SHSMD 2017 Session Summary: Successful Implementation of your Ambulatory Strategic Plan

SHSMD 2017 Session Summary: Successful Implementation of your Ambulatory Strategic Plan

By Lee Ann Lambdin


In 2013, Centura Health was a four-hospital system in the Denver area on the verge of becoming irrelevant in their market. Solely hospital-centric and expecting people to come to them, they had no ambulatory presence. In search of some fresh ideas and guidance on how to implement change, they engaged Health System Advisors to increase their ambulatory services in the market.

Centura initiated an eight month planning process and gave themselves four years to implement new thinking and reinvent themselves. Through strategic repositioning, Centura Health has now grown to four hospitals, five clinics, six Free-standing Emergency Departments (FSEDs) (or Urgent Care Centers), seven Imaging Centers, 10 Neighborhood Health Centers, and one post-acute facility. They have also recruited over 100 primary care providers. The result? 9.5% growth per year in clinic visits, 19% EBIDA improved budget performance, 99% patient satisfaction, and double the number of new patients in their system.

How did they achieve this impressive ambulatory system in just four years? They started with a clear strategic planbeginning with a system-wide growth objectiveCentura Health 2020.

  • They used a structured approach with the right team and the right attitude of “it will be what we make it”  
  • They created an “ambulatory playbook” with included “first encounter” principles and building design direction


“First Encounter” Principles

Ambulatory is a “first touch” point where a person becomes a patient. This first touch is a key encounter with patients, one that is crucial for health systems of the future to learn how to correctly engage. The “first encounter” principals are:

  • Be customer-centric
  • Create efficiency
  • Implement future focused design
  • Ensure care team collaboration across the continuum
  • Integrate total care into the community


Connecting with Their Community

Using focus groups, Centura asked the communities what they wanted in their neighborhoods and had them use paper to draw a picture of what healthcare means to them. Surprisingly, the hospital didn’t always make it into the picture. Concentra saw this as  significant and took it as a sign that they needed to take action.

They created wellness areas, yoga for example, and brought the outdoors in. They focused on patient needs using Care Teams—exercise physiologists, physicians, nurses, and navigators. Centura created good memories for the patients by knowing expectations, making a good first impression, and having positive encounters and interactions with the care team.


Modifying Internal Resources

The ambulatory playbook included building design specifications with very specific colors and materials, and on-stage and off-stage areas. They had to re-evaluate their leadership structure, which included removing hospital-focused leadership from the management of ambulatory locations. They also had to create a dedicated ambulatory team. Lastly, Centura updated their pricing to be more consumer friendly. They focused on specific metrics for the ambulatory enterprise and kept these separate from the hospital volumes. The centers had to stand on their own and not be tied to driving business to the hospitals.


The Takeaway

Developing ambulatory care services that adapt to the changing healthcare industry and demand for health services is vital to realizing more efficient resource allocation and decreased costs compared to care received in a traditional hospital setting. However, the current healthcare model is still focused strongly around the hospital.

Centura Health provided a case study that detailed the successful implementation of their wide reaching strategic ambulatory plan. Thanks to a willingness to change and try new things, Centura is now a consumer-focused, growing healthcare provider. Centura has added partners to their efforts including other providers, Walgreens, and city partnerships. The end result is that the population they serve now sees Centura as a  health provider that is both available and valuable to their market.

Successful Implementation of your Ambulatory Strategic Plan was led by Kevin Jenkins, Vice President of Operations Centura Health and Luke Peterson, Principal, Health System Advisors. It took place on Wednesday, September 27 from 9:45 AM–10:45 AM.



Article by Lee Ann Lambdin, SVP of Healthcare Strategy for Stratasan 

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