Expansion of mental health services discussed at hospital board meeting

The North Big Horn Hospital Board of Trustees spent a significant amount of time discussing the need for additional mental health services in the community at its most recent meeting held on May 21.

Nurse practitioner Ali Wagner spoke to the board about her decision to pursue advanced studies in mental health. As a provider at the clinic, Wagner said she’s already treated patients who need these services, noting limited resources in the community for referral. She said treatment of mental health patients is currently creating a demand on the emergency department that could be alleviated if those services were available through the hospital.

Board chairman Dave Winterholler asked if telemed services could fill the gap while the need for and creation of these services is under review. Wagner said the district is already relying heavily on telemed as a resource.

“I think in the interim it (telemed) is working fine, but we need to offer one-on-one, face-to-face interaction to help patients,” she said.

Wagner said mental health has always been an area of interest for her. She currently provides services in women’s health and family medicine through the clinic, since joining its staff in 2020. She is enthusiastic about adding mental health to her area of expertise.

CEO Eric Connell agreed that there is a need for more mental health services in the community, adding that Wagner could provide these services when her advanced education is complete in addition to the services she currently offers. He said as the need grows, more of her time and an additional provider could be added to accommodate the need.

Master’s degree student Tyler Drennen joined the meeting via teleconference. Drennen is pursuing a degree in health administration and is studying the need for these services within the hospital’s service district. He noted that nationwide studies have shown about one in five adults or 20 percent of patients seek these services. With roughly 6,000 patients currently being served by the district, an estimate of 1,200 need these services to varying degrees. He added that mental health patients require an average of seven visits per year. Connell added that the numbers project the potential for 8,400 visits per year.

Further study of this matter is ongoing. Connell passed around a piece of paper to each of the board members asking them to write down their thoughts regarding the need, as he and others move forward exploring the idea of expanding these services. In the meantime, Wagner continues to pursue further training in this area.

In other matters, the trustees voted to approve revised professional policies and procedures for medical practice evaluation after reviewing a policy that includes peer review, provider-specific feedback and evaluation of competency in the areas of patient care, knowledge, practice-based learning and improvement, professionalism and systems-based practice. Trustees also reviewed conflict of interest guidelines.

Clinic Manager Amber James reported 1,143 patient visits to the clinic in April. Additionally, visiting nurses saw 187 patients. Clinic staff were able to schedule 129 same-day visits for patients.

James noted that some of the current clinic goals include improving registration accuracy, increasing electronic survey collection and to improve survey scores about how reception staff interact with patients.

She also reported that a potential grant may be available for a community health worker. This is an individual who can conduct wellness checks and monitor certain vitals like blood pressure and anti-coagulation.

Director of Nursing Michael Henley reported that 13 patients were admitted for observation in the month of April. There were 17 inpatients. No covid related admissions were reported in the month of April.

Henley also introduced employee of the year Kaycie Mangus, RN. Mangus has been with the hospital since 2011.

“There are so many positive words that can and are used to describe Kaycie,” he said. “She is kind, caring, compassionate, competent and supportive. Kaycie is a hard worker and an amazing nurse. She always has a great attitude, is pleasant to deal with and treats everyone with the utmost respect. Kaycie works hard to establish a good rapport with patients and their families, takes extra time to listen to their concerns, as well as advocate for and address them. She really does go above and beyond to ensure that her patients have a great experience.”

Henley also reported six swing bed patients in April. Two were admissions referred by Billings Clinic. Two were recovering from surgeries performed by Dr. Hill.

The foundation reported raising more than $12,000 at the annual Evening with Friends event. The funds will be used to update patient rooms.

Connell presented the groundwork senior leadership is laying regarding strategic planning for the next five years. Some of those aspirations include: Achieve the Top 20 overall in quality and become a CMS Five Star Care Center, maintaining a positive operating income and doubling the number of patients served.

The issue of moving the date and time of the regular board meeting was raised again. Trustees voted to keep the date and time the same for now.