Becker's Hospital Review

170 THOUGHT LEADERSHIP of the day. ere was no consistency in this approach, no transparency with a scorecard, and no turn-down policy in existence. Q: How has this impacted your orga- nization? KS: By streamlining the admitting process through this call center, community and ru- ral hospitals' loyalty and reliance on Erlanger increased and demand for services and align- ment strategies enhanced. One outgrowth from this: We have signed 15 affiliation agree- ments with community hospitals. ey all had an acute need to further align with a larger hospital system to ensure proper patient care, which was not available before this. Addi- tionally, our admissions grew exponentially, and so has our efficiency from the auto-ac- cept policy in EROC. By opening our doors to community and rural hospitals, we saw a better payer mix, an improved case mix, and regional growth — significantly above what we saw when we used to have on-call doctors screen all of those transfer calls. MG: Affiliates of Erlanger are, on a regular ba- sis, thankful to us for adding the services and improving the quality of care for them because they oen don't have the capability, physicians or workforce to handle high-acuity patient cas- es. Also, before this program and streamlined process, they were forced to treat severely ill patients without the proper resources. Additionally, as a result of this process, we have been able to grab more market share and are now the clear leader in market share in our greater region. Further, our 'culture of yes' has helped im- prove momentum and team morale because we have so much pride in the growth that this organization has seen in recent years — es- pecially since we used to just be a safety-net facility. We have so much pride in the call cen- ter, too, which is unlike anywhere else. Q: What inspired this idea? KS: Above all, the idea that we are keeping a promise to the community: Our doors will al- ways be open. But, I can take a step back. Leadership changed at Erlanger about five years ago. [Executive Vice President and] COO Robert Brooks, FACHE, and I were both pre-hospi- tal care providers in a different life. Both of us understand the flow of patient care and how strategies with the prehospital care commu- nity affect the acute care hospital. When we both got here about five years ago, we knew the pre-hospital relationships were fractured. So we met and aligned with every pre-hospital care company in Northwest Georgia, Eastern Tennessee, Alabama and North Carolina, and soon understood what was happening. We then worked to strengthen those relationships. Rob and I had a unique skill set to align with pre-hospital care companies, which included various EMS agencies such as ground and flight, because we lived in those shoes before. Q: What were some of the challenges you encountered while implementing EROC and the streamlined transfer program? KS: When we first implemented this, some of the doctors on call were used to being able to manage and defer admissions. e doctors had total autonomy; they were able to deny admissions and no one would challenge them. We moved from a closed system to a very open and transparent system. Data is very transpar- ent, everyone's on-call behavior is known, and everyone is given a scorecard about how quickly and efficiently they run their service. By losing that autonomy there was some level of frustration among physicians. is led to a small group of doctors moving from active medical staff status over the change. Some- times you and I may think [transparency] is the way it should be. But this transition may not be as palatable if you are used to operating the way it was done 30 years ago. MG: Another challenge I would add — largely because of the success EROC has achieved — is meeting the demand from these new affili- ates, which is definitely a good challenge. n Transforming leaders who will transform healthcare. An intensive 16-month master's degree designed for mid-career professionals. • Join a cohort of exceptional healthcare professionals. • Tackle challenges facing all healthcare sectors. • Online and residential format tailored for busy executives. • Apply classroom content in real time. Explore the program at brown.edu/emhl Brown-34220 EMHL Ad_75x3625.indd 1 2/28/18 1:09 PM

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