The reinvention of the hospital that’s underway across the country can succeed only with a heightened level of participation from hospital board members and people in the community.
Hospital leaders who want to improve overall community wellness and tackle health issues should seek out the voices that aren’t being heard in typical board meetings, says Thomas Burke, M.D., executive vice president of the University of Texas MD Anderson Cancer Center.
“Most hospitals are focused on those who are sick enough to require admission to the hospital and the reality is, if we really want to change the dynamic of the people who live in our country, we need to be focused on what prevents that from happening,” says Burke, who also chairs the American Hospital Association’s Committee on Performance Improvement.
Reaching out and partnering with organizations connected to the community — whether the local YMCA, churches or schools — is critical to redefining the hospital mission. Allegiance Health in Jackson, Mich., is doing just that and has undertaken a number of efforts to become a “health improvement organization,” including employer-based wellness efforts and educating and encouraging people to take control of their nutrition and fitness.
Allegiance is one of the featured systems in a recently released AHA guide to gaining more community participation in health care, called Leadership Toolkit for Redefining the H: Engaging Trustees and Communities.
After more than a decade of pursuing wellness, Allegiance has amassed some 30 community partners, including the United Way and the county health department.
“We did realize that we couldn’t go it alone,” says Allegiance Health President and CEO Georgia Fojtasek, R.N.
Local employers played a vital role in Allegiance’s move to a wellness-based system. Its service area is filled with small, mostly manufacturing businesses, which the health system found were most affected by the consequences of poor health and well-being. Roughly 70 percent of Allegiance’s patient population is covered by Medicare or Medicaid, according to the report, and the system incurs about $15 million in bad debt annually.
The toolkit includes five possible paths toward transformation that aren’t mutually exclusive:
• Specializing in certain types of care
• Partnering with others to add reach and gain efficiency
• Redefining toward a system more focused on ambulatory or long-term care
• Experimenting with new payment and delivery models
• Integrating by adding health insurance or other types of care
A community health needs assessment, required of nonprofit hospitals in the Affordable Care Act, is one key vehicle to bringing about change, says Jonathan Perlin, M.D., chairman of the AHA board, and president of clinical services and chief medical officer of HCA, which is based in Nashville, Tenn.
Educating hospital trustees also is critical, he adds, to ensure that institutional memory is not lost when members leave, and that boards and their CEOs are on the same page.
“It is incumbent on leaders and boards to invest in each other, so that they are able to work effectively on today’s agenda, and so that they can envision a healthy, constructive future for serving their mission in ways that may depart from decades of tradition.” Perlin says.