The Value of Health Systems During the COVID-19 Pandemic: SCL Health – Broomfield, Colorado

Health systems often serve as the major employer in their communities and serve as conveners of key stakeholders to leverage new strategies. SCL Health is honored to share insights from its President and CEO, Lydia Jumonville, about how being part of a health care system improves access to care, the top priorities for SCL Health over the next five years, the organizational transformation experienced at the system as a result of the pandemic, changes coming to SCL Health, and lessons about leadership during a crisis.

The Value of Being Part of a Health Care System

SCL Health is a faith-based, nonprofit healthcare organization with a mission of improving the health of the people and communities we serve, especially those who are poor and vulnerable. Our health network provides comprehensive, coordinated care through eight hospitals, more than 150 physician clinics, home health, hospice, mental health, and safety-net services, primarily in Colorado and Montana.

The size and scale of our system benefit our patients because having multiple hospitals in different regions allows us to share best practices, resources, and information. However, we are small enough to be agile and flexible to adapt to the rapidly evolving challenges quickly.

During the pandemic, we have proven that we are innovative and nimble when a crisis hits. To avoid the problems created by idle capacity, we will continue to work closely with emergency planners to be ensure there are enough resources on hand to scale up when the next challenge unfolds.

While the last year was undoubtedly challenging for all of us, both personally and professionally, we have seen exceptional resiliency and commitment from our associates and caregivers. What is also amazing is how the pandemic brought all of us together as a truly unified system.

A great example of this unfolded in our Montana hospitals, which didn't see a significant first wave of COVID-19 until late summer/early fall of last year. The situation with COVID-19 had stabilized somewhat during that period in Colorado. As we started to see challenges with staffing in Montana related to the pandemic, we could dispatch nurses and other caregivers from our Colorado hospitals who volunteered to travel to Montana to support their sister hospitals.

Looking Forward – Top Priorities

Our top priorities through 2025 fall under four categories:

• Aligned and Empowered Organization
• Growth
• Aligned Clinician Network
• Clinical and Operational Transformation

Aligned & Empowered Organization

Our associates are at the heart of our success, so creating an aligned and empowered organization is foundational to our ability to execute any of our strategic initiatives. We empower our associates by building an inspiring, supportive culture that embraces our core values to ensure everyone who comes to work for SCL Health feels they can make a difference. We have accomplished this in part by creating a unified SCL Health brand and experience for our associates, providers, and patients. We have also focused a lot of effort on associate recruiting, engagement, and retention.

Growth

As an organization, our goal is to be an essential provider with strength in the right geographies, specialties, and services in every community we serve, ensuring the healthcare needs of each community are addressed. We do not seek growth for the sake of gain; our goal is to advance our mission and pursue opportunities that enhance services across the care continuum to meet the unique needs of individuals in the communities we serve.

Examples of this include:

• Building out our Front Range acute services and seeking opportunities to improve access to care across the care continuum
• Expanding statewide in Montana, mainly through partnerships and other strategies that help ensure access to quality, affordable care
• Building solid relationships in Western Colorado, including support for and partnerships with rural healthcare providers in the region
• Building on our leadership in key service lines in each area to best serve the needs of patients

Aligned Clinician Network

At SCL Health, we continue to focus on building a robust and aligned network of providers, creating an outstanding experience for them, giving them tools to increase resiliency, reduce burnout, develop their leadership skills, and foster a strong connection to our culture and mission. Expanding our primary care base is critical. So too is increasing our base of employed providers in select specialties, consistent with our service line strategies to minimize our continuity of care gaps for our patients.

Clinical & Operational Transformation

The healthcare environment is constantly evolving and changing. This means we must think differently about how we deliver care to our patients and keep up with the ways healthcare is shifting.

To achieve this goal, we are focused on advancing strategies to ensure an outstanding patient experience, implementing continuous improvements in quality and safety with all of our care sites aspiring for CMS 5 Star, and leveraging technology and innovation to redesign care delivery and create greater efficiencies.

Transformation Facilitated by the Pandemic

From the beginning, we knew COVID-19 was going to be bigger than just one system or state could handle on its own; we were going to have to join forces on a whole new level and focus on collaboration, communication, and taking care of our associates.

