarkable job improving its scores in a variety of areas," he said, explaining the hospital's ranking on independent surveys that evaluate patient, physician and employee satisfaction, as well as quality of medical care has steadily risen in recent years, as new facilities and services have been added.

"San Joaquin was a good cultural fit. It was values-based and had proven quality. It was evident that they treated employees, physicians and patients with respect. They placed emphasis on treating mind, body and spirit."

"We are called here to the hospital. We are not just here for a pay check," said Sandy Johnson, executive director of mission and culture. She explained employment procedures have been customized to hire people with "a servant's heart," who commit to the values of "caring for ourselves, each other, patients, families, physicians and community."