By Michael Howell
Marcus Daly Memorial Hospital was recently ranked among the top 100 Critical Access Hospitals in rural America by the National Rural Health Association’s Rural Health Policy Institute, iVantage Health Analytics and the Chartis Center for Rural Health. Rural hospitals in the United States were analyzed through a comprehensive and objective performance assessment of their success in managing risk, achieving higher quality, securing better outcomes, increasing patient satisfaction, and operating at a lower cost than their peers.
Higher quality? Better outcomes? Increased patient satisfaction? Of course, perfect outcomes and total patient satisfaction may be an unachievable goal. But they are nonetheless goals. And progress towards those goals can be measured. Just ask Mira McMasters, the Director of Quality Management at the hospital. In fact, the amount of information that is being collected and stored in a usable database concerning issues of safety, cost and quality of service has increased astronomically over the last decade. McMasters likes that because it does give an objective basis for assessing the hospital’s performance. The statistics can indicate where improvements are needed and help guide policy and process decisions. She considers the award a validation of the hospital’s continuing efforts in that regard.
“It’s one thing to think you are doing great, but it’s another thing to have that validated by the numbers that someone else is crunching,” said McMasters. This is the fifth time since 1990 that the hospital has been recognized among the top 100 rural hospitals in the nation.
John Bartos, CEO, said, “I am very proud of the hospital employees and medical staff for receiving this award, it speaks to what our mission is all about.” He said the first item in the hospital’s mission statement is “Quality.”
“We really do strive for that every day,” said Bartos. He said the second item in the mission statement is “personalized accessible health care.” He said since getting its first award in 1990 in recognition for being in the top twenty-five rural hospitals in the nation, the hospital has worked hard on developing a culture of excellence.
“It is very much discussed at orientation and our staff lives it,” he said.
MDMH has joined an Accountable Care Organization (ACO) which leads the hospital to strategically focus on population health throughout the entire organization. Quality initiatives in the ACO strive to improve health or reduce acute episodes for chronic diseases that have led in the past to frequent emergency visits or hospitalizations. Another value added initiative is joining the Hospital Improvement Innovation Network (HIIN) through the American Hospital Association which is a patient safety organization focusing on reducing patient harm.
Bartos said the hospital works hard not only at patient service and care, but also values its staff and strives to be an employer of choice. He said they have employees who have worked in the hospital not just five to ten years, but some 20 to 30 years.
He said the economic impact of the hospital’s work force in the community is big. Thirty years ago they had 80 employees and a gross budget of about $2 million. Now they have 545 employees and a budget of about $130 million.
“Thirty years ago we had eight physicians, now we have 41 on staff,” said Bartos. “That’s not your typical rural hospital.”
“What I’m sharing with you is the cornerstone of our hospital policy. We listen to residents of the community, we hear what they need and we try to deliver it,” said Bartos. He said the board contracted a phone survey and found out that the number one priority for residents of the county was to have a well trained Emergency Room staff with well trained nurses and a facility that can handle them and if not, stabilize them until they could get to an appropriate facility.
“Every one of our physicians in the ER is emergency trained and board certified,” said Bartos. “You will not find this in any other rural hospital.” He said all but one of their Hospice staff was a board-certified hospitalist.
Bartos said the hospital has always worked hard on listening to the community and addressing their express needs. He said community assessments showed that many residents of the south valley were concerned about emergency response. As a result they put an ambulance in Darby. Only two hospitals in the state, Marcus Daly and St. Peters in Helena, operate their own ambulance service. The hospital has three 9-1-1 crews, consisting of a paramedic and an EMT, operating in Darby, Hamilton and Stevensville on a 24/7 basis. Two ambulances are stationed in Hamilton with one serving as a back up in either direction.
According to Bartos, the ambulance in Darby has a 90% response time within twenty minutes. Runs up the East and West Fork can take longer. He said five years ago they were getting 175 to 200 ambulance calls per month, but now it’s up to 225 to 300. Bartos said they developed an ambulance response team that can beat the Life Flight helicopter to Missoula. The Life Flight rescue can cost from $20,000 to $60,000 while the ambulance cost ranges from $3,000 to $6,000.
But the local hospital is not here just for emergency services and acute responses.
“We have a commitment to the community’s health and wellness that requires preventative efforts and a focus on maintaining their general health and well-being, as well as responding to acute issues and illnesses,” said Bartos. He said, in his opinion, this was going to be the emphasis of health care in the future.
That focus also emphasizes the importance of primary health care. The hospital is doing its part by developing primary care clinics in Darby and Victor.
The hospital has expanded and improved its facility over the years and another major expansion is in store as the hospital prepares to upgrade its operating rooms. The new structure will add another 25,200 square feet to the hospital’s footprint. The $12 million project will certainly enhance the hospital’s surgical capabilities.
That’s one thing that Bartos has heard a lot from community members, he said, “if you can take care of me, I want to stay here.” He said having to leave the county for hospital treatment was very hard on patients and family alike. “Everyone would rather be near home,” said Bartos.
In the Bitterroot, now a lot of people have that option and in an “award winning” rural hospital to boot.