Endeavor, Mindhaven to open downtown memory care center. Endeavor Health, and the non-profit organization Mindhaven, announced this week they are colloborating to open a 10,000 square-foot memory care center in Downtown Evanston. The facility, located at 820 Davis St., will provide daytime clinical care, recreational therapies and support care for individuals experiencing memory loss. The site will have three exam suites and two testing rooms, according to a news release. It will also include an indoor garden, a public cafe and multipurpose convening spaces for activities and events. "Mindhaven and Endeavor Health share a commitment to ensuring that individuals with memory loss continue to lead productive, full and manageable lives. Together, we will champion that mission on an even greater scale while connecting patients with world-class care close to home," David Rahija, president of Endeavor Health Northwest Community Hospital, said in a statement. Construction of the new space is expected to begin during the first half of 2027. It is expected to open in early 2028. Endeavor, which is headquartered and operates a hospital in Evanston, announced plans earlier this month to merge with Rush University System for Health. The merger is set to create one of the largest health systems in Illinois.

Rush Oak Park parent looks for Endeavor Health merger. Proposed hospital system would be among the largest in Illinois Rush University System for Health, the corporate parent of Rush Oak Park Hospital, announced last week that it is planning to merge with Endeavor Health to form what would be a healthcare powerhouse in Northern Illinois. If approved by federal and state regulators, the Rush-Endeavor combination would create one of the largest hospital groups in the state, with 12 hospitals and more than 400 healthcare sites, from the northern suburbs through Chicago and out to the western suburbs. "Together, Rush and Endeavor Health have an opportunity to create a stronger, more connected health system that sets a new standard for how care is delivered and experienced across our communities," said Gerald "J.P." Gallagher, president and CEO of Endeavor Health. Dr. Omar Lateef, president and CEO of Rush University System for Health and Rush University Medical Center said the proposed healthcare system "will embody and expand the foundational values for which both systems are known: excellence, access and health equity, backed by a leading university that drives research and trains our future healthcare leaders." Lateef said the proposed system "will expand upon the work Rush has done on the West Side of Chicago to strengthen our impact in communities across the region to ensure more patients benefit from the expertise, innovation and compassion that define us." The proposed healthcare system would operate under the Rush name, which both parties say reflects "the brand's strong national reputation and position as a leading academic institution, and reinforcing a shared commitment to advancing excellence in health sciences education, quality care and innovation." The merger would combine Rush's widely respected academic medical training capability with Endeavor's financial strength and broad geographic presence. It would also help assure what one professional observer said was a more seamless healthcare experience within the new healthcare group. Endeavor Health said it would provide $1 billion in incremental investment in the new hospital system. A "significant portion," they say, "will be dedicated to community partnerships addressing social determinants of health and creating a sustainable infrastructure to support the underserved." Elyse Cutler, an Oak Parker whose background includes work in healthcare mergers and acquisitions, gave the proposal a thumbs up, saying, "It makes a ton of business sense. It fills in the market geography." Cutler said the merger would fill in Endeavor's geographic gaps, including the absence of a presence of a teaching hospital in the city of Chicago. Endeavor has hospitals in eight municipalities, including Evanston, Glenview, Highland Park, Skokie, Arlington Heights, Elmhurst, Naperville and Chicago (Swedish Hospital), as well as Linden Oaks Behavioral Health Hospital in Naperville. Besides Rush Oak Park, there are Rush hospitals in Chicago and Aurora. Rush University is comprised of Rush Medical College, the College of Nursing and the College of Health Sciences. It is ranked among the top hospitals in the nation by U.S. News & World Report, and a Top Teaching Hospital by The Leapfrog Group. "The community hospitals Endeavor brings to the table are really strong," said Cutler. She praised Rush's medical academics "for what they've done and what they've built. I think they do a good job." Cutler said the merger has a potential to improve outcomes for people, "especially those who might divide their (health)care across the two institutions right now, to improve outcomes meaning make their care easier and more convenient." "It would definitely make things easier