BACKGROUND
Conemaugh Meyersdale Medical Center (CMYMC), part of Duke LifePoint Healthcare, is a 20 bed rural Critical Access Hospital (CAH) located in Meyersdale, PA. Situated about 50 miles from Johnstown and 85 miles from Pittsburgh, the facility provides a wide variety of inpatient and outpatient services including emergency care, family and primary care, radiology services, pathology, physical therapy, respiratory therapy, ultrasound, post-acute care in the swing bed program, and a wound care center.
The hospital joined the CAH Swing Bed Outcomes Measures Project conducted by the University of Minnesota Rural Health Research Center in partnership with Stroudwater Associates in April 2018 to simplify its swing bed data collection, maximize insights, and gain instantaneous multiple-hospital benchmarking. More than 230 CAHs in 21 states currently participate in the program. The web-based tool developed by Stroudwater is the first and only tool dedicated to measuring Critical Access Hospital swing-bed performance data.
ORGANIZATIONAL CHALLENGES & STROUDWATER’S APPROACH
Before working with Stroudwater, CMYMC tracked swing bed metrics at a high level but did not have the ability to drill down to data on ages, average length of stay, and where the patient went at discharge. Case Manager Darlene Yoder, RN, BSN, ACM, says there’s a great deal more data available at her fingertips today—she especially likes the graphs she’s able to produce and share with leadership, physicians, and clinical staff to identify performance gaps and drive improvement.
Yoder, who has been managing swing beds for nine years and is a huge proponent of keeping people close to home in her rural community, says the web application is very user-friendly and fast. “I like how it’s easy to find the info I need, and we’re discovering new ways to use it all the time.” She is looking forward to further tool enhancements including greater detail on patient conditions at admission.
As at many rural CAHs, resources are scant at CMYMC and most of the staff wear multiple hats. Yoder, for example, is the only case manager and also performs social service duties. Despite such time constraints, she finds the tool very worthwhile and has enlisted the help of an administrative support person to help enter the data she gathers. Staff that were originally dubious about a new process worried it would create more paperwork, but are now fully engaged and appreciate how the application provides multiple ways to prove the value of the swing bed program. CMYMC uses a straightforward and effective approach to charting: nursing and rehab each have a dedicated folder color for each swing bed patient. While the insights revealed using the Stroudwater program have mostly validated what the hospital knew about swing bed patients, Yoder says having hard evidence to support the value of the program is a big win for all the people dedicated to quality care and outcomes.
RESULTS
The hospital staff takes great pride in returning community members to their prior living conditions, especially given that many swing bed patients are 70-89 years old and have multiple comorbidities. The hospital also employs swing beds for younger members of the community requiring IV antibiotics for an extended time or for wound care.
Yoder believes that being close to home and avoiding a nursing facility is best for the psychological health of many patients, which aids in healing. Loved ones can visit much more easily and patients are seen by doctors and other caregivers they know. Receiving care locally also alleviates travel and financial hardships in an area where people struggle with poverty to a point that gas money can be a big hurdle and public transportation options are scarce. Meyersdale’s swing bed program is an important part of this priority to keep patient care local.