Collaboration

In the early days of the pandemic, I brought together my fellow CEOs from other systems to discuss how we could work together as we were all navigating uncharted waters. Our CEO group then charged our Chief Medical Officers (CMOs) to meet and track, compare and share learnings throughout the pandemic. This type of information sharing across our organizations was unprecedented. The CMOS met daily during the height of the pandemic, and they continue to meet weekly.

We included members of our Governor's team in these weekly meetings. We learned early on that collaboration was critical for us to understand, pivot, and address the needs of our frontline associates and patients during the surges.

In addition, there are two examples of where we stepped forward to partner because the communities we serve needed us. We recently partnered to build a free-standing rehabilitation hospital in Montana. We are currently working to finalize a joint venture for a free-standing behavioral health hospital in Colorado.

Communication

Along with collaboration, we changed and increased our communication; we learned how to communicate through various channels consistently and concisely. We learned that our communications were held as sources of truth, as there were so many competing headlines and miscommunications in our communities.

Taking Care of Associates

We also chose to invest and take care of our associates from the very beginning. We put them first; they were all being impacted in so many different ways, both professionally and personally. Our leadership team came together, and we focused on resources from HR, Mission, and Philanthropy to help support our associates.

One example of this in action came in March 2020 when we created an Associate Relief Fund that granted associates struggling financially because of COVID-19 a $1,000 grant. Our foundations and our donors stepped up to fund the program, which ended up providing 4,007 grants to our associates totaling just over $3.4M.

Changes Due to COVID-19 That Will Occur in the Mid- to Longer-Term?

We will continue to leverage what we stood up at the onset of COVID-19 and what has now become our "new normal." For example, we extended the use of our transfer center, centralized staffing support, and developed a systemwide command center. We also moved to financial forecasting instead of using a fixed budget. And we are very focused on Health Equity. The pandemic has shined a light on health inequities in our communities, and it is helping facilitate a broader discussion and focus on how we as an industry can look more strategically at addressing the challenge and setting up both short and long-term plans.

The acceptance and advancement of telehealth are positives coming out of the pandemic. In March 2020, we launched new virtual and telehealth options for our patients to continue to receive needed medical care safely and effectively. Immediately, we saw hundreds of virtual appointments in Colorado and Montana. We now see consistent demand for virtual care options that are likely to stay well into the future.

For our providers, there is a realization that virtual care and video visits will be something that we need to continue to offer in addition to in-person care. While there are still some appointments that require a hands-on approach, the convenience of virtual care for low-acuity needs is something our patients now expect and must be maintained. Our challenge is to make our virtual care as comprehensive as an in-person appointment while retaining the ease of access.

Leadership in a Crisis

The most important characteristics of a leader, especially in a time of crisis, are:

1. collaboration
2. team
3. communication and transparency
4. flexibility
5. empathy

Collaboration

Collaboration was and is going to be essential for all of us moving forward. COVID-19 taught us so much about the power of partnership. For example, bringing health systems together to collaborate was critical to successful crisis response and greatly benefited the patients and communities we serve.

Team

The power of the group is the only way to come through a crisis successfully. Empowering individuals who bring the right skills needed to address the challenge and bringing them together to each own their role ensures success. A crisis can make or break a team, and for us, the way our team stepped up and worked together allowed us to come through COVID-19 even stronger and more unified than ever.

Communication and Transparency

In a crisis, communicating confidently, frequently, and transparently can make all the difference. Fear and uncertainty are high, and misinformation from outside sources can amplify these fears. Being open and positive while also being honest and transparent when things are challenging builds trust and confidence.

Flexibility

Recognize that you don't have all of the answers. It is critical to build a culture that allows for practical decision-making by the people closest to the situation. If a leader were to wait for answers to become crystal clear or stick to a strict chain of command, they would miss out their team's creative thinking, and we may miss critical opportunities.

Empathy and Connection

Work and personal lives have collided in an unprecedented way over the past year. It was essential that we took care of our team so that they in turn could meet the needs of our patients and communities. We must continue to show empathy and keep them connected to the team and to the organization.