3 Steps to Define a Hospital's Role in the Community

Healthcare today is changing from an inpatient-based endeavor to an outpatient-based industry in which providers are concerned with keeping patients healthy and at home, while offering appropriate services when inpatient care is needed. As this shift from inpatient to outpatient care occurs, hospitals need to redefine their role in the community. Cathy Fickes, RN, president and CEO of St. Vincent Medical Center in Los Angeles, shares three steps for determining how a hospital or health system can remain relevant in healthcare today.

Cathy Fickes1. Know your organization. When beginning a strategic plan, hospitals and health systems have to understand their culture, including their mission, vision and values. St. Vincent Medical Center is a Catholic institution and a member of the Daughters of Charity Health System based in Los Altos Hills, Calif. "We believe in the ministry of healthcare. That's our mission: We are a ministry for the provision of care," Ms. Fickes says. "With those guidelines, we look at our strategic plan to fulfill our mission to be of service to the poor."

2. Know your populations. Hospitals and health systems also have to understand the patient populations they're serving. St. Vincent Medical Center looks at three different populations — regional, national and international — based on the different services it offers. The hospital's inpatient services attract patients from the region, and the majority of these patients have chronic conditions, according to Ms. Fickes. Meanwhile, the hospital's centers of excellence in cardiology, orthopedics and spine, neuro-otology and transplants attract patients from across the country and world.

3. Determine the desired relationship between the organization and populations. Once hospital and health system leaders understand their culture and their patient populations, they have to decide what kind of relationship they want with patients. "The strategic planning process is part of your team-building process of listening to your doctors, your managers and directors, evaluating your patient population and looking at the outside world and saying 'Where do we fit in this world?'" Ms. Fickes says. "A lot of analysis and soul searching goes into it, to say 'How do we want to relate?'"

St. Vincent Medical Center's role: Part of the continuum of care
St. Vincent Medical Center aims to play a central role in patients' full continuum of care. To excel in this role, the hospital is exploring how to market its strengths and how to work with physicians, payers and accountable care organizations so patients are taken care of from before they enter the hospital until after they are discharged.

For example, one of St. Vincent's strengths is its centers of excellence and its relationship with the House Ear Institute and Clinic, which treats skull-based tumors. "There aren't a lot of people who do the work that House Ear does," Ms. Fickes says. "We need to go out to insurers to say, 'We can show you evidence of the quality of our care. We would like to be your primary referral.'"

St. Vincent Medical Center also has a great deal of experience treating patients with chronic diseases, according to Ms. Fickes. Partnering with physicians helps the hospital ensure patients receive the necessary follow-up care after an inpatient stay. "We offer a high level of expertise in dealing with patients who have chronic disease states. We bring in patients for the acute phase, and we work with physicians as we transition [patients] back out to the community," she says.

Another opportunity for partnership in managing patients with chronic conditions is California and CMS' coordinated care program for dual eligibles. The Cal MediConnect program, which will launch no earlier than January 2014, will coordinate medical, social and mental health services for seniors and people with disabilities. "In strategic planning, we need to [think about] how to become a central part of the continuum of care for this patient population who is going to move into managed care," Ms. Fickes says.

By having a clear understanding of the organization's mission, vision and values as well as the patient population, hospitals and health systems can begin to define their role in the community.

More Articles on Defining Hospitals' Roles:

Strategically Positioning Health Systems in a Dynamic Environment
The Times They Are a-Changin: Why Hospital Strategies Need to Adjust
Health System Strategy: Remaining Relevant by Building Primary Care Delivery Beyond Physician Employment

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