The Birth and Growth of Hospital Wellness Centers
The integrated medicine model that hospitals embrace for their fitness centers combines traditional fitness/medicine with a psychological approach, like counseling, pastoral care and stress reduction; a therapeutic approach, such as massage and acupuncture; and an integrated approach, including fitness and mind-body activities. It recognizes that a patient's/client's/member's health and well being go far beyond medical procedures and medications.
Hospitals, experiencing a decline in net revenue due to changes in state and federal regulations and reimbursement strategies have looked outside their traditional model at a relatively new paradigm which is the hospital allied, medically integrated fitness industry.
They are attempting to capitalize on what the over 15,000 health/fitness centers across the country already know; fitness/wellness is a prosperous industry. According the annual report published by the Medical Fitness Association (MFA) there are an estimated 550 hospital associated fitness centers currently in the United States and Canada. They have seen and average growth of 19% annually since 1991.
MFA predictions estimate over 800 centers by 2004. If this trend is to continue, and there is no reason to doubt it will, hospitals will need to be schooled in the appropriate management of said facilities in order to fulfill their fiduciary responsibilities to the board of directors and establish/maintain their credible image in the community.
The future, however, is bright. Hospitals have the opportunity to provide a direct link to the healthcare system utilizing an integrated continuum of care model that incorporates a retail business plan. Managing risk factors, providing early detection, rehabilitation, post-rehabilitation, and overall lifestyle management should be the mission and priority of any hospital based center.
The demographics are skewed towards success. Changes in demographics of the U.S. population have far reaching implications. The number of youngsters (ages 5-17) will reach 53 million in the next decade. This, according the Sporting Goods Manufacturers Association (SGMA), is a key group for growth of several industry segments including fitness.
According to The International Health and Racquet Sports Association (IHRSA) baby-boomers aged 35-54 now account for 12.4 million members within the health club industry. They associate health and quality of life as a priority in their daily lives.
This is why they are spending an estimated $35 billion annually on integrative healthcare. Americans 50-79 are well aware that exercise is the "best thing" they can do for their health (63%). Most (89%) believe a person their age should exercise at least thrice weekly, preferably for 20-30 minutes each time.
The antithesis is the economic burden of obesity in youth age 6-17. The estimated cost in 1999 was $127 million up from $35 million in 1979 (American Academy of Pediatrics, May 2002). This is the market that hospitals stand to dominate should they embrace "out of the box" strategies, employ pundit individuals and avoid embracing the intellectual property of the commercial health club industry.
There is something to be said for large, ecumenical doses of skepticism, towards methods that focus on anecdotal information and theories focused solely on profitability and the physical realm. There is no substitute for clinically based, peer-reviewed literature tempered with wisdom and insight into the integrated medical model. New scientific knowledge based on epidemiological observational studies, cohort studies, controlled trials, and basic research has led to an unprecedented focus on physical activity and exercise.
The operation of a hospital allied, medically integrated facility requires a plethora of knowledge, principles, skills and techniques. It is beyond the scope of this article to explore all that is required to effectively and efficiently operate a facility.
Thus the focus will be on those areas the author feels urgent in the prioritization of operational responsibilities. It is up to the reader to interpret, digest and incorporate the concepts presented and use creative license in the further development of hospital allied, medically integrated utopia.
Operating a hospital fitness facility is infinitely more difficult than operating a commercial health club.
CEOs On the Defensive
The CEOs of large companies, hospitals included, have long lived in a rather rarefied atmosphere. Feared or defied by their employees, courted by politicians, analyzed by academics, CEOs were assumed to know and know how to use the secrets of organizational success and economic growth. They became cultural avatars, more celebrated and more invulnerable than presidents or princes.
Today, the CEO's world appears to have changed. With some of the United States' most prominent companies; Tyco, Enron, Andersen and Adelphia falling into disarray or disrepute, chief executives are finding themselves still on the front pages, not as models of prowess, but as representatives of disorder. Seen in the fitness industry as well as evident by a recent article in the October 2002 issue of Club Business International entitled "Corporate Criminals". A question naturally arises: Are these examples merely anecdotal, or are we indeed seeing the transformation of the chief executives role?
Typically when a CEO needs assistance in venturing into a new realm they will hire a consultant or outsource the realm rather than risk failure. However, prior to outsourcing or hiring a consultant it is incumbent upon the CEO or the administration to become an educated consumer and learn as much about the industry and its leaders prior to inking the contract.
Just because a potential consultant or agency has a proven track record in the commercial health club industry does not make them an expert or even marginally proficient in the operation of a hospital related entity. Everyone wants a piece of the "wellness/hospital affiliated" fitness industry. Why? Because of the potential economic gains. Therefore, both parties compromise their integrity and in the end the consumer is the one that loses. Remember, if someone is selling you a simple solution, reject it.
Operating a hospital fitness facility is infinitely more difficult than operating a commercial health club. Not only will this oversimplification cause the customer to fail, but also the whole hospital fitness movement will be undermined.
