Today’s Community Hospital Requires Creativity and Nimbleness

Mar 1, 2016 | From the SVH CEO | 0 comments

Community hospitals face two seemingly contradictory realities today. The first is to operate with an ever-increasing level of efficiency in response to the financial pressures brought about by health care reform and government mandates to reduce inpatient care. The second is to meet the expectations of the community to provide a range of services locally, including many specialist services.

Discussing financial sustainability and expanded services in the same breath is challenging, but it can be done and I’m pleased to report that’s the case here in Sonoma. What it requires, we are finding, is a nimbleness that’s inspired by a willingness to think outside the box.

Physician Specialists. One of the biggest service challenges facing SVH is finding physicians who specialize in treating different medical needs. Sonoma is a small market and it’s difficult to attract physicians, and especially specialists. Yet many in our community, including seniors and low-income residents, are not easily able to travel 30 minutes to an hour to find the care they need.

Over the past year, we’ve worked to bring many new specialists to Sonoma, as well as help retain those we have. One way we did this was to establish timeshare office space to make it easy for specialists located elsewhere to conveniently schedule times in Sonoma to see patients. And it’s worked, so much so that we found we needed to open a second office.

Our first office, located on 1st St. West, adjacent to the Prima offices, now includes surgical specialists in Orthopedics, Bariatrics, Spine and Vascular surgery, as well as ENT and Urology. We recently added two Nephrologists offering care to those with kidney disease, renal transplantation, hypertension, and complex electrolyte disorders. Separate from the timeshare, I should also mention that last year we had a second cardiologist come in to help Dr. Price.

This month, we are opening a second timeshare office on West Napa Street that includes specialists in Orthopedics and Pain Management.

There are several other new ideas we’ve been working on to expand both services and Hospital utilization, and I’d like to share them with you.

1206(b) Clinic. Early this year the SVHC District board approved establishing a 1206(b) clinic under the Hospital’s aegis for physicians who want an alternative to private practice. A 1206(b) clinic creates greater alignment with physicians and offers opportunities for increased compensation from private and government payers. The first physician who will operate under this model is Dr. Parinaz Azari, a Pain Management Specialist, who is moving her office to Sonoma in April. We hope to expand the clinic to include primary care in the coming year.

Regional Strategy. Thinking regionally is another important strategy, one which can draw patients from outside of our immediate area such as with our Bariatric (weight loss surgery) program. We are taking advantage of the fact that Dr. Perryman, a highly qualified, board certified bariatric surgeon, is one of the few bariatric surgeons in the region. Recent efforts to bring this service to the attention of Primary Care Physicians throughout Sonoma, and in Napa and Marin, are resulting in bariatric patients coming here.

EmployerDirect. Strategic partnerships offer new opportunities as well. Last fall, we signed an agreement to provide surgical services for EmployerDirect, a national leader in value-based health care for large employers with self-funded medical plans. Under the agreement, SVH and our contracted surgeons will provide elective surgeries for patients from companies located in Northern California, Northern Nevada and Southern Oregon. Our Surgery Center is now beginning to see patients from this program and we expect to see it grow in the months ahead.

I should point out that the reason EmployerDirect approached us initially was because of our excellent quality record. As Shane Foss, COO of EmployerDirect, noted at the time, “Sonoma Valley Hospital is ranked high for quality of services, safety and patient care. It provides the range of surgical services we require, and does so in an impressive new Surgery Center.”

Outpatient Services. We continue to emphasize outpatient services to help offset the reduction in inpatient services, with success in several areas. For example, we have doubled our volume in Occupational Health and now work with more than 200 employers throughout our region. We created a Wound Care program and significantly increased volumes in our Outpatient Rehabilitation department. We’ve also expanded our Outpatient Nutrition Counseling program and increased our MRI business by 20 percent.

I should not overlook Emergency Services, which remains a very important part of our commitment to the community. Our new ED is performing as we anticipated and we’ve seen a 20 percent increase in patient visits in the past year even as patient satisfaction remains high.

I’m pleased to say that this is not the end of our story. We will have several more announcements in the coming months which show how seriously we take the challenge to reinvent and re-energize our Hospital to better serve our community. I look forward to sharing more good news with you soon.

In Good Health,


Kelly Mather, CEO 
Sonoma Valley Hospital