Making Women's Health Work

Elyas Bakhtiari, for HealthLeaders Magazine , March 8, 2010
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"We have found that the child-bearing population is extremely Web savvy," says Joan Ettien, administrator of the Women's Hospital at Centennial, a standalone women's facility in Nashville with a 40-bed Level III NICU and a specialized 25-bed perinatal unit. "I've been in on a couple of focus groups, and it's amazing what women look for. They will get on our Web site and research traditional mammography versus digital mammography."

Having savvy consumers means hospitals and physicians need savvy marketing to stand out. Marketing to women requires establishing an ongoing presence and building a relationship, not just making a one-time pitch. Programs rely heavily on classes, workshops, screenings, follow-up communication (like mammogram reminders), and other ways to stay connected with patients. Increasingly, they also rely on social media marketing.

"It's interesting to see Facebook comments about our women's hospital and the experience women have had," says Jenny Barker, manager of public relations and marketing for Centennial Medical Center. In addition to lines of communication on Facebook and other Web sites, Centennial has tools on its own Web site that allows patients to provide feedback. Patients increasingly want to interact with their providers, both in person and online, and Centennial's Women's Hospital typically receives comments several times a week from people wanting to thank nurses or pass messages along about level of care they received, she says.

As Methodist Hospital began designing and planning its new women's hospital, leaders solicited input from patients and members of the community, not only to improve the overall facility, but also to establish lines of communication with its customers. Expecting parents were invited in to test out the furniture in the rooms and offer feedback for improvement; advisory groups reviewed plans throughout the process and even conducted mock rounds with patients.

"We ran everything by patients—what we should and shouldn't have, the gowns we were going to use for patients—everything," says Korth. "We got beneficial and phenomenal input."

Success Key No. 4: Control staffing, supply costs
With competitive pressures and marketing demands on women's health programs, many have little choice but to buy new imaging equipment, invest in a new facility, or offer other amenities. These are all in many ways marketing expenses necessary to win women's loyalties.

But given the tight margins, that makes tight control of operational expenses crucial, and staffing can be one of the biggest challenges for obstetrics-focused programs. Carolinas Medical Center averages about 7,000 deliveries per year, which requires a full staff of nurses, physicians, and other personnel 24/7. But on a day like Christmas 2009, when the hospital performed only one delivery, the costs of staffing the labor and delivery units can dwarf the revenue generated.

That makes planning for volume very important, says Ralyea. "We work with all physician offices as soon as they come in to practice so we can map out over the next six to eight months where volumes and trends will go. That has helped with staffing recruitment and retention."

The hospital also worked to cross-train nurses for both of Carolinas' labor and delivery units so they would be familiar with supply locations, equipment, etc., which has helped cut down staffing needs from nine nurses per unit to six.

For supplies, many of the tried techniques still work fairly well—benchmarking costs across an organization, cost-accounting for supplies as soon as they're taken off the shelf, standardizing processes for greater predictability. But increasingly, it isn't just the management team that has to have a solid understanding of the budget, says Korth. It's the staff, and specifically, nurses.

"The budget is moving out of the executive office suite and moving more into bedside nurses' hands. If they understand the budget mechanisms and how things get charged and what reimbursement is based on, that will give nurses better understanding and bring about more teamwork."

Elyas Bakhtiari is senior editor for physicians and service lines for HealthLeaders Media. He may be contacted at
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