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Consistent Epiphanies

Kathleen Becker, president of the new Saint Louis University HospitalPublic health alum leads SSM Health Saint Louis University Hospital into a new era of health care.

Kate Becker is uniquely qualified to take a lead role in the changes taking place on the Saint Louis University medical center campus. The president and CEO of SSM Health Saint Louis University Hospital is a 2011 graduate of the College for Public Health and Social Justice and one of the few hospital CEOs in the country with an M.P.H.

“I never imagined I’d be sitting in this office,” said Becker. “But my background in public health has proven to be the perfect framework for discussing what an integrated delivery model looks like and where a medical center fits into that model.”

Since entering into a partnership in 2015, SSM Health and Saint Louis University have been developing an integrated model of care that blends health promotion and clinical care. Conceptualized for years as two distinct, albeit overlapping systems, policymakers and providers are finding that integrating individual care and a public health approach into a single system can save resources and improve patient outcomes.

“Over the past decade, I’ve gone to meetings where there’d be consistent epiphanies about integrated care,” said Becker, who, before joining SSM Health, was associate general counselor for Saint Louis University and CEO for SLUCare, the University’s multispecialty medical practice. “You’d have to remind people that there’s a whole discipline dedicated to what they were discussing... that there were people you could ask to help with these initiatives.

“We operated in separate universes with very little crossover for such a long time,” Becker said. “Public health was supposed to deal with seatbelts and smoking and fluoride in the water. Traditional care was supposed to deal with coughs, colds and heart attacks. We’re doing a much better job now of seeing how we intersect because that’s really what integrated health care delivery is – private health care in a public health care space.”

The Affordable Care Act (ACA) has encouraged integration of public and private health care since its enactment in 2010. While the principal goal of the ACA is to improve access to the traditional health care system via expansion of affordable insurance, there are specific provisions that encourage health promotion and disease prevention. Individual health, said Becker, is now considered inseparable from the health of the larger community.

Connective Care

Becker said the goal of any integrated model is to keep people healthy and to deal with chronic conditions better so patients are using more primary care resources and less of the more expensive acute care resources.

“There are some things along the continuum of care, such as trauma, transplant and cardiac care that always are going to take place in a hospital setting,” said Becker. “The new hospital will be dedicated to providing the excellent tertiary and quaternary care that SLU is known for historically. Yet, we expect a lot of folks to be using the expanded outpatient services in the new ambulatory care center.

“It’s about getting patients in the right place at the right time. If we do that, those who should be inpatient are inpatient and those who do not need to be inpatient don’t have to be.”

Toward this end, SSM Health joined the Integrated Health Network, an organization of St. Louis metro area hospitals, federally qualified community health centers and other safety net institutions that work to increase patient access to affordable health care. It also embedded a care referral coordinator in the hospital emergency room to help patients connect with community providers after discharge. For patients admitted to the hospital, disease-specific nurse navigators educate patients about their conditions and help remove barriers to their follow-up care.

“Consequences can be very serious when patients get off track,” said Becker. “It goes a long way toward building relationships with your patients when you individualize care, when you ask whether they have food at home or whether they have a scale to weigh themselves, and you really care to hear the answer.”

Present and Accountable

Saint Louis University has had a footprint on South Grand Boulevard for more than 150 years – first with establishment of the medical school in 1836 and then the opening of the hospital in 1933 by the Saint Louis University Jesuits and the Sisters of Saint Mary. SSM Health Cardinal Glennon Children’s Hospital recently celebrated its 60th year on South Grand.

Keeping the new SLU hospital and ambulatory care center in the same area, said Becker, is a testament to the University’s commitment to St. Louis. She said the medical center campus is strengthening its ties with the Tiffany neighborhood–its longtime home–through free diabetes education classes, cancer screenings, health fairs and back-to-school programs, among other events.

“SLU Hospital is unique because people come from across the region for the high-end services we provide but we’re also a neighborhood hospital,” said Becker. “I think we’re doing a pretty good job of balancing these two things.”

A workforce development project is another initiative designed to strengthen the bond between SLU and the community. SSM Health Saint Louis University Hospital is collaborating with Forest Park Community College to create opportunities for graduates of its health professions programs. The goal is to help people who live in the city find jobs in the city.

In addition, SSM Health Saint Louis University Hospital is in the midst of a health needs assessment – a public health tool used to identify unmet health needs in a community. This process brings community stakeholders together to conduct epidemiological, qualitative and comparative research to describe problems, identify inequities in access to services and determine priorities for the most effective use of resources. For the next couple of years, the three areas of concentration chosen by SLU and SSM Health are behavioral health and substance abuse, access to care for patients with kidney disease and violence prevention.

Becker said she anticipates the integrated care initiatives and community outreach efforts will mean more opportunities for public health and social work students to find practicums and internships at SLU.

In the end, Becker said advancing social justice is the undercurrent of all initiatives underway on the medical center campus.

“Our commitment to social justice goes beyond our shared mission of caring for the underserved,” said Becker. “Social justice is making sure the resources we have are being used to the greatest extent possible and are providing the most benefit possible. That relates to everything – from our workforce development program, to new recycling measures we’ll be undertaking in the new facilities, to our community outreach efforts.

“It’s not about reengineering the system as much as it is about knowing that we have an obligation to take care of one another. In the end, we all do better when each of us does better.”

CPHSJ Communications
Published: April 21, 2017

This article first appeared in the fall 2016 issue of the College for Public Health and Social Justice's SoJust magazine.

About the College for Public Health and Social Justice

The Saint Louis University College for Public Health and Social Justice is the only academic unit of its kind, studying social, environmental and physical influences that together determine the health and wellbeing of people and communities. 

It also is the only accredited school or college of public health among nearly 250 Catholic institutions of higher education in the United States. Guided by a mission of social justice and focus on finding innovative and collaborative solutions for complex health problems, the College offers nationally recognized programs in public health, social work, health administration, applied behavior analysis, and criminology and criminal justice.