Challenges for Small Rural Hospitals

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Response by Michael A. Franklin, FACHE, President/CEO, Atlantic General Hospital/Health System

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Challenges for Small Rural Hospitals

  1. 1. Atlantic General Hospital & Health System Our Mission: To create a coordinated care delivery system that will provide access to quality care, personalized service and education to improve individual and community health.
  2. 2. AGH Population Density Map MD Core MD Secondary DE Core DE Secondary Source: ARC GIS and 2010 US Census data. Each Dot equals 100 People
  3. 3. AGH Service Area Population 2 0 1 1 P o p u la t io n E s t ima t e s %of M D C o re Na me 00- 17 18- 44 45- 64 65+ T otal 21811 BE RLIN 4 ,4 0 5 5 ,8 4 5 7 ,2 1 4 6 ,1 0 9 2 3 ,5 7 3 63% 21842 O C E A N C IT Y 1 ,4 7 2 2 ,8 2 6 3 ,3 8 7 2 ,8 2 2 1 0 ,5 0 7 28% 10% 21813 BIS HO P V ILLE 533 592 787 410 2 ,3 2 2 6% 2% 21841 NE W A RK 155 191 223 114 683 2% 1% 21872 W HA LE Y V ILLE 125 152 190 105 572 2% 1% 6 ,6 9 0 9 ,6 0 6 1 1 ,8 0 1 9 ,5 6 0 3 7 ,6 5 7 M D S e c o d a ry M D Core T otal Na me 21851 P O C O M O KE C IT Y 1 ,7 0 2 2 ,0 8 4 1 ,8 5 9 1 ,1 9 5 6 ,8 4 0 39% 6% 21863 S NO W HILL 932 1 ,5 1 0 1 ,3 7 0 933 4 ,7 4 5 27% 4% 21850 P IT T S V ILLE 679 880 685 312 2 ,5 5 6 15% 2% 21874 W ILLA RDS 669 827 635 272 2 ,4 0 3 14% 2% 21864 S T O C KT O N 109 157 140 81 487 3% 0% 21829 GIRDLE T RE E 82 125 123 71 401 2% 0% 4 ,1 7 3 5 ,5 8 3 4 ,8 1 2 2 ,8 6 4 1 7 ,4 3 2 100% 16% 1 ,2 8 8 1 ,7 3 5 2 ,2 9 1 2 ,2 6 7 7 ,5 8 1 91% 7% 62 102 282 300 746 9% 1% 1 ,3 5 0 1 ,8 3 7 2 ,5 7 3 2 ,5 6 7 8 ,3 2 7 100% • 21% 8% M D Se c o n d a r y T o t a l DE C o re Na me 19975 S E LBY V ILLE 19944 F E NW IC K IS LA ND DE C o r e T o t a l M DC % o f T o t a l 100% 34% %of %of T otal • % o f DE C % o f T o t a l DE S e c o n d a ry Na me 19945 F RA NKF O RD 1 ,6 3 2 2 ,2 8 2 2 ,4 0 6 1 ,6 6 7 7 ,9 8 7 17% 7% 19966 M ILLS BO RO 4 ,0 4 5 5 ,4 5 9 6 ,5 3 6 6 ,0 7 4 2 2 ,1 1 4 47% 20% 19939 DA GS BO RO 1 ,1 2 9 1 ,5 5 8 1 ,8 2 5 1 ,4 1 9 5 ,9 3 1 13% 5% 19970 O C E A N V IE W 960 1 ,2 8 1 2 ,3 8 3 2 ,2 2 6 6 ,8 5 0 15% 6% 19930 BE T HA NY BE A C H 301 506 1 ,3 5 9 1 ,4 1 7 3 ,5 8 3 8% 3% 19967 M ILLV ILLE 25 27 46 39 137 0% 0% DE Se c o n d a r y T o t a l 8 ,0 9 2 1 1 ,1 1 3 1 4 ,5 5 5 1 2 ,8 4 2 4 6 ,6 0 2 100% 42% To ta l S e rv ic e A re a • % o f DE S % o f T o t a l 2 0 ,3 0 5 2 8 ,1 3 9 3 3 ,7 4 1 2 7 ,8 3 3 1 1 0 ,0 1 8 T o t a l S e rv ic e A re a 18% 26% 31% 25% 100% M a ry la n d 24% 36% 27% 13% 100% Un it e d S t a t e s 24% 36% 26% 13% 100% S ou rce:T h om son Reu ters Health care Source: ARC GIS • Berlin ZIP Code (21811) has an estimated population of 23,573 and accounts for 63% of the Maryland Core service area (MDC) population, and 21% of the total service area. The Berlin (21811) and Millsboro, DE (19966) ZIP codes combine to equal 41% of the total service area population. The total service area has an estimated population of 110,018. The total service area has TWICE the percentage of people in the 65+ age cohort than the state or US.
  4. 4. ICU TELEMEDICINE
  5. 5. Rural Maryland Hospitals Form Unprecedented Collaborative to Improve Patient Care Mon Apr 28, 2008 10:00am EDT
  6. 6. MED/SURG CONNECTIVITY
  7. 7. care.connection • Decreased noise • Improved patient satisfaction • Increased patient safety Personal units installed in each patient room October 2012 in conjunction with room redesigns Connection with PERKS upon project go-live
  8. 8. eStrategy Continues… eCare – July 2010 • Remote 24 hr monitoring of critical patients in ICU Wireless phones provided to nursing staff – October 2012 • Connection to telemetry • Nurse call • Text capability • Scanners for those giving meds Additional cardiac monitoring capabilities – October 2012 Introduction of Smart Pumps – coming in February 2013 • Increases safety in medication administration
  9. 9. PSYCHIATRIC TELEMEDICINE
  10. 10. How do we accomplish a Patient Centered Medical Home? Looking Ahead for our Community  Improved Communication within Healthcare Community  Patient Portal  Faith Based Partnership
  11. 11. Health Care Innovation Awards: Maryland ATLANTIC GENERAL HOSPITAL CORPORATION Project Title: “Expand Atlantic General Hospital’s infrastructure to create a patient-centered medical home” Geographic Reach: Maryland Funding Amount: $1,097,512 Estimated 3-Year Savings: $3,522,000 Summary: Atlantic General Hospital Corporation, which serves largely rural Worcester County, Maryland, is receiving a grant to improve care for Medicare beneficiaries with either a primary or admitting diagnosis of congestive heart failure, chronic obstructive pulmonary disease, or diabetes, who currently rely on high cost ER visits and Acute Care admissions. The corporation plans to expand infrastructure and create a Patient-Centered Medical Home, increasing access for patients needing non-emergency episodic care and reducing hospital admission rates and emergency department visits for these Medicare beneficiaries. Over a three-year period, Atlantic General Hospital Corporation will create three new jobs and train 75 workers. New hires will include a patient care manager, a patient advocate, and a care team coordinator.
  12. 12. Patient-Centered Medical Home Achieved NCQA Level 2 Recognition for Berlin Primary Care & Townsend Medical Center locations in Oct. 2012 Received $1.1 million federal grant in July 2012 from CMS to expand PCMH to Health System PCP offices for Medicare patients • Recruitment of a care coordination team underway • Funding also includes purchase of 12 computers for Faith-Based Medical Home partners

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