by Rick Sutton | CEO, Southeast Alabama Medical Center

Southeast Alabama Medical Center (SAMC) started a strategic planning exercise two years ago by examining where we’ve been during the past several years to chart a vision for the future. This process led us to consider current and future industry and hospital challenges – and strategies to address them.

In a recent nationwide survey, hospital leaders identified financial challenges as their most pressing issue. In early 2017, prior to implementing strategic cost reductions, SAMC was on an unsustainable financial path. In the rapidly changing healthcare environment, we found our financial performance would not sustain future growth and new investments in programs and services.

Cost reductions at SAMC, along with the financial success of the Alabama College of Osteopathic Medicine (ACOM), helped us stabilize our overall financial condition and restore our credit rating to A. We have come a long way financially, but we still face challenges.

Access to quality healthcare is essential to vibrant communities, and the economic health of a hospital can have a significant impact on the economic health of the community or region it serves.

Nursing Shortage & Retention Efforts

One of the greatest challenges we continue to deal with is a nationwide nursing shortage, which affects healthcare organizations throughout the country. In fact, the American Association of Colleges of Nursing predicts this shortage will intensify as baby boomers age and the need for healthcare increases. In 2017, the national average turnover for bedside nurses was 16.8 percent.

Such turnover rates affect almost every area of our hospital, including the Emergency Room, where hospital-wide nursing shortages can impact our ability to accept patients.

Realizing the status quo was not acceptable, we sought input and ideas from our nursing staff, and they helped us develop a seven-step retention plan. We have had some success in lowering the turnover rate, but we’re not satisfied yet. There is more to be done.

Emergency Care, Diversion and the Nursing Shortage

We are blessed with employees who are a great source for ideas and problem-solving. More than ever, Americans are using the Emergency Department (ED) as a doctor’s office, so improving ED efficiency has been a priority. We are tracking wait-times, how long patients wait in a bed upon admission, and other factors. Performance indicators in this area have improved and are now within national norms.

Diversion is another issue that affects our Emergency Department and our community – and communities nationwide. First, it’s important to note that hospital administrators, emergency physicians and staff, paramedics, and other EMS professionals understand diversion is a complex operational issue and share a universal dislike of its use. The decision to place a hospital on diversion is not made lightly, and it is a last resort.

Diversion is typically caused by one or more of the following:

• A surge of patients in need of emergency care, which can create a situation where there are more patients in the Emergency Department than can be cared for safely, or a surge of multiple highly complex cases, such as trauma.
• Beds in specialized areas, like critical care, are full, and the Emergency Department is holding patients in need of a bed.
• All general inpatient beds are full, or beds are available but there are not enough nurses to safely care for patients if additional beds were opened.
• Nursing recruitment and retention is our physicians and leadership team’s number one concern. It is a local, regional and national issue. Currently, we have approximately 90 nursing vacancies. If you add in the vacancies from other area hospitals, clinics, nursing homes, and home health agencies, it becomes clear that there are not enough registered nurses to meet the growing demand.

Evolving to Southeast Health

Healthcare, like many other sectors of American business and commerce, will continue to change and evolve. Organizational change can be uncomfortable and stressful. But change is essential to allowing employees to learn new skills, explore new opportunities, exercise creativity, and provide input in ways that benefit the organization.

Soon, we will transition our health system name to Southeast Health, in recognition of the area we serve, which spans three states. Our goal at Southeast Health is to become a health system recognized nationally for top performance in quality and patient satisfaction. We are setting the bar high, but we have a great foundation in place with committed employees, physicians, and volunteers, all of whom have been working to accomplish this long-term goal.

It takes a team effort, and at Southeast Health, we have an outstanding team. It is my pleasure and honor to thank you – on their behalf – for trusting us to provide healthcare to the region.

______________________________________________

This is the first part of an ongoing series covering the impact of changes in healthcare in our region.