These are times of rapid and dramatic change in health care, as it becomes a top-tier concern of nearly all-- from politicians, to professionals to consumers. Health care leaders, seeing reform on the horizon, are moving to meet the difficult challenge by creating systems that are more responsive to patients' needs and less expensive to operate.
Such was the environment in 1994 in which the not-for-profit Lifespan was formed as the state's first comprehensive health care delivery system. It has as its goal the combination of the region's premier hospitals and health professionals, working together to improve the health status of the southeastern New England community in an accessible, cost-effective and patient-friendly manner.
Lifespan began with the merger of Rhode Island Hospital, the state's largest hospital, and The Miriam Hospital, the state's most innovative teaching institution. Upon its birth, Lifespan instantly became the largest health care delivery system in southeastern New England with an operating budget of $420 million.
Today it is also the largest private employer in the state with more than 8,000 employees. There are more than 1,500 physicians and 1,800 registered nurses associated with the two founding hospitals alone. The hospitals contain 966 beds with 42,483 inpatient discharges a year.
Lifespan's goal, as articulated by its President and CEO William Kreykes, is to offer the region's diverse populations a well-coordinated, lifelong continuum of health services that will serve customers from early childhood through adulthood and on to maturity. The system now includes many of the state's top doctors, hospitals and health care services.
Lifespan has now merged or otherwise partnered with numerous other institutions. Its growing partnership includes Emma Pendleton Bradley Hospital, a psychiatric facility for children and adolescents; Rhode Island Hospice Association; VNA of Rhode Island (formerly Visiting Nurses Association); and the rehabilitation unit at St. Joseph's Hospital. Other partnerships are also being examined.
In addition, Lifespan's hospitals are affiliated with the Brown University Medical School and many Lifespan physicians have faculty status at Brown.
Lifespan is a major contributor to the State of Rhode Island as well as the City of Providence, where it adds both value and vitality. It is a major research center and it trains more doctors than any other health care system in New England outside of Boston. Every day, more than 1,000 people -- nurses, technologists, administrators, pharmacists, interns, therapists, residents, medical fellows and others -- learn on Lifespan's campuses.
As Lifespan has moved more toward a health care system, rather than a hospital system, it has crystallized its priorities as a good neighbor. "Through our community involvement, we have been part of the landscape since just after the Civil War," when a concerned group of influential businessmen founded Rhode Island Hospital to provide care to the poor and needy, said Kreykes.
The same dynamic was again evident in the early 20th century when The Miriam Hospital was founded by a group of devout women who were concerned with the health and welfare of family members and friends who were re-settling in the United States, said Steven Baron, chief operating officer of Lifespan. The Miriam became a hospital where Jewish immigrants could receive quality medical care in familiar surroundings where their language and customs were understood.
Today, those qualities of compassion and vision are at work in Lifespan. For example, the Rhode Island Hospital Foundation dedicates both time and financial resources toward organizing a coalition that would provide jobs for unemployed neighbors in South Providence. Taking the initiative, Lifespan has committed itself to hiring 50 such individuals over the next three years. The Foundation is also encouraging South Providence entrepreneurs to bid on such hospital contracts as linen and laundry services.
In addition, since there are no city, county or public hospitals in the state, the non-profit institutions have taken on the role of providing care for people who lack health insurance or are otherwise unable to pay for their care. In 1994, Lifespan's hospitals alone shouldered $22.3 million in uncompensated care expenses, more than all other Rhode Island hospitals combined.
As Lifespan evolved, so have its objectives. Today, it is more focused on maintaining the health of its constituents than treating their ailments. Lifespan's president Kreykes promises that "We will broaden our focus to include a greater emphasis of primary care, home care, prevention and consumer education. Our goal is to enable you to maintain the best possible health status."
To achieve these aims requires fiscal vigilance. According to Kreykes, Rhode Islanders pay the lowest health insurance premiums of any New England state and among the lowest nationwide. In this environment, the challenge for any health care system is to control costs while maintaining high quality.
He promises, "We will leverage our resources to create healthier communities in the broadest sense, often through cooperative efforts with government, the business community, insurers and other partners. These are ambitious goals that demand much change. We will spend years of hard work to achieve them.