Community project is low on costs, high on results
Child patients give thumbs up to winning program
Editor’s note: This is part of a continuing series looking at the hospitals that won American Hospital Association’s NOVA awards for promoting community health.
Yakima Valley Memorial Hospital, a 225-bed hospital in Yakima, WA, had long served pediatric special needs patients. First located in a trailer behind the hospital, then in a converted triplex home, the hospital ran the Center for Child Health Services to provide help to children who had disabilities such as cleft palates or other genetic problems. But as the demand for services burgeoned, CEO Rick Linneweah, MBA, knew that another move would have to be made.
Linneweah brought together about 25 different agencies to see if a different approach could serve the increasing need. Fourteen signed on to create Children’s Village, which opened in 1997 to bring together under one roof area services and agencies for these special needs children and their families. That program was recently honored by the American Hospital Association as a NOVA award winner for championing community health.
Designed to look like an Old West town, Children’s Village allows parents and other caregivers to schedule multiple appointments for treatment and evaluations at one time and in one place. It has served more than 2,100 children since it opened.
A comprehensive patient satisfaction and outcomes-related survey is now being undertaken in conjunction with the University of Utah. But Linneweah says preliminary results indicate that the patients — or in this case, their parents — are extremely satisfied with the services they get, and their expectations are often exceeded by the Children’s Village program.
"By the early 1990s, we realized that there was a real networking between agencies and providers of services for children with special needs," he says.
The groups included the Department of Social and Health Services Division of Developmental Disabilities, several area hospitals, local clinics, and the area school districts. They met regularly to discuss improving care and meeting the needs of the families who used it.
"But we realized that families often had to go to a number of places for services," Linneweah says. "So, we had these two forces come together: one about the desires and needs of the people we served, and one of the individuals and organizations who provided care already working well together."
Of the 25 organizations that originally met, 14 signed on to the program, and three — Yakima Valley Memorial Hospital, the Yakima Valley Farm Workers Clinic, and the youth services organization EPIC — signed on as lead agencies. These two other organizations, like the hospital, were looking for new facilities for their children’s services.
"The other 11 wanted in, but didn’t need a full-time residence," Linneweah says. The group decided the other 11 would be itinerant residents in a kind of health and social services "mall."
The group met monthly with the help of two hospital vice presidents who had a background in facilitating group projects. Linneweah says those monthly meetings were a test to the continued interest in and appropriateness of the project.
"The concept was tested as we went along," he says. "We asked ourselves regularly if what we were doing was right. And after three years, the interest and the desire and the passion was still as strong."
Focus on improving services
While everyone realized that for the Village to succeed it needed to be financially stable in the long term, Linneweah says that the bottom line wasn’t the focus.
"Many organizations that had relationships with these people were charging for services or receiving grant money," he explains. "They weren’t looking at this as a new revenue stream. What we wanted was to improve service to families and children."
The goals were therefore simple, and equally simple to measure: to bring services under one roof. That has been accomplished. That parents are happy with the service is a bonus.
And there has been another benefit of the collaboration, says Linneweah. The organizations that have always worked together in some way are finding their close quarters promote a new synergy. Three of the organizations have already banded to provide a new service in assessing children with behavioral difficulties who are referred by their schools. Linneweah believes other such opportunities and ideas will also arise from the Children’s Village.
The wider Yakima community came together to raise the building costs of $4.6 million in a record 18 months. "It was a real celebration of the community here, of the support towards an element of the population that needed it, and also of working together."
The building houses space for medical evaluations and clinics, drop-in childcare for siblings of patients, mental health services, family support services, resource coordination, and speech, occupational, and physical therapy. The Old West style of the building was designed to make kids feel comfortable, says Linneweah.
Three tenants share overhead
The overheads for the new facility — utilities, information systems, childcare services — are shared by the three main tenants and the other 11 organizations according to how much time they use the facility. Because the money for the facility was donated, no rents are charged; although repairs in each organization’s space are covered by that organization. Each organization is also responsible for its own billing and staff costs. The organizations’ executives meet six times a year to make administrative and policy decisions.
Linneweah says that in retrospect it is surprising how smooth the whole process went. "I’ve asked myself over and over, and I don’t know if there is anything I would have done differently. I will say this: In any project, there has to be someone who provides the infrastructure, the continual push or pull. That came from our staff who had the facilitating capabilities, knew the players, and understood the environment."
While outcomes and patient satisfaction are still being measured, there is anecdotal and interim information that makes Linneweah believe the project is a success. "You get the sense that families think we provide better service. And the community is very aware of the Children’s Village. You say those words here like people in other places say post office. This wasn’t built under the premise that if you build it, they will come. People already were coming; and yet we know demand is on the rise."
In addition, he says that many of the community organizations that were unknown or weren’t highly regarded in the community have seen their "street image" improve dramatically.
"Before, the Yakima Valley Farm Workers Clinic was that clinic for migrant workers,’" says Linneweah. "Now it is seen as a major force in the medical community making services available to those in the community who need it. No one knew what EPIC was when we started. Now, Head Start and other youth intervention organizations see it as an important social change agent."
Linneweah knows that these are hard times for many health care organizations, but argues that there is a reason for expending this kind of effort and money.
"If your covenant to your community is to improve the health of that community; if your belief system is that you can achieve more by working with others; if your desire is to create an image of reaching out in new directions and being innovative; and if you crave to satisfy individuals and make the health care system more easily traveled, then an effort like this is a natural outcome," he says.
Source
• Rick Linneweah, MBA, CEO, Yakima Valley Memorial Hospital, 2811 Taeton Drive, Yakima, WA 98902. Telephone: (509) 575-8001.
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