Reform of the public hospital system of Cook County: A medical staff perspective

In 2007, facing a structural deficit, the Cook County Board of Commissioners cut the budget for the public hospital system serving the city and suburbs of Chicago by $71 million (8%). During an overlapping period of four months, the public hospital's senior leadership changed three times. The service cuts together with the lack of consistent leadership undermined the morale of the workforce and eroded the public hospital system. As the stability of the public hospital system grew more precarious, civic leaders called for governance reform and community activists and medical staff leaders linked the need for governance reform to the need for revenue to restore services. The following year, a divided county board voted for both new revenues and independent governance with a three-year term. The public hospital system is struggling to maintain and extend services, stabilize financially, reshape itself administratively, and define its role in terms of the local demographics of health care disparities and within the evolving local health care market. The community activists and medical staff leaders have remained engaged with the hospital governing board and the county political elected officials to meet health care needs with quality services.