Lessons learned at rural hospitals during pandemic

Lyle Muller - 10/17/2020 posted by timesrepublican.com

Quicker planning. Working together as networks. Focused staff deployment. The COVID-19 pandemic is giving hospital administrators and their healthcare providers ample opportunity in real time to learn new best practices to delivering medical care.

The quick fixes they’ve tried since the pandemic broke have included more reliance on telemedicine, communicating frequently with the public and an old standard: getting government money.

Finding ways to fund the hospitals for stability still is a challenge, though.

Where to start? That could be a laundry list, Shari King, administrator at UnityPoint Health Marshalltown, a central Iowa hospital, said about shifting norms for hospitals already working with tight budgets going into this year.

“I’ve been in health care for about 25 years, and I don’t remember ever experiencing anything where we knew so little going in,” King said.

This is from a hospital saved from bankruptcy in 2017 when the large network, UnityPoint, purchased it through its Waterloo hospital.

The list of COVID-19 era lessons learned, gleaned from interviews by an Institute for Nonprofit News collaboration of journalists examining how small hospitals have coped with COVID-19, reads like a cram course in health care management:

• Planning and implementing as early and quickly as possible, without waiting for federal guidance. Then, adapting quickly to shifting government plans that affect operations.

• Having a clear communication chain internally and for the public to handle information that can change quickly.

• Considering the benefits of global budgeting, which establishes what Medicare will pay a hospital at the beginning of the year in a bid to keep Medicare costs down but also give hospitals some stability when normal revenue-producing surgeries and procedures aren’t done. This kind of budgeting is done in states like Maryland and Pennsylvania.

• Reliance on virtual doctor appointments via the internet, especially for visits from a rural district that otherwise would be a significant distance from specialists. Concerns about this telemedicine explosion include accessible high-speed internet in rural areas and computers for people with low incomes. But,Medicare changed regulations on what it will or will not pay for, bringing telemedicine deeper into its list of covered expenses.

• Paying closer attention to hospitals and their staff ‘s capacity and combining efforts with other hospitals regionally, if not broader geographically, to deliver health care during a surging outbreak.

• Willingness to tackle an extraordinary problem in extraordinary ways.

“Seeing our providers in parking lots at 3 a.m. in the morning, working out of a tent when it was 25 degrees, was bone chilling in a couple of ways because it’s not only from the temperatures, “ Phil Ellis, network director for the Indiana Rural Health Association, said.

“But it was just hard to imagine. It was very surreal. It was hard to imagine that this was really happening, and that these people are out there putting their life at risk by treating patients."

Read the full article here: https://www.timesrepublican.com/news/todays-news/2020/10/lessons-learned-at-rural-hospitals-during-pandemic/