When Robert Harrell retired in 1982 from his executive job with Montgomery Ward in Chicago, he moved to Orlando, Fla., to work on his golf game. But within three months, Harrell was bored.
Enter Gary Strack, president and chief executive officer of Orlando Regional Medical Center. Strack had read in the newspaper about Harrell's illustrious corporate and civic career and thought he'd make a good trustee.
Strack drove out to Bay Hill Country Club outside Orlando to meet the potential recruit. Harrell knew little about the healthcare field but was curious because his wife, Wilma, had developed ovarian cancer the previous year.
"I was never involved in healthcare at all before my wife become ill," Harrell said. "I became very interested in it and didn't have to think long about joining the board after Gary asked me."
Harrell accepted the challenge and began his role of helping to shape the five-hospital system into one of the most innovative in the country.
For his leadership at the Orlando Regional Health System, Harrell, 70, was selected MODERN HEALTHCARE's and John Alden Life Insurance Co.'s Trustee of the Year for hospitals with revenues of more than $20 million.
"He is the most effective trustee I have ever known," said Florida Hospital Association President Charles Pierce. "His tireless enthusiasm and insight empower all who come in contact with him."
During his 12 years as trustee of Orlando Regional, the last three as chairman of the system, Harrell has:
Spearheaded a $10 million fund-raising campaign to build 265-bed Arnold Palmer Hospital for Children & Women. Opened in 1989, it is one of four freestanding hospitals in the country specializing in care for women and children.
Led a difficult effort to distribute charity care more evenly among Orlando-area hospitals.
Encouraged trustee education. The system has an annual trustee retreat, and board members may attend a national conference every other year and a state or regional meeting annually. Harrell created and served as the first chairman of the 2-year-old Florida Hospital Trustees Forum, which has improved governance at the state's 207 hospitals, Pierce said.
Shepherded a joint venture in 1991 with the University of Texas M.D. Anderson Cancer Center in Houston to open the Orlando Cancer Center, now called M.D. Anderson Center Orlando.
To Strack, who has served all but two years of his 14-year career as a chief executive officer with Harrell, he is a mentor.
"It is Bob Harrell's attitude toward his work, his compassion for people, and his personal and professional style that have influenced the (Orlando Regional Health System) team, motivating and inspiring them to reach higher, faster and farther than they thought possible."
Among the 12 people who composed letters supporting Harrell's nomination are Doug Cook, director of the Florida Agency for Healthcare Administration, Orlando Mayor Glenda E. Hood, VHA President and CEO C. Thomas Smith, and golf pro Arnold Palmer, a supporter of Orlando Regional.
Told of his selection, Harrell said, "I do this job because I love it. I'm from the old school. I believe it doesn't matter who gets the credit. Just get the job done."
Beginnings.Harrell was born in
Mullins, S.C., in 1924. He joined the Navy in 1942, helped ferry troops across the English Channel during the Normandy invasion, and also fought in Italy and Sicily. He used the G.I. Bill to earn a marketing degree at Miami University in Oxford, Ohio, where he played football and baseball.
Harrell joined Montgomery Ward in 1948 as a marketing trainee and rose to executive vice president for merchandising. He has served on civic boards, including the Chicago YMCA and Chicago Boy Scouts. In 1977, while working in Orlando, he was president of the Orlando Area Chamber of Commerce.
Wilma, his wife of 391/2 years, died of complications from chemotherapy. In 1990 Harrell wed Emily "Beachy" Perkins, an employee of the hospital's foundation.
From the beginning, Harrell has been an energetic leader and fund-raiser at Orlando Regional. Strack recalled handing Harrell a major assignment-heading the hospital's new foundation-just three months after he was appointed a trustee.
"He picked it up and took off running," Strack said. From 1982 to 1989, when Arnold Palmer Hospital opened, Harrell helped raise $19 million of the facility's $42 million cost.
He also helped persuade Palmer, a part-time Orlando resident, to earmark some proceeds of the golfer's Nestle's Bay Hill Classic to Orlando Regional. The tournament has donated $1.5 million.
Harrell has served during a period of tremendous growth and achievement at Orlando Regional, which was created by the 1977 merger of Orange General and Holiday hospitals. By 1992, the medical center had become a five-hospital system with 1,325 beds.
