OSF Saint Francis Medical Center is celebrating its 125th anniversary in 2002. The flagship hospital for the OSF Healthcare System began seeing patients in the late 1870s and continues to serve patients from throughout central Illinois.
Members of the administrative team at OSF Saint Francis, past and present, gave their perspectives on this rich heritage.
What have been the most significant changes in your 40-year tenure at OSF Saint Francis?
Sister M. Canisia Gerlach, OSF
The impressive changes in technology and medicines were the major forces affecting health care during my time as administrator. In technology, the explosion of lifesaving devices and procedures have been impressive. We can diagnose and treat problems that in earlier days were either fatal or devastating to patients. We now have non-invasive techniques such as the Gamma Knife, which permit treatments of conditions requiring surgery in the past. And we have true miracle drugs to treat everything from high blood pressure to mental illness. These innovations will continue to be part of OSF HealthCare; we can only imagine the possibilities.
Other changes, such as the government programs of Medicare and Medicaid, have been mixed blessings. Both now provide important coverage for many who might not have insurance through any other means. But during difficult economic times, when the need can be the greatest, the government budgets that fund Medicare and Medicaid can be reduced, thus placing a greater and, oftentimes unexpected, burden on us.
Businesses have also become important partners, but partners watching costs and quality very closely. They check on us regularly to make sure our prices are in line and our quality remains high.
It’s been a challenging time, but through it all we’ve been able to keep the Mission alive. For that, we truly thank God.
How do the challenges of health care today compare with the challenges of the past? How has OSF Saint Francis met those challenges?
The challenges in health care today are significant, as the industry is undergoing a fundamental transition. There are staffing shortages, a growing uninsured/underinsured population, reductions in state and federal funding, and significant cost increases to health care providers resulting from new technology, new drugs and new therapies. Additionally, unless some kind of tort reform occurs, medical liability will continue to be a costly drain on providers and payors. These issues are an even larger challenge when we balance them with our OSF Mission to serve all persons—regardless of ability to pay, race, etc. and do it with the greatest care and love.
As we transition to a new era of health care and reflect on the 125-year history of The Sisters of the Third Order of St. Francis, I am reminded of the quote by Mark Shields: “All of us are warmed by fires we did not start. All of us drink from wells we did not dig.”
The Sisters’ steadfast example and leadership has kept our focus on our Mission, values, and core ideologies. We’re fortunate and blessed to be grounded on that framework, which has guided us through many years beset with challenges and uncertainties. Because we continue to be Mission-driven and values-based, OSF has been able to do so much more for those we serve—advanced technologies, care for a population others choose to ignore, and an outreach as a regional referral center which very positively impacts the overall economy of Peoria and the tri-county area. Certainly, the challenges the Sisters faced 125 years ago were as great for them as ours are for us today. With God’s help, they were successful and, with His help, we will succeed, too, for another 125 years.
Tell us about the Sisters’ mission and how their duties blend with their religious role. Tell us about a typical day in the life of a Sister.
Sister M. Ildefonsa Richter, OSF
Our mission statement is as follows: “In the spirit of Christ and the example of Francis of Assisi, the Mission of OSF HealthCare is to serve persons with the greatest care and love in a community that celebrates the Gift of Life.” Mission is why we are here—to serve persons. We care for the whole person in his or her physical, emotional, spiritual, and relational dimensions regardless of race, color, religion, or economic status. “With the greatest care and love” was an expression used by our Foundress, Mother Mary Frances Krasse. This mission of caring for the sick, the injured, the aged, and the dying has been our legacy and heritage for the past 125 years and is a golden thread linking us to our founding spirit, our current service, and our vision for the future. Our Sisters share in that mission through their various services and life of prayer, and by their presence and example.
As the number of Sisters decreased, a plan was developed to internalize and disseminate the Mission developed into the birth of the Ministry Development Program. Many people within the OSF organization have been touched personally and professionally by the implementation of this program and developed a culture of “our Mission” rather than the “Sisters’ Mission,” and it influences all we do.
