Reimagining the Community Hospital in a Challenging Market (61H)

According to the American Hospital Association, 136 hospitals in the U.S. have closed since 2010, with many more at risk, burdened by declining patient volumes, labor shortages and financial challenges. Amid this trend, Decatur, Ill., presents a contrasting narrative of resilience. Once a thriving industrial town, Decatur's population has decreased from nearly 100,000 in 1980 to 70,000 today, impacting the local economy and healthcare infrastructure. HSHS St. Mary's Decatur Hospital, serving the community for over 150 years, faced several challenges: an aging population, worsening payer mix, rising supply costs and staffing difficulties. The discovery of a critical structural issue requiring a $100 million repair forced a decisive moment for the hospital's future. Choosing to remain a cornerstone in Decatur, HSHS St. Mary's embarked on a strategic overhaul to secure its presence. The strategy centered on adapting to a healthcare environment favoring higher acuity patients and surgery-focused services. This necessitated a significant $90 million investment in facility upgrades, emphasizing several strategic initiatives:

• Finance-forward service line rationalization: A focused approach to streamline services and ensure that each contributes positively to the hospital's financial health.
• Hub-and-spoke optimization and regionalization: Leveraging the hospital's network to optimize care delivery and ensure patients receive care at the most appropriate setting.
• Evidence-based nursing unit efficiency: Implementing best practices in nursing to improve care efficiency and patient outcomes.
• Behavioral health protocols in the emergency department.
• Responding to peak demand: Improving the hospital's ability to level load high patient volumes effectively.
• Precise demolition of the failing patient tower: Carefully deconstructing the compromised structure while maintaining safe hospital operations.

This comprehensive approach not only aimed to revitalize the hospital's infrastructure but also to realign its service offerings with the evolving needs of the community and the broader healthcare landscape. This case study exemplifies one hospital system's commitment to stay in a declining community and the strategic planning and investment in facilities and services that enabled a community hospital to navigate through difficult circumstances and avoid closure.