Community Care, Defined

View This Article in BOSS Magazine

Kaweah Delta Health Care District sets the standards for healthcare organizations throughout California, and the rest of the country.

The hidden jewel in California’s Central Valley region is neither a tourist destination nor a national park. It is that most beautiful thing that every community richly deserves but many are denied: an award-winning healthcare organization with an unparalleled dedication to the communities it serves.

The non-profit, publicly-owned Kaweah Delta covers approximately 600,000 residents in the city of Visalia and throughout Tulare and Kings counties — one of the nation’s most productive agricultural regions. Formed in 1961 as one of California’s original 78 healthcare districts (there are now only 36 still operating with hospitals), Kaweah Delta’s Board of Directors are elected to four-year terms by the voters living within the five zones that comprise the 183-square-mile geography of the District.

Kaweah Delta offers comprehensive services including a certified Level III trauma center, cardiac care, neurosurgery services, cancer care, pediatrics, robotic and minimally-invasive surgical care, neonatal intensive care, and much more including a partnership with Cleveland Clinic’s Heart and Vascular Institute, the No. 1 heart care program in the nation for 24 years in a row.

Their eight campuses include the Kaweah Delta Medical Center, imaging center, an acute rehabilitation hospital, outpatient dialysis center, adult inpatient mental health hospital, primary and specialty care outpatient clinics, a skilled nursing and subacute facility, several urgent care centers, and a chronic disease management center.  Through several joint ventures with community physicians and other healthcare organizations, Kaweah Delta’s broad healthcare continuum also includes a comprehensive outpatient surgery center, two large assisted and independent living facilities, a dedicated, 40-bed memory care center, and a medical foundation.  We recently spoke with Gary Herbst, Chief Executive Officer, and Marc Mertz, Vice President of Strategic Planning and Business Development for Kaweah Delta, to discover the organization’s strategic importance and the source of its success.

Caring for the people of Visalia and Tulare County is a challenging proposition, both in terms of the sheer size of its coverage area and in the needs of its residents. “It's pretty unique,” Mertz admitted, estimating that 85 percent of the individuals and families served by Kaweah Delta do not have commercial insurance.

“That's meant we needed to respond to the needs of our community. We are a public institution created to serve this particular population, and we are committed to that. We take that very seriously. We take care of patients regardless of what insurance coverage they have, and we’re constantly working with the community to understand their needs and what services make sense to provide locally,” said Herbst.

An added complexity of serving Kaweah Delta’s market is the limited access to timely but non-emergent specialty healthcare services for uninsured and underinsured people. Limited access often times causes untreated conditions to become chronic, requiring more intervention, or causes such conditions to bloom into multiple chronic conditions.

Patients often turn to the emergency department for primary care, putting additional strain on what is typically a hospital’s busiest department. Kaweah Delta’s Emergency Department is one of California’s busiest, seeing over 90,000 visits annually in a space designed to accommodate roughly 36,000 visits.

“It's a challenge that we live with every single day, but we’re very excited about our current $40 million expansion project which will essentially double our exam room and waiting room capacity as well as modernize the flow and treatment of patients,” Herbst reported. The expansion will develop multiple tracks designed to funnel patients into the right treatment setting at the appropriate level of urgency, lessening the burden on the Emergency Department and decreasing wait times for patients.

Kaweah Delta operates rural health clinics in multiple communities to provide access to care in areas where physicians may be less likely to establish a successful practice because of the payer mix. “Establishing outpatient clinics in more rural areas takes pressure off of our Emergency Department. It also provides patients and communities with more timely and local access to outstanding healthcare providers and allows us to access additional federal funding, which we can use to provide primary care, specialty services, and mental health services for these communities,” said Herbst.

Kaweah Delta’s offerings caught the eye of Mertz, a healthcare executive with more than 22 years of experience, whose previous work in healthcare has spanned across the U.S. and internationally. “One of the things that really impressed me and convinced me to join Kaweah Delta last year was its progressive development of new and innovative services, despite being located in a relatively-smaller community with fewer resources,” said Mertz. “Coming from Southern California, the scope, depth, and quality of services being provided here was very surprising.” The city of Visalia, the largest city in the County and home to the Kaweah Delta Medical Center, is also home to about 130,000 individuals, or about a third of the County’s residents.

