HOSPITALS LOOK TO LEANER, MORE EFFICIENT SYSTEMS

The 21st century will probably see a leaner, more efficient medical system as area hospitals join with other branches of health care to provide a kind of community clinic.

The directors of both St. Francis Medical Center and Southeast Missouri Hospital said they can see projects where both hospitals will work closely to provide services to the community.

"Our two hospitals work together with other businesses in the community, where we try to get a grip on the issues that affect health care," said Jim Wente, administrator for Southeast. "There are a lot of things that affect health care that the average person might not stop and think about: crime, violence, living styles and habits. Both of the Cape Girardeau hospitals are interested in outreach programs that go out into the community and try to provide ways for people to take better care of themselves."

Wente said the association Southeast has with the Main Street Fitness Center in Jackson, and St. Francis's association with Universal Health and Fitness Center in Cape Girardeau, are examples of the hospitals' efforts to keep people healthy instead of just treating their ailments.

"These are the kinds of things that traditionally hospitals did not get involved in," he said. "When you were sick you went to the hospital. When you were well enough to go home you went home and that was it."

Jim Sexton, president and CEO of St. Francis, said hospitals will have to find creative ways to provide services with less state and federal funds.

"In the face of more cost-efficient provisions of health care we're going to go with what services we have and look for better ways to maximize the utilization of our assets," Sexton said. "You have to have profit. But the reinvestment has to be back into the community and back into the delivery of quality care."

That does not mean either hospital has intentions of decreasing services. Wente said the hospitals have been pushed by aggressive St. Louis competitors who are eager to move into the area. Southeast's new education service, called Generations, is an example of the direction the hospitals will go.

"There's about 90 different, health-related, service agencies in this community," Wente said. "This is an attempt to bring those kinds of resources together in one place. This would be a place where we could provide education and reference material."

Wente said, "The objective is to provide a way that people can access and learn about health-related issues. Medical services are a significant part of the local economy. So there are a lot of reasons why we want to continue to find ways to grow."

Dr. A. Louise Hart, chairwoman for Southeast Missouri State University's nursing program, said family nurse practitioners will become the primary care provider as services expand into the community.

"It is just too expensive to keep people in hospitals," Hart said. "Not that we are not going to need hospital care, we are. We are going to need high-level, intensive hospital care. But if you are in a hospital you are going to have to be very sick."

A bachelor's degree in nursing, which is a division of the university's college of health and human services, now requires classes in psychology, community skills and leadership management skills.

"It is really an exciting opportunity for nurses to use their whole gamut of skills that they're taught," Hart said. "As we are looked upon as the most cost-effective quality care providers the Medicare and Medicaid will look to that kind of reimbursement."

"You will have to know how to lead a team, how to facilitate other people, to delegate and what legally you can delegate."

The move toward outpatient care will also mean more opportunities for nurses. "My master's degree program has at least doubled from what it was this time last year," Hart said.