Russell County Hospital Listens to their Community to Improve Transitions of Care

Russell County Hospital (RCH), located in Russell Springs, Kentucky, stands by their mission “To provide quality compassionate healthcare consistent with the trust and support of the communities we serve.”  RCH is a 25-bed Critical Access Hospital (CAH) offering cardiac and pulmonary rehab, ICU, swing bed, diagnostic imaging, emergency services, surgical services, sleep lab and wound care.

Carla Wilber and Lindsay Corcoran, consultants with Stroudwater Associates, worked with Russell County Hospital in 2017 through the Small Rural Hospital Transition (SRHT) project on a Transition of Care and Quality Improvement (QI) Project. RCH was previously supported with a Financial Operational Assessment (FOA) project in 2015. Center staff spoke with Teresa Bricker, Director of Quality and Risk Management, in October 2018 and again in May 2019 to discuss the implementation of their QI project consultant recommendations.

Measurable Outcomes:

• Increased net patient revenue by nearly $200k
• Increased days cash on hand by 11 days
• Reduced days in net accounts receivable by 9 days (from 44 to 35 days)
• Improved HCAHPS scores for questions on discharge planning for “Patients who reported that YES, they were given information about what to do during their recovery at home.” from 78% to 81%
• Improved transition of care processes for “Patients who Strongly Agree they understood their care when they left the hospital.” from 81% to 83%
• Improved HCAHPS score for “Patients who reported YES, they would definitely recommend the hospital” from 84% to 86%

RCH went through a CEO transition during their SRHT Project. The new CEO, Scott Thompson has been speaking at town hall meetings to improve community collaboration, listening to the needs of the people, and promoting the services RCH provides. RCH is very involved in community events, strengthening partnerships with local businesses and schools, and held a health fair that involved over 1000 attendees.

RCH is responding to the health needs of the community and is expanding specialty services. Since there is a large aging population in their community, they are marketing and promoting their swing bed services which is keeping patients at home. Currently, there is no urgent care, so they are planning to extend clinic hours during the week, and to twelve hours on Saturday and Sunday (specific hours to be determined). Recently, RCH has purchased a second rural health clinic. RCH has switched to a new electronic health record (EHR) for rural health clinics that will be more user-friendly. They have built a new lab, increased the number of mammograms they provide, and started an infusion center. Due to the fact that Kentucky has the highest population of Hepatitis C, RCH has started a HEP C clinic that meets every other month.

The hospital is doing interior and exterior renovations and built a prayer garden. They are also re-constructing their admissions location and will expand the front of the hospital so that patients do not have to come in through the emergency department (ED). RCH also believes that interior/exterior renovations will positively impact HCAHPs scores. RCH has been focusing on ongoing hospital-wide HCAHPS Training which has already impacted HCAHPS scores positively! Staff are now looking at the HCAHPS scores quarterly so they can quickly address issues.

To improve communication internally about the current status of the hospital and where they are heading in the future, departments are meeting more often. RCH is focused on staff satisfaction and recognizes that happy staff will allow the hospital to provide even better patient care.

To improve the way RCH coordinates care, they are sending out reminders to patients about wellness visits. Case managers refer patients to relevant agencies and make sure they have what they need before they go home. They are analyzing data and tracking transfers from emergency department (ED) admissions to see how many of those patients can be seen in the after-hours clinic and that they will staff with nurse practitioners or physician assistants.