When In Doubt Outsource
Companies outsource for a variety of reasons and hospitals are no different. Over the last decade the reasons have shifted as strategic needs have evolved. Consider these six motivations when debating whether to outsource or not. 1. Factor cost advantage 2. Superior competence 3. Asset transfer 4. Utilization improvement 5. Economy of scale 6. Business risk mitigation Outsourcing may initially be attractive but there is no substitute for a loyal employee, schooled in the science of operations and public health with a keen eye on the hospitals mission and fiscal solvency.
The industry is young, too young in fact for arguably any entity to stand out as the leader in evidence-based, clinically-tried, peer-reviewed methodology of hospital allied, medically integrated operations. There are however many qualified, degreed, experienced individuals available for hire for commensurate wage and loyalty.
Know Your Clientele And Cater To Their Needs
As Hippocrates said "listen to your patient, they are telling you the cure". Listen to your members and they will tell you what they want. The rest is easy; just deliver.
When working with adults engage them in the learning process. At first this may seem fairly straightforward. I'll just tell them everything I know. But if you really want to convey knowledge and have them walk away with skills they can use, you need to be aware of some adult learning basics. Adults are different and the "say and spray" method is extremely ineffective.
Saying the most information in as short a time as possible is not the best approach. Unfortunately, the drenching doesn't penetrate and the small percentage of information they do remember is likely to evaporate quickly. When designing a training class, teaching the use of equipment or conducting a class start at the end and work backwards.
What specific action do you want the learner to be able to take when the training is finished? Try not to overwhelm but rather identify some core tasks or behaviors that are most important. If the participants master these tasks, they will learn enough of the basics, and be confident about experimenting on their own to figure out the rest.
Staff Should Mirror the Membership
The hiring of staff should take into account the age of the membership and reflect it accordingly. Having staff of various ages will allow the membership to feel comfortable and at ease in the facility. The dress code should reflect the image and mission of the facility without offending anyone. Staff training and certification should reflect the overall philosophy and clientele of the facility also. Hospitals are steeped in tradition and conservatism. In many cases the "clinical" setting needs to be perpetuated but understated. Therefore, the level of expertise of the staff will need to reflect the expectations of the membership and the medical community.
Additional considerations: ¨ Consult a color professional to decorate the facility to stimulate the age groups and gender appropriateness. ¨ Provide greater space between equipment and strategically place rest stations for members. ¨ Provide adequate signage with large letters for directions, instructions and way finding. ¨ Provide extra space, seating, privacy coverings in locker rooms and wet areas. ¨ Consult a Feng Shui professional to optimize the prosperity and comfort of the facility. ¨ Invest in staff continuing education. Professionals need continual stimulation as well as continuing education credit towards the maintenance of their certifications.
You Get What You Pay For
Clinical staff is expensive. Staffing budgets should reflect the level of education, experience and expertise necessary to work in a hospital allied, medically integrated facility. Good staff is hard to find and even more difficult to keep. Look to the organizations grounded in clinical, evidence- based scientific research to meet your staffing requirements. Maintaining high standards will lend credibility within the medical community and provide extraordinary service to the membership.
Quality leads to growth and profitability. The essence of quality can be distilled into four cornerstone principles. They are continuous improvement, customer focus, employee involvement and commitment to measurement and evaluation.
Marketing: Conserve Energy and be Creative
Hospitals tend to utilize outside agencies to market their product. Know one knows your product better than you do. Therefore do it yourself internally. Even if you don't have much to spend, take heart. There is no proven rule of thumb on how much capital should be spent or allocated to marketing and public relations.
Large mailings usually end up in the circular file and if done by an outside agency deliver the wrong message and may offend your target market. Newspaper ads appropriately placed can be effective but don't overdue it. Obtain the editorial calendar form local publications and strategically place ads that will highlight the facility services and compliment the main feature of the publication.
Here are some guidelines that should help determine where to spend the hard fought for marketing dollars. Conserve energy and be creative. After all, who knows the market better thank you do.
Marketing material basics:
Buy good-quality letterhead and business cards. All employees should have business cards and feel free to dispense them liberally. Facility staff are marketing extenders and their enthusiasm and expertise will pay dividends. Incentivize the staff with commissions on membership. Be sure not to pay commissions until the member has stayed at least a year. Staff and member loyalty is a critical success factor.
Paid advertising:
Don't spend money on paid ads early in the game. They are usually expensive and sometimes not effective.
Speak, speak, speak: Speak for free to audiences who are part of the target market. That could be rotary clubs, chambers of commerce (the women's chambers are extremely powerful and influential within the community) and trade associations.
Look to the local/state medical associations as they typically allow presentations that are pertinent to their association. The hospital most likely has a variety of special interest groups that always welcome guest speakers. The local chapters of American Heart, American Cancer, Arthritis Foundation, Diabetes, etc. to name a few.
Write, write, write:
Write how-to or advice articles for the weekly, daily newspapers, local business magazines, trade publications, and print electronic newsletters. Be sure to maintain the copyright so you can offer the same articles to other publications.
