Minnie Hamilton Health Care Center (MHHCC) is an 18-bed, not-for-profit Critical Access Hospital (CAH), providing acute care, emergency medicine, rehabilitation therapies, imaging and related outpatient ancillary services to the residents Grantsville, West Virginia and surrounding communities. In addition, MHHCC operates a rural health clinic (RHC) in Grantsville and an FQHC in Glenville, WV along with various community programs including dental services, and 24-bed long-term-care facility. MHHCC is one of two Federally Qualified Health Centers (FQHC) in the United States that operate a CAH. Their mission is to provide personalized, high-quality care on an as-needed or preventative basis. They proudly state, “We have created a practice that we believe in and choose for our own family members.” Carla Brock Wilber, Senior Consultant, with Stroudwater Associates, worked with MHHCC in 2017, through the Small Rural Hospital Transition (SRHT) project, on a Quality of Care and Transition of Care Project. Center staff spoke with Stephen Whited, CEO; Sandra Ellis, Director of QI, Risk and Patient Safety; and Brittany Frymier, Administrative Assistant, just six months after the implementation of the consultant recommendations to discuss their progress.
Q: What are some of the recommendations that you’ve implemented in these first six months and what are your next steps?
A: Regarding the Emergency Department (ED), MHHCC closely tracked time on “Decision to admit to time of ED departure.” They educated ED providers concerning details of the measure and they provide the data monthly to providers and nursing staff so they can see each individual patient times and provider and nurse information. This has decreased from pre-project measure of 122 minutes to a recently low of 57 minutes. Currently they are at 74 minutes, very close to the goal of 70.
Previously, daily huddles to discuss discharge planning were held three days a week and they now conduct them five days a week and strongly encourage providers to participate. In preparation for this change, administration shared ideas with their providers about with this topic. Participation is tied to incentives. The huddles also include representatives from pharmacy, physical therapy and other disciplines relevant to individual cases. Recently the discharge planner implemented LACE tool. This is a new strategy for MHHCC and they are closely evaluating patients for risk for readmit in 30 days. This has been very important since it’s been difficult to identify readmissions to other facilities. Internally, their readmission rates are very good (0 for 12 months) but they are most interested in preventing external readmissions. Another strategy to reduce readmissions has been to enhance their swing bed program. They developed brochures for this program and communicate this service to patients before they are transferred from the ED. They plan to increase marketing to other hospitals for referral back to MHHCC and track transfers so that the discharge planner can follow up with the receiving hospital to discuss a referral back.
MHHCC believes their biggest accomplishment on the SRHT project is the improved education of providers and staff on data. The board quality committee is very involved and HCAHPS training is conducted for all supervisors. Each supervisor receives a monthly dashboard of current data to post in their departments.
Q: What has been the impact of this project so far on MHHCC?
A: The measurable outcomes will be reported in six months. Non-measurable impact has already been clear and includes:
• Improved information and data sharing with supervisors and then driving information down to staff
• The addition of quality as a topic to staff meeting agendas
• More transparency as they create a culture of quality and safety
• A desire to continue to improve even though they are doing well in comparison to peers
Q: Lastly, how do you believe this project has helped you move forward in the newly emerging system of health care delivery and payment?
A: “Things are working; we are getting there. Ready to have conversations about raising the bar without settling. All the documentation and quality impacts reimbursement and we have a better understanding of this now. Understanding better how to meet patient needs and prevent readmission while impacting wellness.”
What is Microresearch?
Microsearch is a community-based research approach that supports, with small “seed grant” funding, locally generated and implemented projects leading to local solutions to problems in underserved communities, resulting in big impact.
Rural PREP’s Microresearch Approach
Rural PREP is providing multiple awards of up to $4,000 each to encourage research by learners in rural health professions education and training about:
- Rural primary care
- Rural population health
- Rural health workforce education and training
A faculty mentor will be assigned by Rural PREP or approved as requested by the student.
