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SLU's Grand Commitment to Improve the Region's Health

On September 1, 2015, members of the Saint Louis University family, employees of SSM Health Saint Louis University Hospital, civic and political officials and guests had no idea they’d be attending a surprise party.

They crowded into the hospital lobby for a quick program that marked two milestones: the official start of an expanded partnership between SSM Health and Saint Louis University aimed at improving the health of the St. Louis region, and the first day the hospital operated under the new partnership. A row of television cameras and reporters with notebooks hinted that more was coming.

St. Louis Mayor Francis Slay, an alumnus of SLU's School of Law, praises the SLU-SSM Health partnership. Photo by Kevin Lowder

St. Louis Mayor Francis Slay, an alumnus of SLU's School of Law, praises the SLU-SSM Health partnership. Photo by Kevin Lowder

SSM Health CEO William P. Thompson was nearly at the end of his brief remarks when he broke the news. SSM Health would invest $500 million in a new hospital and outpatient care center on Grand Boulevard. He said SSM also would make immediate capital investments in the current hospital.

“While the current hospital has served the community well, we have the opportunity to construct state-of-the-art academic facilities that incorporate the best practices in patient-centered design,” said Thompson, who was flanked by St. Louis Mayor Francis Slay (Law ’80) and Saint Louis University President Fred P. Pestello, Ph.D. “This significant investment will enable us to deliver an improved patient experience and even better care for our community.”

The crowd erupted into cheers.

Work in Progress

Details about the new hospital and outpatient care facility have yet to be decided. The original hospital, formerly named Firmin Desloge Hospital, opened in 1933 and is used mostly for medical offices. The hospital’s 365 patient rooms and other operations were moved into a connecting facility in 1988.

The nearby Doctors Office Building was constructed as a temporary facility in 1977. While it has been renovated periodically throughout the years, it is not considered ideal for handling its more than 100,000 outpatient visits each year.

In October, SSM Health St. Louis hired a programming architect to meet with hospital faculty and staff to gather information about what they, their patients, services and students need. This information will include an eye to the future of the dynamic and changing health care environment. Once this future program is completed, SSM will hire an architectural firm to design the new facilities based on these identified needs. Approximately two years later, builders will break ground.

The first patients are expected to be admitted to the new SSM Health Saint Louis University Hospital in September 2020.

  University President Fred P. Pestello, Ph.D., shakes hands with Robert Heany, M.D., SLUCare's chief medical officer. Photo by Kevin Lowder

University President Fred P. Pestello, Ph.D., shakes hands with Robert Heany, M.D., SLUCare's chief medical officer. Photo by Kevin Lowder

Follow Through

Although plans for new facilities are down the road, SSM Health is demonstrating its commitment to making capital investments in current facilities. Less than three weeks after the September event, SSM Health issued a purchase order for a new linear accelerator, a device commonly used for external beam radiation treatments for cancer patients; and a 3T MRI, the gold standard in neuroimaging. Hospital administrators also met with architects who will design a radiation-oncology suite to house the new equipment. The total cost of the project is more than $9 million.

“There is quite a bit of pent-up demand on this campus,” said Kate Becker (A&S ’83, PH ’11), president of SSM Health Saint Louis University Hospital. “Our number one goal is exceptional patient care, and these investments will ensure that we can support our physicians in providing that exceptional care.”

An Inspired Move

The shared mission of providing exceptional patient care inspired the expanded partnership between two of the region’s outstanding faith-based health care organizations. While the two Catholic non-profits have committed to work together to define the best practices to care for patients, they will retain their individual identities, which complement each other.

As part of the expanded partnership, the University bought back Saint Louis University Hospital from Dallas-based Tenet Healthcare Corp. over the summer and contributed it to SSM Health in exchange for a minority financial interest and two seats on the board of SSM Health St. Louis. The deal became official in September when the hospital was renamed SSM Health Saint Louis University Hospital.

In addition to the hospital, SSM Health now owns what had been the Anheuser-Busch Eye Institute, the Anheuser-Busch Eye Institute Annex, the West Pavilion, the Saint Louis University Hospital garage and the Auxiliary Hospitality House. The Doctors Office Building on Vista remains part of Saint Louis University, as does the University’s physician practice, SLUCare Physician Group, which will collaborate closely with SSM’s physician group

The Path Toward Partnership

Robert Heaney, M.D., professor in the department of internal medicine, assistant vice president of medical affairs and chief executive officer for SLUCare, said the University began exploring the idea of partnership about three years ago.

