6 Key Practices for Community Hospitals

As demographics shift and some suburban areas experience population explosions, community hospitals are being asked to evolve along with patient expectations. Healthcare reform is likely to place even more pressure on these smaller hospitals, which can no longer afford to be second in their service offerings to some of their larger, urban counterparts. Virginia Dempsey, president of 89-bed Saint Joseph – London (Ky.) hospital, and Debra Sukin, CEO of St. Luke's The Woodlands (Texas) Hospital, share their thoughts on how community hospitals can be successful in a competitive environment. Both hospitals are part of Catholic Health Initiatives, based in Denver, Colo.

1. Identify, develop and implement physician alignment strategies. Ms. Dempsey says Saint Joseph – London is growing and preparing to open a replacement hospital in August. Expanding to match population growth and building a national reputation within its medium-sized market helps attract physicians, she says. "This increasing awareness positions us for excellent physician recruitment opportunities."

Ms. Sukin says community hospital growth is all about program development and medical staff development. "In some ways, that's far more challenging than actual physical construction and growth," she says. Alliances with physicians will be even more important under healthcare reform. "I think those can take a number of forms," she says. "However, healthcare reform and other market stresses impact the physicians who work with us."

2. Focus on a few service lines and achieve excellent outcomes. These outcomes should focus on service quality, clinical quality and quality of work life, says Ms. Dempsey. "We cannot be all things to all people," she says. "Many hospitals make the mistake of spreading themselves too thin. Focus on what you do well, and align your employees and physicians around those centers of excellence."

That said, community hospitals are increasingly being asked to take on services formerly left to larger, urban facilities, says Ms. Sukin. "As the communities have moved outside the central city, quite frankly the expectations of the communities have grown," she says. "We should be able to provide a sophisticated level of service." Physicians also have higher expectations of how they expect hospitals to provide care, she says.

"You take what we used to know as a typical community hospital, which would provide some secondary level of care, but not necessarily representing comprehensive service lines," that model has changed dramatically in recent years, Ms. Sukin says. Eight years after St. Luke's The Woodlands opened, it has a women's and children's service line with a perinatologist, a full cardiovascular service line and a neurosciences service line.

3. Think about joining a larger system. Both St. Luke's The Woodlands and Saint Joseph – London are part of regional systems and a larger national system. In today's competitive environment, this can provide valuable access to capital and payor contracts, says Ms. Sukin. "The strength of being a community hospital that's a part of a system is incredibly important because of the healthcare environment we're in," she says.

4. Communicate, communicate, communicate. Ms. Dempsey says communication is key, whether it is to a hospital's community, physicians, staff or volunteers. "Tell it like it is," she says. "Transparency is not just for the public. Your internal audiences will become your most verbal external ambassadors if you involve them in the process and strategy."

5. Be involved in your community. Hospital leaders should make themselves available and build personal relationships within their local areas, say both Ms. Dempsey and Ms. Sukin. "Hospital relationships are extremely personal and emotional," Ms. Dempsey says. "You do not want to be seen as an unapproachable corporate entity."

Ms. Sukin says that St. Luke's was involved in the local Chamber of Commerce before its doors even opened. It also seeks out local chapters of philanthropic organizations that complement its health-related goals, such as the area cancer society and heart association.

6. Develop trust with all stakeholders. Part of building relationships involves being credible, says Ms. Dempsey. "Live the mission and core values of the organization in everything you do," she says.

At St. Luke's, those core values are patient satisfaction and quality, says Ms. Sukin. The hospital ranks above the state and national mean scores on patient satisfaction, but its goal is to rise to the top 10 percent of hospitals nationwide. "We're really looking at how to think outside the box, how to approach care in a very comprehensive and all-inclusive manner," says Ms. Sukin.

Contact Barbara Kirchheimer at barbara@beckersasc.com