Comparative Analysis 1

Comparative Analysis: Sutter Center for Psychiatry and Sierra Vista Hospital

Thuy Lindsay Dao

Saint Mary's University of Minnesota

Schools of Graduate & Professional Programs

HS720 Strategic Health and Human Services Leadership

Professor Becky Brodin, RN, MA, CNOR (e)

January 30, 2018

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Organizational Overview: Sutter Center for Psychiatry and Sierra Vista Hospital

Sutter Center for Psychiatry is a not-for-profit behavioral health care entity, which

provides services to the Sacramento, California region since 1990. It is part of the Sutter Health

network of care that spans more than 20 counties across Northern California. Sutter Center for

Psychiatry is a 69- bed freestanding inpatient acute psychiatric hospital and serves children (ages

4-12), adolescents (ages 13-17) and adults (18+). It is the only comprehensive mental health

system in the Sacramento region, which operates as part of a nonprofit, integrated health care

system. In addition, Sutter Center for Psychiatry operates an off-site Partial Hospitalization and

Intensive Outpatient Program (IOP) under its umbrella of care. The Partial Hospitalization

program provides a full range of psychiatric, mental health and co-occurring substance abuse

services. Their vision statement aligns with the Sutter health system by stating, “Sutter Health

leads the transformation of healthcare to achieve the highest levels of quality, access and

affordability.” Similarly, their seven core values are visually designed in a pie chart with

Honesty and Integrity in the center, being supported by Excellence & Quality, Innovation,

Affordability, Community, Compassion & Caring and Teamwork. (www.sutterhealth.org). Each

core value is further explained in a narrative paragraph to provide further depth on why and how

they will adhere to their core values.

As part of the Sutter Health system, the hospital provides to a specialized population that

requires a therapeutic approach. This is evident in their individualized mission statement

identifying that, “Sutter Center for Psychiatry places the patient first and always. We provide

compassionate care, showing respect and dignity to the individual while focusing on safety and

involvement of the individual and their family. Our recovery focused services empower and

encourages the patient and family to be active participants in treatment decisions and
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development of skills and tools to support them in their daily life” (www.suttercenter.org). Their

mission statement reflects their holistic approach to treatment by utilizing the Recovery Oriented

Care Model of emphasizing on the importance of building resiliency, hope and empowerment for

individuals with mental illnesses in their path of creating a meaningful life. Although Sutter

Center for Psychiatry is the only not-for-profit psychiatric hospital in the greater Sacramento

area, the competing acute psychiatric hospital is twice as large in bed capacity and is located a

mere 15 miles away.

Established in 1986, Sierra Vista Hospital is a private, for-profit 172-bed acute care

psychiatric facility located in Sacramento, California. Similar to Sutter Center for Psychiatry,

they offer both inpatient and outpatient services working with individuals suffering from

emotional, behavioral and substance abuse problems. Sierra Vista Hospital has contracts and

referral relationships with 33 counties in California, are a Medicare provider and have contracts

with most commercial health plans and Medicare HMOs (www.sierravistahospital.com). Their

vision statement can be identified as “Sierra Vista Hospital will be the behavioral health care

provider of choice for our patients, employees. Physicians and other health professionals by

consistently performing at a superior level while maintaining sound ethical standards and

returning a fair value to our financial partners.” Their mission statement is as followed, “Sierra

Vista Hospital is a provider of behavioral health care services, delivered with compassion for

patients and their families, with respect for employees, physicians and other health professionals,

with accountability for our fiscal and ethical performance, and with responsibility to the

communities we serve.” Sierra Vista’s hospital identifies 8 guiding values in the form of short

single sentences and an emphasis on providing a fair return to investors

(www.sierravistahospital.com). They follow the medical model of mental illness that treats
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mental disorders in the thought that there is a physical cause to the illness. In mental health

settings, psychiatrists adopt this model approach, rather than psychologists, and supporters of the

medical model consequently consider symptoms to be outward signs of the inner physical

disorder.

Mission Commitment and Stakeholders

In 2010, Sutter Center for Psychiatry transitioned from their focus on the medical model

to the recovery oriented care model. The implementation of the philosophical theory of the

model, along with the Lean Management approach, fostered a culture of care and excellence

built on bests practices that aligned with the organization’s mission statement. According to the

Joint Commission, Sutter Center for Psychiatry is one of the leading facilities with a lower than

average rate in hours in seclusions in hours in physical restraints. An example of supporting their

culture of care, the organization made the ethical decision to have every employee receives

annual training to be certified in Nonviolent Crisis Interventions. The primary focus

(approximately 80% of the training content) in the program is to learn how to identify the nature

of various verbal outputs from patients and how to implement an appropriate and therapeutic

verbal intervention (Temple, Zgaljardic, Yancy, and Jaffray, 2007, p. 431). These initiatives and

changes were to address the CMS Value-Based programs, the Joint Commission’s Hospital-

Based Inpatient Psychiatric Services quality measures, and most importantly, to address the

growing need for safe mental health services in the community. As a not-for-profit organization,

internal stakeholders are the employees and patients. External employees are local, state, federal

and regulatory agencies, community providers and members and most importantly, to future

patients and to improving public health initiatives while reducing the stigma of mental health.
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Sierra Vista Hospital is owned by Universal Behavioral Health Inc., which operates as a

publicly traded for-profit company and its stock is traded on the New York Stock Exchange.

