Hill Country Memorial Hospital: Steve Sosland, COO

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Much of the healthcare debate in the United States focuses on large healthcare facilities, regional healthcare systems, and urban healthcare. According to the 2000 U.S. census, however, there are still independent regional hospitals providing care to the nearly 21 percent of Americans who live in rural areas.

Hill Country Memorial Hospital, located about 80 miles west of Austin, Texas, is one of those hospitals. Opened in 1971, the hospital received contributions for its construction from 93 percent of households in Gillespie County.

“We want to lead the way for rural healthcare, which is a huge responsibility” said Steve Sosland, chief operating officer. “We have nearly 500 volunteers, and our history of community support has given us a vested interest in staying an independent nontax-supported facility to care for our community.”

Having a home in the community

Sosland has a realistic view of what Hill Country Memorial can and needs to provide to the community. Hill Country is an 86-bed acute-care hospital serving an eight-county area. The primary service lines offered are orthopedics, women’s services, and geriatrics.

“We are not trying to be all things to all people,” he said. “We have evaluated the top procedures we do and the top procedures we refer elsewhere. But we want to make sure we are providing value to our patients so that they don’t have to drive 80 or 100 miles to receive care.”

Sosland said the hospital’s current focus is on quality, safety, and patient-experience measures. These measures are critical not only to providing good patient care, but also to prepare for a future pay-for-performance fee structure.

Hill Country Memorial has consistently ranked in the top 10 percent of the nation for HCAHPS scores. The Hospital Consumer Assessment of Healthcare Providers and Systems survey is a patient survey that helps determine a patient’s experience at a particular hospital. The hospital has also received awards for quality in Texas.

In addition to core measures, Hill Country is pursuing initiatives to enhance its three main service lines. It opened a destination joint center in 2011 with a focus on patient experience.

“Patients are greeted throughout the hospital by name, and care is focused on wellness,” Sosland said. “Joint-replacement patients are well, so we don’t treat them like they’re sick.”

A goal of the center is to lower the total hospital stay to 2.2 days, which is about half the length of the average stay.

Hill Country has also developed a state-of-the-art breast center and a unique collaboration among specialists focused on breast care. The hospital holds a monthly multidisciplinary breast conference where imaging-center specialists, radiologists, pathologists, oncologists, and surgeons come together to review every case from the previous month. Sosland says this allows for discussion of how to most efficiently treat each patient and an opportunity to capture lessons learned.

“We feel this conference is leading the way for rural health,” he said. “It is an initiative we hope to expand to all medical and surgical departments, and it allows us to work toward one of our goals of creating value for patients in rural areas. We also share our data with other rural healthcare centers.”

Other initiatives include investments in two cath labs and adding teleneurology to improve geriatric care. Teleneurology has allowed the hospital to provide 24/7 stroke care.

To prepare for the future, Hill Country Memorial has implemented Lean processes throughout the hospital to improve efficiency. It has also purchased a 53-acre site for future service-line growth. Working with consultants, Hill Country plans to expand services based on the needs of the community.

Following a golden compass

Sosland would attribute much of Hill Country’s success to its guiding principles and Golden Compass Leadership Development System.

“We use the golden-compass symbol to focus on our true north,” he said. “In the absence of direct guidance from a leader in the hospital, our true north gives staff members direction in putting patients first always.”

He said the true north is the hospital’s values and principles. The other seven points on the compass are individual development, skills development and competencies, team building, behavioral development, business acumen, strategy, and organizational skills. These points are taught to staff at all levels and are looked for when hiring new staff.

The hospital’s three core strengths also set it apart from other facilities–community support, quality patient care, and a “spirit of calling.” Through volunteers and fundraising, the hospital receives incredible support from the community it serves. The “spirit of calling” is one area that Sosland feels is unique at Hill Country Memorial.

“We have an active staff that believes working here is where they belong, where they can apply their talents to provide care for patients,” he said. “We seek to hire the people who believe healthcare is their calling.”

-by Patricia Chaney

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