for patients and improve access," she said. She said that a system that made it easier for patients to access different but related medical services would also make it easier for the healthcare system "to ensure people get the preventative care that they need." Nothing can happen, of course, until regulators approve the merger. Cutler said the merger process will generally play out in two parts, official approval and then long-term integration. "You still need to go through an antitrust review," she said. "So they can't just merge. They need permission from the (Federal Trade Commission) and that's called a Hart-Scott-Rodino Review. I'd guess next summer is when they would close the merger." The second part would be the likely the biggest challenge, said Cutler, who likened hospital groups to battleships, saying, "they're big and complicated." "The integration of the entities will take a long time, getting the IT systems to talk to one another, getting all of its administrative infrastructure to get integrated can take several years." Regulatory approval for healthcare mergers isn't guaranteed. Back in September 2014, Endeavor's precursor, NorthShore University Health System, applied unsuccessfully to merge with Advocate Health Care. In December 2015 the FTC and the Illinois Attorney General filed a lawsuit to block the deal, arguing it would give the combined system control over 50 percent of general acute care inpatient hospital services in northern Cook and Lake counties. It would also, regulators argued, have enough market power to force insurance companies to accept price increases as high as 8%. After a federal judge granted an injunction in March 2017, Advocate and NorthShore abandoned their application. NorthShore eventually merged with Edward-Elmhurst Health to become Endeavor Health. And Advocate Health Care merged with Aurora Health Care in April 2018. Endeavor's Gallagher said their intent with the proposed merger is to create the best healthcare system possible. "Our teams know how to keep people healthy," he said, "and our vision for true community health expands access to quality care, reduces life expectancy gaps and achieves measurable progress in advancing health and well-being across the region. We take seriously our responsibility to every community, patient and team member who interacts with our system, and we are committed to doing our very best for everyone we serve."

The exec: how to manage ER staffing, operational efficiency, and quality. For effective staffing, emergency department leaders need to be keenly aware of patient volume trends and staff shifts accordingly, this new CMO says. Key takeaways. Emergency medicine physicians and nurses are well trained to provide high-quality care for life-threatening conditions such as trauma, but CMOs and other senior leaders need to engage ER staff on the importance of publicly reported quality measures such as hospital-acquired infections. In addition to ensuring that ERs are well staffed, promoting operational efficiency involves leaders focusing on hospital departments that impact ER patient throughput such as radiology and laboratory services. To serve well as physician recruiters, CMOs should share features of their institutions that are special with candidates such as camaraderie among the medical staff and open-door policies for engaging with senior leaders. The new CMO of Ascension Alexian Brothers has extensive experience in emergency department management. Bruce McNulty, MD, was named CMO of the Elk Grove Village, Illinois, hospital in September. Prior to joining Ascension, McNulty had served as senior vice president and CMO of Endeavor Health Swedish Hospital in Chicago for nine years. An emergency medicine physician, McNulty's ED leadership experience includes serving as chairman of emergency medicine at Swedish Covenant Hospital in Chicago and chairman of the ED at Ravenswood Hospital Medical Center in Chicago. For effective staffing, ED leaders need to be keenly aware of patient volume trends, according to McNulty. "I'm a big believer in staffing EDs based on the hourly variations in patient volume and arrivals," McNulty says. "If an ER is going to be efficient, you need to staff shifts at different times to match when patients are arriving and you need to be nimble. You need to look at patient volumes frequently and adjust your staffing ratios accordingly." Ensuring high care quality in the ED setting involves engaging the staff, McNulty says. In particular, ER doctors and nurses are well trained to react quickly and effectively to life-threatening situations such as patients who present with a myocardial infarction, brain hemorrhage, or trauma, but leaders need to stress the importance of publicly reported health measures such as catheter-associated urinary tract infections, McNulty says. "Although ED physicians may not think as much about CAUTIs as they think about life-threatening conditions, they are impactful for patients if they get that kind of infection at an emergency room," McNulty says. "So, you