The University realized that in order for the School of Medicine and SLUCare to thrive in an increasingly complicated health care delivery system, it needed a strong network partner, he said. With new payment models aimed at rewarding quality and affordability, partnering with a larger system would be critical. Health care organizations with limited patient populations and inefficiencies in care delivery would be left out of the game. In addition, a larger system could help with capital needs, as well as with technology and infrastructure upgrades that are needed in the hospital.

In light of these changes in the health care landscape, Heaney said the University’s first step was to buy back the hospital from Tenet Healthcare, which was changing it health care delivery model. While SLU previously operated its own teaching hospital, he said the University did not want to return to that model.

“You don’t want to have a stand-alone tertiary, quaternary teaching hospital especially when contracts are being set with systems, not individual groups or hospitals,” said Heaney, who helped facilitate the buyback and structure the SSM Health partnership. “We also had about 400 clinicians in 40 different locations spread across the St. Louis metro area, and we needed a coherent, cohesive way forward with a network that had the same vision and mission we had.”

SSM Health quickly emerged as the frontrunner. The two organizations have a history that stretches back to 1903 and a proven track record in working together. For the past several decades, the SLUCare Physician Group and SSM Health have partnered to provide pediatric care services to patients at SSM Health Cardinal Glennon Children’s Hospital and maternal-fetal medicine services at SSM Health St. Mary’s Hospital.

The partnership will significantly strengthen our university by advancing our ability to deliver high quality and compassionate medical care, which the SLU community has identified as a key initiative in our strategic plan."

Philip O. Alderson, M.D., vice president of medical affairs and dean of the School of Medicine

A Continuum of Care

Becker said it made sense for SSM Health to partner with SLU. While SSM Health had a strong network of community hospitals, the system lacked a tertiary, quaternary care facility that offered the specialized care and equipment; access to rare procedures, researchers and clinical trials; and an academic hospital and physician practice. The hospital is SSM Health’s first adult academic medical center in its four-state (Illinois, Missouri, Ohio and Wisconsin) 19-hospital network.

“Both SSM and SLU have a vision for the future of health care, and it involves integration of the delivery network,” said Becker, who was associate general counsel at SLU for more than four years and SLUCare CEO for more than two years before joining SSM Health in 2011 as president of SSM Health St. Mary’s Health Center.

“What that means is that from the time patients enter our health care system – whether it’s through the emergency department, an urgent care or their primary care physician’s office – all the way through their outpatient procedure or inpatient stay and aftercare, we want to offer an entire continuum of care. Through this continuum of care, we’re able to provide better care at a reduced cost because we’re not duplicating services and we’re sharing information. We’re able to follow up and stay connected to our patients in a meaningful way.

“Our goal is to provide this level of care to all patients, including the underinsured and uninsured in our community.”

Both SSM Health and SLU are interested in maintaining ties to federal health care centers, regional health commissions and integrated health networks.

“The partnership will significantly strengthen our university by advancing our ability to deliver high quality and compassionate medical care, which the SLU community has identified as a key initiative in our strategic plan,” said Philip O. Alderson, M.D., vice president of medical affairs and dean of the School of Medicine. “The deal also reflects a major investment in the future of SLUCare, which is vital to our mission and essential to the University’s overall financial health.”

A Team Effort

The partnership is a long-term, 50-year agreement. Alderson noted that many university faculty and staff leaders made important contributions to the planning of the partnership. In the later stages of what was a complex three-way agreement involving Tenet, SLU and SSM, a small core group worked hard to bring the transaction to a successful conclusion. Bill Kauffman, SLU vice president and general counsel, led the overall transaction team and the core negotiation group. Alderson and Heaney, represented academic and clinical interests. Anne Garcia, SLU senior associate general counsel, provided vital legal support, and David Heimburger, vice president and chief financial officer, led SLU’s financial issues group. Critical contributions were made by outside consultants from Hogan Lovells (legal issues) and Raymond James (financial issues). Among many others who made important contributions were SLU trustees Frank O’Donnell, M.D., and Al Litteken; Kathy Merlo, SLUCare chief operating officer; Marty Clay, SLUCare director of administrative operations; and Gary Whitworth, School of Medicine chief financial officer.

