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Development Office
Because Boston is densely packed with health care institutions, BMC is not aiming to overtake other institutions or duplicate all of their strengths. Its position in Boston's health care landscape is special: BMC anchors the city's safety net and strives to level the playing field in the delivery of care in the community. BMC's vision of community health encompasses the broader wellbeing of families and neighborhoods that struggle with poor housing, poor schools, violence, drug use, HIV/AIDS, hunger and job security. BMC focuses on reducing disparities in care and outcomes between white and non-white, rich and poor, citizen and non-citizen. Everyday, BMC's employees work towards the vision of a community where:
Anticipating the merger, the Public Health Act of 1995 formally linked BMC's leadership with the Boston Public Health Commission (BPHC) to ensure that BMC would be an active participant in public health. The Act amended the composition of the 206-year old Boston Public Health Commission so that, as a matter of law, BMC's chief executive officer is always a member. In turn, BMC's by-laws mandate that the executive director of the public health commission and three community health center directors will always be on BMC's board. The public health mission of the city hospital is stated explicitly in the BMC merger agreement. The Health of Boston report published annually by the BPHC provides a snapshot of the health status of the people of Boston. It is a resource for policymaking and discussions at the national, state, and local levels. BMC President and Chief Executive Officer Elaine Ullian uses the report to evaluate programming at BMC. Are BMC's efforts in specific health areas impacting the neighborhoods primarily served? What new health issues are arising which BMC's programs aren't adequately addressing? Many, many programmatic partnerships develop between BMC and BPHC to address issues identified in Health of Boston reports. In addition, BMC is an active member of the Roxbury Community Alliance for Health (RCAH). RCAH's mission is to improve the overall medical and social health of Roxbury, one of Boston's poorest, historically black neighborhoods. The coalition brings together hospitals, health centers, area businesses, schools, and grassroots organizations to look at the connected issues of health, education, human services, housing and economic development. Each year, at least one BMC board meeting is open to the public. In addition, regular meetings of Boston HealthNet working groups, board members, and management and of individual programs' community advisory boards keep neighborhood health issues at the forefront of our programming. 2. Sharing BMC's strengths and resources with other community health organizations [The merger] is what the health centers need to survive and continue their missions of being medical healers and community builders. . . . The new Boston Medical Center is our best hope to have a health care system for the people of Boston, with their particular health care needs, cultural and linguistic groups and neighborhood concerns. From the beginning, BMC and eight community health centers realized they would all be stronger if they aligned their common goals. Part of the plan for sustaining BMC as a safety net involved the creation of Boston HealthNet, an integrated system of community health. Boston HealthNet formalized existing collaborative efforts between the old Boston City Hospital and health centers. For example, BMC's pediatric residency program was one of the first in the United States to bring community-based primary health into a residency program through placements in health centers. Today, Pediatric, Medicine and Family Medicine residents have placements, and undergraduate medical students have community-based education opportunities, at Boston HealthNet centers. As Boston HealthNet, BMC and 15 neighborhood health centers at 18 sites share risk and resources as Boston HealthNet. The relationship facilitates a plethora of outreach efforts and community education collaborations between BMC providers and health center staff. All Boston HealthNet physicians are members of the BMC medical staff and are invited to participate in Grand Rounds and other opportunities on campus. "Training the Trainer" efforts abound:
An example of how BMC leverages its institutional strengths to assist health center partners and support individual, family and neighborhood health is an anonymous, $6 million gift secured by BMC from a local business in 2001. These funds are being used to establish an electronic medical record system linking eight Boston HealthNet centers to BMC. BMC's ability to show that its Chief Information Officer would oversee the system implementation convinced the donor to make this generous investment in technology. 3. Enlisting new partners in the private sector who are committed to sustaining our mission When the city hospital became a private entity, the financial lifeline from the City of Boston was cut. Although BMC is the largest beneficiary of the state's free care pool (which reimburses hospitals for a portion of free care provided), the amount received falls far short of the amount expended. BMC's plan for financial health relies on the increasing investment of private individuals and companies in its mission. A priority of CEO Elaine Ullian and the hospital's development committee is to expand the number of relationships between BMC and the private sector. Professionals working downtown need to understand how poverty affects everyone's health in the long and short term. BMC reaches out to help potential friends cross borders (real or imagined) that prevent communities from joining together to solve problems. We encourage support for the work that goes on here in ways that our impoverished patients cannot. Since a development office was reestablished three years ago, funds raised annually through philanthropy have grown from $500,000 to $10.5 million. Groups like the trustee development committee and Friends of Pediatrics bring lawyers, business leaders, and others from the financial district together at the hospital to discuss challenges facing the communities we serve. This program is creating independent ambassadors into the business community. Knowledge