MCHI’s recent recognition reflective of high standard of care

by Cheyenne Rowe 

Aurora’s Memorial Hospital was recently honored as a recipient of a 2018 Rural Provider Excellence in Quality Award from the Nebraska Office of Rural Health. 
This award was presented during the most recent Nebraska Critical Access Hospitals Conference on Quality and Memorial Hospital was one of 10 critical access hospitals to earn this honor for overall performance in the area of quality. 
According to Memorial Hospital CEO Diane Keller the term “critical access” is a financial designation that the federal government came up along the line with a change in licensure which allows smaller hospitals to be paid a different way than their larger counterparts. Most of the smaller hospitals in Nebraska are considered critical access, as they are providing critical access to healthcare for rural Nebraska. 
The Rural Provider Excellence in Quality Award is based on analysis of Medicare Beneficiary Quality Improvement Project (MBQIP) measures for all of Nebraska’s critical access hospitals. The analysis was conducted by The Chartis Center for Rural Health utilizing iVantage Health Analytics’ Hospital Strength INDEX framework. The INDEX is rural healthcare’s most comprehensive and objective assessment of rural provider performance and the data foundation for several national rural recognition programs, advocacy efforts and legislative initiatives.
“There’s a lot of different portions that go into what we report,” said RN Lindy Mosel, MCHI’s director of nursing, on the topic of what is looked at for recognition like this. “A couple things being when someone comes, let’s say to the emergency room, it’s those standards of care like how soon we get a strip of their heart or how soon they get medication.” 
She also stated that this level of care would be the same as it should be at any other place a patient may be, no mater the size or location.
“There’s not really any certain set or just a few (criteria), there’s a lot of different things that are reported on quality on the survey,” Mosel explained. 
“We have had a focus on quality. The whole 10 years I’ve been here I don’t know a year when we haven’t been focused on quality. It’s just kind of a recognition of our ongoing efforts, maintaining that standard of care.”
Keller added that part of that standard of care also includes a constant push for improvement of those standards. 
“Those standards of care that we report are national standards,” Keller stated. “They’re the same for everyone and they’re constantly changing. We want to make sure that those best practices are always in place for our patients when they show up at our facility, whether it’s the clinic, the hospital, or the emergency room, wherever, that we have those standards in place so that they have those same expectations.”
According to quotes provided by Nancy Jo Hansen, Flex and SHIP program manager for the Nebraska Department of Health, quality is a vital component of care. 
“Quality is such a vital component of the care process and we established the Rural Provider Excellence in Quality Award as a way to honor the ability of our Critical Access Hospitals to deliver outstanding quality to their communities,” Hansen said. “The 10 hospitals recognized with this 2018 award have set a benchmark which I am sure other critical access hospitals in Nebraska will work diligently to reach -- and surpass.”
When asked what that quality looks like to patients at Memorial Hospital, Mosel stated that some of it includes how quickly they’re taken care of and how fast a physician, physician’s assistant, or other provider would be seen. 
“It’s also how fast nursing care is provided as well,” she continued. “How fast medications are given, those kinds of things.”
Clinical Coordinator Jamie Dibbern added to that statement, saying Memorial Hospital’s standard of quality care also benefits from strong communication. 
“I think a lot of it too is just communication with the doctors,” Dibbern said. “The patients see that when they’re sitting in there, how well the nurses interact with the doctor in getting what we need and giving quality and timely care.”
According to Keller, there are also a lot of pieces related to a high standard and level of patient care that the public won’t ever see. 
“There are a lot of things that the patients won’t ever see that we want them to trust that we do,” she said. “They know they got their antibiotics timely, but they may not know that it was the correct antibiotic. We know from those standards of care that it’s the correct antibiotic for the reason why they’re here.”
The quality award was a special and unanticipated recognition for the staff at Memorial Hospital, as it wasn’t something they were expecting or ‘preparing’ for. Nevertheless it was a high honor for everyone involved.
“I think it’s a tremendous honor, I mean there are 64 total critical access hospitals in the state and just being in the top 10 is huge,” Dibbern said. “That just goes to show that community is our focus and providing that great care, like Diane said, we’re not the most rural hospital but as long as we can show that we are great and that you can come to us, we just want to keep everybody here in the community and provide the services that they need.”
Mosel added that it was great recognition for the staff, letting them know that you’re doing a good job. 
“Everyone wants to know that they’re doing a good job and that we’re giving great care and quality care to all of our patients,” she said. “It definitely has a lot of staff recognition and honor in it as well.”
Keller agreed, saying it was “certainly” well deserved because the staff members are the ones doing the hard work -- everyone from nurses, to lab workers and radiology. 
“Everybody has to be involved,” she said. “I guess that is what I hope the community sees, knowing they can be comfortable coming to us with the quality of care we provide.”
When asked what made Memorial Hospital’s level of care unique, staff members said there really wasn’t one piece, but instead an overall commitment to ongoing excellence and creating a standard of high quality care.
 “What stands out is that this isn’t something we worked ourself up for necessarily, as in we really focused on quality for three months or one month,” Mosel reported. “It’s kind of an ongoing kind of thing that’s key to know. It wasn’t just we’re working on something for a couple of months and then maybe not the rest of the year.”
The group was sitting in the front row when the top 10 critical access hospitals were announced in terms of excellence of care and were elated to hear their name called. It was earned out of the standard of care the hospital upholds daily. Dibbern concluded by stating that the surprise to the staff was part of what made the recognition so special. 
“We want our community to expect that quality and safe care are the baseline of what they can expect when they come in our doors, but we also think that we can do things because we are friends and neighbors and family taking care of friends and neighbors,” Keller concluded. 

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