Saint Anthony Hospital declares its independence
September 4, 2009

Saint Anthony Hospital President and CEO Guy Medaglia. (Photo by Troy T Heinzeroth)

By Jean Lachowicz | September 2009

Some call it crazy. Some call it risky. Guy Medaglia, president and CEO of Saint Anthony Hospital, calls it “nothing short of triumphant. We are a hospital without walls, out in the neighborhoods promoting health as a faithbased community hospital.”

On July 1, Saint Anthony Hospital became an independent facility. As a stand-alone hospital, Saint Anthony now is among only 14% of American Hospital Association – registered hospitals that are part of no system or network. “Our independence allows us to be nimble,” said Medaglia. “We are able to respond to ideas that arise out of the community and from our own staff without going through a long bureaucratic process of corporate approval. It is amazing how fast we can get things done now.

“Sure, there is a lot of risk. It might not be the right choice for every community hospital because it depends on the hospital’s mission and the needs of the community. But it is absolutely possible for other hospitals to replicate what we are doing,” he explained.

Saint Anthony de Padua Hospital’s history is intertwined the history of Chicago as well as the evolution of healthcare in the United States. The hospital was founded and run by the Franciscan Sisters of the Sacred Heart, in its red brick building at California Avenue and 19th Street, for nearly 100 years. In 1993, Saint Anthony’s management was transferred to the Missionary Sisters of the Sacred Heart of Jesus-Stella Maris Province, and in 1995 the Missionary Sisters partnered with the Daughters of Charity to incorporate as Catholic Health Partners. By 2002, Catholic Health Partners disbanded and Saint Anthony became a member of Ascension Health, a network of 67 acute-care hospitals in 15 states.

Economic and technological shifts in the healthcare industry left Saint Anthony struggling to survive. In 2007, Ascension Health and the hospital’s board of directors began to meet to discuss the hospital’s future. Saint Anthony began shopping for other hospital networks, and even gave consideration to scaling down to an outpatient facility. Peter Fazio, the president of the board of directors of Saint Anthony Hospital, credits the 2007 arrival of Medaglia as CEO as the turning point.

Urban mission

Medaglia was recruited after helping to achieve dramatic success for a Catholic hospital in Delaware and a hospital in northern New Jersey. Raised in the inner-city of Cleveland, OH, he is familiar with the healthcare needs specific to urban areas. As managing director of FTI Healthcare, a Tennessee-based consulting firm that specializes in hospital performance improvement, he immediately began working to strengthen Saint Anthony’s relationship with its own physicians and staff by upgrading surgical suites and obstetrics facilities and meeting with them one-on-one to listen to their ideas and concerns.

Raquel Mendez waits in the lobby of the Saint Anthony Community Wellness Program, which features a mural in the background. (Photo by Troy T Heinzeroth)
Hospital admissions began to rise. Within one year, by July 2008, Saint Anthony overcame a $12.4 million loss the previous year and ended the year with a gain. So far in 2009, medical/surgical cases are up ten percent pediatrics admissions have grown 12%, and surgeries are up six percent.

“Fifty percent of patients treated in our emergency department are children, far higher than the national average,” said Medaglia. Saint Anthony Hospital is one of only 26 hospitals in Illinois certified by the State as Emergency Department Approved for Pediatrics (EDAP). Mohammed Chaudharry, MD, president of the medical staff at Saint Anthony, said a key advantage of the new independent status is, “The administration and the physicians know the neighborhoods and we are most familiar with our patients’ specific needs. Being able to make decisions on a local level makes excellent sense.”

Rosemary Meganck, director of Women’s and Children’s Services at Saint Anthony, said that the hospital has excellent prenatal and maternity programs and is among the top hospitals in the state for outstanding prenatal statistics.

“Because we are independent of networks and bureaucracies, we can jump right in to innovative ways to help our patients,” she said. “For example, we discovered that many women in the community feel isolated after bringing home their baby, so we have created a post-partum support group. New mothers drop in once a week for peer support and education on how to care for their baby. The program is off to a great start and we have eight to ten regular participants.”

Well-positioned

Medicaid covers approximately 50% of the hospital’s patients. As a hospital with above-average numbers of charity cases, Saint Anthony has staff members who feel some trepidation about the upcoming changes associated with healthcare reform. Jim Sifuentes, vice president of mission and community development at Saint Anthony, said, “We’re doing all we can to make sure that our operation runs smoothly and efficiently. No one knows exactly what will happen with government payment for the very low-income patients, but we believe we are in a good position. We talk with our legislators frequently to share our thoughts and viewpoints. As long as we constantly strive to serve the patients the best we can, we will be okay.”

