Thursday, June 15, 2017 1:00 am
Opportunity out of upheaval
Drs. William Cast, Matthew Sprunger and J. Philip Tyndall
The opening of Dupont Hospital in 2001 represented everything possible when health care professionals, business and a community come together.
As a collaborative effort of physicians, Lutheran Health Network and then-LHN-parent Quorum, the goal was that the expectations of every guest, team member and physician would be exceeded. These goals were retained after Quorum was purchased by Triad, and the hospital thrived. The effort was anchored in a passion for safety, quality and efficiency, not maximizing quarterly results or achieving the highest margin on the financial capital deployed. That focus allowed Dupont and the other LHN facilities to set a standard of care matched by other local hospitals which made northeast Indiana envied throughout the country.
Today, we see what can happen when that focus is lost. The recent acrimony between LHN, local physicians and for-profit LHN parent company Community Health Systems is the direct result of health care driven by quarterly reports and stock price. CHS' prioritization of cost-cutting led to deferred maintenance and a lack of investment in talent, which has led to a crisis in quality and chaos at the top of the organization.
CHS has attempted to control the message by terminating LHN CEO Brian Bauer – and it's no small irony that the firing followed strong statements of support for Bauer from physicians, LHN staff, and local business leaders and elected officials.
Suffice it to say that this not what we, as members of the team that brought Dupont Hospital to life, had envisioned. In fact, it's about as far afield from that vision as we can imagine.
In response to these concerns, we have formed Northern Indiana Citizens for Healthcare Excellence (NICHE), a nonprofit designed to bring together the community, physicians, nurses and other parties who share an interest in quality health care for this region. Our purpose will be to promote education in all aspects of health care. Our focus is to hold CHS accountable to our community and to its own seemingly abandoned goals, and to make public whether it realigns its priorities with ours: patient safety, quality and respect for professionals who have dedicated their careers to improving lives.
The questions we are most ardently interested in include:
• Will CHS negatively affect patient care by replacing LHN executives with stand-ins who know little to nothing about northeast Indiana and LHN's employees?
• When and how does CHS' cost-cutting begin to affect the quality of care or access to care?
• How might cost cutting have affected recruiting of health care talent, including the challenging work of recruiting new physicians to northeast Indiana?
• How does LHN rate against measurements of quality against its regional peers?
• Will mistakes be buried and workers' comments muzzled by threats or litigation?
• Will candid testimony be eliminated by nondisclosure agreements paid for within contracts with departing managers?
• Is it in the public interest and the interest of quality health care that any worker or even a corporate officer be prevented from attesting to events and decisions made?
We intend to focus on the facts, but we also share a point of view. We are convinced that when the many facets are discussed, the citizens of northeast Indiana will find a consensus.
CHS has had nearly 10 years to prove it is committed to northeast Indiana. Recent events have been a significant step backward, and our community is experiencing a breakdown in trust. We feel that CHS has yet to demonstrate the competencies or vision needed to successfully navigate a highly competitive market for high-level care that exists in northeast Indiana. We deserve better – and CHS has an opportunity to be part of a conversation educating our citizens about these issues, or to be absent from that conversation.
Every crisis presents the opportunity of a gift. This chasm, now seen in public, is giving all in northeast Indiana an opportunity to create better health care. As strong local proponents for quality health care are silenced, we believe the community must turn up the volume. NICHE exists to promote that effort – and to ensure that, in our community, quality of care takes precedence over CHS profits.
The authors are the founders of Northeast Indiana Citizens for Healthcare Excellence (NICHE).