Small hospital makes big impression

Creative customer service key to success

How does a 64-bed hospital with no formal occupational health program court employers so well that they flock to the hospital in ever increasing numbers? By focusing on community service and having faith that goodwill pays off in the long run.

Danbury-Angleton Hospital is a small, publicly owned facility serving the communities of Danbury and Angleton in Brazoria County, TX, south of Houston on the Texas coast. Together, the cities have a total population of about 30,000. Other hospitals are located in the county, but local employers are in love with the service they get from the smallest facility.

And it pays off for the hospital. Danbury-Angleton started an intensive effort to serve local employers two years ago, and the past year has been the most financially successful in the 29-year history of the facility. Utilization of hospital services is at an all-time high.

Old-fashioned TLC gets results

The increased business is not the main goal of the service to the community, but no one at the hospital is complaining, says Patty Sayes, director of marketing. She has spearheaded the effort to increase the hospital’s work with local employers, and she explains that the hospital takes its community service efforts very seriously.

"Both the employers and the residents in our district pay a lot of taxes that go into this hospital, and we feel very strongly that our job is to take wellness and prevention services out to the people that need them," Sayes says. "We’re aware that these efforts encourage people to use our hospital whenever they need service, and we certainly encourage that, but serving the community is our real priority."

With ingenuity and creative use of a tight budget, the hospital staff can provide occupational health services of a caliber you might expect to find only with larger, better funded programs. The hospital has no separate occupational health department or budget, yet the marketing activities are exactly those that can make an occupational health program successful. The benefits are the same, too. Even without a formal occupational health program, the hospital benefits by having employers and employees choose Angleton-Danbury Hospital when they need services.

The best example of the hospital’s ingenuity may be its wellness bus. Angleton-Danbury has its own specially outfitted wellness bus that staff drive to local work sites for health fairs, special screening campaigns, and other wellness efforts. When administrators first had the idea of purchasing such a bus two years ago, the initial cost estimates were substantially over budget. A company that specializes in customized buses offered to do the job for $200,000 — much more than the hospital could afford.

But instead of shelving the idea, the persistent planners decided to build their own bus. They went to a company that builds basic buses and ordered the stripped-down version, minus most of the seats and other amenities.

A hospital staffer, who happened to have a degree in drafting, was recruited to design the interior of the wellness bus.

"We just all got together and decided what we needed in the bus. We wanted a sink over there, and we needed an electrical outlet over here and draw station back there," Sayes recalls. "Then we decided exactly what we could afford."

With the design in hand, the hospital hired "just a regular sort of carpenter" to actually build the bus interior. The hospital’s maintenance department helped install some of the equipment.

In the end, the total cost of the bus was $70,000. For that comparatively modest sum, the hospital now has a 22-foot wellness bus equipped with generator, water supply, air conditioning, heat, clinical workstations, a patient bed, air quality control, various equipment, and supplies. The bus has a system to automatically request an emergency response to the bus’s location, and all the equipment necessary to provide first aid and basic life support and to initiate acute care life support.

A television and video player are included so the bus can be used for educational programs. It seats up to eight people at a time. A nurse and hospital volunteer staff the bus, along with anyone else needed for the service provided. (See photo, below.)

Employers wait in line

The bus can be used in a variety of ways, including providing first-aid services at public events and assisting in disaster response, but the primary use is in providing wellness services at local work sites. Employers have responded well in the bus’s first year of service, so much so that it is booked two months ahead of time. The hospital sends it out about twice a week but sometimes more often for a special effort such as providing flu shots.

"We’d like to provide the bus to employers as often as they request it, which is much more than twice a week, but we have to limit it because of our budget and the time necessary for follow-up," Sayes explains. "If we do any sort of testing or screening, that always requires a certain amount of follow-up reports and phone calls over the next weeks."

The wellness bus is a good addition to health fairs and screenings because it provides a psychological incentive to employees who may feel reluctant to discuss health problems at work. The bus offers privacy and the sense the employee is speaking with a health care professional, not the employer.

Lunch & Learn series popular with employers

Sayes regularly meets with employer representatives to determine how the hospital might best serve the companies’ needs. Services like the wellness bus, health fairs, and education sessions may be requested at that time. Sayes has lunch each month with the occupational health nurse at Intermedics, a biomedical manufacturing company that is one of the largest employers in the community with 1,600 people. Their meetings recently led to an unusual form of assistance for an Intermedics employee.

The woman needed to donate a kidney to her brother in Oklahoma, but she could not afford to travel there repeatedly for the necessary tests and medical procedures. The Intermedics staff worked with Angleton-Danbury Hospital to provide much of the care locally, coordinating the woman’s medical benefits so the care was affordable. The effort meant that the woman had to travel to Oklahoma only twice, the second time for the transplant itself.

The hospital provides many other services to Intermedics and other employers, and the medical staff works closely to provide on-site services. Intermedics, for instance, has its own occupational medicine department on-site, but Sayes helped the company find an Angleton-Danbury Hospital physician who would serve as medical director at the site one day a week. If a company needs an occupational health nurse due to staff absenteeism or special events, a representative can call Sayes, and she will help find an available nurse.

The hospital’s Lunch and Learn series also has proven immensely popular with local employers. Sayes organizes several sessions per month, including a monthly visit to Intermedics. The company’s wellness committee determines what the employees would like to learn more about, and then Sayes organizes a short educational program featuring hospital staff. Obstetrics and gynecology are the most popular topics, but past sessions have included a wide variety of issues.

Lunch and Learns at Intermedics have included a "For Women Only" session, followed by a "For Men Only" session when the male employees complained they were shortchanged. The company even requested a session on plastic surgery, at one point.

"That’s not the typical thing you discuss at these lunch sessions, but the employees of the company really wanted to hear more about face lifts and tummy tucks," Sayes explains. "If that’s what they want to know more about, we’re glad to tell them."

The hospital provides a healthy lunch for attendees, and there always is a waiting list for the next month’s session. Attendance usually is limited to 30 people, but occasionally the sessions will fill the employer’s 75-seat auditorium. The sessions are kept short because the employees must attend on their lunch periods, which are only 30 minutes long. The employees often use 30 minutes of their vacation time to attend the 45-minute Lunch and Learn.

Chuck Davis, director of administrative services for Intermedics, says "Lunch and Learn is one of the most significant programs Angleton-Danbury Hospital provides to our employees in-house. Without the Lunch and Learns, our employees would not have access to these health and wellness concerns that they express to us on a daily basis."

The hospital staff also helps the Intermedics staff develop creative wellness activities at the work site. Many of the activities must be done on employees’ break times; so brevity is important. Past events have included short educational sessions on breast cancer that allowed women employees to stop by, pick up some literature, watch a brief demonstration of a breast self-examination, and practice on a breast model.

Employees also were encouraged to find all the lumps in the breast model and then enter their answer in a drawing for a prize, Sayes says. "They also have tons of people with hypertension, so we encourage them to come by frequently for a blood pressure check by entering them in a drawing each time they come by. The prize is something like a television, so it’s a good incentive."

Most of those services are provided free, or the hospital charges just enough to cover its expenses. Flu shots may be provided for $5 each at a work site, for instance. Some of the wellness efforts will result in immediate referrals and business for the hospital, but in all cases, the goal is to provide whatever service the employer needs, whether there seems to be an immediate payoff for the hospital or not, Sayes says.

"Some of these employers have their own occupational medicine programs on-site, so there is a limit to how much we can offer them and expect them to be interested," she explains. "But they will always have some needs that we can fill. Whatever those needs are, that’s what we do."