Opinion: Porter is ready for the ‘road ahead’

Porter Medical Center will soon celebrate our second anniversary as part of the UVM Health Network and welcome a new president to take our organization forward. It is an exciting time for our organization. The past three years has been a busy, productive and positive period in the history of Porter, and it seems like a good time to pause and reflect on what we have learned and what we as an organization see as our “Road Ahead” for the next 3-5 years, and to share with our community this vision for the future.
Recently, we have spent significant time at the leadership level talking about the UVM Health Network itself, why it exists and what exactly we are working to accomplish and how we plan to get there. To state the obvious, clarity of purpose and total alignment among all of the affiliates around our short and long term goals are key ingredients of success.
The product of these conversations has been a new plan, which we have called “The Road Ahead.” It is a comprehensive plan that has been developed and approved by the leaders of each affiliate and is a “call to action” to every employee at Porter and throughout the Network to work together with a shared vision of what we are doing today, and what we must do tomorrow, to truly fulfill our promise to the patients and residents who depend on us every single day.
Why do we need such a plan? First some background.
The University of Vermont Health Network is an affiliation of six hospitals in New York and Vermont, a multi-specialty medical group and a home health and hospice agency. Although each affiliate of our Network, including our academic medical center, brings unique characteristics, history and contributions to the creation of this new integrated rural health Network, what binds us together is our singular commitment to putting our patients at the center of our efforts: To improve the health of our communities.
Sound familiar? This is exactly how we describe Porter’s mission. The alignment between our mission at Porter and the mission of the Network is powerful.
But there are challenges that we are facing, and the evidence can be found by simply looking around. Nationally, rural hospitals continue to struggle as costs rise and workforce becomes increasingly scarce. According to Becker’s, between 2010 and January 2018, 83 rural hospitals closed and an additional 11 more closed in 2018 alone. The reasons for these closures are varied, but all have failed to weather the myriad changes in health care in recent years. Throughout the country, hospitals have responded to these challenges by coming together to form networks, including the UVM Health Network, and developing regional strategies to better serve their communities. Our health Network has done just that. Our affiliations are borne from a shared commitment to preserve access to critical health care services across our region.
Here is our core belief as leaders of Porter Medical Center — As an affiliate of the UVM Health Network, we are stronger together.
What does this mean to us at Porter?
There are several current initiatives that touch Porter and our community directly and that must be accomplished if we are to fulfill this promise of “stronger together.” These include the implementation of the Epic unified health records system, addressing the mental health and opiate addiction crisis and executing our strategic facilities plan.
This strategy recognizes that our people are our greatest asset as informed and engaged advocates of positive change, and that we must maintain our “local culture” as we become more aligned with the culture of the Network.
Here is an important point about culture. A “Network culture” and a “local culture” are not mutually exclusive. Porter has an organizational culture that has evolved over the past 95 years, a way of doing things here in our community. There are many great things about our Porter culture we are all committed to preserving.
In addition, as a “young” network, we also need to develop a Network culture, a way of doing things Network-wide and a shared understanding of why we are stronger together. This Network culture will be based on our collective values — putting patients first, valuing our workforce, excellence and quality in the care we deliver, responsible stewardship and ensuring appropriate access to the right care in the right place.
We must, and we will, meld these cultures — leveraging the strengths of each — and use these foundational concepts as guiding principles to frame our approach:
•In all decisions, we put the needs of our patients and families first;
•We are creating for our region a locally led, non-profit care delivery network in collaboration with community partners;
•Our patients should get the high-quality care they need as close to home as possible, indeed at home if possible;
•We must be good stewards of resources. At times, this means making difficult decisions.
•Across the Network, we need to “meet people where they are” relative to change and communication.
At Porter, our patients and residents are at the center of all our decisions. This is true of the Network as well. We need to leverage our relationships to provide coordinated, consistent high-quality care for our communities. To do more of what we are already striving for at Porter with the strength of the Network behind us.
There are several high-level strategies that are directly related to the Network Strategic Plan that we are focused on to accomplish the vision I have outlined above:
•Hospital Margin Improvement. “No margin, no mission”. All of the UVMHN hospitals must work together to create efficiencies and be financially sound.
•Clinical Integration and Care Delivery Optimization (CDO). CDO is a provider led process to examine what services should be delivered where. The decisions of CDO are driven by quality, access and cost – in other words – what is best for our patients. I imagine the day when “the promise” is true – you walk into a UVMHN-Porter clinical area and get exactly the quality of service we all expect from a University Medical Center. The approach to common clinical problems is consistent, driven by best practices.
•Shared Services. Shared Services refers to the sharing of non-clinical administrative services. Some of these services are “back office” such as legal or supply chain. Others are more apparent, such as IT, Communications and Human Resources. We need to leverage our size to have the best IT support, the best priced purchasing, and the best possible recruiting and communications functions.
•Integrating Hospital Operations. The goal here is to integrate and coordinate clinical and care related services such as pharmacy, linens, supply chain and more to ensure we are delivering care in a more integrated, efficient and coordinated way.
We believe that this “Road Ahead” plan will continue to lead Porter toward a positive future and allow us to “Improve the health of our community, one person at a time.”
Dr. Fred Kniffin is president of UVMHN/Porter Medical Center in Middlebury.

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