The Seton Healthcare Family: Charles J. Barnett, FACHE, President and Chief Executive Officer

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As organizations across the United States prepare themselves for the implementation of healthcare reform, one system in Central Texas is determined to lead the revolution in making healthcare less fragmented and more efficient for its patients.

Already a leader in perinatal safety and pressure-ulcer prevention, The Seton Healthcare Family is pioneering many innovations and forming multiple partnerships that are laying a solid foundation for the future.

A history of leadership

Seton was founded as the 40-bed Seton Infirmary in 1902 by the Daughters of Charity of St. Vincent de Paul. In 1975, Seton Medical Center (Austin) was built.

Today, Seton serves 11 counties with a population of 1.9 million. A member of Ascension Health, the largest private charitable healthcare system in the United States, Seton is a fully integrated healthcare-delivery system and features the broadest range of services in Central Texas. Seton also offers the most diverse and wide-ranging services of any regional healthcare system in the United States.

Seton is the largest Austin-based private employer in Central Texas with 12,000 associates and about 500 employed physicians. It provides a broad range of community services, including supplying the Austin Independent School District with all of its student-health services nurses. Seton is the largest safety-net provider in Central Texas, administering care for approximately 325,000 uninsured and underinsured patients.

Meeting increasing demands

Given its reputation, it would be easy for Seton to coast on past acclaim, but Charles J. Barnett, president and chief executive officer, said the system continues to work hard to improve the safety of the clinical environment in which its patients are served, especially since the demand for services has never been greater.

“We have seen an increase in individuals who come to us who don’t have anywhere else to turn as the economy has created larger numbers of people who do not have any insurance,” Barnett said.

Barnett chairs the Integrated Care Collaboration, comprised of representatives from both public and private organizations who provide care to the uninsured and underinsured. The collaborative’s chief goal is to create a robust communication system that can provide a more coherent infrastructure for delivering care.

Also on Barnett’s radar is a coming population boom. Central Texas is expected to grow by one million people over the next 10 years. In preparation, Seton is building a third bed tower for its pediatric facility, Dell Children’s Medical Center, at an urban redevelopment site. It also constructed three new hospitals over a 36-month period during 2007 – 2009.

“We are finding that the demand for services continues to be pretty robust, but we will need to do other things besides adding beds to bring some additional capacity online,” Barnett said.

He added that this growth will demand a provision of service beyond what Seton already provides, and this demand is going to require more collaboration.

Partners for the future

Seton places a high priority on its numerous partnerships. For example, the organization has teamed  with Austin Regional Clinic, the largest multi-specialty group in Central Texas, on a number of initiatives, including making care less fragmented. Seton is also working on clinical-translational research with The University of Texas Southwestern Medical School and the University of Texas System.

At Dell Children’s Medical Center, Seton has been working on expanding its quaternary services, and it is collaborating with Children’s Medical Center in Dallas and UT Southwestern on introducing new services like echocardiography in congenital heart surgery. Thanks to its historic collaboration with the University of Texas, Seton’s involvement in clinical-research trials has expanded exponentially.

Seton’s ongoing partnership with the nursing programs at universities and colleges in the area continues to yield fruit. Seton hires approximately 200 RN residents per year through the 18 to 30-week Seton RN Residency program. Each available slot typically attracts six to eight qualified applicants, making this program highly competitive.

During the past decade, Seton has also committed itself to being a national leader in patient safety and innovation. Barnett said that it hasn’t been an easy road, but the results are promising. For example, Seton’s perinatal safety program has earned national acclaim thanks to the adoption of evidence-based practices, such as restricting elective inductions prior to 39-weeks gestation.

Furthermore, Seton has rolled out two highly successful pilot projects in partnership with local communities and donors. For children with asthma, Seton’s Asthma Management Pilot has resulted in a 37-percent drop in emergency-department visits and a 63-percent decrease in hospital stays.

In its first year, Seton’ home-based diabetes education program for uninsured and underinsured Caldwell County residents reduced emergency-department visits and hospital stays among patients enrolled in the program by 33 percent and 75 percent, respectively. Seton number-crunchers estimate a $2.85 benefit for every dollar spent on the program.

“What these two projects show is that, by taking the time to visit with patients in their homes and offering specific tools such as written diets, exercise and medication plans, we are improving the quality of care and quality of life while reducing costs,” Barnett said.

An obligation to collaborate

Barnett believes that healthcare organizations are obligated to their patients and their communities to expand partnerships and collaborations, especially in light of the industry’s multiple paradigm shifts.

“I think one of the greatest weaknesses of the current healthcare-delivery system is its compartmentalization and the degree to which that sort of siloed mentality creates a more fragmented system, and individuals who are seeking healthcare services experience care as fragmented,” he said, adding, “If we had a more cohesive delivery system, one that provided services and care across the full range of needs of an individual, one that was more person-centric, we could cut costs out of the system in a way that would benefit our community and our state, and I think that’s true for the whole country.”

-by Pete Fernbaugh

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