Joan Coffman started as CEO of St. Joseph's Hospital in Chippewa Falls, Wis., in March. Here she discusses the future of St. Joseph's Hospital, part of Hospital Sisters Health System, how she plans to improve colleague and physician satisfaction and why Chippewa Falls attracts physicians despite the Wisconsin winter.
Q: How do you plan to improve profitability and cut costs, especially at a time when many hospitals are struggling in the face of fee cuts?
Joan Coffman: Hospital Sisters Health System, which includes St. Joseph's Hospital, is undergoing an initiative called "system evolution." We're moving from a holding company to an operating company, and system evolution allows us to look at opportunities and initiatives as they relate to supply chain, group contracts and revenue cycle initiatives and make sure we're offering value-based care to our patients when appropriate.
We're also managing productivity, so as the census waxes and wanes we're able to adjust the volume in our workplace. We develop standards for each of our various service areas, and then based on our census and in coordination with that standard, we adjust the volume of what we need in the workforce each day to make sure we have enough staff. We have not laid off and have no intention of laying off, but adjusting the volume in different areas helps us provide cost control.
System evolution engages each of our colleagues through the organization. We use the word "innovation" a lot, and we tell people to look at their service area and look at the supplies and equipment and see how you might be able to make your processes more efficient. We have incorporated lean methodology to build on the crafting of a culture of process improvement.
Q: How do you plan to improve colleague satisfaction?
JC: Obviously, our colleagues are our greatest asset. They create an environment and culture that is consistent with our mission and our core values. We just completed a colleague engagement survey, and of the colleagues we have currently employed, we had a 93 percent participation rate, which is significant. As soon as we get the results from that survey, we will look into the areas we might need to focus on and create action plans to address those.
We address all issues that arise and have fixed problems in unexpected areas. The last engagement survey that was done here at St. Joseph's two and a half years ago resulted in improved lighting in the parking lot, for example. The survey was structured so colleagues could enter free text comments and not just answer questions, and one of the things they wanted us to improve was lighting from a safety perspective.
In the past couple of years, we've incorporated "Your Voice at Work," a tool where colleagues can anonymously submit questions, comments, feedback and recommendations to me. We respond weekly with those questions and our answers. Questions can range depending on what's going on, from questions about hospital community events to questions about a revenue cycle initiative to questions about productivity standards.
Q: How do you plan to keep your physicians happy?
JC: On July 1, we appointed physician champions to our administrative team. One will serve as chief medical officer, one will manage primary care and one will manage tertiary care. They will focus on improved quality and growth across the division, and they will also work with our chiefs of staff at St. Joseph's and Sacred Heart Hospitals, as well as with the medical directors and with the chairs for the various service areas. We're very excited about this. They have their finger on the pulse of [physician opinion] and they give our team a bit of diversity, so that we have a combination of administrative business folks and physician leaders.
Q: How do you attract to quality physicians to your hospital?
JC: We really focus on the fundamentals. Quality and service are key here at St. Joseph's. Our metrics are stellar, and we have a very small community. Our primary and secondary service areas are about 100,000 folks. Chippewa Falls was voted one of the best places to live about 3 years ago, so we let people know it's a great place to grow a practice, network within medical groups and physicians groups and raise a family — if they can deal with the winter.
Q: How do you keep your hospital in tune with the needs of the Chippewa Falls community?
JC: The hospital is completely in tune with the community. We perform a community needs assessment, and we did our last one in the fall of 2006. We're performing another one this fiscal year in tandem with United Way, Chippewa County and Luther Hospital, a competitor within the community.
From that, the hospital hosts Chippewa Health Improvement Partnership, a collaborate endeavor [that establishes community health needs and creates activities to enhance quality of life for Chippewa Falls residents]. We have created a steering committee of area business leaders so they can really focus on the needs that have been identified by the community.
Our community has specific problems, such as obesity in children. So we are working on that. In addition, because of sweetened drinks and a lack of fluoride in the water, there's a real need for dental care. We have created a dental program in collaboration with Marshfield Clinic to help benefit the community and address that need. We have also developed a 28-day residential treatment program at our LE Phillips-Libertas Treatment Center.
Q: What advice have you received about hospital administration that you've found especially helpful?
JC: I think you have to stay very, very close to the pulse of your colleagues, medical staff and community. Trust and transparency is critical, visibility is key and listening is an absolute must. And honesty — people may not like what you tell them, but if it's something that has data to support it and they understand why you made the decision, they'll trust you.
You also need to have clarity of purpose. What is the mission of your organization? For us, it's care of the poor and vulnerable. We need to understand what their needs are and make sure we can address their needs.
Q: What are your plans for St. Joseph's over the next few years? What are you excited about?
JC: From a high level, aligning with physicians is our primary endeavor right now. We've also been very, very fortunate to secure grant funding to put fiberoptic cable down to connect all our providers to our IT platform.
Our community recently raised $4 million dollars to help double the footprint of our emergency room. We'll complete that project in December, and we're expanding from 5,000 square feet to 13,000 square feet and placing our urgent care program within the emergency room. That will also let us expand our urgent care hours.