Editor’s note: This commentary is by Louis Josephson, Ph.D., the president and CEO of the Brattleboro Retreat.
For nearly 200 years the Brattleboro Retreat has been a valuable health care resource and an important economic driver here in southern Vermont. That’s why one of my primary goals as hospital CEO is to ensure that the decisions we make today will allow the Retreat to continue serving the mental health and addiction treatment needs of people for generations to come.
Recently our board of trustees approved our new three-year strategic plan, which represents the culmination of lots of hard work over the previous winter and involved the energy and talents of many individuals. Together we gathered input from a variety of sources including our employees, community supporters, consumers/patients, other hospitals and providers, elected officials and government stakeholders. What we learned became the roadmap for our new strategic plan.
That roadmap illustrates some important challenges for our institution — challenges we must face in order to achieve our goals. These include questions about how we will meet the increasing demand for mental health and addiction services in an era of falling or flat reimbursement rates. How can we recruit, hire and retain quality staff in a rural region with a declining population? And how do we re-envision our beautiful buildings and grounds, built in a bygone era, in order to meet the requirements of modern psychiatric care in the 21st century and beyond?
I feel these challenges are symbolic of the issues facing many Vermont businesses and organizations today. That’s why I would like to share an overview of the Retreat’s four-part strategic plan for 2017-2019, which starts with clinical excellence.
While Vermont is recognized as one of the healthiest states in the nation overall, many of our communities are experiencing serious challenges with opioids and other drugs. And the patients we treat today often have the kinds of increasingly complex medical challenges we were not seeing just 10 years ago. That’s why the first part of our strategic plan involves an intense focus on achieving clinical excellence.
Our vision for the future is about setting new standards of care and advancing excellence in our work as mental health and addiction specialists.
We are now well into an initiative to introduce evidence-based clinical practices, which are scientifically proven approaches that combine data with clinical expertise and patient perspectives to measurably improve outcomes, in all our programs and services. For example, Acceptance and Commitment Therapy and Dialectical Behavior Therapy, both treatments based on concepts of mindfulness, are being adopted by programs across the Retreat.
We are doing this as we simultaneously take steps to optimize our electronic medical record and improve access to mental health and addiction services through a new telemedicine program that promises to bring the expertise of our medical staff to interested hospital emergency departments across the state.
Over the next three years the Retreat will also implement steps to achieve financial stability. We will do this through a comprehensive plan to greatly improve our cash flows and realize an annual operating margin to support our long-term financial needs — a critical factor in the survival of not-for-profit organizations like ours.
We have already launched a modernization plan for our financial systems. Because health care reimbursement can be unimaginably complicated, we have made a decision to manage those complications by investing in the technology, talent, and training that will ensure we capture every penny we are owed.
In order to successfully adopt new services, new technologies, and new ways of doing things, you must support your staff and help them adjust to new performance expectations. Our new strategic plan addresses this under a heading we call “Increase Accountability.” It calls on the organization to clarify the roles and expectations of all our employees, from the CEO down to front-line workers, while providing the training and support they need to perform at their best. We are also working to overhaul our performance management process and bring new ideas and energy to our recruitment and retention efforts.
And last, our new strategic plan asks us to re-envision our aged campus to ensure our environment of care will meet the future needs of our patients, staff and programs. This will involve the creation of a long-term vision for the Retreat that aligns with our philanthropy goals and anticipates how the hospital will be used in the years and decades to come.
Like many historic Vermont institutions, the Retreat’s buildings and grounds were designed for service in centuries gone by. Anyone who has visited our campus will see and understand why the Retreat is an architectural treasure. Our task will be to determine how to build a bridge to the century before us that pays tribute to our roots while enabling the Retreat to embrace the best-researched, most effective, most patient-centered practices our new millennium will no doubt have to offer.
Our vision for the future is about setting new standards of care and advancing excellence in our work as mental health and addiction specialists. The health care needs of our fellow Vermonters demand no less. And we in turn will certainly require the ongoing support of the communities we serve, and our partners in state government, in order to sustain our mission and safeguard the Retreat as a resource for those who follow us.