Part of Comprehensive Health-Care Network : Hospital an Addition to Unique System

University Memorial Hospital will be more than a “state of the art” hospital when it opens this year. It will be part of a system that is unique in the nation and a model for hospitals of the future, officials say.

“This is the only comprehensive system of health care in the United States,” said Al Pruitt, spokesman for Charlotte Memorial Hospital, the hub of the system. “This is a new concept. Inquiries are already coming in from around the nation.”

The system provides varying levels of care at varying costs, depending on the patients’ needs. For example, a patient who has had heart surgery at Charlotte Memorial Hospital, where room rates average $515 a day, may recuperate at University Memorial Hospital, where rates will average $310 per day.

Other patients may go to the Oaks Nursing Home or, if they need the lowest level of care, the Magnolias Rest Home at $590 per month. Other facilities under the Charlotte-Mecklenburg Hospital Authority are the Charlotte Rehabilitation Hospital and Huntersville Hospital.

“Health care has been late in applying good business practices from the private sector,” Pruitt said. “In order to compete, for some systems to survive given the reduction in payments from federal and state sources for patient care, some hospitals have to learn good management practices. Rather than being forced to do it, we are taking the lead.”

The system is taking advantage of an economy of scale by pooling its best managers, by combining services like laundry, computers and telecommunications and through group purchasing.

An independent expert on hospital management said other hospitals had operated nursing homes for years, but he agreed that the Charlotte hospital system was “on the cutting edge of change.”

“We’re basically talking about vertical integration,” said Rick Lee, public policy director for the Washington Business Group on Health, which represents large employers in health-care matters. “They’ve got it from birth to death, from the least intensive to the most intensive level of care. That’s the kind of hospital system that’s going to be profitable in the long run.”

Since 1981, Charlotte Memorial’s 3,500 patient-care employees have been under a merit pay system, an unusual practice that may become commonplace, Pruitt said. Eventually, all of the system’s 4,600 patient-care employees will be paid according to their performance.

University Memorial Hospital, taking shape in northeastern Charlotte amid several other projects near the University of North Carolina, will be the most advanced hospital in the region, Pruitt said. The 130 beds are laid out in six corridors radiating out from nursing stations on each of six floors. Each patient room will be private and within 36 feet of a nursing station. “It’s a prototype in that it’s the minimum size--130 beds--where a hospital can operate efficiently,” he said. “With anything below 130, the expenses of operating the hospital are out of proportion.”

The $15-billion hospital will have all the normal hospital services, including surgery, emergency, lab work and labor and delivery. If necessary, a second patient tower of the same “snowflake” design can be added, he said.

Pruitt said the new concepts were largely the work of Dr. Harry Nurkin, who became president of the 901-bed Charlotte Memorial Hospital in 1981 and of the hospital authority in 1983.

The hospital system, which is totally self-supporting, has a long-range strategic plan that includes a new rehabilitation hospital, a women’s hospital, new ambulatory care centers and programs designed to allow chronically ill people to stay at home.

The system is working partly because there are only two other major hospitals in Charlotte--Presbyterian and Mercy--while many cities have dozens of competitors.