The 598-bed medical center is a teaching hospital specializing in cancer treatment, cardiology, orthopedics and rehabilitation. It also is the only Level I trauma center in central Florida.
The system bought 84-bed St. Cloud (Fla.) Hospital in southwest Osceola County in 1984 and opened 150-bed Sand Lake Hospital to serve the Disney World area in 1985. Sand Lake features a brain injury center.
In 1992, the system formed a joint venture with for-profit Healthtrust to operate 206-bed South Seminole Hospital in Longwood, Fla. With Healthtrust merging with Columbia/HCA Healthcare Corp., Orlando Regional plans to buy Healthtrust's interest in South Seminole this year, Harrell said.
In 1997, Orlando Regional is scheduled to complete a $70 million renovation of its 35-acre main campus. Since 1990, eight of its 40 buildings have been renovated or removed.
The system also operates Healthchoice, a managed-care company with a 78,000-enrollee PPO; a home infusion company; a home health agency; and a laundry service.
Charity-care battle.In 1986, Harrell
successfully led Orlando Regional through one of its biggest controversies. Taking the community by surprise, Orlando Regional announced it would no longer treat the bulk of Orange County's indigent population. It proposed a formula to divert indigent care to other hospitals according to patients' ZIP codes.
As he was with most issues facing Orlando Regional in the 1980s, Harrell, as chairman of the finance committee, was outspoken about the need for the change.
"We took on the newspaper, the other hospitals in the county and the ambulance drivers," Harrell said. "But other hospitals were dumping people in our emergency department. We had to do something to change our image as the `county hospital."'
In 1985 Orlando Regional had 35% of the area's beds and 70% of Orange County's Medicaid-eligible recipients.
Quality suffered and Orlando Regional was losing millions of dollars on indigent and Medicaid patients, Harrell said. He argued the hospital needed to free up obstetrical beds and reduce costs to compete successfully for managed-care contracts.
The plan was approved with modifications by Orange County, which also required other hospitals to treat poor obstetrical patients.
"The other (hospitals') administrators howled about it at the time. But it has worked out well for everyone over the years," Harrell said.
Nine years into the program, Orlando Regional treats 38% of the county's Medicaid-eligible patients, a hospital spokesman said.
From 1986 to 1994, the system's charity care has increased to $14.9 million from $4.5 million. But uncompensated care, which includes charity care and bad debt, decreased as a percentage of gross patient revenues, to 5.8% in 1994 from 11.8% in 1986.
At the top.Since 1986, Orlando
Regional has become one of the top hospitals in the area in terms of size, profitability and quality. Its admissions have risen 18%, to 41,609 in 1993 from 35,138 in 1986. Operating income in 1993 was $28.7 million on net patient revenues of $358.3 million.
Over the past three years, the system has earned $86.8 million on net patient revenues of slightly more than $1 billion, for an 8.6% operating margin.
Harrell attributes much of the system's success to its quality-improvement program, which he helped start in 1988. Using data from three information systems, Orlando Regional cut $22 million in
administrative and clinical expenses, or about 1.6% of total costs, in four years, Harrell said.
Together, managers and physicians review utilization data of individual doctors and advise them on how to reduce costs.
Physicians were wary of being told how to practice medicine, but Harrell convinced them that a team approach was needed, said Leroy Oetjen, M.D., Orlando Regional's chief of staff and a board member.
"He is a tremendous supporter of physicians," Oetjen said of Harrell. "A lot of what we have accomplished as a system is because of his leadership and support."
Quality improvement allows Orlando Regional to profit on Medicare-an area where it took an annual loss of $12 million just three years ago. In 1994, the system reported earning $11 million treating 8,649 Medicare patients.
"If other hospitals took our approach they could at least break even with Medicare patients," Harrell said.
With its finances in order, Harrell said the system now needs to "zero in on the needs of the community."
In 1993, following a comprehensive community assessment report, Orlando Regional formed the Community Health Improvement Team to coordinate prevention services. Its 100 members include the Orlando Police Department, the city of Orlando, Orange County, the United Network of Indian Tribes and the Central Florida YMCA.
Through Orlando Regional's Community Benefits Committee, physicians, trustees and management work to develop programs to serve the county's poorest citizens.
Orlando Regional also is working with longtime competitor Florida Hospital Medical Center to develop community healthcare programs, Harrell said.
"We feel real good about the work we are doing," Harrell said.