Becker's Hospital Review

Save the date! Becker's Hospital Review 6th Annual Meeting — May 7-9, 2015 — Chicago. Please call 800-417-2035 to register. 53 The hospital's books have been in the black for the last few years now, but sustaining financial growth remains as a top priority. Norwegian American has laid plans to achieve this by creating collabor- ative, coordinated care entities with outside part- ners, as well as investing in various departments inside the hospital that serve the community's immediate needs. Norwegian American collaborated with four oth- er Chicago hospitals, six family health centers and one behavioral health provider to propose My- Care Chicago, an accountable care entity and new managed care healthcare plan to serve the Cook County area. Illinois approved MyCare in early 2014, while the state rejected three other local ACEs for preliminary approval. The ACE brings providers from each of these organizations together through shared data and processes to improve healthcare delivery to the growing Medicaid population. MyCare Chicago has already signed a contract with the state to sign on 40,000 Medicaid enrollees. The hospital also has two initiatives in place to further enhance volume. One focuses on provid- ing care for individuals with physical disabilities, and a second one is the creation of a coordinated care entity that focuses on individuals who have mental illness. To continue growth, Norwegian American has identified various services it can further develop based on the needs of the community. For ex- ample, because cancer is prevalent in the popu- lation the hospital serves, Norwegian American has invested in growing its oncology department, Mr. Sánchez said. Over the past year, the oncology department has grown 159 percent. Similarly, the hospital has invested in cardiology to address the prevalence of heart disease in the community, and today the cardiology department is three-times the size it was in 2011. As part of the hospital's investment in increas- ing behavioral health services, it has converted 17 beds to serve patients receiving behavioral health care, and this program has grown about 28 per- cent in the last two years. Contrary to market trends, the hospital's inpa- tient utilization has gone up by about 4 percent from 2013, and emergency department visits have increased by 7 percent. "With every decision we make, we address the question, 'How will this help the patient?'" Mr. Sánchez said. "We measure and trend our perfor- mance to help us guide our decisions and make the necessary changes to improve our services across the entire hospital, and this has been the key to success." Enhancing culture and engaging staff at all levels is key to organizational success Another key element of Norwegian American's suc- cessful turnaround is the hospital's human capital. "We knew that if we wanted to be successful, we had to change the culture, be more efficient and have quality people onboard," Mr. Sánchez said. While much of the cultural change was a natural impact of positive quality outcomes and perfor- mance, Mr. Sánchez recognized that the turn- around had to be backed by the entire hospital staff, including employees at every level. "As a CEO, I feel our greatest assets are our staff," he said. Every executive, including Mr. Sánchez, meets with hospital staff from different departments of all levels to ensure hospital employees' feedback and concerns are heard. In doing so, Mr. Sánchez breaks down the barrier of the C-suite. "I make sure they know how critical they are to the team," he said after describing a meeting he held with the housekeeping staff. Norwegian American today, and what lies ahead In addition to quality improvements, financial growth, increased patient volume and a cultural renovation, Norwegian American's turnaround has resulted in two consecutive Joint Commission accreditations. The hospital also maximized all of its federal incentives for implementing its EMR system, was clear of any citations on the federal EMR audit, attested to stage 1 for meaningful use and is on its way to stage 2. When thinking about the future of Norwegian American, Mr. Sánchez is optimistic. The hospital has shown marked improvement on every mea- surable level, and the organizational culture forti- fies it as a fixture in the community. "In 2010, when I arrived here, no one wanted to work here. Now I have people calling me every day asking if there is an opportunity. Now I have doc- tors calling me and saying they want to move their practices to Norwegian or refer their patients here." Because of large populations of undocument- ed immigrants in the area, Norwegian Ameri- can is uniquely challenged by the impacts im- migration reform will bring. While Norwegian American is faced with the usual health reform woes, the uncertainty of what will happen to the millions of undocumented immigrants poses the biggest challenge. Safety-net hos- pitals see many patients who are not docu- mented citizens and are therefore ineligible to acquire healthcare subsidies. At the same time, the uncertainty of where immi- gration reform will go gives safety-net hospitals the opportunity to continue playing a significant role in healthcare. Furthermore, many residents of Norwegian American's surrounding commu- nities that are eligible for healthcare coverage of- ten cannot afford it, and continue to depend on the hospital for medical care. "Our success will depend on figuring out how to manage everything in front of us with limited re- sources," Mr. Sánchez said. To do this, executive leadership of Norwegian American will continue to stay sharp. "As a leader in this healthcare environment, you have to be very flexible, adaptable and never lose a business opportunity." In addition to maintaining a business-oriented leadership team, Mr. Sánchez emphasized the importance of maintaining good relationships and strong partnership. Partnership is criti- cal with various types of organizations, he ex- plained, including other hospitals, federally certified healthcare centers, faith-based health- care centers, schools and community-based or- ganizations. "You cannot do it by yourself in this environment. You need to have partners and the support of the community," he said. n

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