To meet rising demand for care and access, hospitals and health systems are considering various approaches as they respond to the needs of patients and workers, as well as industry pressures, leaders say.
These include expanding interventional services and behavioral health capacity, stabilizing leadership, boosting clinic access and improving finances.
Becker’s recently asked four executives what has been the most significant change their organization has made in the past year to address patient demand and access, and what results they have seen.
Note: Responses are listed in alphabetical order and have been lightly edited for length and clarity.
Elaine Batchlor, MD. CEO of MLK Community Healthcare (Los Angeles): We have developed a new program for providing interventional radiology and cardiac procedures at the hospital, and that has enabled us to save patients’ lives. It’s been really significant for us, because as a small safety-net hospital, we have many patients who need a higher level of care, and it’s very challenging to find other hospitals that are willing and able to accept patients with Medicaid insurance. Often our patients are delayed in getting life-saving treatments, and developing the capacity to provide those treatments ourselves has allowed us to really save our patients’ lives and provide care without delay.
We also have created multidisciplinary teams to strengthen the care we provide for our patients with diabetes. Diabetes is epidemic in our community and responsible for a lot of disability and suffering and hospital admissions. And getting upstream of those complications and providing the best care across the continuum is really important to people in our community. And that’s what we’ve been able to do with these multidisciplinary teams that include doctors, nurses, pharmacists, educators, social workers and community health workers — all working together to support our patients in managing this really damaging chronic illness.
And then a project that we are still working on, but that we anticipate launching in the next couple of months, is an EmPATH unit. EmPATH stands for Emergency psychiatric assessment, treatment and healing, and it is a unit where we can transfer patients with behavioral health problems who have been medically cleared in our emergency department — and where those patients can receive stabilization treatment and then hopefully be discharged to a lower level of care. This is important because hospitals across the country that are not psychiatric hospitals, but do have emergency departments, are receiving many patients with psychiatric problems.
Those patients are then boarding in the hospital and in the emergency room, waiting for a bed in a psychiatric hospital that is in very short supply. And this will allow us, instead, to transfer those patients to a therapeutic unit where we can treat them and then discharge them to a lower level of care.
Wesley Burks, MD. CEO of UNC Health (Chapel Hill, N.C.): About two years ago, we started a strategic plan called Forward Together 2030, and one of our main goals was to have a better patient experience, and embedded in that better patient experience is better access. We’ve worked hard in the areas that we need better access — which, for most places, is a small number of clinics and other places that people are seeing — but that’s where the lack of access is the most significant. We made significant investments to try to increase that access. We monitor it on a weekly basis, and we’re working hard to make sure that people have access, whether it’s virtual, by phone, in person or through the hospital-at-home program that we’ve developed.
We’ve seen real significant changes, even in the last six months. There are a number of national benchmarks that we use, and a number of areas where we want to be better than those benchmarks. So we do a lot of network tracking that gives us an idea about how we’re doing.
Ed Curtis. CEO of Memorial Health (Springfield, Ill.): Healthcare was the first in the pandemic five years ago. We’re the last out. Why are we the last out? Because the constraints of labor have driven up the cost beyond the level at which reimbursement is growing, and we’ve had to make some strong changes in our expenses.
We’ve had a very robust Strengthen Our Future initiative, but it did lead to a reduction in force in August 2023, which is the most challenging thing that ever occurred in my career — because you consider that a failure on the part of the leader if you get to the point where you got to reduce force. We didn’t take it out of front-line workers, but 20% came out of leadership, and an overall 5% reduction in the workforce to get it back where we’re a profitable organization for the last year and a half.
That’s a byproduct of this pandemic, and the labor shortages and reliance on temporary help has driven up salaries faster than our reimbursement can grow, so we had to reset our baseline.
Michael Fosina. President of Calvary Hospital (New York City): Calvary has gone through some leadership changes over the last couple of years, so stabilizing the leadership has been important to us. And bringing in and hiring a new chief nursing officer, a new COO, a new hospice administrator. Bringing new blend — they come from different organizations, they bring new ideas, but they bring a different level of energy to it because it’s all new. And we now have a stable leadership team here, and it is apparent when the staff talk to us.
We have the executive team making rounds, talking to patients. And on the weeks we’re not doing that, we have employee roundtables, and we get 10 or 15 people in a room, and we talk to them about their job, what they think, what we’re doing well, what we need to help them improve, what’s getting in the way of them taking care of their patients. It’s open communication.
We talk about our strategic plan and where we’re going for the future. There’s a lot of optimism about where we’re going and what we’re doing, and how our care is fitting into that, and how we’re completing the picture of post-acute care in the New York City metropolitan area.
