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3 Actions That Could Save Community Hospitals

Philip Betbeze, for HealthLeaders Media, December 10, 2010

2. Establish a physician council, or something similar, to ensure that you and the docs agree on how to work together.
Ironically, integrating the financial and clinical information systems, which is extraordinarily difficult might be the easy part here. What's more challenging is the change in process and patient care that are necessary parts to effective clinical integration. At RWJ-Hamilton as well as other community hospitals, says Cimino, "we'll have to deal with a far more competitive environment," he says. That requires treating physicians as strategic partners. Cimino established a physician council to help further that strategic partnership. "This is really different from the medical executive committee in that it's about strategic relationships and ensuring that we are dealing with and resolving those in partnership with physicians." 

3. Build a focused outpatient growth strategy:
The growth is not in inpatient. If you don't have strong outpatient facilities, you don't have much hope. RWJ-Hamilton created a center for health and wellness years ago, for example. But what might have been seen as a white elephant back then is now a key strategy in diversifying revenue streams and for patient engagement, says Cimino. "This is 88,000 square feet of medically based fitness," he says. It also houses our community education program where we touch more than 150,000 lives."

This is by no means a complete list. If you ignore all this opportunity for innovation, perhaps you still rest comfortably, believing you can make up all your disadvantages with a family feel and a local vibe. The decision on strategy is up to you, but that didn't get the neighborhood hardware store very far.


Philip Betbeze is senior leadership editor with HealthLeaders Media.
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2 comments on "3 Actions That Could Save Community Hospitals"


scott Bork (12/14/2010 at 5:26 AM)
Sorry, but I can't agree with this article largely embedded with advertisement for the big box guys, why everyone should connect with this hospital or any other large facility. The killer is the ending statement "If you ignore all this opportunity for innovation, perhaps you still rest comfortably, believing you can make up all your disadvantages with a family feel and a local vibe". First of all you are assuming the smaller hospital is a disadvantage! Ask the public and you will be surprised to find more and more patients are doing exactly the opposite of your proposal. They are choosing the smaller hospital for just that[INVALID]a local commitment to serving the community they live in with yes, a dedicated team with yes a very real family feel. The smugness is revolting, but given the state of medical errors, big system inefficiencies, a profound difference in quality outcomes and lower infection rates, and the future may be exactly opposite[INVALID]developing niche hospitals focused on (sorry to say this) family feel and local vibe. Small hospitals can't offer the high level neurosurgery or the open hearts[INVALID]yet. 5 years ago we shipped everyone for a heart cath intervention. Today thousands are successfully done each day in small hospitals with excellent outcomes, against the same rhetoric from years ago, saying the same thing that it couldn't be done. The future of healthcare lies in collaboration, but not the smugness that the family feel doesn't count. It certainly does, and it will continue to change the direction of the big box stores in the future.

bob (12/10/2010 at 4:32 PM)
One modest comment on the first of Skip's good recommended actions for community hospitals: It is more important to recognize that any community hospital is already involved in one or more hospital systems than it is to decide to join one. Anyone examining the behavior of the patients and the members of the medical staff of any community hospital is able to identify how closely the community hospital is involved with one or more systems, even when there is no formal communication at all between the management teams, Boards of Trustees, and Medical Staffs. .Much more important than "joining" is developing formal collaborative agreements that build on existing relationships and serve the self interests of the community hospital and of the more complex institution or institutions in the larger city, preferably a teaching hospital. That was the original idea of the Hill-Burton Program of the l940's and 50's and of the Regional Medical Program of the 1960's and '70's. Much has changed since then, but there still is no need for the community hospital to give up its identity and to make its commitment to its community subservient to the larger hospital's basic interests. In general, the relationship will be better for both organizations if based on recognition of the greater value of interdependent, enlightened formal collaboration, reflecting mutual self-interest, rather than any other form of "joining". For more details, take a look t my web site "sigmondpapers.org" or telephone 215-561-5730.