Sifuentes explained that the two major groups served by the hospital are Hispanics and African Americans. He not only works to build partnerships with religious organizations and businesses within the community, but he tries to build bridges between the racial groups in the area as well.

“Health issues go hand-in-hand with poverty, educational opportunities, violence, employment, and the economy,” Sifuentes said. “We take wellness to the people. We talk. We listen. We invite people to events that will be of interest to them in their lives, like a discussion on teen violence from a religious perspective or an exhibit on ‘The African Presence in Mexico.’ We have vans to help them get to us easily. We go to the churches, the schools, the block parties….we want people to know about our hospital and the programs we offer,” says Sifuentes.

Approximately 40 of the hospital’s management-level staff are expected to engage in community outreach activities at least three hours per week. Most staff members do substantially more than three hours per week.

Phyllis Murillo, Manager of Employee Health and Occupational Health, described some of the programs aimed at building staff morale and loyalty. “Our School at Work (SAW) program invites employees and community members to come to the hospital for pre-GED or pre-college education. We help people get back into the swing of school, set goals, and support each other. Last week we had our first SAW program graduation. We are working on a partnership with Wright Junior College for next year.”

Alicia Velasquez-Hill, clinical manager of labor and delivery at Saint Anthony’s Hospital, shows Phyllis Murillo, manager of employee health services, the “Sleep Sack.” Saint Anthony’s is trying to get the SIDS Foundation-supported garment for every infant born at the hospital. (Photo by Troy T Heinzeroth)
Murillo added, “Also from listening to our staff members, we learned that parents are frequently worried about leaving their teenage kids at home while they are at work. We established a volunteer program for teens to help at the hospital during their out-of-school hours to give them something positive to do. The kids work the reception desk, read to patients, and many other jobs that are fun and rewarding for them.”

One of the most popular new events is the Annual Custom Car and Motorbike Show, which is held in the hospital parking lot each June. Madaglia recounts, “The first time we did it, we were watching as Latino gang members gathered on one side of the parking lot and African American gang members gathered on the opposite side. We held our breath there would be no fighting. Eventually they started walking toward each other and we were so relieved to see they were slowly coming together to talk about each other’s engines.”

The hospital engages in many types of medical outreach, including participation in local health fairs and health-related events. A parish nurse program has been established to send Saint Anthony nurses into Catholic and Baptist churches in the area to provide basic care. “The hospital works closely with religious and political leaders to bring our core values of compassion, reverence, service to the poor, and dedication to the community,” said Sifuentes.

Rev. Dr. Richard Nelson, pastor of Greater Open Door Baptist Church, 1301 S. Sawyer, says that the whole community has benefitted from Saint Anthony, especially since it became independent. “Several years ago, Guy [Medaglia] and Jim [Sifuentes] made it a point to come and introduce themselves to the African American pastors in the community. They initiated the relationships, and asked ‘what can we do to help you and your congregation?’ “We now have a parish nurse from Saint Anthony who comes to our church every week to do wellness checks, heart and diabetes testing, and just to talk about symptoms with our members. It goes a long way toward the well-being of the community,” said Rev. Nelson. “Recently a member of our church board of directors had surgery at Saint Anthony, and the access they gave me to minister to him made the whole thing a whole lot easier.

“They do a great job building bridges between Catholics and Protestants, and it benefits the whole community. I want to say how happy we are for what they are doing, and we are praying that God continues to bless them in their work,” Rev. Nelson said.

Saint Anthony Hospital is a nonprofit organization and its board of directors includes physicians, community activists, and business and religious leaders. The hospital has fundraising events throughout the year to support special needs. Last year’s golf outing generated enough money to purchase several vans the hospital uses to transport patients. This year’s golf outing and silent auction will raise funds to buy additional television sets for patients’ rooms.

Antonia Hernandez, Marketing and Public Relations, explained, “It’s bad when you are sharing a room or sitting in a waiting area with someone who wants to watch TV in a language you don’t understand. By adding more televisions, we can accommodate our bilingual community much more comfortably.”

Although Catholic hospitals need to have a sponsor, usually a religious order or a large Catholic healthcare organization, Saint Anthony has established a special board called the “Public Juridic Person,” which allows it to remain Catholic. Cardinal Francis George, OMI, said, “The step that Saint Anthony Hospital is taking is an innovative one. In Chicago, this represents the first time that a Catholic community hospital will be governed in this manner. We are happy that Saint Anthony Hospital will remain a Catholic hospital. It is doing important work in providing excellent care for underserved communities.”

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