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Neuroscience: Growing Beyond Stroke Care

By jfellows@healthleadersmedia.com  
   April 15, 2016

Success key No. 2: Partner for specialty care
Stanford Health Care's resources are enviable. Smaller hospitals that have patients with the same needs may not have easy access to an academic medical center or a large, integrated system. One solution is to merge with a larger organization, but Silver Cross Hospital, a 296-staffed-bed community hospital outside of Chicago, has resisted that trend and instead aggressively pursued affiliations with organizations that could bring their expertise to the suburbs.

"We have five partners, and every year we meet with the board to review them," says President and CEO Paul Pawlak.

Silver Cross' journey to tracking down partners began in 2009, with the Rehabilitation Institute of Chicago and rehab services. It was a weakness at Silver Cross, with only 305 patients per year. Now, patient volume is nearly doubled to 604 patients annually, he says.

Pawlak set out to similarly improve Silver Cross' neuroscience service line because he wanted the hospital to be a primary stroke center. Earlier efforts to develop neuroscience in the 1990s fell apart, he says.

Two things happened in 2012 that made a partnership to grow a neuroscience service line possible. First, Silver Cross built a new $365 million hospital in a new location in New Lenox. Second, a neuro-interventional radiologist—Harish Shownkeen, MD, at Cadence Health, which is now part of Northwestern Medicine, the health system that includes 1,500 employed physicians, an academic medical center, and outpatient clinics in metropolitan Chicago—needed space to practice. "Shownkeen reached out to us," Pawlak says.

The partnership between Cadence and Silver Cross meant that Pawlak would build an endovascular neuroradiology lab that would be staffed full-time by Cadence neurointerventional radiologists and neurologists. There are now five neurologists and also three neurointerventional radiologists. "I knew what we were doing was so important to our community," Pawlak says. "It meant that people who were suffering from a stroke didn't have to travel."

Still, the effort was not enough to generate substantial patient volume in the first year. Pawlak says transfer agreements from hospitals were more difficult than expected, and recruiting staff for the new neuro lab at Silver Cross was hard. "We needed to recruit radiology techs with experience working with the brain," he says. "Those people are hard to find, and it took another one and a half years for sustainability."

Given the slow start of the program, financial arrangements of the partnership with Northwest Medicine had to be modified. But, Pawlak says, it reinforced the need to be nimble and adapt. "Each service line is different," he says. "We have to bend and be flexible."

Jacqueline Fellows is a contributing writer at HealthLeaders Media.

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