It's rare to see clinicians, unions, hospital administrators and community leadership cooperate, but there is one event that will bring them all together: Fighting to keep a hospital from closing.
Adversity can breed unexpected alliances, but few events can galvanize a diverse group of people with vastly different priorities like the threat of a hospital closure says Ramon Rodriguez, CEO of Wyckoff Heights Medical Center in Brooklyn, NY. But the closure of a hospital affects so many people, that finding allies might be easier than expected.
"Everyone understands how important these hospitals in these communities are… These institutions are some of the most important institutions in the area," Rodriguez says, and that the ability for hospital administration to work with unions and members of the community might be the difference between life and death for troubled hospitals.
Along with 27 other New York state hospitals, Wyckoff is in danger of imminent closure if the state senate and assembly do not elect to include $290 million in vital access hospital funding in the final state budget, which is to be decided before April 1.
While the funding was included in Governor Andrew Cuomo's (D) original budget, the money was unexpectedly omitted in the senate and assembly version of the budget. "This issue was proposed in January, but it wasn't until two weeks ago that the preliminary house budget was released," explains Helen Schaub, vice president and New York state director of policy and legislation with the 1199SEIU labor union.
The Governor's office announced over the weekend that a budget agreement has been reached. Details are to be released today (Monday, March 30).
This is not an isolated incident. Across the country, community and independent hospitals skirt closure yearly, weekly, or monthly as they face the rocky transition toward value-based-healthcare, and as it becomes increasingly difficult for a community hospital to operate without a parent healthcare system.
While the C-suite and administrators take on much of the visible advocacy of keeping hospitals open, human resources can work behind the scenes to mobilize employees, work with unions, and reach out to their communities for support to help fight for their hospitals.
Mobilizing Clinicians
"I think it will be devastating," says Tammy Wilson, a licensed practical nurse at Auburn Community Hospital in Auburn, NY, when asked what would happen if her hospital, which is among the 28 currently at risk, closes.
"There are people who [have worked] there for years… I especially worry about the people who are close to retirement. Good jobs with good benefits are hard to come by," she says. Wilson also expresses concern for the patients she sees daily, most of whom are elderly and would have a hard time adjusting to new providers, in her view.
She is not alone in her reaction—many clinicians feel the same way, and are eager to help save their hospitals. Schaub suggests releasing clinicians to lobby state legislators, as several hospitals in New York have done. The presence of a nurse or physician visiting in person can have a strong influence on an elected official. Other clinicians have organized letter writing, telephone, or email campaigns among fellow staff, community members, and patients.
If your hospital's employees are represented by a union, you should definitely involve them in this process. Not only do unions have the respect of employees, but they also have experience in advocacy and lobbying—and know how to get heard.
"We have working relationship with the unions who represent our employees, and we are consistent with them in our goal to save our hospital," says Rodriguez. "Without unions, I'm not sure our voice would have been heard."
Schaub agrees. "The leadership of each group can sit down together and come up with a joint plan where everyone can work together to keep their hospital doors open."
Act Locally
Community leaders are growing increasingly aware of the importance of keeping local hospitals alive.
"We have about 1,600 employees," says Rodriguez, "those employees contribute in our community about one billion dollars [annually] in spending power. For that reason, people who live in our neighborhood are very interested in making sure that the community has our hospital."
Another growing concern in both urban and rural communities are healthcare deserts—areas with limited access to healthcare. It's no secret that every minute counts in a medical emergency, and every mile a stroke or heart attack victim has to travel to get care hurts their chances for recovery. Forward-thinking community leaders will fight hard to prevent becoming one.
One hospital in New York state hosted a community event with a press conference and asked a local firefighter to talk to both the media and neighborhood leaders about the importance of access to a hospital in the area, says Schaub. It was well attended, and allowed a member of the community who was not affiliated with the hospital to explain to both the media and the locals why the hospital needs to stay open.
Rodriguez sends representatives from Wyckoff to different community boards, business associations, and health committees to share data and information on an ongoing basis, so the community is aware of the importance of the hospital long before the crisis hits—and is ready to work on his hospital's behalf when it does.
While healthcare leadership, clinicians, unions and members of the community might not always see eye to eye, it's important to utilize these opportunities where everyone wants the same thing and work together. "While we may have a different point of view at the bargaining table, at end of day, we must work together and build respect," says Rodriguez.
Lena J. Weiner is an associate editor at HealthLeaders Media.