As Inner-City PJP, St. Anthony Expands

November-December 2011


When Chicago's Saint Anthony Hospital debuts its "community campus," a replacement (and more) for its 113-year-old facility, the new site will properly depict and represent its organizational philosophy. Simply stated, the mission is: "Saint Anthony Hospital lives out the loving ministry of Jesus Christ offering health, healing and hope to the families of our community." Expanding upon that theme, its vision is "to strengthen our community through the power of partnership and quality healthcare that leaves no one behind."

Now in its planning stages, the new site will open in five years. It will serve the same inner-city neighborhoods that Saint Anthony Hospital has been synonymous with for more than a century. The highly anticipated Saint Anthony Community Campus — a medical center, park and recreation area, wellness center, education facilities, retail mall and social and family center — is a unique blend of not-for-profit services and for-profit initiatives that will allow it to be sustainable. In addition to private philanthropy, this model is supported by the city of Chicago and its current administration as well as county, state and federal officials because it will leverage both the private and public sectors for its long-term success.

Philanthropists and government officials aren't the only ones taking note of the project. Recently, Saint Anthony Hospital was approached to take part in a research study with the University of Nebraska along with its Omaha-based partner, HDR Architecture. The study seeks to determine how community hospitals promote health, wellness and health education as well as improve urban settings and social opportunities in their communities. Planning for the innovative Saint Anthony community campus looked at each of those issues, and Saint Anthony's research will be an important contribution to understanding the role of community hospitals in urban health care delivery.

Located across from an expansive, well-shaded park on Chicago's South West Side, Saint Anthony's current 151-bed facility is recognized for an inclusive, neighborhood-driven philosophy that reflects its core population: the underinsured and uninsured that characterize much of Chicago's inner city. Saint Anthony Hospital's leadership, as well as its 1,000-plus associates, wear the emblem of community hospital gladly and with determination.

"We're absolutely committed to serving the poor and those most in need," said Guy A. Medaglia, president and chief executive officer. "The word ‘failure' isn't in our vocabulary. We can't afford to make mistakes because doing so would put the hospital in jeopardy, and that's not going to happen."

Among its values, Saint Anthony Hospital counts inclusion — caring for all, regardless of financial status.

"We don't turn away anyone, and we're very proud of that fact," said James Sifuentes, vice president of mission and community development. "Even though our patients are among the poorest in the city and many are undocumented, we're doing what we've always done — caring for them."

The hospital's time-honored commitment to watchfulness extends far beyond medical care. For example, when a female patient recently was treated for the aftermath of domestic abuse, she remained at the hospital until staffers located an open spot for her at a nearby shelter. Employees routinely engage in follow-up action that extends beyond the momentary crisis, knowing that an above-and-beyond effort is integral to treating the whole person. (In fact, the community campus will include temporary accommodations for patients whose needs are complicated by difficult personal circumstances.)

The health care landscape in Chicago is increasingly competitive. More than 20 Chicago-area hospitals have closed over the past 30 years, and many more have joined larger systems to stay in business. Because Saint Anthony Hospital recently has navigated some challenging currents, its belief in its own staying power is hard-earned. In July 2009, it separated from Ascension Health, the nation's largest Catholic and largest nonprofit health system. As Ascension's only Illinois affiliate, Saint Anthony wasn't able to fully take advantage of the benefits of being part of a large system. Medaglia felt that Saint Anthony's unique model of health care delivery and community programs would be best achieved as an independent hospital.

Medaglia is a former managing director of FTI Consulting, a Baltimore-based consulting firm that specializes in performance improvement. Initially, he came to Saint Anthony to determine the feasibility of keeping the hospital open. However he saw the hospital's strong ties to the surrounding neighborhoods and, as a passionate advocate of community hospitals, he has helped Saint Anthony strengthen its operations while increasing its charity care. In fiscal year 2010, charity care increased to $6 million, up from $4.9 million in the previous year. Total community benefits increased from approximately $15 to $18 million, which includes language assistance (translation services), donations, education, government-sponsored programs, subsided health services, charity care and more.

Saint Anthony is financially strong and in an expansion mode. Medaglia is quick to credit others, beginning with a loyal and talented leadership team and an employee base with a particularly strong work ethic. In its role as a Catholic faith-based hospital, Saint Anthony also shares a close relationship with the Archdiocese of Chicago.

In 2009, Saint Anthony became one of the first freestanding hospitals in the country to receive permission to operate as a public juridic person. Fr. Francis G. Morissey, OMI, Ph.D., J.C.D., a noted canon lawyer, helped develop the canonical statutes and bylaws, and in a memorable highlight, Cardinal Francis George, OMI, archbishop of Chicago, celebrated Mass at the hospital's campus in the summer of 2010.

A recent in-service session for staff focused on what it means to be a Catholic hospital. Sifuentes said that meetings like this help employees to better connect their work lives to their personal values. From the patients' perspective, Saint Anthony Hospital lives out its Catholic mission visibly in the community each day.

Sifuentes speaks with authority about the responsibility that this hospital carries in a neighborhood where Latino and African-American communities abut and where tensions inevitably result from the poverty that burdens them both. He grew up only blocks from Saint Anthony Hospital.

He believes one reason the organization remains so robust lies in its powerful grassroots support. Even though the hospital invests some funds in marketing its medical services, positive word-of-mouth remains, by far, the primary business driver. Many hospital associates are people of color whose heritage is tied to the African-American and Latino cultures, and virtually all services are available in both English and Spanish.