A typical day in the life of a Sister here at OSF Saint Francis begins about 4 a.m. during the week. A period of personalized and meditative prayer of about 45 minutes is spent in the main chapel, considering the many intentions of those entrusted to our care. At 5:40 a.m., our community prayers begin with Morning Prayer, followed by the celebration of the Holy Eucharist. After the Mass, there is breakfast in the Sisters’ dining room. Following breakfast, the Sisters spend their time in various work activities, which are mostly managerial or administrative positions throughout the medical center. Dinner is served at noon. Depending on the individual schedule of activities, sometime in the afternoon each Sister makes a private Holy Hour in front of the Blessed Sacrament. At 5:15 p.m. we pray together the Rosary and the Divine Office, which is then followed by supper. During supper and afterwards is time for recreational activities. The rest of the evening until retiring can be used for personal activities such as reading, talking, walking, or other personal enjoyment.
What are some of the big changes you’ve seen in nursing education?
Sister M. Ludgera Pieperbeck, OSF
Dean, Saint Francis Medical Center College of Nursing
Many changes have taken place over the years since I graduated from St. Francis Hospital Diploma Nursing program in 1956. There were many restrictive requirements in regard to admission, such as social status and finances. Also, time, hours of experience, and curricular requirements were different and somewhat restrictive.
Although the diploma program was the general mode of preparing nurses at that time, throughout the years of its existence, Saint Francis Hospital School of Nursing developed, nourished, and improved its educational program based upon the needs of health care consumers, changing trends in nursing health care, and education. During the time period from 1905 through graduation of the last class in 1987, Saint Francis Hospital School of Nursing contributed significantly to the profession of nursing by graduating approximately 3,400 students from the diploma program, while maintaining continued state approval and National League for Nursing (NLN) accreditation.
During the 1980s, external forces and pressures were primarily responsible for an investigation into alternatives in the level of education preparation for Saint Francis’ graduates. The decision was made to close the hospital’s diploma program upon graduation of the class of 1987, and continue a nursing education program that would have degree-granting power and provide baccalaureate nursing education.
During the academic years 1982-1983, the administration and faculty of the school had concluded a baccalaureate approach to nursing education would best serve the graduates, nursing profession, community, and society.
As a result of a strategic planning process, which included an in-depth study of nursing, nursing education, higher education, health care, and needs of the community, the Saint Francis Medical Center College of Nursing was established in November 1985 by obtaining approval from the State of Illinois. This process has as its long-range goal the achievement of institutional and program accreditation. The first class of baccalaureate students was admitted as juniors in August 1986 and graduated in 1988. Since 1986, initial and continued institutional and program accreditation by The North Central Association of Colleges and Schools and NLN have been realized and maintained. The college graduated 814 students as of May 2002.
In keeping with the Mission of the Sisters, the college continues a tradition of excellence and quality of nursing education. The administration and faculty recognize that the changes in health care increased the need for nurses to gain new knowledge and skills.
National trends are predicting a shortage of both baccalaureate and master’s-prepared nurses. With this in mind, a faculty ad hoc committee formed in September 1998 to investigate alternative educational offerings that will facilitate career mobility for nurses and the preparation for qualified nursing in the workforce.
As a result of this investigation, a Distance Education program for registered nurses seeking the baccalaureate degree was initiated in 1999. Additionally, a master’s of nursing program was implemented in 2001.
You have been involved in several high profile projects such as RiverPlex, Center for Health, and the Mother Frances Krasse Family Health Center. What have you learned from these experiences?
Susan C. Wozniak
Chief Operating Officer
All three of these projects were major steps in moving away from a traditional focus on inpatient acute care services. Yet each had a different set of opportunities and unique challenges.
With the RiverPlex and Mother Frances Krasse Family Health Center, OSF Saint Francis collaborated with other entities in the community to bring the projects to reality. The Mother Frances Krasse project came about as a result of intensive study of health care access for low-income persons in zip codes 61601 and 61602. Most people in these areas either were going without primary health care or were using an emergency department for routine care. We were able to collaborate with Neighborhood House to develop a facility next to theirs. Neighborhood House was a place people were already coming for services. We also were able to pull together several other community agencies to provide services to the people of the area. The outcome was an opportunity for the Sisters to provide comprehensive primary health care services, while adding social service, mental health, public health, and counseling services to the south side community.
