Over the past few years, Creighton University, Omaha, faced a challenge in achieving its health sciences education mission. The intensely competitive health-care environment, combined with the structure of Creighton’s primary teaching hospital affiliation, made it increasingly difficult to secure the necessary patient volume for quality clinical instruction. The university’s physician practice included mainly specialists and subspecialists, with few primary care physicians. Creighton owned a minority share of its primary teaching hospital, which was a stand-alone facility in competition with local and regional integrated health systems.
These dynamics hindered our ability to increase patient volumes in ways that benefited both the university and our hospital partner. We con-cluded that an affiliation with a larger health system was the best option for ongoing achievement of the university’s academic mission.
A Viable Option
We already had limited affiliation arrangements with other health-care providers, including Alegent Health, a regional not-for-profit health system. After intensive analysis and review of several options, we identified Alegent—sponsored by Catholic Health Initiatives, a national health-care organization—as the most attractive partner for a new affiliation. Both organizations are faith-based, with a close mission alignment and a history of collaborative agreements. Additionally, our new partner’s physician practice group consisted mostly of primary care physicians, an excellent complement to Creighton’s practice.
An official affiliation agreement took effect Sept. 1, 2012, with Alegent Health acquiring the university’s physician practice and its primary teaching hospital and—concurrent with the new affiliation agreement—changing its name to Alegent Creighton Health. Clinical and support staff transitioned employment from the university on the effective date, with the majority of physicians expected to transfer on July 1.
In the new affiliation, Creighton retains control of the educational component of the health sciences schools, with Alegent Creighton Health’s network of facilities becoming the primary teaching sites. An academic affiliation council, with equal representation from both parties, was established as the primary governing organization for the academic mission within Alegent Creighton Health.
The affiliation was a major step forward, benefiting the entire community and enhancing the university’s goal to provide the best possible teaching environment.
Tackling the Transition
Once the strategic affiliation was set, the real work began:
- Engaging working groups. Both organizations brought together physicians and other personnel to create the design, governance, and operational aspects of the long-term strategic affiliation.
- Facing new challenges. These included transitioning more than 800 clinical staff to a new employer, standardizing job descriptions, carefully defining roles and responsibilities between patient care and teaching, and ensuring that critical operations continued.
- Communicating the details to stakeholders. The university conducted regular updates for staff affected by the transition, by way of town hall meetings that allowed for dialogue and discussion, and human resources–facilitated gatherings to provide employees with detailed information about benefits and policies.
The transition has been relatively smooth, considering the complexity involved. We’ve already achieved cost savings through the need for fewer contracted employees, enhancements in productivity, and incorporation of shared best practices. We’ll also be integrating the continuing education process under a single office at Creighton and formulating long-term plans for clinical research integration throughout both enterprises. We continue to evaluate the impact of the removal of the clinical practice operations and personnel from Creighton’s operating environment—specifically regarding services and staffing in support areas—to ensure we achieve maximum efficiencies.
The new affiliation will allow us to focus attention on delivery of our academic mission, leaving the operation and management of the health-care enterprise to a trusted partner with a demonstrated track record of success. As Timothy R. Lannon, Creighton’s president and one of the architects of the plan, often says, "This affiliation is a match made in heaven."
SUBMITTED BY Dan Burkey, senior vice president for operations, Creighton University, Omaha