Engagement at a Glance: Aligning Health System Structure with Shifting Market Demands

Client Overview

Tidelands Health [Tidelands] is an integrated community health system located in coastal South Carolina, serving the region that spans from Charleston County to Myrtle Beach. In recent years, the U.S Census Bureau recognized Tidelands’ primary service area as one of the fastest growing metropolitan areas in America.

To accommodate the needs of this booming market, Tidelands invested heavily in expanding its ambulatory provider network – evolving rapidly from a small group of independent physician practices to a 215 provider, 30+ sub specialty provider base.


The Challenge

Although Tidelands’ market demand and strategic focus had shifted from the inpatient setting to the ambulatory enterprise, it’s organizational structure and management infrastructure remained inpatient hospital-oriented. While this structure had historically allowed for meaningful leadership accountability across Tidelands’ inpatient business, it impeded transparency and hindered leadership’s ability to drive desired outcomes from the burgeoning ambulatory enterprise. Over time, this legacy structure became too flat to effectively manage, and leadership had no mechanism or ability to meaningfully impact performance in the outpatient network.


The Solution

Tidelands engaged Knowledge Capital Group [KCG] to facilitate the development of a new organizational model to mitigate these challenges. The goals of this new model were to better align and unify the hospitals with the physician network, realize efficiencies across the ambulatory enterprise, and establish a scalable foundation for future organizational growth and expansion. This solution focused on two key areas:

1. CLINICAL DELIVERY FRAMEWORK: KCG facilitated the creation of a clinical delivery framework that organized both inpatient and ambulatory network providers into clinical Service Lines. These units were defined around care pathways, rather than practice of origin, with each having a named Medical Director who would be responsible for clinical delivery. With all aspects of clinical quality and patient safety aligned under a single physician leader, Tidelands was better able to align incentives, drive clinical metrics, implement evidence-based protocols, and stimulate the sharing of best practices and clinical innovations across the health system.

2. ALIGNED & INTEGRATED OPERATIONS: KCG collaborated with Tidelands leadership to develop and implement an operating model that would support the standardization and alignment of procedures, goals, objectives and best practices. This model was designed to empower physicians to lead patient-centric care across inpatient and ambulatory enterprises, better integrate supportive care operations throughout all settings of care, and drive heightened transparency and accountability across the continuum.