KEN IGE / KIGE@STARBULLETIN.COM Kapiolani Medical Center at Pali Momi Chief Operating Officer Art Gladstone began his career there as a nurse.

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Art Gladstone >> Position: Chief operating officer and chief nurse executive at Kapiolani Medical Center at Pali Momi. >> Age: 39 >> Previous positions: Staff registered nurse, emergency department charge nurse, supervisor of surgical services, clinical services line manager for perioperative services.

How difficult will it be to balance your new position as chief operating officer at Kapiolani Medical Center at Pali Momi with your other position there as chief nurse executive?

I don't expect any difficulty in balancing the two at this point. I've been at this facility for 13 years now so I know the facility very well. I know the departments, the employees and the physicians that we work with.

What are your roles in each position?

As chief nurse executive, I'm responsible for the nursing practice here at the hospital. I'm responsible for ensuring that we have the right number of nursing staff, which involves recruitment and retention programs. Also, I'm responsible for ensuring compliance with regulatory agency guidelines, rules and standards. Then, as chief operating officer, my responsibility is to manage the hospital organization from a quality standpoint, ensuring the quality of services delivered, fiscal management and ensuring that we're implementing programs that are supporting the needs of the community. I'm also involved in a leadership role interacting with our physicians and identifying and supporting what their needs are in order for them to practice at the hospital.

How unusual of a career path is it to go from a staff registered nurse, which is how you started in 1990, to chief operating officer?

It really is uncommon from a nursing standpoint. As a staff registered nurse, your focus is very clinically focused, taking care of patients. The chief operating officer adds so much more of a business component. There definitely is a bridge between the clinical side and the business side and I've been able to achieve that.

How beneficial is it as chief operating officer to have been a nurse before?

It's been very beneficial in that I can truly appreciate what it means to take care of patients and what it means to be a clinician as we develop programs to support the community. That is our business to take care of patients. By understanding what it takes to do that, adding the business piece, it's a very nice combination.

What do you think is the biggest challenge facing your medical center today?

I think it's very similar to health care organizations across the nation in ensuring that we have adequate funds to continue to provide services and build programs for the community. One of the areas we're expanding here at Pali Momi is in the emergency department. So, as we need to continue to expand to support the community, one of the concerns is whether we will have enough resources to be able to do that.

In what kind of financial shape is Pali Momi?

We're in good shape, but it's something we always have to continue to focus on. As health care costs continue to rise and reimbursements decline, managing our margins is key to our longevity and success in being here for the community. One of the other areas that is of concern is the shortages we're seeing overall in people going into health care careers. We're seeing shortages in a number of areas, including nursing, radiology, pharmacy and others. I'm thinking how will we fill these shortages and how will we get out to the young people to get them interested in careers in health care?

How many beds are there at your center and how many employees do you have?

We have 116 beds and 528 full-time-equivalent employees.

How is the Hawaii Pacific Health integration going involving Kapiolani Medical Center at Pali Momi, Kapiolani Medical Center for Women & Children, Straub Clinic & Hospital and Kauai's Wilcox Memorial Hospital and Kauai Medical Clinic?

We're right on track where we anticipated being, if not slightly ahead.

What issues have come up since the December 2001 merger?

We continue to fully integrate. We're dealing with four medical centers with four distinct cultures and we continue to build the cultures amongst the four organizations.

What do you see as the biggest hurdles for integration that you still have to overcome?

We actually haven't seen any problems. We've seen an increase in collaboration across the system, so we may have someone who understands a service better than we do. What the merger has done is make that expertise accessible to us. Just like we've been able to access expertise in some areas we don't have, we've been able to offer expertise to others in HPH that they don't have. It's been a real reciprocal relationship. That's been one of the positives about the merger -- that increased collaboration. The other thing that's been a benefit of the merger is that department heads have come together and collaborated on program development, equipment purchases and services development for the communities served by the HPH facilities.

What do you think of Wahiawa General's plan to relocate its facility to Koa Ridge?

With the growth in the population in Leeward Oahu, there is a need for us to continue to expand our services to ensure that we have the services to meet the needs of the community. I think that SHPDA (the Hawaii State Health Planning and Development Agency) will have to take a hard look at what's available and what are those needs as they work through that decision with Wahiawa General. I think it is an important balance to ensure that there are the right number of services available for the patient population.

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