“SLU trustees, led by Chairman Joe Conran and University President Fred Pestello, were unwavering in their belief of the importance of completing the agreements,” said Alderson. “Without all of this support and the efforts of countless others, this transformative transaction could not have been completed.”

Guests pack the SLU Hospital lobby during the press conference announcing the new partnership. Photo by Kevin Lowder

Guests pack the SLU Hospital lobby during the press conference announcing the new partnership. Photo by Kevin Lowder

Nuts and Bolts

Medical staff members are meeting monthly to determine logistical details such as the operational configuration of the expanded partnership and what care will be provided and where. As a Level I trauma center, SSM Health Saint Louis University Hospital will provide for the critical care needs of patients. Heaney said SLUCare physicians also plan to maintain their signature programs, such as solid organ and bone marrow transplantation, and cardiovascular and spine surgery; and expand in other quaternary programs.

“The good news is we appear to be on the same page, and we’re excited about the opportunities,” Heaney said.

Each entity brings strengths to the partnership. Saint Louis University is a leader in medical education and research, as well as in the advanced health care delivered to patients by an academic medical practice. SSM has a superb network and knowledge of where care needs to be provided and how to deliver it. Heaney and Becker said SSM Health and Saint Louis University want to build a system that provides care where patients live and work.

“We have to think about what patients want, where physician capacity exists and where the infrastructure and equipment are,” Becker said. “This transition isn’t like flipping a switch. It’s a process that will unfold as we plan for the new facilities on this campus.”

Good Stewards

Saint Louis University anticipates the partnership will lead to dramatic improvements in the educational experience for SLU’s medical students, residents and fellows. Heaney said the new facilities will match the high quality of their education and will allow students to learn about best practices in medicine in an environment where performance will be judged not only by the quality of care physicians provide but by the degree to which they provide just stewardship of the resources available to them.

“Our students, residents and fellows deserve to learn about the best care in a great facility. Now we’ll offer that opportunity,” he said.

More importantly, Heaney said expanded clinical services will provide students with greater learning opportunities. He said they will be involved in the care of a much larger population of patients with a broader range of specialties and subspecialties. For instance, Heaney said the school will be able to consider offering programs in new specialties, such as child psychiatry or rehabilitative medicine.

“We have a way forward to build out those experiences, and SSM has expressed a willingness to build them with us,” he said.

Alderson noted that students in SLU’s other health professions programs, including nursing and physical therapy, also will benefit from the expanded opportunities. In addition, Alderson said the partnership can lead to extended clinical research trials of new medications and new technologies area-wide in the SSM Health network.

The Jesuit tradition of care for the person will remain at our center."

Robert Heaney, M.D., professor of internal medicine, assistant vice president of medical affairs and chief executive officer for SLUCare

Similar Cultures

Becker and Heaney said the feedback from staff and faculty within both organizations has been overwhelmingly positive. And they hope to keep it that way by giving priority to one key aspect of the partnership – cultural integration.

“Inability to find compatibility in culture means you will fail, no matter what else you do,” Becker said.

She is confident that because SLU and SSM Health have similar missions their partnership will succeed.

SSM Health’s mission: “Through our exceptional health care services, we reveal the healing presence of God.”

SLU’s mission: “The pursuit of truth for the greater glory of God and for the service of humanity.”

During her first two weeks as president of SSM Health Saint Louis University Hospital, Becker held town hall meetings at the hospital daily, sometimes twice daily, to explain SSM’s mission and identify common ground. SSM Health established a Mission Partnership Team comprised of staff from both organizations and different disciplines (housekeeping to medical staff) to find ways of fostering cultural integration. SSM Health took members of SLU’s pastoral care department, which will have a leadership role in the cultural transition, on a heritage tour that celebrates the Franciscan Sisters of Mary and their founding of SSM Health in St. Louis.

Becker said SSM and SLU employees are encouraged to serve together not only in their health care settings but in their communities as well. This fall, employees from SSM Health Saint Louis University Hospital and SSM Health Cardinal Glennon Children’s Hospital teamed up for a Habitat for Humanity project.

“The Jesuit tradition of care for the person will remain at our center,” Heaney said. “We’re collaborating with a partner that not only understands our values but understands the importance of care providers as people in their own right. That gives me the greatest hope for the future.”