Becker's Hospital Review

96 Executive Briefing: Critical Access Hospitals Examine supply chain costs Another area where many critical access hospitals could stand to improve is in the supply chain. Here, critical access hospitals' size tends to put them at a disadvantage, Mr. Weber says. "We see critical access hospitals paying 10 to 15 percent more than what a larger hospital may be paying for the same item," he explains. Officials at Community Hospital in McCook, Neb., experienced this first-hand. The hospital was in a supply spend contract with a national hospital network, but wasn't getting the desired results. "As a smaller hospital, we were subject to higher fees and less representation," James Ulrich, Community Hospital's president and CEO, says. By entering CHC's group purchasing organization and shifting peri- operative supply chain management from clinicians to the hospi- tal's materials department, Community Hospital was able to save $532,000 in one year alone, showing the major impact supply chain changes can have on a critical access hospital's thin bottom line. Think like a large hospital Even though critical access hospitals are different in many ways from larger acute-care hospitals, that does not mean lessons learned from acute-care hospitals cannot be applied in the critical access hospital space. "If we can apply best practices to critical access hospitals, we can move to positions of strength," says Mr. Santilli. "I'm not certain if there's really much of a difference between being successful in a large hospital versus a critical access hospital. If we really under- stand there are key formulas to driving strength within the healthcare industry, we just need to apply them in a critical access hospital." Mr. Weber agrees. "A lot of the same practices that work at larger hospitals we try to bring to critical access hospitals," he says. Janet Coates, CEO of Mother Frances Hospital-Winnsboro (Tex- as), had experience leading non-critical access hospitals before joining her current critical access hospital and draws on those ex- periences in her current role. "This is my first rural [critical access hospital], but the focus is very similar," she says. "There are a lot of similarities between acute care and non-acute care hospitals." For example, strong leaders who execute projects and engage employees have helped hospitals of all sizes find success. So, at GVH, leaders go through training to understand employee en- gagement and become stronger leaders. "It's really about training leaders to be goal-oriented and to drive [project] execution," Mr. Santilli says. More generally, Ms. Coates focuses on large national trends that affect all hospitals, she says, like reducing costs and increasing volumes. Seek opportunities for growth After sweeping through and making improvements in existing ar- eas, critical access hospital leaders can and should start looking for areas to grow to continue to strengthen their organizations' position as the healthcare industry continues to change. Now that GVH's finances are stable, Mr. Santilli has started looking at strategic initiatives to help grow the hospital. GVH has added new surgeons and hospitalists that have "made a tremendous dif- ference in the organization," he says. Additionally, GVH has moved to provide urgent care services as that was a community need. At Mother Frances Hospital-Winnsboro, the critical access hos- pital is using its relationship with a larger system, Trinity Mother Frances, and CHC to grow its outpatient service offerings. After performing a community needs assessment and mapping out its area's future healthcare needs, the hospital added an orthopedic program using TMF specialists. "Over the past four years we've experienced growth every year in volumes," Ms. Coates says. Though critical access hospitals do face some unique hurdles that can make running them a challenge, they also play a unique role in their communities and are an indispensible resource for their patients. Harnessing that feeling is important to their future suc- cess. "So often CEOs are viewed as someone who is there for the business component — you're really there to change a com- munity," Ms. Santilli says. "You're there to change the lives of the people in the community." Keeping the preceding five tips in mind can help critical access hospitals stick around and continue doing just that. n ® Community Hospital Corpor ation owns, manages and consults with hospitals through three distinct organizations – CHC Hospitals, CHC Consulting and CHC ContinueCARE, which share a common purpose to guide, support and enhance the mission of community hospitals and healthcare providers. There have been recent discussions of pulling the critical access hospital designation all together, taking away the cost-based reimbursement advantage critical access hospitals currently enjoy.

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