Ten Qualities of Leading Women’s Hospitals

Mark Dubow, for HealthLeaders Media , July 16, 2008

The strategic and economic rationale to maintain a strong relationship with female patients is well documented. Now healthcare organizations are renewing their focus in this area, developing new women's hospitals and expanding existing facilities.

Beyond full-service obstetric programs, personalized care in private rooms, and strong branding, cutting-edge women's hospitals have a number of common characteristics, such as a core physician leadership that focuses on programs such as urinary incontinence, gastrointestinal disorders, and minimally-invasive surgery.

To be a "player," you must replicate these characteristics—although it's not enough to distinguish your women's program in an increasingly competitive market.

Achieving a strong market position and annual net revenue or income growth of at least 7–10% requires clinical and operational innovation and an emphasis on customer service.

The following ten characteristics are fundamental to accomplishing that end:

1. Penetrate previously untapped or underserved patient pools by implementing clinical services unique to the market. Highly successful women's hospitals focus resources on implementing clinical services that will "drive" significant inpatient and outpatient profitability. In general, they are early adopters of new clinical technology and practices. For example, one women's hospital has a strategy to be one of the first to combine genetic testing and counseling for multiple diseases rather than just antepartum care. Another women's hospital has implemented cryopreservation of eggs for career women who desire a delayed start of families and patients requiring cancer treatment who wish to retain reproductive capability. A third women's hospital is providing intrauterine fetal surgery. Although wellness, education, retail, and other non-clinical services supplement core services, they're not sufficient to enable a women's hospital to achieve sustainable market leadership and generally do not have large net revenue or income potential.

2. Adopt a regional and potentially a national market penetration strategy by creating recognition for clinical expertise. Recruiting a physician or physicians who are regionally or nationally renowned for a particular service can bring both an established patient referral network and develop new relationships based on his/her clinical skills and entrepreneurial track record. Examples drawn from leading edge women's hospitals include attracting physicians with national reputations in minimally-invasive reproductive surgery, genetics, and urogynecology. In addition, strong women's hospitals also identify established members of the medical staff and work with them to build regional/national reputations and referral networks.

3. Provide superior service to primary care physicians (PCPs) in outlying target markets, encouraging them to shift referrals to your women's hospital. Achieving this end requires effective, ongoing interaction with the targeted physicians to understand and respond to the issues of greatest importance. Adequate capacity must be provided to treat their patient. On-line scheduling, utilizing electronic linkages (CPOE, PACS, and EMR) to achieve timely sharing of patient progress information should be offered. Clinical advancements should be ongoing, and patients should also be referred back to their PCP for continuing care. No amount of clinical innovation and architectural enhancement can substitute for these fundamental requirements.

4. Enhance operations to make the women's hospital unique in its ability to meet the needs of your medical staff. Leading-edge organizations stretch beyond the basics of regular investment in upgrading clinical tools and equipment and maximizing the clinical and interpersonal skills of the nursing and other staff. They devote resources to anticipating and resolving operational issues before they become bottlenecks. They aggregate and, where this is not feasible, virtually link interdependent clinical services are. They take proactive steps to maximize the cross-referral of patients between specialties/departments. And they employ a dedicated director of budget and business development.

5. Establish strong physician leadership. Commonly, physicians play an active role in setting the vision and direction of the women's hospital on a clinical and a strategic basis. Physicians frequently play a role within the senior management team. Some women's hospitals that are components of a larger hospital campus appoint a physician as chief administrative officer. Others involve physicians in management through medical directorships and medical advisory panels. At the same time, those individuals are held accountable for the performance of the women's hospital (financial, clinical quality, patient satisfaction, etc.) through pay-for-performance initiatives.

6. Make the facility unique in its ability to meet the needs of women in the market. Most significant to achieving this end is establishing an operational environment in which the diagnostic, therapeutic and related educational and psychosocial support services are more convenient than those available through competing providers. As an example, one women's hospital has established a single point of "entry" to health services for women. Patients are able to call one number or go to one site and schedule visits and procedures with physicians and multiple hospital departments. They receive the assistance of a care navigator in working through the process.

7. Develop relationships with niche patient pool segments. One of the best opportunities to achieve growth is to create relationships with patients in previously untargeted niche groups that are attractive from a payer mix standpoint. Several women's hospitals have developed culturally sensitive clinical programs specifically oriented to the Hispanic, Middle Eastern and Asian-American communities. Similarly, other women's hospitals have designed clinical programs to age-specific niches such as adolescent medicine; women athletes; and other groups.

8. Establish an environment that enables the organization to become an innovation center in women's health. Form strategic partnerships with other organizations. Physicians and researchers who are clinical entrepreneurs frequently find the patent rights and other economic restrictions of universities and some corporations too restrictive and are willing to move to more favorable environments. This presents an opportunity for a women's hospital to act as a catalyst in establishing an independent, freestanding facility that is one part collaborative "think tank," one part applied laboratory and one part funding mechanism. Several benefits may be derived. First, the innovation center may be used to draw to the hospital leading-edge physicians that can lend their clinical reputation and "star power" to the women's hospital by practicing at the facility. They can contribute their own clinical advancements to the continued evolution of medicine delivered at and thus differentiation of the hospital. They may also draw pharmaceutical, biotech and information technology companies eager to use the facility as their beta site for advancements in care specific to women.

9. Maximize the impact of market visibility tools. Most women's hospitals utilize a multi-media approach to build awareness and preference for their medical staff and facility. The use of the Internet is crucial. Women avidly conduct online research in support of healthcare decisions. Innovative organizations will convert these Websites, particularly social networking sites, into proactive relationship vehicles through the use of bi-directional communication and the single point of entry concept referenced in point 6 above. Actual social networking also plays a prominent role. A competitive edge may be achieved through a combination of establishing physical and virtual networking events.

10. Demonstrate clinical quality in a proactive way. Quality initiatives must go beyond internal data collection, benchmarking, and corrective action plans. Given the proliferation of public report cards and patients who are increasingly conducting Internet-based research, it's crucial that women's hospitals proactively manage their quality of care image. This entails setting and managing to operational performance targets that will enable differentiation. It also entails use of proactive public relations campaigns to highlight distinctions achieved by members of the medical staff and the hospital as a whole.

Establishing a successful, cutting-edge women's hospital is a huge logistical challenge. However, a dedicated management initiative following these steps can make it possible.

Mark Dubow is a senior vice president with the Camden Group. He may be contacted at (310) 320-3990, or by e-mail at mdubow@thecamdengroup.com.
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