Viewpoint
The Rural Development Imperative: Fundraising to 'Own' the Hospital
By Bill Henry
Many rural hospital boards take pride in the fact that they have never had to ask their communities for financial support. They see this financial independence as a sign of strength and assume that, as a result, the community views the hospital as virtuous. Indeed, many rural hospital boards hold such independence as proof of their governance skills. However, I take the opposite view.
There are two reasons why it is essential that rural hospitals raise money in the communities they serve. The first is obvious: Rural hospitals need the money to develop and enhance the services they offer. The second is less obvious but equally important to many hospitals: Raising money is a critical way of helping community members feel that their local facility is “my hospital.”
The bald fact is that almost all rural hospitals must compete with larger, more visible, better-equipped urban facilities with more well-known medical staffs, better marketing and deeper pockets. Rural hospitals’ attempts to compete with sophisticated urban health care organizations on technology or physicians is risky. There is no way that most rural hospitals will be the provider of choice for that new heart valve that “Eleanor” needs, or “John’s” new knee.
Does this mean that rural hospitals are destined to be only temporary way stations, where victims of auto crashes and farm accidents are stabilized until the med-evac helicopter whisks them off to the city? No, but it does mean that rural hospitals have to be clear about the market segments in which they can compete and be smart about building on the advantages they have in those market segments. That’s where fundraising comes in.
Fundraising for rural hospitals should be viewed in the context of a four-dimensional approach to their viability. The first dimension is hospital leadership. This means sound strategy development and governance accountability, effective administration, cost control, quality improvement, reimbursement management, including critical access hospital (CAH) status, among other elements.
The second dimension is clarity about what kinds of conditions can best be treated at the hospital and what kinds of conditions will require patients to be treated elsewhere.
In almost every rural community, the prevalence of patients with chronic conditions is high—and the hospital should consider that treating these patients in the community is a top priority. That prevalence also means that the hospital must collaborate effectively with its medical staff and many other community resources to develop effective management systems for area patients with chronic diseases.
The third dimension is demonstrable quality in caring for the conditions that the hospital chooses to treat locally. This quality should be evident to everyone in the community, so that most locals with those conditions would never consider going elsewhere for care.
Among other things, that means that “Sylvia” can brag to her sister in the city—and to her neighbor next door—about how helpful the local hospital is in managing her diabetes.
The fourth dimension is creating the image of the hospital as “my hospital” in the minds and hearts of as many local people as possible. This is the singular advantage that rural hospitals have over their urban competitors—once they have demonstrated that they provide excellent care, they must build on their importance in the lives of people in their community.
There are several ways of building a sense of hospital ownership among community members.
First, the hospital must provide authentic opportunities for people to participate in planning its future. One option is to hold community forums in which the board and top management respond to community members’ expressed needs and explain what services the hospital can and cannot provide.
Another method is to create “leadership councils” that bring together business, professional, consumer and public sectors of the service area to advise hospital leaders on strategy. “Alumni” boards comprising former trustees and retired physicians and administrators can also foster communication between the community and the hospital.
Second, the hospital must provide myriad opportunities to the community so it feels real ownership of what the organization is and does.
For some people, ownership will mean volunteering their services to the hospital. For many more, it will mean opportunities to provide financial support to the organization. That support can take several forms—e.g., annual fund drives, capital and other special campaigns, planned giving.
But in order to take advantage of this support, the hospital must first establish a thoughtful and well-managed development program, possibly in a separate foundation established for the purpose. It will require active leadership by the board, physicians, employees and hospital executives.
Most importantly, it will require that the hospital proudly ask people in the community to contribute, recognizing that such a request is an opportunity for people to participate in determining the hospital’s future.
It will also mean that the hospital must recognize contributions in a meaningful way. As a trustee of a rural Nebraska hospital told me, “We believe that people whose name is on the plaque next to the emergency room door are unlikely to drive by the hospital to get service elsewhere.”
Providing quality care is essential for rural hospitals, but it is not sufficient. The rural hospital’s success depends on the community’s investment in the hospital’s future, as well as its quality. Creating opportunities for community members to contribute financially and strategically are critical to the hospital’s viability.
Bill Henry is president of ForeSight Strategy Associates, Arden Hills, Minn., and faculty director for applied business and health systems management in the University of Minnesota’s College of Continuing Education. He can be reached at (612) 720-2135 or via e-mail at wfhenry@comcast.net.
This article 1st appeared in the May 2008 issue of Trustee Magazine.
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