Case Studies



Swedish Hospital










Swedish Eastside Hospital

The Challenge
Swedish Medical Center based in Seattle, was seeking to build its first hospital in Issaquah, a rapidly growing community east of the city. At the same time Overlake Hospital, based on the eastside, also applied to the State of Washington to build a hospital there. Overlake was viewed as the “home team” and already provided service to the area.

The challenge was to build sufficient support for Swedish in the community to compete with the “local” provider, and then demonstrate that support to the State Department of Health (DOH), which would make the decision on the requisite Certificate of Need indicating sufficient demand for a hospital in the community and approving the operator to build and operate it.


Don and his team developed and executed a plan that included:

  • Creating a local presence for Swedish by opening an Issaquah office with an on-the-ground employee.

  • Identifying supporters through a two-level strategy of personal visits to opinion leaders coupled with direct mail with response cards.

  • Educating supporters through a town hall meeting, print advertising, and further direct mail.

  • Activating supporters to turn out for the public hearing through direct mail, advertising, and phones.


Competing on turnout for the respective hearings, Swedish was able to pack the hearing room, equaling or bettering Overlake’s turnout. Dozens of letters were generated supporting Swedish.

Having achieved parity in political importance with Overlake, the DOH found itself facing with a choice between two equally competitive proponents and proposals. It based its decision on a regional bed-count that included a nearby Group Health facility that was to be closed and decided against granting either hospital a Certificate of Need.

However, the campaign had developed a very strong current of public support for a new hospital and for Swedish to operate it. In an environment of continued pressure, the DOH decision was eventually thrown out in court and Swedish was granted a Certificate to build its hospital.



Who We Are...









©2010-2023 Smith & Stark | All Rights Reserved
P.O. Box 16174, Seattle, WA 98116