Altru is recognized for outstanding orthopedic, cardiac, cancer and diabetes care.

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At a time when healthcare systems are becoming more fragmented and competitive, Altru Health System in Grand Forks, N.D., has taken the opposite approach by providing integrated care. As a result, more than 250,000 patients today consider the system their provider of choice, CEO David Molmen claims.

This integrated approach started several years ago when Grand Forks Clinic and United Hospital merged on a 90-acre medical campus in Grand Forks to create Altru in 1997. “Those two organizations decided that they could do better jobs together, and I think that was very forward thinking,” Molmen says.

Altru serves roughly a quarter-million people at 20 locations in North Dakota and Minnesota within a 200-mile radius of its main campus. Molmen says Altru is recognized for outstanding orthopedic, cardiac, cancer and diabetes care, and also provides services through Altru Home Services and Altru’s Outreach Therapy.

“Our consistent approach is to ensure that services are tightly integrated and comprehensive,” Molmen explains. “Where some servers have tried to super-specialize or carve out a niche, we are a general healthcare provider, and we have done a superb job.”

A Better Outcome
Serving a broad geographic area through several locations requires the system to work cooperatively to provide high-quality services. For the past four years, the company has developed and implemented an electronic medical records system, which Molmen says supports Altru’s goal to get the best outcome in care. “We have been working on high-reliability care,” he says. “That means that we make sure that everything that needs to happen in healthcare happens every single time.

“North Dakota always rates as one of the best healthcare outcome states in the country, and the reason for that is that the healthcare here tends to be tightly coordinated and multidisciplinary,” Molmen says. “I think one reason you get better outcomes here than in some parts of the country is that when you are cared for, all of your records go into a common medical system.”

The provider is also working to create higher reliability through lean and Six Sigma methodologies. In practice, these philosophies can eliminate unwanted steps in healthcare, which creates more efficiency and better service for the patient. “Medicare and other reimbursements for healthcare services in North Dakota is about the lowest in the whole country,” Molmen says. “I think that has been something that we have been very sensitive to by being efficient and avoiding costly mistakes.”

Altru took a step to streamline its processes this year when it consolidated its primary care scheduling. After examining the call volume at its call center, Molmen says it found it was missing as many as 10 percent of calls because lines were busy. Without creating any added costs, the company created a call center where all scheduling inquiries were routed. By making the change, Altru improved its call response from 90 percent to almost 100 percent, Molmen notes.

“People are really concerned with what they pay for health insurance right now, so we are trying to save money and improve our results,” he says. Altru has also consolidated more specialized services like radiology imaging to create seamless connections between the care providers give and care patients receive. “We have to do a better job dealing with the human side of care,” he says. “People have higher expectations than they used to in the experiences they have and the way they are involved with their quality of care.”
 
Preparing for the Future
Maintaining its position as the provider of choice in its region will require the organization to maintain and grow a strong work force. “We have found that the quality of our labor force is excellent; however, the numbers of the labor force are really changing,” Molmen admits. “Right now, there is an intense shortage in some health professions and categories. We compete nationally for staff. It’s very challenging in rural areas.”

Today, Molmen says employees value job location and the quality of their co-workers as much as a paycheck and good benefits. Altru faces tough competition from urban healthcare hubs such as Minneapolis/St. Paul.

“In our area we are seeing an extreme shortage in nurses and we are working with area universities and colleges to provide unique opportunities in engaging nontraditional students in health programs,” says Sharon Fletcher, manager of Altru’s Learning and Organizational Development.

Altru’s Learning Institute is its solution to maintaining and developing its work force. The institute provides learning opportunities such as risk management, infection control and safety improvement workshops, as well as tuition reimbursement and career development and planning.

Altru’s internal “Grow Your Own” program provides financial support for employees who acquire licensure and certification in clinical professions that are classified under a critical shortage status. Professions supported by the program include radiation therapy technicians, ultrasound technicians, cardiovascular invasive specialists and registered nurses