Who is eligible to apply?
Current students in a medical school or a nurse practitioner or physician assistant program, residents in a rural physician residency program, or other health professionals training for primary care practice in a rural location.
We will begin reviewing the first group of applications after January 12. If funding remains after the first review, we will fund additional applicants through March 1 on a rolling basis until all funds are expended.
Photo by MarineCorps NewYork/FlickrCC
By Shannon Muchmore/Healthcare Dive
- The U.S. Department of Veterans Affairs has released a proposed rule that would allow its healthcare providers to treat patients anywhere through telehealth, regardless of state laws.
- The proposed rule would bring about change more quickly than legislation introduced earlier this year that would also waive state telemedicine laws for VA physicians. The Veterans E-Health and Telemedicine Support (VETS) Act has been referred to the Senate Veterans’ Affairs Committee.
- Health IT Now Executive Director Joel White said he supports both the proposed rule and the VETS Act. “This proposed rule will be instrumental in breaking down geographic barriers that, for too long, have prevented our nation’s heroes from accessing the care they need where they need it,” he said in a statement.
The VA says its proposed rule is needed for the agency to continue growing its telehealth services, which are particularly crucial for veterans who need mental health care.
The VA has been quite active on the telehealth front recently, as it works to improve care for veterans in rural areas and remove hurdles to accessing care. It comes in the wake of the agency’s scandals from the past few years, which included care quality lapses, excessive appointment wait times and falsified records…
Read the full story at www.healthcaredive.com
We’re excited to tell you that Try This Second Stage grant applications are now available online.
For the second year, Try This is offering funding for larger projects created by West Virginians who have already created successful minigrant projects. Second Stage grants are for projects with budgets between $5,000 and $15,000. The deadline is December 4 at midnight, so you have 2 1/2 months to get a team together and talk with us about your application if you decide to go for it.
There will be an online Webinar with Stephen Smith on October 10 at 2 pm. You’ll have a chance to ask questions then, and we’ll post the Webinar online afterward. To register for the Webinar, go to http://kaylahinkley.enterthemeeting.com/m/CPVND2U4.
For these grants, you’ll be asked include an economic development impact statement. We all know that healthier communities = economic development. Economic development includes most of what Try This promotes: creation of a healthier workforce and making a community more appealing for tourism and businesses, as well as actual job creation or income opportunities.
This will be a highly competitive process, so if you’re interested, now’s the time to get started. We’ll be glad to talk/brainstorm with you about your idea after you absorb all the info about the application process. In fact, you are required to have at least one such conversation. When you’re ready to have a conversation, please email Kristen O’Sullivan at firstname.lastname@example.org, and we’ll schedule it.
Photo by Nan Palmero/FlickrCC
By Caroline Cunningham/Washingtonian
The patient is lying on the table in front of me, bright fluorescent lights shining down on her blood-stained clothes. I know she’s been in a car accident, but I have no idea of the extent of the damage yet.
I step closer to the table and glance at her vitals on the screen next to her. My scrubs-clad team stands nearby, waiting for my instructions. I wonder where to begin, trying to shut out the sounds of the emergency room around me.
Suddenly, the patient begins to convulse—she’s vomiting. If I don’t make a move soon, she’ll choke and die. Her skin is turning a sickly bluish-gray.
Finally, I remember what I’m supposed to say: “Check for breathing.” One of the doctors jumps forward to follow my command.
Gently, I lift the goggles off my eyes, blinking as I come back to reality. The ER, the patient, and the other doctors have all vanished, and I’m standing in the MedStar Institute for Innovation office, surrounded by the people who built this virtual-reality program from scratch.
With the help of headphones, a microphone, VR goggles, a handset controller, and laser sensors on the wall that followed my every move, I’d been thrust into an “emergency” where the commands I gave and the clinical decisions I made determined whether the patient lived or died…
Read the full story at www.washingtonian.com