RHS entities discuss collaborative relationship at leadership conference


CRESCO - Regional Health Services of Howard County CEO Robin Schluter, Chairman of the RHS Board of Directors George Willis, and Mitchell County Regional Center’s President/CEO Shelly Russell and Board Chair Jon Koster recently spoke about their collaborative relationship at The American Hospital Association Rural Health Care Leadership Conference in Phoenix, Arizona.
The four presented ‘Collaborative Governance and Staffing Practices leading to Rural Health Success.’
Schluter said, “We presented our story, how we worked together to strengthen both of our systems, and the successes we had achieved. We shared the background of Regional Health Services and Mitchell County Regional Health Center, so that they had an idea about where we were collaboratively.  One of the things we shared is that while we are close enough to compete, we chose to collaborate because it is better for both of us.
“We started collaborating in 2015 and it’s changed the trajectory of profitability for both organizations,” Schluter said. “All of these programs we brought in together are playing into the bottom line as well, and we’re in a better position to pursue those when we’re working together.” 
Schluter said the idea of two hospitals choosing to work together toward mutual success is an uncommon practice.
“That is one of the reasons we were asked to share our story,” Schluter said.
They presented an overview of how Critical Access Hospitals can look to each other to strengthen viability and service delivery to the communities they serve, whether they are part of a system or not, and how two Critical Access Hospitals in rural Iowa have achieved greater success through CEO-driven and local board-endorsed collaborative practices.
Specifically, the collaborative arrangement between Regional Health Services and Mitchell County Regional Health Center entails the Chief Financial Officer (CFO) serves both organizations; builds solid teams at both locations; the CEOs and CFO create a succession plan, and both locations teams now collaborate and do some cross training.
“The CFO serves both organizations, and we’ve created a succession plan because our CFO is further along in his career, and we want to build internal expertise,” Schluter said.
Additional shared positions include director of accounting/comptroller, director of radiology (short term and ongoing mentor role); director of laboratory (short term and ongoing mentor role); director of health information services, cross-trained local credentialing staff, pharmacist back-up coverage and a shared purchasing coordinator.
The facilities’ collaborative service delivery expansion includes Senior Life Solutions, Respiratory Therapy Services, Intergovernmental Transfers (IGT), Orthopedic Services, Wound Care Services, and the LeRoy, Minnesota Clinic (Lime Springs and Riceville).
Shared positions key factors include all shared roles create savings for both organizations; all shared roles meet or increase the level of expertise; all shared role employees see an increase in compensation, and written agreement between the two organizations with clear monthly billing and time accounting.
Among objectives noted in the presentation were the path to collaboration and lessons learned; how the two community boards have approached collaboration; considerations in transitioning the board mindset from competition to collaboration; how collaboration has improved each organization’s processes/procedures; how collaboration enhances service delivery to the communities, and the unexpected benefits of collaboration.
Schluter notes the collaboration between the two facilities changes “our local culture to more of a merged culture.”
She continues, “We share ideas, expectations, and values. We do have competition between the two facilities; we have this ongoing competition to get the lowest days in accounts receivable; we do it for fun but it spurns the teams on.”
Schluter adds, “The Board chairs spent some time with both Boards; they are open to looking at new models for success. Unexpected benefits include the full intention of both of us using the same payroll system, so we can back each other up for absences and vacations.”
Other unexpected collaborative benefits include expense comparisons such as benefits, workers’ compensation, payroll systems and consultants, as well as employee support and knowledge sharing.
Meanwhile, Schluter said she is pleased by the interest expressed by attendees at the conference.
“When we submitted, I wasn’t sure how interested others would be in our local story, but the amount of interest in looking at doing things differently to pursue greater success was surprising to all of us that attended,” she said.
“When we presented at the conference in Phoenix, we had over 200 attendees and standing room only. We had a line of people afterwards that had questions; there was a great deal of interest and what we are doing.”
Schluter said the two organizations will next present their story of collaboration for the Iowa Hospital Association.

Cresco Times

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