“We serve a much broader geography and a lot more people, but to have a scope of services that includes neurosurgery, a Top 50 U.S. cardiac surgery program, a trauma center, advanced pediatrics, and a NICU is both surprising and impressive,” said Mertz.

With the closure of a number of smaller community hospitals in the area, the district has expanded its geographic reach to provide access for those who can’t realistically get to Los Angeles or San Francisco for care. With that in mind, Kaweah Delta has built a reputation for delivering world-class healthcare services that often cannot be provided in small, remote communities, said Herbst.

Award Winning Community Care for All

“Our leadership, staff, and physicians recognize that we're people taking care of people—taking care of our family, our friends, our neighbors, and sometimes our colleagues. With this responsibility and promise in mind, there has been a genuine commitment to always provide the best possible care in anything and everything we do,” Herbst noted.

That commitment has resulted in a slate of accolades that would be impressive for any healthcare organization in a major American city. In February, Healthgrades named Kaweah Delta as one of the Best 250 hospitals in the United States, after rating 4,500 hospitals across the country for performance in 31 different clinical measures. It is also a winner of the American Hospital Association’s Foster G. McGaw Prize, a distinction created to “recognize hospitals that have distinguished themselves through efforts to improve the health and well-being of everyone in their communities.”

Physician recruitment is both a major challenge and a major focus for Kaweah Delta. In addition to partnering with local physician groups to aid in this effort, Kaweah Delta works to leverage access to federal grants and loan forgiveness programs to attract new clinicians.  “In July 2013, we welcomed our very first class of medical school graduates to our graduate medical education residency program, hoping they would come here to further their education and training, enjoy the community, enjoy the hospital and want to stay,” Herbst said. “With four graduation ceremonies now having been celebrated and almost 40% of the physicians choosing to stay and practice in our local community, we couldn’t be more excited and pleased.”

Kaweah Delta continues works to improve its efforts to attract the best and the brightest, but also on employee retention. “We're constantly working to create an ideal work environment,” said Mertz. “That’s one of the pillars of the organization and everything stems from that: If you have a great workforce that's engaged and high performing, you're going to provide great quality and great service. You're going to be successful.”

The organization recently revisited its mission and vision statements. Said Mertz, “Our vision is simply ‘To be your world-class healthcare choice, for life.’ We realize that’s bold and ambitious, but that's exactly what we aspire to be. Again, for those things that we provide to fulfill the community’s needs, we are committed to being excellent in service and quality.”

Connecting with Our Community

In 2017, Kaweah Delta formed three Community Advisory Committees and several Community Ambassador Groups to help it determine the future healthcare needs of the community, the facilities and technology needed to meet those needs, and how Kaweah Delta could better communicate and engage with its community. Since then, Kawhea Delta has grown to 10 community groups. These committees and groups have met monthly with Kaweah Delta leaders and staff over the past year and a half and have greatly influenced much of Kaweah Delta’s decision-making.  According to Herbst, “the creation of and participation in this Community Engagement Initiative has been one of the most rewarding, meaningful and important things we have ever done.  We truly feel honored and blessed to have such a caring and engaged community.”

Mertz said community input has been needed and well received. “It's been really helpful to us to determine the kind of care and services this community truly needs and engage them in a different way,” said Mertz. “We've actually involved these groups in our annual strategic planning process, so they've got a fingerprint on the direction Kaweah Delta is going in the coming years. It's a great experience for us and has allowed us to work in the community in a way that I haven't seen other hospitals do.”

Kaweah Delta is currently working with an architectural firm to develop a master facility plan which will “rethink” all of its facilities located on its main campus, as well as other campuses.  Through this master facility planning process, they will attempt to forecast what their community needs will be 10 or 20 or 30 years from now, intending to design the best, most-efficient facilities possible.

And when you’re taking care of your friends and neighbors, lifting every burden as much as you can is what really matters.