NBHH earns Top 100 award

North Big Horn Hospital employees gathered in the hospital lobby Monday morning for a big announcement, several wearing special headbands with the number 100 swaying on antennae-like projections.
The “100” headgear was a dead giveaway for the announcement, made by CEO Eric Connell: North Big Horn Hospital has been recognized by the Chartis Center for Rural Health as a Top 100 Critical Access Hospital for 2024.
Chartis’ annual Top 100 award program recognizes outstanding performance among the nation’s rural hospitals based on the results of the Chartis Rural Hospital Performance INDEX(TM).
“I think a few of you may know; the secret’s out, but we’re celebrating today and this week and this year because we’re a Top 100 critical access hospital, so thank you to everybody who made that possible,” a smiling Connell said in making the official announcement Monday as staff members applauded.
Connell asked if anyone in the room knew the significance of the date February 7, 1955. That, he said, was the date when the North Big Horn Hospital District was formed, and he said the community had a strong legacy of medical care for decades before that.
Since the formation of the district in 1955, Connell said he estimates, based on current data and historic patterns, that North Big Horn Hospital District has served about 1.1 million patients, and there have been roughly 120,000 patients treated in the emergency room, with personnel ready to care for people day and night.
“24/7, 365 (days a year) someone has been here since the formation of the district almost 70 years ago,” he said of the ER and referring to both the current hospital and the previous facility. “I’m just so proud of you all for your contribution to our organization and the difference you make in our community. There aren’t a lot of 2,200 population communities in our country that have such strong, vibrant medical communities, and that’s a testament to all of you.”
Through the Chartis program, the hospital is ranked based on eight categories, Connell said, some of which are financial or based on market share, but “the cool part” of the Top 100 award is that other categories include quality of care and patient satisfaction.
Three years ago, during the COVID-19 pandemic, North Big Horn Hospital was around 65th percentile, which is “still pretty good, better than average as an organization overall,” Connell said, but this year the hospital is in the 94.4 percentile, adding that the hospital has seen the biggest rating increase in quality, patient outcomes and patient experience, which is “what people say about how they feel about the care they received here.”
“I couldn’t be more proud of you all,” he said. “This is an amazing team.”
Connell finished with a quote from protestant minister Jenkin Lloyd Jones, who stated that many aspects of life are average, rather than filled with bliss, like an old-time train ride with delays, sidetracks, smoke, dust, cinders and jolts “interspersed only occasionally by beautiful vistas and a thrilling burst of speed. The trick is to thank the Lord for letting you have the ride.”
“So with that, this is one of those days when we get to celebrate,” he concluded. “We’re not done. We’ll continue to improve and get better as an organization.”
In a follow-up interview, Connell said North Big Horn Hospital is in rare company as a Top 100 hospital, with more than 1,300 critical access hospitals operating in the United States among more than 1,800 rural hospitals. Three of the Top 100 hospitals are in Wyoming, he said, located in Lovell, Worland and Afton.
The numbers
Chartis is an independent organization, Connell said, that works as a consultant in the healthcare industry – “a healthcare advisory services and analytics firm.”
Based on the latest Chartis Rural Hospital Performance INDEX report, North Big Horn Hospital received a score of 75 for Inpatient Market Share, 66 for Outpatient Market Share, 57 for Finance, 10 for Cost, 53 for Charge, 73 for Outcomes, 90 for Patient Perspective and 100 for Quality of care. It is in the latter three categories – Quality, Outcomes and Patient Perspective – that the hospital has made the most improvement, all three showing patient satisfaction, which he said means the most.
With a percentile of 94.4, based on the Top 100 Critical Access Hospitals, that means only 6 percent, or six hospitals, scored higher than North Big Horn, Connell noted.
During an interview Monday afternoon, Connell said the strong rating by North Big Horn comes at an interesting time for the industry. He recently read an article in Becker’s Hospital Review magazine stating that some 418 rural hospitals are at risk of closure nationwide, according to a review by Chartis, including 26 to 30 percent of hospitals in Wyoming listed as “vulnerable.”
And yet, he said, North Big Horn Hospital is “doing really well right now and is on good footing” during a time when it is “more and more difficult for facilities just because of the payment climate and communities that have declining population,” among various issues.
“It gives me confidence to know we’re doing some of the right things, and we just want to keep it up,” he said.
Connell said Chartis has been rating and ranking hospitals for 14 years now, and while North Big Horn’s Top 100 honor provides validation for the work of the district, providers and staff members, it is merely a reflection of the quality of care the hospital strives for every day.
“Our senior leadership is aware of this award, and we set organization goals for the good of the organization, and they happen to coincide,” he said. “Our goal isn’t Chartis Top 100, our goal is run a great hospital, and if the award comes, great. So we’re aware of it. The board is aware of it, also. We’re not teaching to the test on this.
“It’s all CMS reported data; it’s the publicly reported data. That data isn’t something we change. It looks at quality (and) outcome measures, those type of things. It’s nice to occasionally get validation that the things the team is working on are the types of things worth working on, like ‘You guys are doing the right things. Keep on plugging away at it.’
“I think it’s just a continuation of our commitment to the community. It’s no different. We got the award now, but that doesn’t mean high quality care started a week ago when we found out about the award. It’s a validation that we’re working in the right direction as an organization. The people I shared the news with seem genuinely happy and excited to have that recognition and kind of set ourselves apart in the area.”
Connell noted that all of the hospitals in the Big Horn Basin are critical access hospitals as designated by the Centers for Medicare and Medicaid Services (CMS), a designation designed to help with federal reimbursements from the federal programs. The program came to be in 1997, he said, as a way to support rural hospitals.
There are limitations for critical access hospitals, he said. For instance, a hospital with the designation can have no more than 25 inpatient beds. North Big Horn has 15 beds, he said, Cody and Powell 25 each, Basin 10.