The RiverPlex was an opportunity to partner to provide fitness and wellness services. As with any new idea, many barriers had to be overcome to see the project come to a reality. It took collaboration, not only with the Peoria Park District, but the City of Peoria, the Bielfeldt Family Foundation, and many others to move the project forward. We’re very pleased with the membership enrollment; in less than one year, we have more than 6,000 members. We’re serving many people with health risks and people of all income levels. Management has been outstanding, and the focus on service very good. We’re reaching people who may not have had access or who have not felt inclined to exercise in a non-medically based fitness center.
The RiverPlex project was a learning experience. We learned public perception is very important, and constant communication is necessary to enroll people in the idea. I am so pleased we were able to persevere and the RiverPlex is now available to our community. It’s truly something to be proud of.
Of all the projects I’ve been involved in, the OSF Saint Francis Center for Health has been the most exciting and rewarding. We set out to create a whole new environment for outpatient diagnostic and surgical services, with a goal of easy access and wayfinding in a relaxed environment. We also set very high service standards, which required us not only to build a building but also to redesign the process of care and service within the building. The project took more than four years of time and energy from planning to completion.
The Center for Health has been overwhelmingly successful. Patients like the experience. Its PromptCare has grown faster than any of our other locations. The surgery center is very busy, and both surgeons and patients report very high satisfaction. The medical office building is fully occupied. The employees at the Center for Health are doing an outstanding job of conveying a service attitude. Many of the processes developed for the Center for Health are now being implemented here at the main campus.
OSF Medical Group is a fairly new addition. What advantages does it offer to patients and to the medical center?
Dr. Donald Baker
Regional Director, OSF Medical Group, PEORIA
As OSF Medical Group grows, a team develops that benefits patients by helping with access. When we say “access,” we have to move away from the traditional meaning of the term to look at such things as help through the Internet, a parent advice line, or nurse triage.
There is also an important sharing of information for patients among the OSF Medical Group practices—information from basic health and medical information to information on specialists to where a patient or a parent can go after hours for care without having to go the emergency department. With a centralized ASK OSF Call Center, that information can be readily shared.
Resident physicians benefit from their time in our practices. We offer a considerable amount of medical education in the office environment. This enables the residents to learn management plans for patient care in a variety of settings.
The medical group gives the medical center a group of more than 60 medical providers joined by a network and able to address clinical issues following a common pattern of care or management. This service is valuable to multiple payors, as well as the hospital. We also give OSF Saint Francis a considerable community presence both in the Peoria area and smaller towns in the tri-county.
Most importantly, OSF Medical Group is comprised of caring, loyal providers committed to delivery of Mission-oriented care.
What attracts people into the nursing profession?
Susan Ehlers, RN, MSHA
Assistant Administrator, Patient Care Delivery Systems
Throughout the years, the attraction of being able to help people in times of crisis has kept nursing a popular career choice. Nursing is currently the fastest-growing profession in the United States. There have been many articles on the current nursing shortage, but in fact, more nurses are working in hospitals today than ever before. The main driver of the current shortage is increased patient demand driven by our aging population. Much has been done to recruit young people into the profession, and we’re beginning to see a rise in the enrollment at nursing colleges across the country.
Nursing is one of those unique professions where a person can make a difference every day in the lives of patients and families. It’s an all-encompassing role that challenges daily. Every action taken directly affects a patient’s outcome and ultimately his or her life. Nothing is more rewarding than having a family or patient say “thank you for being there.”
The rewards of nursing go far beyond personal satisfaction in helping a family through an intense crisis. There are wonderful opportunities for personal and professional growth as well.
The flexibility of nursing as a career has always attracted people into the profession. Nurses can work in a variety of settings, ranging from hospitals to outpatient clinics. A nurse can specialize in education, management, advanced practice, or clinical expertise. Specialties range from emergency medicine, intensive care, and pediatrics to high-risk obstetrics. The possibilities for career changes are endless. In essence, it’s the perfect combination of high tech and high touch.
