Marquette's Hospital: Is It Improving?

The Latest from Marquette, MI by Brian Cabell

IT’S BEEN SIX months since we last checked in with Tonya Darner, the new CEO at UPHS-Marquette—our local hospital that had faced a barrage of criticism from locals over the previous several years. The problems? Heavy turnover, disgruntled employees, long wait times, inefficiencies, and the general sense that this was a hospital being run for corporate profit and not for the welfare of its patients in the Upper Peninsula.

Some of the criticisms were, no doubt, exaggerated, but many were not. And the problem was, the perception of the hospital in the minds of many locals had soured. Badly. They had lost faith in the hospital—the biggest and best equipped in the U.P.—and many were looking elsewhere for their healthcare.

So, Darner, who took over as permanent CEO back in December of last year, faced the task of turning things around. How are she and her staff doing?

THE EMERGENCY DEPARTMENT

The “Walkaways”—patients who decided to leave the ER rather than waiting to be treated—have declined significantly in the last year. In 2023, from January to May, 3.56% walked away from the ER. This year for the same period, it was 1.48%. A huge improvement.

Boarding time—the time patients are forced to wait in the ER before they can be sent to a bed upstairs for more specialized care—has also declined slightly, from 3.6 hours from January to May last year…to 3.5 hours this year. A further, more telling comparison: From November 2022 to January 2023, waiting time was 4.6 hours. So, major improvement in the last 18 months. The generally accepted hospital standard is four hours; anything longer could jeopardize the safety of patients.

“The Emergency Department is fully staffed,” says Darner. “We have zero locums (temporary doctors) in the ER, zero traveling nurses (temporary nurses). Mike Phillips, the Clinical Director of Emergency Nurses, has done a great job. He’s making sure that new hires have gotten additional training. We’ve also added two new Emergency Department assistants.”

EFFICIENCY

An entire section of the hospital adjacent to the Emergency Department has, until now, been strangely unutilized. No more, according to Darner. It’s going to become the Observation Unit, with six to eight beds. It’ll allow doctors and nurses to monitor patients who don’t necessarily need emergency care, but warrant further observation before they’re either sent upstairs to another unit or they’re sent home. It’ll free up more beds for genuine emergency patients in the ER.

Another improvement: Critics have long pointed to an inefficient and sometimes confusing check-in process for patients. It has improved in the recent months, and soon, Darner expects, a second check-in station, which is already built but still unstaffed, will open up for patients.

And then there’s the 8th floor of the hospital—purposely left vacant when the building was constructed. “We hope to start using it within two years,” Darner says. “It’s just a matter of figuring out the smartest way to use that space. We’ll be putting beds up there. It’s just deciding which beds, which departments.”

TURNOVER

The employee turnover rate for hospitals nationwide is about 22% annually. Hospital work is tough, demanding, and often exhausting. Darner reports that the turnover rate at UPHS Marquette so far this year is in line with that national average, right around 22%. That’s high, but considering what we’ve heard and seen in the past—doctors and nurses leaving in droves and grumbling about Duke LifePoint—maybe that’s something to applaud…We’re average!

“We want to hire people who want to live here,” Darner says. “We still have turnover. Many of our employees choose to leave, but many more are staying, and some have decided to come back.”

Seventeen new doctors have been hired so far this year, and several more are now being courted. Nine doctors have left the hospital in 2024.

BEHAVIORAL HEALTH

When last we checked, three staff psychiatrists were considering resigning from the hospital, which would have left the department distressingly undermanned, but two were talked into staying.

“We’re now fully staffed,” Darner says, “and we’re looking to grow. We’re now seeing 14-15 patients a day. We’d like to be seeing more like 19 because the need is there.”

Behavioral Health, along with several other departments, will be moving into new and more spacious quarters—the old Office Max store—within two weeks.

GASTROENTEROLOGY

This was a major problem for UPHS when we checked several months ago—not enough doctors. Darner says they now have three doctors on staff, and they’re recruiting a fourth.

JOB OPENINGS

Currently, there are 130 job openings at UPHS-Marquette. “Recruiting is still challenging for us because of the limited housing in Marquette,” Darner says, “but we’re working at it.” The hospital is filling the gaps—which are more serious during the busy summer season—with temporary employees. At this point, Darner says, the hospital is employing four locums, and 61 travelers—both nurses and techs.

UNIONS

The hospital is currently engaged in negotiations with the Steelworkers Union, which represents various UPHS workers. “We’re at the table with them,” Darner tells us, “and I think the negotiations are going well.”

COMMUNICATION

The relationship between the 1600 hospital employees and the executive team (and the corporate owners in Tennessee) had long been strained. Many employees felt they weren’t being heard. Darner’s trying to rectify that.

“We’ve had two town halls for employees so far this year, and we’re planning two more,” Darner says. Each town hall is actually three separate meetings on the same day to accommodate the different shifts. “They submit questions and concerns to us, and we try to answer them. We try to show the changes we’re making, what we’re focusing on, and our strategic plans.” The sessions are 90 minutes long. Darner says they’ve been well-attended.

CORPORATE INVOLVEMENT

Executives from Duke LifePoint in Tennessee have visited UPHS-Marquette twice this year, and Darner says the meetings were fruitful. “They were supportive,” she says, “and I think they understand that sometimes we have to take a different approach in Marquette.”

OVERALL, Darner says she’s pleased with the progress that the hospital is making—in its daily operations and its relationship with its employees and the community. “A Board member recently told me that he thought this was the best executive team we’ve had here in the last ten years,” Darner says proudly. “We’re totally engaged in our work and our plans to make the hospital better. And if we have to blow something up to make it better, we will.”

She monitors the detailed hourly operations of the hospital—the patient load, their waiting times, the employees on duty, the individual surgeries—with recently installed video screens just outside her office door. If something goes awry, she wants to know about it immediately.

The progress seems clear over these last several months, though there’s a long way to go. Darner knows it.

The biggest problem? “Our priority remains the staff and the culture here,” she emphasizes. “We have to make it better. We have to make this a place where people want to come to work every day, where they feel supported, and listened to.”

QUOTE OF THE WEEK

“The only way to keep your health is to eat what you don’t want, drink what you don’t like, and do what you’d rather not.”

—Mark Twain