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NC Hospital Adminstrators Innovate to Improve Rural Health [1]
['Liz Carey', 'The Daily Yonder']
Date: 2023-11-29
Hospitals must look to and work with their rural communities in order to create healthier outcomes, concluded a panel of rural hospital executives at the “Creating Healthier Communities” webinar from the North Carolina Healthcare Association on Wednesday, October 11, 2023.
Panelists included John Green, president and CEO of Iredell Health System; Penney Burlingame Deal, president and CEO of Onslow Memorial Hospital; Todd Hickey, Chief Strategy Officer at ECU Health; Chris Lumsden, president and CEO of Northern Regional Hospital; and Annie Carpenter, assistant vice president of community engagement Mission Health.
Administrators discussed the need for hospitals to become more patient-centric when it comes to providing patient care. The webinar comes as the state’s planned adoption of Medicaid expansion slated to go into effect on October 1 is delayed, and rural hospitals across the country face closure due to financial risks.
According to the Cecil G. Sheps Center for Health Service Research at the University of North Carolina, 195 hospitals have closed across the country since 2005, including 11 in North Carolina.
John Green, president and CEO of Iredell Health System, said his hospital faced an issue when another hospital in Statesville, North Carolina closed, leaving Iredell Health with the problem of absorbing care for an additional 20,000 or more emergency room visits per year.
“Overnight we had to figure out how we were going to handle a significant increase in volumes,” Green said. “First, we obviously had to increase our Emergency Department staffing, ASAP. Secondly, we altered a building project that was going to be for the intensive care unit, and we made an intensive care unit and emergency department because we recognized that we were going to have to handle that increased volume.”
In addition, he said, the hospital created an urgent care that was located near where the closed hospital was to handle patients who needed timely care and may not have had a primary care physician to handle it. Because the community near that urgent care facility was mostly working parents, the decision was made to keep it open from 7 a.m. to 11 p.m. so community members could access it outside of work hours. Being consumer-centric, instead of hospital-centric, helped the hospital to provide services the community needed, he said.
With 11, North Carolina ranks as third in the number of rural hospitals closed, following Tennessee with 14 and Texas with 29. The top 10 states with the most rural hospital closures – which includes Georgia, Missouri, Oklahoma, Kansas, California, Florida and Alabama – make up 60% of the total rural hospital closures.
All but three of those states had not implement Medicaid expansion under the Affordable Care Act.
North Carolina was poised to expand Medicaid on October 1, bringing health care coverage to an estimated 600,000 residents. In March, the move to expand Medicaid passed in the legislature.
However, the General Assembly tied that expansion to the enactment of a state budget which was slated to go into effect by June 30. In August, the North Carolina Department of Health and Human Services said that since the General Assembly failed to take the necessary steps to pass the budget, the launch date was pushed back to December 1.
Northern Regional Hospitals’ Chris Lumsden said listening to what the community needs, and being able to react quickly to those needs, should drive hospital decision-making. In Mt. Airy, North Carolina, where Northern Regional is located, the hospital met with industries in the area. The listening session revealed that in Dobson, North Carolina, about 40% of one industry’s employees were Spanish-speaking, and that the community needed primary family medicine because many in the community couldn’t travel the 10 miles to get to Mt. Airy.
“Within a year after that visit, we opened up a family medicine clinic in Dobson,” Lumsden said. “And we employed two providers, both bilingual, to provide health care needs in that community. The point isn’t just primary care. It’s the ability to move quickly to meet the needs of the community.”
Being in a rural area allows hospitals to focus more on their communities and helping their residents with proactive solutions to health, ECU Health’s Todd Hickey said. ECU Health is a 1,400-bed system operating in eastern North Carolina, in communities like Beaufort, Roanoke Rapids, Kenansville and Edenton.
“We don’t necessarily in these rural areas have two hospitals right down the road from each other trying to compete,” he said. “In rural areas, if there’s advantages to it, it’s that we can focus our time… that allows us a great framework to partner with community organizations and other social services to help align a standard of care.”
Hickey said the system offers a lifestyle clinic to help residents in the communities it serves – like Beaufort, Roanoke Rapids, Kenansville and Edenton – deal with weight and other health issues.
The panelists also said that continued success for rural hospitals rides on creating a workforce pipeline. Lumsden said only eight percent of his workforce lives in or within 25 miles of Mt. Airy, and that 85% of high school students from Mt. Airy do not return to the area once they work outside of it. To combat this, his hospital worked with area schools to introduce students to healthcare as a career, as well as working with local governments and schools to create an apprenticeship program.
“It’s just an example of creating the pipeline for keeping young people, and older people, in our community to work in healthcare and hopefully within our organization,” he said.
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[1] Url:
https://dailyyonder.com/n-c-hospital-administrators-talk-innovations-to-create-healthier-rural-communities/2023/11/29/
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