Competition has been shown to be useful up to a certain point and no further, but cooperation, which is the thing we must strive for today, begins where competition leaves off. - Franklin D. Roosevelt
It has been said that a little competition never hurt anyone. It pushes people to do their best and achieve great success. But for the hospitals in the five northern counties in Idaho, they have found success through collaboration, not competition.
For the last 27 years, the Northwest Hospital Alliance, previously known as the North Idaho Rural Health Consortium, has worked together for the benefit of the five northern counties—Bonner, Boundary, Benewah, Kootenai and Shoshone.
”The guiding principle behind the Alliance is that it makes more sense to work collaboratively rather than competing against each other,” said Sheryl Rickard, the CEO of Bonner General Health in Sandpoint.
Rickard and the CEOs from the other four hospitals—Boundary Community Hospital, Benewah Community Hospital, Kootenai Health and Shoshone Medical Center—make up the board of the Northwest Hospital Alliance. Rickard has been involved with the Alliance since its inception when she then served as CFO of what was then Bonner General Hospital.
The mission statement of the Alliance states that they “exist to provide a regional cooperative approach to the delivery of rural health care in the five northern counties of Idaho.”
By working together, each hospital is confident that they can improve the quality, efficiency and cost of the health-care services they bring to each community.
“We are all committed to remain independent hospitals, recognizing that there are things that we can do together to ensure that independence,” said Rickard. “We are a hospital alliance.”
Through grants received due to their collaborative efforts, the Alliance has been able to purchase equipment and provide education that would not have been possible if each hospital worked independently from one another. Some of the things they have purchased through collaborative grants include: tele-radiology equipment, diagnostic imaging archiving equipment, tele-pathology equipment and interactive video equipment. Furthermore, they have brought to their hospital staff educational opportunities that include trauma, coding and documentation, and rehab continuing education.
“We have also been able to reduce cost by participating in group purchasing,” said Rickard, who cites Meditech conversion, medical-waste joint pricing and MDStaff physician credentialing software as some examples.
But it is not just the CEOs who meet. Each hospital has specific departments that also collaborate on a less regular basis than that of the CEOs, who meet monthly. Rickard shares that some of the Peer Groups who meet include CFOs, nurse managers, facility directors, emergency management coordinators, human resource directors, information systems directors, laboratory directors, quality/performance improvement directors, rehabilitation directors, community development directors and credentialing specialists.
“These staff members articulate that the relationships formed through these group meetings have been extremely valuable,” said Rickard of the feedback she has received from her staff members. “The collaboration in these peer groups is extremely beneficial to all.”
Caryl Johnston, director of the Northwest Hospital Alliance, agrees. “Collaboration through these peer groups creates an environment of trust and communication,” said Johnston. “The peer groups provide a great resource for those at all the hospitals and allow those in similar roles to come together and share ideas.”
Johnston said because of the education that happens in these peer groups, a patient who is transported to Kootenai Health may even be able to bypass the emergency room and go straight to surgery or wherever they may need treatment. “The smaller hospitals know how to prep and transport the patient. This saves time, and time often dictates outcomes,” said Johnston.
One of the goals of the Alliance is for individuals to be able to stay in their own community for their health-care needs. The members of the Alliance have had a longstanding agreement to not advertise in one another’s counties unless that county does not provide the services advertised.
One significant advantage of the collaboration is that all of the hospitals, with the exception of Shoshone Medical Center, share the same electronic medical record.
Sharing a medical record electronically becomes extremely important in critical situations. Rickard said that there are many examples of when this saved the life of a patient. “When patients come into Bonner General Health and need to be transferred to a higher level of service, the receiving hospital is able to pull up all the records online and have a plan in place before the patient arrives,” she said.
The costs associated with implementing electronic medical records is very steep, so the fact they can share in those costs makes it feasible for each of the hospitals to afford them.
With almost three decades of history, the Northwest Hospital Alliance is a model for other rural hospitals seeking to share costs and collaborate their resources. “We are very unique,” said Rickard.
Johnston said that the Alliance’s goal is to benefit each of the communities in the five northern counties. “It’s really about patient-centered care,” she said. “If a patient needs a higher level of care than the smaller communities can provide, Kootenai Health can provide those services. But we know it is best for the patients to return home and to their own communities so we can assist in that transition as well.”
When looking at the services that smaller hospitals such as Bonner General Health and Boundary County Hospital now offer, it is clear that it is a result of the collaborative effort.
“If it weren’t for the relationships formed through the Alliance, we would not have Kootenai Cancer Services [at Bonner General Health],” said Rickard.
The fact that Bonner General Health, through Kootenai Cancer Services, can provide services that include chemotherapy is a great benefit to those battling cancer. The commitment of time and resources—and of course a patient’s limited energy—it takes to travel to Coeur d’Alene can be overwhelming. So the fact that cancer services are provided in Sandpoint benefits not only those in Bonner County, but those in Boundary County and Western Montana as well.
“The establishment of Kootenai Cancer Services in Sandpoint all came from the relationship we have built with Kootenai Health over the years through the Alliance,” said Rickard.
For nearly three decades, the Alliance has collaborated to bring medical services that do not exist in most rural communities to the people of North Idaho. While Rickard said they have considered expanding the number of hospitals in the Alliance, the focus is on that which has already proven to be a resounding success.
“If each of the [rural] hospitals is healthy, then Kootenai Health will also be healthier,” said Rickard. “The smaller hospitals can take care of those in their own communities.”