Teach classes:
The local adult education program might need assistance and the facility staff is a valuable resource.
Do media interviews:
Call local reporters who write for publications read by your target audience. Invite them to call on the facility when they need background, commentary or story ideas about your industry.
Start a newsletter:
Publish an e-mail newsletter, and pack it with helpful information and special offers. This is much cheaper than a paper-and-ink newsletter because you don't have to pay for printing or postage. Link the newsletter to the facility web site.
Create a web site:
This is mandatory in today's operations and marketing arena. If money is available spend it on the development and maintenance of a premiere web site.
Build strategic alliances:
Introduce the facility to other businesses that don't compete but sell products or services to the same target audience. Offer to promote them if they promote you. Make sure they are people you can trust.
Do pro bono work:
Offer services free to an influential nonprofit group. It will provide a chance to get in front of their board members who may be in a position to bolster membership or provide influential introductions.
Customer Service
You never get a second chance to make a first impression! Words to live by. With all the billions being spent on customer service and training, one would think that service would be great everywhere. Wrong. Service is still lousy- - in fact it seems to be getting worse. Here are several suggestions to ponder when evaluating customer service in your facility.
- The facility has the wrong mission statement. The ad agency probably created it. It does not relate to the customer; it relates to the facility. Why have a mission statement no one knows, understands, follows or lives by?
- Establish written principles for the members. Policies and procedures are great but most are written in terms of the facility not the customer. Principles are what you live by; policies are what you lie with. Develop customer principles to guide the employees and the business.
- What examples does upper management set? The ones who are inaccessible to customers and employees alike are poor role models for the rank and file. Be more concerned with helping others rather than helping yourself. How much day-to-day contact does upper management have with the customer? Could be time for a reality check.
- Complaints are opportunities in disguise. Handling an angry customer in a hostile environment is an art. Take every opportunity to hone this skill and teach all employees the art and science of diffusing a hostile situation.
- Responsibility-takers are so rare that they often receive awards. Reward employees that follow through and provide extraordinary customer service and complaint handling.
- Companies are overly concerned with customer satisfaction rather than loyalty. The fitness industry is notorious for this. Satisfaction is the lowest form of loyalty. Satisfied customers will shop anywhere. Loyal customers will fight before they switch and will get others to do business with you by referral. Does your facility measure satisfaction or loyalty?
- What is the facilities training budget? Typically there is no money for training but money is squandered on big ads, fancy brochures etc. Look at General Electric, Microsoft and Franklin Covey for guidance in employee training. They are the leaders in employee training and accountability thereafter.
- The facility concentrates on competitive issues rather than competitive advantages. Capitalize on your competitive advantages and grow them.
- Don't fail to realize who is really in sales and service. Anyone who talks to a customer. Do the people that interact with the customers the most frequently understand, execute and deliver the mission and customer service principles of the company in a world class way?
Be Mindful Of The Technology Pitfalls
Technology is great and facilitates operations, customer service, marketing and data mining. It is also mandatory for data collection and outcomes analysis. However, it is a double-edged sword. Technology wrongfully used to replace customer service (staff) and breeds complacency among the staff. How many facilities have your visited only to find the staff huddled around a computer screen rather than on the floor servicing the membership?
If the facility is to "techno" there will be greater issues with service and inoperable equipment. There is nothing more frustrating to members than equipment that is not in good working order. Treadmills with TV's, sound systems, management stations will confuse, and frustrate the typical member of a hospital affiliated facility. Typically the buttons are to small, illegible and inaccessible for the decconditioned, visually impaired and untrained member.
Remember, these people have never set foot in a fitness facility and everything is new. They need to be educated to use the technology in a logical systematic fashion with reinforcement on a regular basis. Be patient, speak slowly and use terminology easily understood by all. Technology is wonderful if used appropriately. It will excite, motivate, captivate and incentivize the member to be compliant and consistent in their fitness quest and lifestyle enhancement journey.
Choose the technology wisely; educate the staff and membership on the how and why it is beneficial to them and the perpetuation of the operation.
Hospital allied, medically integrated fitness centers continue to be an emerging market and a financial contributor to the hospitals bottom line. With appropriate and insightful operations these facilities provide a vital service to the community and have the potential to positively impact the delivery of healthcare.
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About Stephen Black
Stephen Black is internationally recognized as a leader in the Sports Medicine/Wellness industries. Mr. Black has published extensively in this area and writes regularly for trade publications. He has twenty-two years experience in the development, implementation and operation of health related facilities. He currently works with hospitals, health clubs and organizations world wide providing expertise and education.
Mr. Black is a clinical instructor at Boulder College of Massage and serves as an advisor and board member to several nationally recognized leaders in Wellness. He also conducts research and provides clinical expertise to a variety of equipment manufacturers and Internet companies. Said expertise relates to product development, testing and market strategies. As a nationally recognized leader in sports medicine, Mr. Black provides expert testimony for legal and legislative matters.
Visit the Author's website at: www.rockymountainhpc.com
Email: rockymountainhpc@hotmail.com
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