A Conversation with Steve Snelgrove

The president of Howard County General Hospital discusses his five years in the job and what lies ahead.

Steve Snelgrove, top left, shares lunch and conversation with hospital employees, clockwise: Jon Oravec, Tammy Liu, Rachel Lee and Bianca Chang.

Published in Dome - Dome March/April 2019

As president of Howard County General Hospital (HCGH), Steve Snelgrove works to ensure patient safety and satisfaction and to create an excellent system of care for county residents through good relationships with hospital employees, community providers and outside organizations.

Since 2014, when Snelgrove arrived, the 245-bed hospital has earned several health care awards, including a designation from the Blue Cross Blue Shield Association for excellence in maternity care and in knee and hip replacement. Additionally, the hospital continues to receive top honors from the American Heart Association/American Stroke Association for its primary stroke program.

In a recent interview, Snelgrove discussed his time at the 46-year-old hospital.

Q. How have the hospital’s priorities changed since you became president five years ago?

A. In many ways, our priorities remain the same. Our main goal has always been to create a delightful experience for patients and their families, and to keep them safe. That’s a focus of everything we do. 

I came here seeking to ensure that Howard County is the healthiest county in Maryland. I knew this could only be accomplished by building trust and partnerships — both within and outside of the hospital — to create a community-based system of care. We are doing that — through our partnerships with physicians and other providers, through our population health efforts and through our work with the Local Health Improvement Coalition. 

I knew we needed to create an organization that was physician-led and physician-accountable, and where physicians were partners in the hospital’s leadership. We are continuing to work on that goal as well.

Q. What are some ongoing challenges?

A. Howard County General Hospital serves a densely populated county of more than 325,000 people. It’s the only county in the state whose population is both growing, and aging, at more than twice the state average.

Although Maryland’s new hospital reimbursement model is innovative and designed to align with our mission, it is constantly being fine-tuned and is not necessarily accommodating to our county’s changing demographics. We want to serve the needs of our community in our community hospital when this makes sense, and we need additional funding to invest in new programs, technology and facilities. The Maryland reimbursement model, as currently structured, makes this very challenging. 

We also need to find the necessary resources to invest in our employees’ education, training and development so that we have the skills we need to meet our strategic objectives. 

Finally, we are working on strengthening our servant leadership culture, where the main goal of the leader is to serve, respecting and empowering those closest to the patients to live our values and to deliver extraordinary care with empathy and compassion.

Q. Tell us about your population health initiative.

A. We aim to keep Howard County residents healthy and out of the hospital by aligning our work at the hospital with the needs of the community. 

Our model is organized around a framework we call the Howard Health Partnership. Its goals, developed in collaboration with community groups, include improving access to care and addressing behavioral health and healthy aging.

We offer wellness screenings and education programs, many through our Journey to Better Health program that connects faith-based organizations to health care resources. We also encourage and help patients write down and file their advance care wishes with us so that all end-of-life decisions reflect their expectations.

Our Community Care Team identifies patients in the hospital who could benefit from additional support after discharge, and connects them with a nurse, a social worker and a community health worker. Team members make sure these former patients have food and transportation and can get prescriptions filled. Their work has led to a 40 percent reduction in hospital use by that patient population, saving more than $1 million in avoidable costs from readmissions.

Q. Howard County General Hospital now receives programmatic funding from the Howard County government. How did you manage to get it?

A. It started by building trust and a strong relationship with the county executive based upon our common goals of making Howard County the healthiest community in the state. I explained the facts of the state’s reimbursement system, and projected those constraints and their long-term impact on the county. I told him I was seeking investments that, if made now, could mitigate longer-term problems like increased volumes in our emergency room and a dire shortage of primary care physicians in our community.

The county executive recognized those needs and decided to make investments that assist us. For example, Howard County partners with us to bring in new primary care physicians and to put social workers and peer recovery specialists in the ED to help people with behavioral health issues.

This is nearly a half-million dollars a year for programs that we just couldn’t otherwise afford, and which benefit the whole community.

The money we receive from the county comes with our commitment to measure progress and to make adjustments if things aren’t hitting the outcomes we expect.

Q. Since 1998, HCGH has benefited from Johns Hopkins’ academic knowledge and clinical expertise. What else sets it apart as a community hospital?

A. First, our location. Planned 52 years ago, Columbia is one of the most diverse communities in America. There’s a talent pool we can employ that understands the issues of diversity, inclusion and equity. We have an open and transparent environment where we talk about these issues, and we embrace different cultures — like the Korean community and the deaf and hard of hearing community — to make sure we’re meeting their needs. 

We’re also looking at how we can work more effectively with skilled nursing facilities, assisted living and home health.

As a member of Johns Hopkins Medicine, we benefit by bringing the latest evidence-based best practices to our community. We also serve as a training facility for medical students and other allied health professionals, ensuring a steady supply of quality employees for all of Hopkins.

Q. What keeps you up at night?

A. Finding enough resources over the next decade to add new services, such as an ambulatory surgery center, and replace antiquated ones, like our ICU, maternal child unit and neonatal intensive care unit.

I wonder how to demonstrate the value of a hospital in a world that is moving quickly toward outpatient care and home-based care. I also think about succession planning: identifying our next generation of leaders and making sure they’re prepared for the challenges society is thrusting upon us. 

Q. What does your workday look like?

A. Each day begins with a daily safety briefing. The entire leadership team of the hospital comes together to talk about any issues that could put a patient, family member or an employee at risk for harm and what we have done to mitigate that risk. Then we put the right people together to work on making improvements. That process has gone beyond achieving our safety goals to establishing a culture of trust, respect and accountability among team members.

I usually spend about a day and a half a week at Johns Hopkins Medicine to assist in working on the strategy and operations of the health system. I participate in a couple of Maryland Hospital Association committees and chair their Behavioral Health Task Force. I serve on a couple of community boards and work with our foundation on our philanthropic strategy. I make sure we stay close to our elected officials on the state and local level so that they understand our challenges and the solutions that will help us going forward.

Our patients’ goals and wishes are at the center of all we do. Each day, after the daily safety   briefing, I try to visit patients to hear what’s on their minds and learn firsthand how we are doing. I also strive to meet regularly with our employees. I want them to understand what a special difference they make in the lives of our fellow citizens through the care and compassion they provide every day. —Interviewed by Sharon Sopp

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