• The Transformation of Safety-Net Hospitals

    An interview with John W. Bluford III Nov 06, 2013

    John Bluford is raising the profile of safety-net hospitals by setting high expectations and inspiring other healthcare leaders to do the same. 

    John Bluford III

    John Bluford prefers to call the safety-net hospital he leads a “quality-net” hospital to reflect his expectations for excellence throughout the organization. 

    While Bluford is a staunch advocate for delivering high-quality health care no matter what challenges an organization faces, his mission-oriented efforts have also had a positive fiscal impact at Truman Medical Centers (TMC), an academic medical center in Kansas City, Mo. Under Bluford’s leadership as president and CEO, TMC has increased net revenues 165 percent during the last 14 years, which has allowed the hospital to invest more than $300 million in capital improvements. 

    Bluford’s accomplishments at TMC and previously at Hennepin County Medical Center, another safety-net hospital in Minneapolis, have set an example for hospitals around the country. “We have set the stage for creative and innovative programs. There is no question that excellence is excellence, and it doesn’t matter where it happens,” said Bluford. 

    Starting in the Community

    With limited access to preventive and chronic care management, many patients arrive at TMC with advanced or out-of-control health conditions. At TMC, Bluford has addressed those challenges with an initiative called Thinking-Outside-of-the-Bed, which attempts to tackle the socioeconomic determinants that impact the well-being of the community with tactics such as the following:

    • A farmers market that serves 500 to 700 customers each Wednesday
    • Festivals, held in conjunction with the Kansas City Chiefs football team, that feature health screenings and healthy-food tastings 
    • A full-service branch bank within the hospital that helps local residents become more financially independent through loans and banking services
    • A proposed full-service grocery store near the hospital that will address the current limitations on fresh food options for community residents 

    “Thinking-Outside-of-the-Bed is an example of how we need to deliver health care in the future. The focus will be on prevention, wellness, and tackling social challenges within the community,” said Bluford.

    Creating Culture Change

    Bluford emphasizes consistent messages to staff that highlight the quality-net mission. “Once you have the right people and skills in place and have that consistent message, the job of leadership is getting other people to believe where you want to go and demonstrating victories,” said Bluford. 

    To ensure that hospital staff has the right skills to accomplish TMC’s goals, Bluford established the Corporate Academy in 2001—a training program that carries the tagline “Extraordinary things happen when ordinary people choose to learn.” More than 5,000 employees and their families have taken classes through the Corporate Academy, which offers classes needed for GEDs and master’s degree programs, sessions on social issues (for example, violence in the community), and health and lifestyle programs, such as fitness classes and home decorating courses. 

    “Our quality message permeates the organization down to the brainpower of our environment. The Corporate Academy helps us achieve that goal,” said Bluford. 

    Recognizing Mission-Based Work

    Bluford’s achievement in raising the quality focus of a safety-net hospital was recognized in 2006 by the University HealthSystem Consortium when TMC was recognized as one of the top five U.S. academic medical centers, alongside Mayo Clinic Hospital, Brigham and Women’s Hospital, University of Wisconsin, and Rush University Medical Center. 

    Bluford encourages safety-net hospitals to be proud of their work, especially as they embrace the transformation to quality-net hospitals. “We have much to be proud of in the field. Many of us work very hard, and we engage in hard work. Safety-net hospitals should be proud of their essential roles in the communities they serve, and they should be respected for the work they do.”  

    John W. Bluford III, FACHE, is president and CEO, Truman Medical Centers, Kansas City, Mo. 

    Web extra: Bluford’s 2011 American Hospital Association speech