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Eastern Plumas Health Care’s (EPHC) March board meeting was a roller coaster of good and bad news. The poor financial news was met head on, and in other areas the board learned of several positive and innovative ways in which EPHC is seeking to reach out to the community.
Chief Financial Officer Jeri Nelson reported that after starting the year on a positive note, February’s financials were dismal, with a resulting $500,000 loss in net income. March isn’t looking much better, she added. The good news, according to Nelson, was the community had “not had an unhealthy year,” compared to last year, when there were a large number of flu, respiratory and other emergency room cases. In addition, she said, the weather is keeping people away — and other businesses are feeling the financial pinch acutely, too.
CEO Tom Hayes said it’s possible that “this may be our new norm.” As a result, he’s met with all department managers and, after explaining the financial situation, asked that each department decrease their budget by 10 percent starting at the beginning of April. He said he’s had positive meetings with staff and that everyone is getting creative in finding ways to save money. In addition, the hospital is putting a freeze on hiring and purchasing new equipment. Hayes termed the above “reactive” solutions.
He also plans to instigate a series of “proactive” solutions. Hayes emphasized the necessity of working to instill patient confidence. One of the ways he wants to “change the culture of this organization,” is to ensure that EPHC offers excellent customer service. “We have to train people to do it the way it should be done … that hasn’t been done in the past,” he said.
For example, Hayes wants patients who call to feel they can get an appointment within the next few days in most cases. A member of the public and a board member who attended this meeting both said they’d called the clinic during the past week and were offered appointments the following day.
Hayes also told managers to create patient satisfaction forms to measure how well EPHC is doing in the clinic, the hospital, the emergency room and the lab. He wants to get a clear sense of how well the hospital is doing in many different areas, since patients “access our services in different ways,” he said. In addition, he hopes to improve the no-show rate by making sure patients receive phone calls to remind them of their appointments, and he said he’s instructed the clinics to start keeping track of patient wait times, as lengthy wait times have been a problem.
Hayes said these proactive changes “ultimately will lead to an increase in confidence and trust, and patients will start coming to us again.”
Director of Nursing Mark Schweyer reported on the progress he’s made in EPHC’s telemedicine program. Schweyer has a multidimensional approach, focusing on grant funding, partnerships with other organizations in the region (including Tahoe Forest, Plumas County public health, schools and public libraries), educational opportunities and patient specialist services.
The Sierra Institute for Community and Environment is providing $10,000 for a telemedicine-equipped cart. EPHC is also slated as a recipient on a University of California, Davis (UCD) telemedicine grant, which will fund a second telemedicine cart. In addition, UCD will provide “pediatric emergency room coverage,” allowing EPHC’s ER doctors to access UCD’s expertise at a moment’s notice. This physician time is also grant-funded.
A Tahoe Forest grant-funded project will see EPHC as a partnering site for cancer services. This will allow cancer patients to “see” an oncologist from Tahoe Forest via telemedicine, so that they don’t have to travel at a time when that would be most difficult. As a part of this program, additional services will be provided to EPHC’s cancer patients by UCD physicians.
The county’s low income and elderly residents would also see great benefit from telemedicine services, which will allow them to stay close to home and still get the health care they need. Schweyer quoted some sobering regional statistics in this regard: “18 percent of kids live in poverty, 6 percent don’t own a vehicle, there’s no hospital in Sierra County and no taxi service or bus system,” making “access of care issues” of high importance for EPHC.
Further, Schweyer is looking into the possibility of having EPHC offer distance academic education courses through the California Telemedicine Network (CTN), partnered with Butte College in Chico. And finally, he said that he’s researching the possibility of utilizing a specialist group out of Bakersfield that would allow for much greater flexibility for patients needing to see a specialist. “If we only have two patients, it’s worth it with telemedicine. With a live specialist, we need more patients.”
Hayes presented the Strategic Plan Scorecard during his CEO report. Hayes is adamant that the plan will serve as a working document by which the hospital will set out what it needs to do and the time needed to accomplish each task. It will present quarterly progress reports and will designate a key person responsible for completing each task.
Hayes plans to keep this scorecard in front of all the key players — from the board, to managers, to staff. “People may get sick of it,” he said, “but that’s OK.”
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