RENO, Nev. — With more than a decade of executive leadership experience at Saint Mary's Regional Medical Center, Helen Lidholm has seen it all, from ownership changes to regional facility expansions and forging key community physician partnerships to drive increased patient access.
The Northern Nevada Business View recently sat down with Lidholm for a question and answer session to discuss Saint Mary's Health Network and the many ways it's prepared to serve the influx of new residents to Northern Nevada in the upcoming decade, as well as the longtime residents who have deep ties to the revered medical facility located in the heart of downtown Reno.
Q: Discuss the healthcare industry locally, with an eye toward the next decade — with 2020 almost upon us, what are some of the big impacts the industry should expect to see develop here locally in the coming years?
A: There are a few major impacts. First, patient preference is trending toward lower acuity care, such as provider offices, walk-in clinics and urgent care centers rather than hospitals and emergency room settings. This has caused our community to be over-bedded for clinical sites like hospitals and have access shortages in primary and specialist offices. This impact will continue to grow over the next couple of years as we work to correct our clinical continuum in the community.
Secondly, healthcare is moving more and more toward population health. From a payer perspective, population health drives cost containment and quality improvement. For example, CMS (Medicare) is now focusing on quality outcomes in hospitals with financial impacts if the highest standards are not met at the lowest cost. At the same time, CMS is adding payments in the outpatient arena to providers who ensure appropriate management of chronic care diseases. This includes looking for issues that can be health factors, such as smoking cessation, screening for glaucoma, creating an advanced care plan for patients with chronic conditions, and screening for depression, prostate cancer, diabetes, etc. Other payers are following closely behind CMS in this “pay-for-performance” cost containment strategy, with national payers leading the way. This matters to our community, because as we continue to experience an influx of national and startup businesses, the national payer presence grows.
One of the other big impacts communities are facing across the nation, and one we are not immune to, is the mental health crisis. Healthcare providers are working with community agencies and organizations to work on long-term solutions through increasing access to inpatient and outpatient programs. The biggest hurdle is overcoming the stigma that comes with mental health, which keeps a lot of people from acknowledging it and seeking help.
Q: What is Saint Mary's (and other regional care providers) doing to combat the growing issue of rural healthcare access?
A: The biggest issue for our rural colleagues are recruitment and retention, finding specialists willing to provide telemedicine, and care coordination between tertiary facilities and the rural primary care providers. UNR's School of Medicine's Family Medicine Center is focusing on rural health through including rural rotations in their program. Saint Mary's is exploring ways to build resources through recruitment efforts and partnership with providers in the community to overcome these challenges and meet the needs of Nevada's rural communities.
Q: What's changed at Saint Mary's since Prime Healthcare Services took over from Dignity Health (formerly Catholic Healthcare West) in 2012?
A: Saint Mary's is still Saint Mary's! We work hard to maintain a culture of caring and compassion established by the Dominican Sisters of San Rafael in 1908, 111 years ago. Saint Mary's has always been patient-care and safety-focused, and that continues with Prime Healthcare, which is owned by a physician and where patient care and outcomes always come first.
Q: What are the main challenges Saint Mary's has in meeting demand for services?
A: Saint Mary's challenges are in line with national healthcare challenges right now, which is nursing and provider shortages. These shortages impact access to healthcare services across the community. Our recruitment team works diligently on outreach to residency and nursing programs to find and secure talent for our network.
Q: Saints Mary's may be older and smaller, yet residents often prefer the care at Saint Mary's when given a choice ... why is this so?
A: Saint Mary's goal is not to be the biggest in the community, but we are focused on being the best. We've achieved this, as seen through our quality and performance scores, with watchdog and regulatory groups. One of the main reasons for this is we empower our staff and providers to lead the way to excellence. When they see issues, they are not afraid to bring it to leadership's attention. Our staff is invested and engaged in the success of Saint Mary's, and that shows in the level of care patients receive.
Q: Name a few points of pride for Saint Mary's that sets it apart?
A: We have impressive employee engagement. The average employee has worked here at least eight years, and our nurse turnover is 5 percent compared to the national average of 17 percent.
We are also the highest quality-rated acute-care hospital in Nevada. Some of the key recognitions include:
• Being the first hospital in the community to receive Leapfrog's patient safety grade A, and we've kept that A for six cycles in a row.
• Being the first hospital in the community to earn a 4 star rating from CMS's for Safety.
• Earning the distinction of being one of America's Best 250 hospitals from Healthgrades out of the over 4,500 hospitals in the nation. This places us as one of the top five percent of performing hospitals in the United States, and we're the only hospital in Nevada to receive this award.
At Saint Mary's, we're leading the way in improving healthcare quality in our community by triggering healthy competition. Since receiving those quality and outcomes recognitions, other hospitals have followed in increasing their scores and performance, and that good for our community.
Q: What is your vision for the hospital moving forward?
A: The vision for Saint Mary's Health Network is to continue providing quality healthcare services to our community. Our hospital will remain the highest quality and provide the best outcomes. Our medical group and outpatient services will continue to grow to meet the expanding population and increase access where patient are seeking care.
Q: What does the next decade hold in store for Saint Mary's?
A: Healthcare is shifting from the hospital campus to outpatient settings. Our intent is smart growth of our outpatient services without expanding our physical footprint since that adds to the cost of patient care. In mind of the cost of patient care, Saint Mary's will continue to be conservative in our capital acquisition and purchase only those things that are necessary to care for our community, such as our recent upgrades in our cath lab, a brand-new infant security system, and our new behavioral health unit.
Q: What are the biggest challenges you face in leading Saint Mary's into the next decade and beyond?
A: Ensuring we maintain a laser focus on quality and outcomes — and not on shiny things or new buildings.