Nursing is an exceptionally fulfilling and challenging career, which continues to attract people who want to make a difference.
Human resources today is far more than taking job applications. What special challenges face your department?
Assistant Administrator, Human Resources and People & Organizational Development
One of the most profound challenges facing all of industry is the declining U.S. workforce. There are fewer potential workers coming behind the baby boomers. Compounding this issue is our aging population and the baby boomers entering years of higher incidence of disease, driving the increased demand for health care services. The Bureau of Health Professionals projects the number of health care jobs will need to grow from 10.4 million in 2000 to more than 14 million in 2010. Competition for health care professionals has never been greater.
In this environment, the human resource function becomes one of differentiating yourself as an employer and transforming corporate culture to create an environment that attracts and retains the best and the brightest.
Leaders must be developed, enabling them to sustain a culture where employees are committed to our core purpose and values, are important as people and professionals, and where leaders are able to remove barriers to performance through process improvement. Re-focusing on the basics that brought us all into health care in the first place is rewarding, and this higher sense of purpose is a powerful draw into the field.
Why is outreach into the region important to the medical center? Why have so many hospitals chosen to affiliate with OSF?
Dr. Dave Gorenz
Assistant Administrator, Regional Network Development
Because of the unique nature of OSF Saint Francis Medical Center, regional outreach is very important. OSF Saint Francis serves as the tertiary referral hospital for patients throughout more than 30 counties in Illinois and even other states. We receive more than 30 percent of our patients from outside the tri-county area because of the highly technical and specialized serves available at OSF Saint Francis. Most often these patients begin receiving their medical care in their local community and then are referred to us for a specialized service. Thus, it’s very important we work closely with regional providers to coordinate the care of the patients we jointly care for.
We developed independent affiliations with nine hospitals and another nine health care providers and agencies throughout Illinois. These affiliations foster communication, help us to coordinate the care of patients, and allow us to plan together to best meet the health care needs in our respective communities.
What impact has managed care had on health care?
Chief Financial Officer
I would divide the impact of managed care into three eras, each one lasting five years and each one building upon the prior one.
The first era was price competition. Because hospitals competed through a bidding process for an employer’s group for the first time, there was an instant renewed emphasis on cost management. The days of “cost-shifting” vanished instantly.
The second era was member/patient satisfaction. This originally focused on hospitality aspects, but quickly evolved to cover access and wait times in the inpatient, outpatient, emergency department, and physician offices. It then evolved to looking at and monitoring quality outcomes and a more active role by the patient in his or her own care.
The current era is still evolving but will focus on quality information. This is still in its infancy, but will continue to grow with the advent of the “dot coms.” Currently, the dot coms are given more credibility then they deserve; however, the general population is eager for this type of information. For example, report cards for hospitals and physicians will be routinely accessed on the Internet and used to make health care decisions.
How do regulations affect what can and cannot be done in construction and renovation of the medical center?
Assistant Administrator, Administrative Services
The campus of OSF Saint Francis Medical Center includes approximately 1.5 million square feet of building space spread over more than 33 acres. The medical center operates 24 hours a day, seven days a week, with more than 5,000 patients, visitors, and staff using the facilities daily. In many ways the medical center is like a small city within a city, with unique needs for fire protection, traffic control, security, and utilities.
The unique facility needs derive from the patients who receive services within our facilities on a daily basis. Many of those patients have diminished mobility and physical stamina by virtue of their current health problems or the treatments they are undergoing. The majority of the regulations that impact building construction and renovation are driven by the safety needs of the most vulnerable of building occupants: our patients.
These regulations prescribe the number of exits, the thickness of the doors and walls, the operation of the ventilation systems, the locations and sizes of rest rooms, and even the type of furnishings that can be used. To achieve regulatory compliance, the costs per square foot of construction for clinical space is approximately double that for custom-built residential space. The Illinois Department of Public Health reviews all construction plans for regulatory compliance prior to substantial construction.
Since the Children’s Hospital first opened, many pediatric specialists have come to practice there. What attracts them to Peoria?
