Public Health Commons^™

Performance Improvement For Rural Hospitals: Front Line-Driven Change To Decrease Transfer Time From Ed To Inpatient Admission, Chasatie Whitley, Eddie Perez-Ruberte, Linda Kimsey, Bettye Apenteng

Research & Practice Briefs

Highlights: A recent performance improvement project undertaken by a Georgia Critical Access Hospital (CAH) demonstrates the potential for use of Plan-Do-Study-Act (PDSA) techniques to improve operations in the area of patient transfers from Emergency Department (ED) to Inpatient Ward. Implemented process improvement, including visual tracking of inpatient hold in the ED and bedside handoff led to reductions in admission decision to ED departure time and delayed or omitted ED admission orders.

Background: The Georgia Southern Flex Team, funded by the Georgia State Office of Rural Health, assists the state’s CAHs in pursuing financial and operational excellence. Under an ongoing grant, …

A Role For Scenario Planning In Rural Hospitals, Linda Kimsey, Bettye Apenteng, Anna Rose Moore, Angela Peden

Research & Practice Briefs

Highlights: Scenario planning typically focuses on the future, beyond the normal strategic planning horizon. It has been used primarily by large organizations, but it can be useful to organizations of any size trying to develop strategy for the future. COVID-19 has arguably broadened planners’ perspectives, thus emphasizing potential benefits from scenario planning for organizations, both large and small. Rural hospitals may find some scenario planning beneficial.

Background: Formal introduction of scenario planning in the U.S. can be traced to Herman Kahn’s use of stories in military planning. Royal Dutch-Shell’s use of scenario planning is widely noted as the first big …

Ceo Turnover In Georgia Rural Hospitals, 2011-2017, Bettye Apenteng, Samuel Opoku, Linda Kimsey, Charles Owens, Bill Mase, Angela Peden

Research & Practice Briefs

Highlights: The average annual turnover rate in Georgia rural hospitals between 2011 and 2017 was 24%, with a low of 17% in 2012 and in 2015 and a high of 37% in 2016. Between 2011 and 2017, rural hospitals had on average, approximately two CEO changes, with 46% reporting three or more CEO changes. Annual turnover rates were found to be consistently higher in rural prospectively paid (PPS) hospitals, compared to Critical Access Hospitals (CAHs).

Background: Hospital chief executive officer (CEO) turnover rates have increased nationally over the last decade, increasing from 15% in 2007 to 18% in …

Georgia Rural Hospital Tax Credit, Samuel Opoku, Bettye Apenteng, Charles F. Owens, Linda Kimsey, Imaobong B. Ekpo, Emmanuel Akowuah, Michela Hizine, Oluwadamilola Onifade, Bill Mase

Research & Practice Briefs

Background

Eight rural hospitals have closed in Georgia within the last decade, and more are financially distressed. In 2016, Georgia legislation created a state income tax credit for individuals and corporations that donate to qualifying non-profit rural hospitals of their choice. This law, the first of its kind in the US, was intended to provide struggling hospitals with financial support to improve viability. Using a mixed- methods approach, this study assessed the perspective of hospital executives concerning the program, examined community awareness of the program, and evaluated how hospitals used the money to enhance access to care for rural populations.

Strategies For Improving Profitability Of Rural Hospitals: Are Profitable Hospitals Doing Something Different?, Bettye Apenteng, Angela Peden, Raymona Lawrence, Emmanuel Akowuah, Samuel Opoku, James H. Stephens, Bill Mase

Research & Practice Briefs

THE TOP FIVE STRATEGIES adopted by rural hospitals for the purposes of improving financial performance included improving patient satisfaction and care experience, adding new service lines or expanding existing service lines, community outreach, employee engagement, and physician engagement. Profitable hospitals were more likely than other hospitals to have implemented cost-cutting and internal and external stakeholder engagement strategies.

Background

Nationwide, hospitals, as well as policy makers, are exploring strategies for improving the financial viability of rural hospitals. These efforts are in response to the critical need for sustainable hospital infrastructure in rural America and the negative impact the lack thereof can …