need to educate the ER staff about publicly reported quality measures and why they are important." Another quality concern for ED leaders is readmissions, according to McNulty. "When a patient returns to a hospital at an emergency room, there is the temptation to admit them to the hospital, but that is often not the best thing for the patient or the best thing for the hospital," McNulty says. "It is better to involve care team members such as case managers to see whether a readmission can be avoided and still get the patient the care that they need." When it comes to operational efficiency, in addition to ensuring that EDs are well staffed and that staffing is matched to variation in patient volumes, leaders need to focus on hospital departments that impact patient throughput in the ED, McNulty explains. "These include radiology, laboratory services, and transport," McNulty says. "Senior leaders need to ensure that the ancillary departments that impact ED throughput function efficiently. For example, a radiology department should have goals for when a film is read and when the results of a radiological exam are placed in the electronic medical record, so ED physicians can react quickly with diagnostic decisions." Physician recruitment and retention. For a CMO and other senior leaders, one of the keys to success in physician recruitment is sharing with candidates why a health system or hospital is special, according to McNulty. "Sharing attractive qualities of institutions such as camaraderie among the medical staff, open-door policies for engaging with senior leaders, and the capabilities for physicians to be successful from the beginning of their employment such as adequate space and appropriate support staff are all helpful in recruitment," McNulty says. With physician recruitment in mind, a hospital CMO must be aware of what works well at the facility and what needs to be improved, McNulty says. "In those areas that do not work well, a CMO needs to look for opportunities to improve," McNulty says. In physician recruitment, offering compensation that is competitive in the market is essential. "If you do not offer competitive compensation, most physicians are not going to consider you as an employer," McNulty says. For retention, a CMO must stay in close contact with physicians, McNulty explains. "I often give physicians my cellphone number and let them know that they should contact me before they get frustrated," McNulty says. "Physicians have direct supervisors such as service line directors, but if they feel they are not getting the attention they deserve, they should be able to reach out to their CMO. Then the CMO must remove any barriers to the success of physicians." Flexibility is also important in retention of physicians, according to McNulty. "If you can be flexible with work hours and weekend coverage, it boosts retention," McNulty says. "I like to work with doctors to help make sure they have a good work-life balance." Effective risk management. Reducing the risk of adverse events among patients requires a high-reliability culture that includes ensuring that staff members feel comfortable speaking up, according to McNulty. "Nearly every hospital has reporting software for adverse events," McNulty says. "If your event reporting system works in the right way, leaders will receive reports about adverse events, the problems will be examined, and changes will be made." When adverse events or near misses are reported, it is important for CMOs and other senior leaders to circle back to staff members who make the reports, McNulty explains. "It can be as simple as picking up the phone or sending an email," McNulty says. "When I was CMO at Endeavor Health Swedish Hospital, the risk manager would focus on key events that had been reported every week and send thank you cards to the staff members who made the reports." When there are serious adverse events, leaders must invite the staff members who were involved in the events to participate in the resolution process, according to McNulty. "Frontline workers should be involved in root cause analyses, so leaders can understand why the care of a patient did not go as expected and what can be done to make sure mistakes do not happen again," McNulty says. Promoting professionalism among clinicians is an important aspect of risk management, McNulty explains. "Ascension has a well-developed physician professional program that includes documents that guide frontline physicians to act with the utmost professionalism when they are interacting with patients and co-workers," McNulty says. "If a physician goes outside the lines of professional behavior, there are structured ways for senior leaders to explain professionalism standards and give feedback about how to avoid unprofessional behaviors in the future." There is data showing that strong relationships between physicians and patients as well as a high level of physician professionalism builds trust with patients that leads to lower litigation for physicians and hospitals, McNulty says.