Executive Director, Children’s Hospital of Illinois
Since the Children’s Hospital of Illinois first opened in 1990, more than 60 pediatric specialists have come to town. These doctors represent 24 pediatric specialties. There are many things about the Children’s Hospital that attract these physicians, both personally and professionally, to Peoria.
Personally, Children’s Hospital provides a unique environment within a faith-based institution to practice medicine. We often hear from new recruits that our Mission was instrumental in their final decision to choose Peoria. It’s this rich, value-based culture which often tips the scale in our favor. Likewise, physicians find the Children’s Hospital location appealing. Peoria offers the physicians a wonderful place to raise their families, with many of the attractions of a larger metropolitan city, while maintaining the attributes of a small town.
Professionally, physicians choose Children’s Hospital of Illinois because of the opportunity to work with other highly qualified pediatric specialists—excellence attracts excellence. In many instances, the new specialist can grow and mold programs in the initial stages of development. In addition, those physicians in pursuit of teaching and research recognize the many opportunities available through our affiliation with the University of Illinois College of Medicine—a key component when recruiting. It really is this complete package that continues to draw pediatric specialists to Children’s Hospital and bring the very best care to families throughout Illinois.
OSF has a longtime commitment to education. How has its role as a teaching hospital been good for patients?
Dr. Tim Miller
Director of Medical Affairs
The OSF Saint Francis Medical Center residency program, in partnership with the University of Illinois College of Medicine at Peoria, has grown to include nine residency programs: Emergency Medicine, Obstetrics/ Gynecology, Internal Medicine, Pediatrics, Medicine/Pediatrics, Radiology, Neurology, Surgery, and Neurosurgery.
Over the years, this steadfast commitment to education has been good for patients in several very important ways. First, the presence of learners (medical students and resident physicians) motivates health care professionals to keep their skills sharp and their knowledge up-to-date. Research that benefits patient care has historically been driven by academic medical centers.
Second, the opportunity to teach the next generation in one’s profession is important to many of our most highly skilled practitioners. OSF’s teaching programs help our community attract and retain many key medical specialists.
Thirdly, our residents are active participants with us in our Mission of providing care to those we serve. In many instances, such participation provides the primary health care needs of a significant portion of Peoria residents without health insurance or who are underinsured.
Finally, the educational programs have been good for patients because many of our graduates choose to remain in the community to practice as professionals. For example, in the last 25 years, almost 300 graduates of OSF’s residency education programs have stayed in central Illinois to practice medicine. Indeed, more than 200 of our residency graduates are currently practicing in the tri-county area.
Your roles are unique in that you are a practicing physician with direct input into the administrative team. Why is it important that practicing physicians like you have a voice in administrative decisions?
Dr. Patrick W. Elwood
I believe it’s critical for physicians to be intimately involved in the management of the hospital since medical care is our sole product. In regard to the Illinois Neurological Institute, I believe the institute should be at the cutting edge in clinical care, research, and education.
I really feel it would be difficult for a non-neurological clinician to have insight into the appropriate strategic directions in each of the technologies developing. There’s a very big opportunity in the Midwest for a comprehensive center in the clinical neurosciences, so this is an exciting position.
Dr. Steven C. Schrader
As we approach the uncertain future of medicine, value-based care of patients will be a cornerstone of successful tertiary hospitals like OSF Saint Francis. This care will reflect the relationship between cost and patient outcomes and require constructive and meaningful dialogue between practicing physicians and members of the hospital’s administrative team.
I joined the administrative team at OSF Saint Francis three years ago in the role of medical director of surgery. As an anesthesiologist, I understand the perioperative process and can critically evaluate all of the steps a patient takes in preparing for surgery, having an operation, and convalescing. My clinical practice at OSF Saint Francis and other medical facilities in Peoria offers insight into the divergent yet interdependent needs and wants of physicians who practice in an academic and/or private setting and treat patients from regional and/or local areas. Perhaps the most important role I have as medical director of surgery is to share and debate this inclusive perspective of surgery at the administrative team meetings. Better and more appropriate decisions can then be made on how to distribute the increasingly limited resources available to care for our patients. IBI