Medical Center Barbour Reduces Readmission Rates

June 2017
National Rural Health Resource Center (The Center)

Medical Center Barbour (MCB) is a prospective payment system (PPS) hospital located in Eufaula, Alabama and has been affiliated with Southeast Alabama Medical Center (SAMC) for 9 years. Services offered include laboratory, respiratory, radiology and diagnostic services; emergency and acute inpatient care including inpatient dialysis and inpatient rehab; surgical services; a senior care center; specialty services including cardiology, dermatology, nephrology, orthopedics, podiatry, ENT (Ear, Nose, and Throat); as well as additional services through Medical Center Barbour Family Clinic in Louisville, Medical Center Barbour Family Care Clinic in Eufaula and Eufaula Family Practice. As Ralph Clark, CEO, shares in his website message, “At Medical Center Barbour, we understand the importance of being your neighborhood hospital. We sincerely want to be, as our slogan says, ‘Here for you.’”

Carla Brock Wilber, Senior Consultant, with Stroudwater Associates, worked with MCB in 2016, through the Small Rural Hospital Transition (SRHT) project, on a Quality of Care and Transition of Care Project. RHI staff spoke with Ralph Clark, Debbie Norton, CFO, Missy Thomas, Director Case Management and Christy Moore, CNO concerning their progress on this project.

Q: What are some of your hospital's successes regarding implementation of Carla’s recommendations?
MCB created a care transitions nurse position. This nurse focuses on providing patient education at admission and throughout the stay. If a patient discharges on the weekend, then she handles that process for them. Because she works with the patient throughout their stay, she knows the patient well and is very familiar with their needs and understanding of discharge teaching. This has resulted in a smoother discharge and allows the bedside nurse to focus on other needs of the patient. This nurse also is responsible for quality rounding, something that several people were doing before. She can check on quality issues such as infection control, cleanliness and patient satisfaction while she is with the patient. This new role has already positively impact readmissions which have dropped from a pre-project rate of 11.8% to a recent low of 8%.   

MCB is raising employee and visitor awareness of HCAHPS scores. Scores are publicly posted in all departments and non-direct patient care staff are more aware of ways they also impact the patient experience. They have received an “A” on Leapfrog and received an outstanding patient experience award for 2017 from Healthgrades for being in the top 10th percentile. MCB attributes this progress to their continued attention to strategies such as nurse teach back, bedside shift report and continued recognition of staff excellence through “shout out” boards that post thank you cards and letters from patients.

Q: What are some of the outcomes from this project and ways it impacted your hospital and community?
In addition to a decrease in readmission rates, MCB identifies non-measurable outcomes such as:

  • Improved communication
  • Smoother discharge process
  • All staff, both clinical and non-clinical, in the hospital are more aware of what goes into quality care
  • More time for nurses to care for patient

Q: How do you believe this project has helped you move forward in the newly emerging system of health care delivery and payment?
Staff is more aware of how quality impacts patient experience and in turn, reimbursement. It’s not just about being busy.