08 Apr From Dan’s Desk: What makes a good hospital?
Dan Grigg, CEO Harney County Health District
I recently asked my sister, who lives in Wyoming, about her rural hospital. Immediately she responded “I would never go there.” When I asked why, she responded “I just wouldn’t — it’s terrible and I would never go there.” As I pressed further, I learned she had never been a patient there and had not had any bad experiences personally. I think what my sister was saying was reflective of a general belief throughout the country that “bigger is better.” Rural hospitals everywhere have an uphill battle to gain the confidence and trust of their communities.
What makes a hospital a “good hospital”? I think most people would agree that a good hospital would have the following:
• Access to needed care and minimal wait times;
• Experienced and well-trained staff with good clinical judgment and decision-making skills;
• Staff who are compassionate, caring and friendly;
• Up-to-date equipment and modern clean facilities;
• Good communication and application of best practices to enhance quality and safety;
• Privacy and confidentiality;
• A culture of continuous improvement.
As it turns out, both small hospitals and large hospitals can either do these things well, or do them poorly. The first twenty-two years of my career were spent in big suburban hospitals. During most of those years, I was directly responsible for monitoring and improving quality and patient safety. I worked in some very good hospitals that have earned awards and accolades, but still had room for improvement.
Harney District Hospital will never provide all the services of a big hospital, but we can be as good as or better than the big hospitals at the services we provide.
We have several providers who have joined our team recently. We have seven primary care providers in our clinic and a new OB/GYN. Two new full-time surgeons have joined our practice. Wait times to see providers have decreased significantly, and for those who have emergencies, the average wait time in our ER over the past six months has been 17 minutes.
Our doctors, nurses, technicians, therapists and other staff members have the same training as their counterparts in big cities. They are very competent and caring and do an outstanding job of providing quality patient care. Because we are small, our providers and staff have the ability to connect on a more personal basis and to individualize their care. If there is expertise needed beyond what we can provide, there is a strong network available to help patients get what they need. All of our caregivers have annual training to keep current in their knowledge. We are also collaborating with St. Luke’s in Boise to provide additional hands-on obstetrical training for our nurses.
We have a modern facility and great equipment. We spend approximately $500,000 per year toward capital equipment to keep us on the cutting edge. We have one of the cleanest hospitals I have ever worked in. Our staff take great pride in keeping our facility clean and in good repair.
Over the coming months, we will be providing training for all our staff to enhance skills in communication, teamwork, decision making, situational awareness and coping with fatigue. While strong clinical skills are expected of all our caregivers, these non-technical skills are equally important in assuring patient safety and quality.
We have high expectations for confidentiality and privacy. This is especially important in small towns where everyone knows each other. No one is allowed to access your medical information unless they have a work related need for it. We also have strict policies that prohibit staff from discussing personal health information with anyone who does not have a need to know.
We use LEAN (improvement concepts created by Toyota) as our improvement methodology. These techniques are used to improve processes and systems that support efficient, high-quality care. Every serious patient event is reviewed and scrutinized with the intent of preventing future occurrences and is reported monthly to a committee of board members, physicians and nurses. We meet daily with our staff and managers in huddles to anticipate any needs for the day and to ensure we are addressing any barriers to providing great care. We always welcome your suggestions and input. If you see things we can do better, please let us know.
There are some outstanding big hospitals and there are some outstanding small hospitals. Harney District Hospital is a very good hospital and is constantly getting better. We are committed to making your experience with us exceptional in all aspects. I am proud of the health care available in our community and appreciate the opportunities you give us to keep earning your trust.