The company owns nearly 200 of the estimated 500 total free standing behavioral health

hospitals in the U.S. In 2015, they reported $9.0 billion in revenue and $680 in net profit, it’s

behavioral healthcare business is highly profitable. Specifically, for every dollar that Sierra Vista

generates in revenue, Universal Behavioral Health Inc. takes nearly a quarter of the profit

(www.uhsbehindclseddoors.org). In Sierra Vista’s commitment to meet the fiduciary aim of their

mission statement, they expanded their 120-hospital bed facility to include 51 additional beds as

a strategic business approach to increase their average daily census.

Conclusion

As a for profit organization, Sierra Vista has the same internal and external stakeholders

as Sutter Center for Psychiatry, with the dominating addition of meeting the financial

expectations of their investors and financial partners. Their commitment to financial value is

achieved by focusing all of their efforts in decreasing their expenses while increasing their

revenue. According to the California Department of Public Health (CDPH), in just the past two

years, Sierra Vista Hospital had four substantiated incident reports under the allegation category

of resident/patient/client abuse, 7 reported complaints to the facility and 25 survey deficiencies

founded by the Joint Commission and CMS. In their business strategy approach for financial

growth, they are risking ethical practices by engaging in unsafe practices and standards of care.

According to Niles (2015), the Iron Triangle of Health Care is “a concept that focuses on the

balances of three factors: quality, cost, and accessibility to health care” (p. 12). The definition of

quality is being able to provide standards of care that includes best practices for the safety of the

consumers.
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As part of the not-for-profit system of care, the healthcare delivery system profoundly

influences the cultural environment of Sutter Center for Psychiatry. Collaborating with schools,

county programs, local political leaders or government programs, the list of external stakeholders

continues to grow in an effort to determine the best standards of care to meet the growing mental

health needs of the community. Sutter Center for Psychiatry follows the leadership principles of

Lean Management. Lean is a set of operating philosophies and methods that help create a

maximum value for patients by reducing waste and waits. It emphasizes the considerations of the

consumer’s needs, employee involvement and continuous improvement (Lawal et al, 2014). The

implementation strategy of utilizing the Lean management approach influenced the ethical

culture of the leadership team within Sutter Center for Psychiatry. The leadership principles of

having front-line employees be involved in the decision-making process of the organization, of

establishing patient advisory committees to have former patients evaluate and provide feedback,

and of focusing on providing safe quality care, Sutter Center for Psychiatry is able to

demonstrate financial growth while addressing the significant needs of the community. With the

statistical data and reports for Sierra Vista Hospital, there may be a need to re-evaluate their

management and leadership approach to adopt the Lean Management principles as a means to be

able to meet the financial obligation of their external stakeholders, and to be able to protect and

preserve the safety of individuals served.

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REFERENCES:

Behavioral Health Care Mission/Vision. (n.d.). Retrieved January 31, 2018, from

https://www.sierravistahospital.com/about-us/missionvision/

Health, S. (n.d.). About Us. Sutter Center for Psychiatry. Retrieved January 31, 2018, from

http://www.suttermedicalcenter.org/psychiatry/aboutus.php

Home. (n.d.). Retrieved January 31, 2018, from https://www.sutterhealth.org/about/mission

Lawal, A. K., Rotter, T., Kinsman, L., Sari, N., Harrison, L., Jeffery, C., . . . Flynn, R. (2014).

Lean management in health care: definition, concepts, methodology and effects reported

(systematic review protocol). Systematic Reviews, 3(1). doi:10.1186/2046-4053-3-103

Niles, N.J. (2015). Basics of the U.S. health care system (2nd. Ed.). Burlington, MA: Jones & Bartless

Learning.

Temple, R. O., Zgaljardic, D. J., Yancy, S., & Jaffray, S. (2007). Crisis intervention training

program: Influence on staff attitudes in a post-acute residential brain injury rehabilitation

setting. Rehabilitation Psychology, 52(4), 429-434. doi:10.1037/0090-5550.52.4.429.

Universal Health Services: Behind Close Doors. (n.d.). Retrieved January 30, 2018, from

http://uhsbehindcloseddoors.org/about/.