Tuesday, March 20, 2018

A Hospital Update from BCMC

Having completed my first year at BCMC I wanted to provide you with an assessment of where we are, what we are working on, and why. I will start my discussion at the national level, then move into our regional area and lastly discuss specific local initiatives.
First, the national healthcare market place is in the most unstable environment that it has been in for as long as most of us can remember, especially for rural hospitals. Declining patient volumes and declining revenues have hit rural hospitals hard – to the point that rural hospital closures have been occurring in our nation at the rate of almost one a month since 2010. And, the National Rural Health Association has stated that of the just over 2000 rural hospitals currently operating in our nation, 673 of them are in risk of closing in the foreseeable future. Add to all of this the national shortage of physicians and nurses and I assure you that you will never have a boring day in hospital administration, even in Southeast Arkansas. Especially in Southeast Arkansas.

Along the lines of the national physician shortage, it is projected that there will be a shortage of 90,000 physicians in this nation by the year 2025. This growing physician shortage has been instrumental in the expansion of Physician Assistants and Advance Practice Nurses (“APN”) to help provide the necessary primary care needs in our nation. While Physician Assistants are less prevalent in our state, the number of APN clinics has really expanded across the state in providing an additional level of primary care. This growing demand for an APN is also driving more Registered Nurses to go back to school to get their APN. And while this dynamic is filling a necessary gap, it adds to the fact the U.S. Health Resources and Services Administration has projected that our nation will have a shortfall of 1,000,000 (yes, one million) nurses by the year 2020.
For rural hospitals, the overall national healthcare market place is not so different for our corner of the state. It is no secret that the population in Southeast Arkansas has been in decline. With a population decline, it is easy to understand why hospital volumes have also been in decline for several years.  With hospital revenues operating by the narrowest of margins (a 1% margin is typical for a rural hospital in our nation) it is also easy to understand how a decline in hospital volumes can be catastrophic if action(s) are not taken. We are not, and have not been, immune to these forces. Actions are necessary.
First, how do you stabilize declining volumes, in a geographic area of population decline? You must reach out beyond your normal, historical borders and bring in new patients. We have started our Hospitalist Program to address this necessity. By partnering with rural health clinics in surrounding counties we will ultimately be able to bring back some volumes that we have otherwise lost. A Hospitalist Program is a common element in most hospitals today and most importantly to understand is that it is not designed to compete with the local physicians. Rather, the programs are designed to work with the local physicians so that they may focus more of their time on their clinic practices. The program also allows us to provide a hospital home to clinic patients in surrounding counties that may not otherwise have been associated with us.
We are also taking actions that will allow us to keep more patients here in our community so that we do not have to transfer out as many patients. This will allow more of you and your family and friends to stay closer to home and not have to travel far distances for your fundamental healthcare. One of these actions is our reopening of our Monitored Care Unit (“MCU”) that will allow us to keep more patients here locally.
And along the lines of locally, we have recently opened the new clinic across from our emergency department with the goal of bringing in new clinicians to our community. Doctor Worley’s clinic moved there, and Doctor Biggers was originally brought in as a Family Practice physician. Doctor Biggers is currently balancing his role as a hospitalist with also seeing patients in the clinic. I hear in the community that we need a more accessible clinic(s) for patients – more is coming. Soon. In the next few weeks you will start seeing advertisements for Kristen Harvey, APN to start a Monday through Friday weekday clinic that will be open to new patients. You will also be seeing advertisements for Pretrescia Grubbs, APN to start a Friday evening and Saturday walk-in clinic for those of us that cannot make it to a clinic appointment during the week days. Pretrescia Grubbs clinic will be Fridays from 2pm to 8pm and Saturdays from 9am to 5pm. Pretrescia’s Walk-In Clinic is designed to support all of our local physicians and to provide you with an alternative to only having the emergency room available during those times. We also anticipate the announcement of an additional Family Practice physician clinic/hours in the near future.
Along with bringing more primary care opportunities to our community, we are also actively seeking to bolster our specialist clinics with additional general surgery, urology and orthopedic services. The conversations regarding potential specialty clinic providers are going well – but will take a bit more time to play out.
And our emergency department. The performance of our ER in past years has frustrated some of you. I understand. From long waiting times, to sometimes multiple visits in just a few days and staff that have not always been as helpful as you would like. Changes in our ER are well underway. Along with some other ER physician changes, we have recently changed the medical director of our ER. I believe that he not only has a great focus on both quality and service, but understands how to deliver them in an ER setting. We are also implementing ER protocols that should expedite your ER experience by allowing the staff to start certain tests sooner. Our stated goal is for the total time of your ER visit to consistently be less than the two and a half hours that is an industry standard goal for ER times.
All that said, I will not mislead you. This is a very difficult time in our nation to be in the hospital business and Southeast Arkansas is no exception. The future of rural hospitals in our nation is precariously balanced and success is not certain. But we are working as hard, and as fast, as we can to improve our hospital and services for the communities that we serve.  We have a dedicated staff with ties to all of our communities. We are Hometown People, Taking Care of Our Hometowns.  I will be happy to have this conversation in more detail with any of you that would like to speak with me.

                                                                                                                       Steve Henson, BCMC CEO

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