NBHH wins Top 100 for second year running

CEO Eric Connell was the bearer of good news at North Big Horn Hospital’s board of trustees meeting on February 18, announcing that the hospital made the Chartis Top 100 list for critical access hospitals for the second year in a row.

Chartis is a national healthcare advisory firm that helps critical access hospitals improve their systems for delivering top quality healthcare services.

With an index ranking of 97.2 percent, Connell noted that the ranking is up by slightly more than one point from the previous year’s rating. He expressed disappointment that, though very close, the hospital did not make the Top 20 list for rural hospitals this year.

“The quality outcome and patient perspective buckets did quite well again this year,” he said. “We’re really happy about that, because those are areas that are important to our patients.”

Connell said he is working directly with Chartis to learn how to improve some of the other categories.

“It’s good to have a lot of market share, etc., but people come to us for quality,” he said. “We are at the top of our class in quality, and that is very important. Having consistent top quality is what matters most to our patients.”

The hospital scored 91 percent in quality, 92 in patient outcomes and 95 in patient perspective. It held a market share of 81 percent for inpatient care and 71 percent for outpatient care, according to the Chartis report.

Support following tragedy

 With the recent tragedy in Byron still fresh in the minds of the North Big Horn Hospital trustees and others attending the monthly board meeting, Connell reported on protocol implemented to support staff who were called into action after multiple shooting victims were brought to the emergency room following the incident that took place on February 10. 

He noted Dr. Michael Hill facilitated a debriefing for staff directly involved in patient care on Monday, Feb. 17, and the initial debriefing was followed by another on Wednesday. The second debriefing was professionally facilitated and held in conjunction with local law enforcement and other agencies to support first responders and the emergency room staff.

Additionally, a trained counselor specializing in first responder support was made available for individual sessions with staff members involved in the incident. The hospital also partnered with local counselors to provide employees with access to community resources at no cost for a period of six months, with employees having the flexibility to choose any counselor they wish to see within the community. The rules for using paid time off accumulated in the “extended illness bank” or EIB were altered, so that employees can use the time off for mental health days, if needed.

A management meeting was scheduled, featuring a guest speaker from Cody Regional Health to provide training to managers that will help them recognize and respond to potential post-traumatic stress in team members in the days ahead. 

Trustee Pat Crumrine commented that she thought the steps taken to support staff were “very positive for a difficult week.”

Connell said there were lessons learned from the incident, and it provided a valuable opportunity to use recently developed command skills from a special training that took place only a few short weeks ago. 

“This experience will enhance our preparedness for future incidents,” he said.

He also noted that since the incident occurred on a Monday, the hospital already had additional staff on board, as Mondays are usually a busy day. He described a scenario where the entire staff at the hospital was called into action. Clinic nurses assisted with inpatient care and supported the ER team. The maintenance team managed traffic control, including clearing the parking lot for additional helicopter landings.

“During upcoming debriefings, we will focus on defining additional roles for large-scale incidents, such as having a dedicated family liaison available in the waiting area,” Connell said.

New service providers

Connell also reported on the progress of new service providers who were brought on staff in the past few months. He said Dr. Brenda Camp’s gynecological practice is gaining momentum. Camp recently completed robotic training and had two procedures using the equipment scheduled in the coming week. He noted that cardiologist Dr. Kristin Scott-Tillery’s practice has also been very busy, so much so that she took appointments for two weeks in February instead of one week as originally anticipated. Connell noted that initial feedback has been very positive regarding the new providers. According to statistics provided by clinic manager Amber James, Scott-Tillery conducted 72 patient visits in January, and Camp had 44.

Clinic and hospital reports

James reported that patient visits in January were above target at 1,279 visits, with 134 patients seen on a same-day scheduling basis. Though not technically a “same day” clinic, it has been a goal to schedule as many same day visits as possible, especially when patients request them. Additionally, visiting nurses conducted 282 visits in January. James noted that “The program helps keep vulnerable patients at home and away from elevated risk environments.” James also reported that Rita Unruh, RN now has 40 patients enrolled in the clinic’s chronic care management program, noting that Unruh recently implemented behavioral health interventions to help her patients.

Director of Nursing Michael Henley reported 12 patients admitted to the hospital in January, along with 16 for observation and seven for swing bed services. He noted that there were no COVID-19 related admissions during the month, though two patients were admitted for pneumonia and another for influenza A.

Fundraiser

The date of the next foundation board fundraiser was announced at the meeting. The fundraiser will feature comedic-mentalist Jym Elders again this year. The event will be held on April 26 at the Lovell Community Center. Proceeds will benefit Women’s Health. Connell said the ticket prices are higher over last year’s prices because a prime rib dinner will be served instead of only appetizers. Tickets can be purchased from any foundation board member or Janet Koritnik.

Connell advised the board that the hospital will be following the recommendation of Billings Clinic to renew its relationship with the group purchasing organization (GPO) Premiere. Dr. Scott Polley, chief medical officer for the region, who was present representing Billings Clinic, explained the benefits of affiliates combining purchasing power to get better pricing through the GPO. Connell noted that the hospital district has usually fared well when following the recommendations of Billings Clinic.

“We purchase as much as we can through the GPO, but not everything,” explained Connell. “It definitely saves on costs.”

AI for providers

Polley and Connell discussed an artificial intelligence program (AI) available to NBHH providers through Billings Clinic. The tool helps providers with the time-consuming task of charting a patient visit.

“It’s cutting edge, and we’re grateful for the partnership with Billings Clinic to have access to that under their license,” said Connell. “Our providers are excited to try it out.”

Connell explained that providers will first ask a patient’s permission to have “the virtual scribe” help with notes. If the patient is OK with the AI tool, the provider will use it to record the details of the visit.

The program is paid for by use and costs $1.50 per note taken. Connell said it will save providers a lot of time.

“The system has been available at Billings Clinic for about a year,” he explained. “The kinks were worked out during that time, so I think it’s a good time to jump into this.”