St. Joseph’s Hospital Invests in Community to Improve Care

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Kathy-Ruscitto-thumb2Understanding the community an organization serves is one of the keys to successfully transitioning to population health. Many hospitals are discovering they need to engage their patient population in ways previously not considered, with transportation challenges, poverty, and literacy comprising some of the intricate issues that prevent patients from adhering to a treatment plan.

St. Joseph’s Hospital Health Center in Syracuse, N.Y., learned this lesson several years ago, and the care it now provides is rooted in serving its community.

Changing plans after listening to the community

About eight years ago, Kathryn Ruscitto, president of St. Joseph’s, and her leadership team implemented a $250-million investment plan for the 431-bed hospital. Architects mapped out what needed to be done, from patient-room renovations to facilities improvement to parking garages, determining when each element should be completed.

However, before construction began, Ruscitto learned that the hospital’s neighbors were not happy with them, even receiving negative letters about St. Joseph’s place in the community. While sitting in a physician’s office on the edge of campus, she was struck by the poverty surrounding the hospital.

“I remember thinking, ‘We’re putting $250 million into this project, and that is outside our door,’” she said, “If we didn’t fix at least these three blocks outside our door, nothing would change. We realized we are an economic catalyst in this community.”

Ruscitto and other leaders began walking the surrounding neighborhoods, holding focus groups, and engaging with local organizations in order to understand the community’s needs.

“We really had to stop and listen and not be defensive,” she said. “People said some pretty tough stuff to me in the early days.”

Revitalizing housing in the community

To start, St. Joseph’s worked with two housing development not-for-profits, Housing Visions and Home Headquarters, to acquire the three blocks adjacent to the hospital. Through state tax credits and public funds, the hospital built a stretch of green townhomes.

The people who were displaced during building were provided temporary housing and were offered the first opportunity to live in the new homes. Ruscitto said many entry-level hospital employees moved in to these homes, deepening St. Joseph’s connection with the neighborhood.

Walking tours and focus groups uncovered such concerns as the lack of local job opportunities and frustration with patients parking in front of homes and blocking driveways. Hospital leaders were then prompted to rework the initial construction schedule, prioritizing projects that would most benefit the community. For example, the parking garage was built first rather than toward the end as originally planned.

Being a good neighbor

Ruscitto said the hospital paid more attention to the impact of construction on its neighbors as well, taking into account inconveniences and environmental concerns.

“We let locals know when noise was coming or when power outages were expected,” she said. “We created a power outage around dinnertime one evening, so we sent pizza to everyone affected.”

The hospital also wanted its appearance to be more inviting to the community and removed high-walled buildings from the construction plans, stepping down to street level in order to present greater accessibility.

Additionally, St. Joseph’s incorporated a greener environment into the plans. The United States Green Building Council recently awarded the hospital its LEED Gold Certification for the new Emergency Services Building.

The newly constructed Nappi Surgical Tower received an American Institute of Architects award for excellence in design. The 104,000 square-foot tower, which opened in September 2014, features 110 private rooms, new intensive care units, and a waiting room with seating for approximately 135. The entire tower has vast swaths of daylight streaming in from tall windows, and it extends St. Joseph’s green footprint beyond the Emergency Services Building.

The building materials and finishes include recycled content, with low- or no-volatile organic compounds in the paints, carpets, and finishes. A storm-water retention system is also in place, and the entire building will be powered by green energy.

Stimulating the local economy with job training

Creating new housing around the campus still didn’t solve the poverty issues confronting the local community, which is why the hospital helped to create a Northside Urban Partnership that developed Health Train, a 12-week class on job readiness. Those who completed the training were given an automatic interview at St. Joseph’s.

“We needed to figure out how to get people into the jobs we have,” Ruscitto said. “The hospital has greatly benefited from this program. Usually, we have about a 40 percent turnover rate for these positions, but the Health Train graduates stick. We’ve had 100 percent retention.”

Seeing how the hospital, community, and Urban Partnership could work together to improve housing, employment, the environment, and health was a profound learning experience for St. Joseph’s leadership, Ruscitto said.

“If we had not first engaged in the community, our interpretation of what we needed to do was not what the community needed us to do. We did have some self-interest on the front end, but then we realized the power of what we were doing, and we have become a much more strategic, externally focused organization.”

In comparison with the hospital’s budget, the community work did not require a large cash investment. Ruscitto said it was time-intensive, and the success was largely because they found the right partners. She estimated the hospital invested up to $55 million into the neighborhood.

The success of this investment attracted other developers and businesses into the community as a result. In fact, after the first transformation, 10 other investors began revitalization projects in neighborhoods around the hospital.

These efforts have all laid the groundwork for St. Joseph’s to transition into population health management.

“We get it now,” Ruscitto said. “We know how to work with the community. We’ve developed wellness programs that meet people where they are. It’s different work than we’ve done as healthcare institutions, but we cannot afford to continue running healthcare the way it has been.”

by Patricia Chaney

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