Updated March 30 at 4:30pm

Five Questions With: A. Robert Buonanno

Chairman of the Department of Surgery at Our Lady of Fatima Hospital talks about why his hospital has received recognition for the quality of health care it delivers

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Five Questions With: A. Robert Buonanno


Recently, Our Lady of Fatima Hospital, a member of the CharterCARE Health Partners network, received quality certifications from The Joint Commission for knee and hip surgeries, for advanced diabetes care, and for advanced stroke care.

Providence Business News asked Dr. A. Robert Buonanno, chairman of the Department of Surgery at Our Lady of Fatima Hospital, to talk about the reasons why his hospital has received such recognition for the quality of health care it delivers.

PBN: Fatima Hospital has received a number of quality certifications – for knee and hip surgeries, for advanced diabetes care, and for advanced stroke care. Why are these important?

BUONANNO: It provides independent validation of the quality care we deliver. There are many different certifications hospitals can receive but the gold standard is The Joint Commission, which accredits more than 19,000 health care organizations nationally. Certification from The Joint Commission doesn’t come from anecdotal information; it is granted because of clinical data, core measures and excellent patient outcomes. All of these disease-specific certifications at Fatima were granted by The Joint Commission, which makes them even more rewarding and meaningful.

PBN: In a health care market that's increasingly being driven by a patient-centered model of care that rewards quality outcomes, how is Fatima Hospital responding?

BUONANNO: A short story best illustrates our approach: two years ago, Fatima opened a dedicated surgical unit called Care One, focused on that patient-centered model of care. Since then, our quality scores for surgery have seen dramatic improvement. This new model of care creates a partnership between the patient, doctor, nursing staff and the family. That partnership is based on openness and communication. It is a philosophy that is now the standard of care throughout the hospital.

We made those changes not because of the impact it would have on our quality scores. We made changes because it is the right thing to do for our patients. If that is your philosophy, your clinical outcomes and quality scores will improve.

PBN: How does Fatima Hospital plan to position itself in the Rhode Island marketplace?

BUONANNO: We have a unique opportunity at Fatima. We are small enough to be completely patient-centered. At the same time, we can point to the recent Joint Commission certifications as evidence of the quality of the care we deliver. And again, this is based strictly on data and clinical outcomes.

Today, patients are more well educated than ever. They can easily access quality scores and hospital ratings. If someone in Rhode Island searches for the term “hip or knee replacement,” they will quickly learn that Fatima is the first and only hospital in Rhode Island to be awarded Joint Commission certification for this specialty. If they need diabetes care, they’ll see Fatima is the first in New England to be certified.

To a patient, this means they can receive personalized care in a setting where clinical excellence is well documented. That combination of personalized care and quality is an appealing one when considering where to go for treatment.

PBN: As a surgeon, what are the kinds of changes in the health care delivery system that you are experiencing?

BUONANNO: There is no question that the overall environment is increasingly challenging for surgeons and other physicians. The level of denials from insurance companies and Medicare often make it difficult to ensure that patients receive the kind of care they deserve.

An uncertain economic climate adds to this; some people are not moving forward with elective surgeries because they feel like they can’t be out of work for any period of time.

Also, many prospective patients are seeing a dramatic increase in their co-pays and this is also a disincentive to choosing surgery.

On the plus side, there are many new technologies that allow us to perform surgery more precisely. We are able to get patients moving and back in their homes more quickly and that is a positive. Today, more surgeries are being performed in the outpatient setting. Our plan is to remain the provider of choice by continuing to provide superlative care.

PBN: What kinds of increases are you seeing in knee and hip surgeries at Fatima Hospital? Does this correlate to the Baby Boom generation getting older?

BUONANNO: We have seen growth in the number of surgeries we perform, but I don’t believe it is a generational trend. To be honest, our patients are our best advocates when it comes to promoting our programs.

And, of course, this works the other way if you are not meeting the standard of care patients deserve. Over the past couple years, that group of satisfied patients telling our story in the community has grown.

When you combine that with empirical data that confirms the quality of care, you have a program that is primed to continue growing. That has certainly been the case with the program at Fatima.


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