Diversity among seniors. A Toledo, OH, hospital assesses the healthcare needs of elderly African Americans and Hispanics.

In 1992, leaders at Mercy Hospital, Toledo, OH, realized the facility's outreach programs were not reaching as many elderly African-American and Hispanic residents from the surrounding neighborhood as they would have liked. Mercy's leaders therefore decided that the hospital could offer cultural-specific programs that better meet the healthcare needs of these populations. To secure residents' perspective, an assessment process was launched. The data gathered from participants in face-to-face interviews revealed that some had problems with access to healthcare. A lack of money and other resources seemed to be the major barriers to care. The key concern of the elderly persons interviewed is securing personalized care or services that help them maintain their independence. A number of participants wanted free transportation (other than to and from the hospital). They need help getting to their physician's office, the pharmacy, the grocery store, and the bank. Public agencies may offer such transportation services. In addition, the Hispanic elderly interviewed would like to see Spanish-speaking personnel in admissions and the emergency department.

Information for integration. A senior services program spurs development of a multi-hospital integrated network.

In 1985 St. Charles Hospital, Oregon, OH, and Mercy Hospital of Toledo, OH, launched a plan to jointly offer a continuum of services to area seniors. A multidisciplinary team of professionals from both hospitals decided that a membership program (titled the Senior Advantage Program) would be the most effective way to market the services and make them available. As part of the program's development, professionals from the two facilities created a personal computer-based software package that enabled them to capture and update information about Senior Advantage participants. The software program includes a detailed application form and a section for recording enrollees' service utilization. The program enables care givers to enter data when they interact with clients in any healthcare or community-based setting. To complement the personal computer software, a program to construct a central data base was written for the two hospitals' main computer systems. In 1991 St. Charles and Mercy hospitals joined two other facilities to form First InterHealth Network, a for-profit integrated delivery network. The Senior Advantage Program became the basis for the first package of services offered by First InterHealth. In 1992 the program became the catalyst for yet another collaborative venture, linking two rural Ohio Mercy hospitals to St. Charles and Mercy hospitals. The expanded network encouraged rural patients to remain within the Mercy network, utilizing inner-city and suburban Mercy-sponsored hospitals when appropriate.