Hospital for Special Care is fortunate that John Votto had a change of heart in college. The chief executive, who has led the New Britain long-term acute care specialty hospital through growth and expansion since 1997, almost chose a different career path.
“My original career plan was to be a biology teacher,” Votto said in a recent interview. “My favorite teachers in high school and college taught biology and I had many relatives that were teachers.”
But during his sophomore year at the University of Connecticut, Votto decided to pursue a career in medicine instead.
Specialty care in Connecticut has reaped the rewards of that decision.
During Votto’s leadership tenure — much of which included a partnership with co-President David Crandall who retired in 2012 — Hospital for Special Care (HFSC) has expanded all of its programs and introduced several new ones.
Today, the hospital — one of only two long-term acute specialty care hospitals in Connecticut — offers programs for neuromuscular diseases like Lou Gehrig’s disease and muscular dystrophy, spinal cord injuries, congestive heart failure and autism.
That expansion has enabled HFSC to grow the number of patients admitted annually from around 50 — when he first joined the hospital in 1990 — to more than 600 today. And meeting his patients’ specialized medical needs has been what’s motivated Votto for the past 23 years.
“We have a challenging patient population,” Votto explained, “in that, given their medical conditions, they’re not going to get better in three days and go home.”
For Votto, a pulmonologist, who was initially attracted to HFSC’s specialized pulmonary medical care, becoming a medical practitioner was about the chance to improve a patient’s quality of life.
He points to the number of patients on ventilators in his early days at HFSC as an example.
“At the time I started [at HFSC], there was work being done in Los Angeles around weaning people off ventilators,” Votto recalls. “We wanted to develop a regional weaning center here in Connecticut, so I visited L.A. to learn more and we were able to build our own weaning program.”
Today, about 70 percent of the more than 1,000 people who’ve arrived at HFSC on ventilators are successfully weaned off of them.
“On average, it takes about 20 days,” Votto explained. “And then [the patient starts] rehabilitation.”
It’s that continuum of care, Votto insists, that makes HFSC so unique and effective.
He notes, for instance, that a patient with a pulmonary problem like pneumonia might initially progress from ventilator treatment to outpatient rehab to a pulmonary support group.
“We provide every level of care,” he said.
That care — in a world of skyrocketing medical costs — can be expensive, a challenge Votto readily acknowledges and has tried to tackle.
“Healthcare isn’t very efficient,” he admits. “But we have made a concerted effort to increase our efficiency with best practices for process improvement, supply issues and delivery of care models.”
HFSC even incorporates efficiency into its building designs. For instance, the rehabilitation facilities are located near patient rooms to save patients and staff time.
Additionally, Votto said, his hospital generally doesn’t duplicate programs that other providers in Connecticut are offering.
“We want to provide services for people no one is serving,” he says.
He notes that HFSC takes, on average, about a year and a half to build any new program because they like to learn and incorporate best practices used by other hospitals around the country.
Much of what’s driving that effectiveness is technology, which Votto contends is changing the medical landscape.
“Today, technology has enabled us to do nearly every type of detailed scan,” he said. But he also sees a challenge with technology because doctors have less eye contact with patients, which is not always a good thing.
Votto’s medical philosophy is grounded in the need to connect with a patient.
“The most important lesson I impart to my staff is compassion for our patients,” Votto said. “A patient will notice if you don’t care.”
And Votto’s care extends beyond HFSC’s patients, to its 1,100-member staff, which has nearly doubled during his tenure.
He makes an effort to meet in small groups with his employees at least three times a year to talk about the state of the hospital and get feedback and new ideas.
“As a leader, I feel I need to be approachable,” Votto said. “Our success as a hospital is due in part to using many staff ideas, not just mine.”
It’s a collaborative approach that has endeared Votto to his staff.
“He inspires those around him through his hands on leadership,” said Lynn Ricci, HFSC’s chief operating officer, who has worked with Votto since 2004. “He is never to busy to sit with staff, patients or other stakeholders.”
Ricci also notes that under Votto’s leadership, HFSC has grown to become one of the five largest long-term acute care hospitals in the nation and the only one — of the 438 in the country — to offer pediatric care.
Despite the hospital’s growth — all without an endowment to support a nearly $100 million annual budget — Votto doesn’t feel he’s done a lot.
He’s proud of the fact that there’s never been a layoff of clinical staff under his leadership and is most proud of his staff, volunteer boards and tireless passion of his colleagues.
“The more credit you give away, the more it comes back,” Votto says.
It’s a lesson he has taught to pulmonary medical trainees and medical students from UConn, Yale and the Veteran’s Hospital, where he has taught for more than 33 years.
It’s a fitting forum for a man who almost passed on medicine to teach biology.
Instead, he’s found the best of both worlds — teaching tomorrow’s medical specialists, while moving one of the country’s premier specialty hospitals through unprecedented growth today.
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