BACKGROUND
Shenandoah Medical Center participates in the CAH Swing Bed Outcomes Measures Project conducted by the University of Minnesota Rural Health Research Center in partnership with Stroudwater Associates. More than 230 CAHs in 21 states currently participate in the study. The web – based tool developed by Stroudwater is the first and only tool dedicated to measuring swing – bed performance data. Shena ndoah Medical Center (SMC) is a 25 – bed Critical Access Hospital (CAH) in Shenandoah, Iowa providing the latest in medical technologies and expertise in a wide array of disciplines including cancer care , emergency, heart health, and orthopedics. In this rural area, the closest cities include Omaha, Nebraska, about an hour away, and Lincoln, Nebraska, about 90 minutes ’ drive from Shenandoah. At the end of 2018, total patient revenue was just shy of $85m.
ORGANIZATIONAL CHALLENGES & STROUDWATER’S APPROACH
SMC was intrigued by the swing bed research underway at the University of Minnesota Rural Health Research Center and became one of the first hospitals to participate in the CAH Swing Bed Outcomes Measures Project. Laura Stofferson, MSN, RN, CCRN and chief nursing officer, saidone of the primary drivers for participation was to assist in developing nationally comparable swing – bed quality measure data for CAHs so hospitals may demonstrate the quality of care provided to swing – bed patients and participate in alternative payment models that include post – acute care. Before working with Stroudwater, SMC did not have a formalized system for tracking swing bed outcomes. While the team — made up of occupational therapists, physical therapists, dieticians, and case managers — believed that swing beds were instrumental in helping people stay in the community, reduce average length of stay, and improve mobility, there was no quantifiable data before the hospital began using the swing bed portal to enter information.
RESULTS
Today, the hospital receives detailed monthly reporting and knows a great deal more about the impact of its swing bed program. For example, in 2019, the average length of stay was four to nine days and 65% of patients returned to prior living conditions at discharge.
Stofferson says the portal is so easy that use her new case manager started entering data right away. She also appreciates that Stroudwater staff are always available to answer questions and offer guidance. “The portal serves as an effective checklist for admittance and discharge, and the detailed reporting is really helpful in documenting outcomes.” Reporting is shared with swing bed staff, senior leadership and the board of directors; physicians will see results in January 2020. Leadership has been very supportive of the program and are pleased to see how many community members are returning to their prior living conditions after a short hospital stay. Stofferson is proud of the hospital staff and of each person’s dedication to helping patients stay close to home. “We have a great crew here – strong occupational therapy, physical therapy and case management. The swing bed tool is a huge help for us to be the best and do the best for our patients.”