Hospital trustees approve equipment upgrades

The North Big Horn Hospital board of trustees approved the purchase of a new CT scanner, a hysteroscopy system to be used in the operating room for gynecological procedures and a new ambulance at its most recent meeting held on November 19.

Radiology Manager Julaine Askvig was present at the meeting to explain that the new CT scanner will replace a piece of equipment that is 12 years old. She said the current equipment is outdated and slow. CEO Eric Connell added that the equipment will soon be approaching its out-of-service window, which means it will no longer be serviced by the manufacturer. Kathy Walker noted that the installation of the new equipment will disrupt mobile MRI services temporarily. Trustees approved the purchase for $589,468.

The trustees also approved the purchase of a hysteroscopy system that will be used in the operating room by incoming gynecologist Dr. Brenda Camp. Connell noted that the equipment, which cost $10,000, is well under the $50,000 previously budgeted for equipment Dr. Camp will need in the operating room.

EMS coordinator Scott Murphey presented bids to the trustees for a previously budgeted new ambulance.

“The EMS staff and I feel that we put out a very good bid specification package and received some very good price quotes in return,” explained Murphey. “We have looked over the bids carefully and feel very comfortable that those we recommended will meet or exceed our needs.”

The trustees approved Murphey’s bid recommendation. Board chairman Dave Winterholler asked Murphey the average miles driven per year on ambulances. Murphey said the average is about 25,000 miles. Anticipated delivery of the new ambulance is June of 2025. The cost is $147,011.

ER Trauma Coordinator Shelley Murphey was also present at the meeting and notified the board that the emergency room was recently re-certified as a trauma center. She noted that the certifier complimented the ER staff and had positive comments about the ER in general. Winterholler thanked Murphey for her efforts.

“You are a big part of the trauma center, and I want to thank you for being part of that,” he said.

In other matters, Connell was authorized by the trustees to continue discussions with a cardiologist who expressed interest in joining the staff at NBHH on a part-time basis. He said the cardiologist has been working with NBHH as a visiting specialist for several years and there is a good relationship with staff and a patient base already established. CFO Darcy Robertson said she has already studied the feasibility of adding the position, and based on the number of patients the cardiologist is already seeing, it appears to be financially feasible.

“Cardiology is a very difficult position to recruit generally,” Connell noted, adding that a representative of Billings Clinic has already informed him that Billings Clinic is “unlikely able to provide an on-site cardiologist in the near term.”

Connell said the cardiologist he is speaking with intends to travel to another state for two weeks per month and is willing to practice at NBHH up to one week per month. He said the cardiologist’s availability “aligns nicely with our physician demand study, which shows a need for approximately 35 hours of cardiology services per month.”

Connell also informed the trustees that provider Brenda Arnett notified him that she will not be renewing her provider agreement, which ends in January.

“She expressed a desire to be closer to her now adult children,” he explained. “The hope of being able to love on future grandchildren was a significant factor in her decision. Brenda has been a dedicated provider over the last two years, and we are grateful for her contribution. In particular, her work helping develop our peer review process will continue to have a positive impact on quality after her departure.”

Connell added that he is actively seeking a provider to fill the position. Arnett currently has about 150 patients she sees regularly at the clinic for their medical needs, and the intent is to bring in a new provider to fill the position.

Connell also reported plans to adjust the “provider mix” for the emergency room and the hospital.

“We are strongly considering the addition of a fourth provider to the rotation, which would allow us to get away from two consecutive 24-hour shifts, which can be a heavy burden for the provider and contribute to burnout,” he explained. “In exchange for working fewer shifts in the ED, the ED providers have expressed openness to providing additional work for NBHHD such as providing additional clinic access. For example, our ED providers could transition from a monthly schedule of 10 24-hour shifts to a schedule of eight 24-hour shifts and four days in the clinic.”  

Clinic Manager Amber James reported 1,211 patient visits took place in the month of October, exceeding the clinic’s target goal of 1,100 visits per month. She also reported 295 visiting nurse service visits and 67 same day patient visits scheduled in October. A few of the trustees asked for clarification of the protocol for same day visits. Connell explained that, though the goal is to grant same day visits when possible, it is not feasible with the current clinic volume and staffing to promise walk-in or urgent care services to patients.

In his monthly census, Director of Nursing Michael Henley reported 13 observation patients admitted to the hospital in the month of October. He also reported 19 admissions and four swing bed patients. He noted that the hospital had two extended surgical recovery admissions and one COVID-positive inpatient admission in October, as well as one other patient with respiratory complications most likely connected to a history of long-haul COVID disease.