Providing quality health care is a prerequisite, the cornerstone of a hospital's reason for being. But how about partnering with every type of entity in its service area — from churches to community centers to city officials? It's in those locations where physicians, nurses, community coordinators and others pursue the essential effort of learning to best provide for local needs; that's where true community hospitals separate themselves from other hospitals.

Each of Saint Anthony Hospital's 45 managers spends at least 10 hours monthly in one of the eight neighborhoods that make up the hospital's service area. Here, also, are several snapshots of the partnerships Saint Anthony Hospital nurtures, relationships that enrich the community it helps anchor:

  • School at Work is a six-month career development program that features on-site instruction for hospital employees and community residents both before and after the workday. The objective is simple but not easy: Help individuals progress in their career paths, get ready for college and make the most of their workplace potential. To date, more than 50 people have completed the program, which consists of two components: "Introduction to Healthcare" and "Becoming a Healthcare Professional." A six-month offering, it's provided at no cost to participants. The program also offers individuals the ability to attain their GED even if they do not have an interest in the health care field.
    Saint Anthony Hospital was the first Chicago-area hospital to pioneer School at Work. Because of its leadership and track record, it was selected by the city of Chicago as the mentor organization for the 13 local hospitals that now participate.
  • A North Lawndale collaborative project, now in its developmental stage, represents an essential partnership with the Steans Family Foundation, a grant-making foundation that focuses on North Lawndale, a revitalizing African-American neighborhood on Chicago's West Side. The project takes a visionary approach to caring for every aspect of a community — from education and health care to support services for families. Local children will go through preschool and grammar school, then progress on to the North Lawndale College Prep charter school, which boasts a 95 percent graduation rate and most students are college-bound.
    Saint Anthony Hospital has been selected as the collaborative project's health care provider, and will build a new clinic that will extend care to entire families — not just kids.
    "We'll help provide the organizational alignment for young people to succeed," says Sifuentes. A North Lawndale community campus will open its door in about 18 months; however, Saint Anthony Hospital already is working with its partners to create momentum and initiate programs.
  • The National Museum of Mexican Art, in Chicago's Pilsen neighborhood, is one of the largest Latino cultural organizations in the U.S. and is the only Latino museum accredited by the American Association of Museums. Pilsen is home to a large Mexican immigrant population and sits within the service area of Saint Anthony Hospital. The hospital collaborated with art students from the community and one of the museum artists to design and create a series of murals for one of Saint Anthony Hospital's patient-care floors.
    One objective was to ensure the artwork would be both culturally relevant and reflective of a medical environment. Before beginning, students invested considerable time at the hospital to better understand its mission, core values and patient population. They titled their project "Alternative Remedy."
  • Local churches. Places of worship remain a dominant force in the daily lives of the community that Saint Anthony Hospital calls home. The hospital's active parish nurse program provides essential services, including health screenings and informal education, to more than a dozen local congregations of various beliefs. Because it's not uncommon for clergy of one denomination to initiate dialogue with clergy members of different denominations, Saint Anthony Hospital decided to act as a conduit two years ago to invite these community leaders into the same room for a frank discussion about the gun violence that plagues the neighborhood.

The past several years have been marked by tremendous expansion at Saint Anthony, including a new, enlarged, emergency department, a greatly expanded physician center/outpatient clinic with improved technology and equipment and a new wound care clinic to provide state-of-the-art care for patients with peripheral vascular disease and diabetes.

The hospital also has expanded its outreach to growing families. Just over 2,000 babies were delivered at Saint Anthony Hospital in fiscal year 2010, making this facility one of the busiest birthing centers in its service area. The hospital has created a series of programs known as Healthy Beginnings in order to promote strong, healthy, parent-child attachments as well as the social and intellectual development of young children.

Making these programs culturally relevant is a key component of their success, especially for the community's immigrant families who must now adapt their parenting skills to life in a new country. Healthy Beginnings is divided into five services that provide an informal continuum of development for children and their parents:

  • Prenatal education classes help mothers learn about how best to care for themselves and their babies before delivery.
  • First-time Moms Club support mothers in forming communities for themselves during one of the most important transitional stages in their lives — new motherhood. Many of the predictable stressors of motherhood — as well as the often intense feelings that accompany birth — are "normalized" in the group setting.
  • A parent-child play group consisting of unstructured play time, structured parent-child activities, coaching, modeling and information on child development. This group helps increase parents' responsiveness to their children's needs so as to promote secure attachments between them.
  • A parent education group for parents of 4- to 8-year-olds works to improve positive parenting and conflict management skills and decrease the use of harsh discipline.
  • Developmental screenings for children up to 5 years old are performed to give patients and families additional education and support related to developmental and behavioral concerns.

In Illinois, inner-city safety-net hospitals are constantly battling to maintain the funding essential to their viability — a challenge made even more difficult by the state's financial crisis. Despite those hurdles, the future beckons with exciting possibilities. In addition to the its new, comprehensive community campus, Saint Anthony Hospital is developing a new business model to create greater access to medical services for those in the surrounding neighborhoods and also allow the hospital to better sustain itself for the future. This initiative is yet another harbinger of promise, progress and a pledge to serve one of Chicago's most economically challenged communities with a richly woven blanket of services.

BETSY STORM is a writer in Chicago and principal of Top Drawer Communications. She works with Saint Anthony Hospital on public relations projects.


Copyright © 2011 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

As Inner-City PJP St. Anthony Expands

Copyright © 2011 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.