empowers, and the message of what is happening in the realm of health care for the uninsured is one that others need to hear and to which they are responding. One Friend of Pediatrics, a busy litigator at a prestigious Boston law firm, convinced his firm's executive committee to dedicate 500 attorney hours to pro bono advocacy projects to help BMC patient families improve housing conditions impacting their health. When asked why he was inspired to join the efforts of BMC's Family Advocacy Program in such a way, he replied, "Because I think the chairman of pediatrics is a hero. This is a small and easy thing our lawyers can do to help those who are struggling with life's basics." The leadership of individuals like Marshall Carter, retired chairman of State Street Corporation and present BMC chairman, energizes our Board of Trustees. Mr. Carter uses his position as a platform to help other business leaders learn more about BMC's mission and the need for corporate support. But his commitment goes beyond ordinary expectations of a hospital board chairman. When he and his wife learned that children arrived in the emergency department on cold January nights without coats, they immediately went out and purchased coats of all sizes and styles for the staff to have on hand. Now, stocking the coat closet is one of their annual commitments to BMC. Private support occurs in small and large ways. Children in churches and temples in Boston and the suburbs hold food drives to fill the shelves of BMC's Preventive Food Pantry. CIBC, a Canadian bank with a trading branch in Boston, has made BMC a beneficiary of its annual Miracle Day, donating $70,000 in commissions last year. The Avon Foundation has brought its Breast Cancer Crusade to our neighborhoods with a grant that supports better case management and outreach to non-English speaking and uninsured women, enabling a reduction in "no-shows" for abnormal breast exam follow-up appointments from 34% to 13% in 11 months. 4. Preserving the cultural competencies on which our reputation for community health was built Boston City Hospital was beloved by the community primarily for the way care was delivered here. The hospital worked for people who weren't "fancy," who might be bringing a load of other complicated issues with them to the emergency room, or who did not feel comfortable at other downtown hospitals. Boston City Hospital was a sanctuary because people felt comfortable there. Preserving this strength in the merger process was critical to BMC's success in maintaining a community-focused mission. It was possible because of:
"Programs that have bloomed out of Pediatrics in my 30 years of working here reflect providers' direct responses to the needs that staff and their patient families experience on a daily basis. They are a key part of the departmental picture we are creating. These direct, creative responses meet the real needs of real people, co-created with them, rather than imposed from above. Our approach is holistic, addressing family systems and taking a community-based approach. Beyond traditional medicine to prevention, we want to foster wholeness, well being, and good health for families and communities." 5. Evaluating our efforts regularly BMC relies on the Boston Public Health Commission's Health of Boston Report to evaluate its impact on Boston and the Press Ganey Patient Satisfaction Survey to gauge impact on patients and to guide internal quality improvement. BMC's CEO and the Director of Community Relations oversee project development. BMC trustees evaluate major community benefits initiatives. Community advisory boards provide input on many individual community service programs. Reporting to external funders and supervising BMC administrators tease out successful initiatives from poor ones. In 1998, hospital administrators developed the Balanced Scorecard, a mechanism to track BMC's progress toward organizational performance goals. The scorecard enables the medical and professional staff to focus on key operating indicators, such as quality of care, patient satisfaction, and public health access, that support the institution. Monthly Leadership for Change meetings, attended by all managers and open to all employees, provide an opportunity to evaluate programs and efforts underway throughout the institution. A broader assessment of our community health successes is found through the evaluation work of the Boston HealthNet. Ongoing programmatic evaluation and annual retreats of Boston HealthNet community health partners assess accomplishments and identify shortcomings in our efforts to work more closely with health centers. A Boston HealthNet working group administering a major federal Community Access Project (CAP) grant is tracking efforts to serve community needs and increase health care access for the uninsured of Boston. 6. Communicating BMC's services and achievements internally and externally Community service doesn't reach its full potential unless programs are shared with our own community, those we wish to serve, and those able to invest in BMC's mission. Through its Community Relations, Corporate Communications and Development offices, BMC distributes publications that inform different constituencies about hospital programs, services and successes. Our Community Connections appears as an insert twice a year in neighborhood papers. A monthly newsletter and frequent electronic mail advise BMC employees of projects and opportunities. Individual departments also have their own forms of outreach to families and providers in neighborhoods they serve, such as the Pediatrics Department's Division of Community Pediatrics Pediatric Update, circulated to Boston HealthNet health center providers. Such communications highlight ways that expertise housed within the hospital may be a resource for smaller agencies. As BMC moves through its second five years, our foremost aim is to respond to the needs of Boston's residents by strengthening the health of struggling neighborhoods. The five programs detailed on the next pages exemplify the breadth and scope BMC's community service initiatives. Each is a component of the sanctuary Boston Medical Center is sustaining in Boston as it goes beyond the traditional medical model to provide "exceptional care without exception". |
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