Hospital board votes to proceed with remodel study

The North Big Horn Hospital District board of trustees voted to proceed with plans to update the hospital facility in Lovell at its regular scheduled meeting held on Jan. 17. The first step in the plan will be to interview banks and see what financing options are available, while at the same time conducting a feasibility plan that will look at current use and how that use can be improved through changes to the facility. The study will also examine whether or not the proposed project makes sense financially.The current plan, which is in the very early stages of planning, will make improvements to the clinic and the emergency room and will reorganize the location of patient services in a way that centralizes those services, making patient visits more streamlined and efficient than with the current floor plan.In a separate meeting CEO Rick Schroeder talked to the Chronicle about the proposed changes in greater depth and why he feels they will improve services offered at the facility.“Right now it’s really early in the planning process,” said Schroeder.According to Schroeder, this early plan calls for a four-phase process. In the first phase the clinic will be expanded. Early estimates call for the clinic to be expanded by 8,500 feet. In the second phase, the emergency room will be expanded, with early estimates calling for an added 2,000 feet. In the latter phases the existing space will be remodeled and reconfigured to create a more efficient use of space by doctors, other medical staff and a better experience for patients. In the third phase, some of the existing clinic space that becomes available when the clinic is expanded will be converted to patient rooms. The fourth phase will take the existing patient rooms on the south side of the hospital and convert them into therapy areas.The idea, according to Schroeder, is to create efficiencies through “adjacencies” (having certain services located physically near each other) so that patients will have to travel a shorter distance from their provider’s office within the clinic to get X-rays or other services called for during their visit.The current plan will increase the number of rooms but not the number of beds available in the hospital. The hospital currently has six beds in three semi-private rooms and six private rooms with one bed in each room. The new plan will have 12 private rooms, each with one bed in the room.In the initial plan, the clinic will be expanded and will be in a newly constructed building. Schroeder hopes the plan will make clinic services more efficient by giving more space to providers.“We’re hoping that the remodel will make things more efficient,” said Schroeder. “Right now with six providers, plus having visiting specialists coming in from outside of the area, we find that we are not as efficient as we could be, because our patient rooms limit us in that there are not enough of them to go around.”Schroeder noted that the industry practice standards indicate that a family practice provider or primary care doctor needs around 2.5 rooms per day to function efficiently. So if there are two providers on duty, they need five rooms between them in order to serve patients efficiently. Schroder would like to increase the number of patient rooms from the current eight to 15. Currently, the clinic has 1.8 rooms per provider. The increase in rooms will allow providers to see more patients on a daily basis, and make it easier for patients to get a same day appointment with their provider of their choice.“One of our challenges is seeing that patients can get seen on the same day that they call,” explained Schroeder. “We pride ourselves in this service. This should lower the waiting time from the time a patient calls to have the appointment and once they get into the clinic, it will reduce wait times before they can see their provider because it will build in some efficiencies that we are not always able to take advantage of within the current amount of space.”Schroeder hopes the new plan will make it easier for patients to get in to see their provider of choice on short notice, noting that although patients are currently able to get same day service, due to space limitations, the appointment may not be with their first choice of providers.Schroeder noted that the outside of the emergency room won’t look any different, but where the ambulances are parked now will become part of the emergency room itself. The interior space will be reorganized to provide more efficient use of the space.“Right now if you go to the clinic, you register at the clinic. Right now if you need an X-ray, you register at the hospital,” explained Schroder.Under the new plan, that registration will be centralized, and according to Schroeder, “once you register at one point, you will be registered for everything.” In other words, a patient won’t have to go somewhere else and register again.“So if you’re not feeling well, or are in a hurry, you will only have to register one time, which will make a patient’s time more efficient, too,” he said.Schroeder hopes this will make a visit to the facility an overall better experience for patients and their families.“What we’ve done to this point, since the board meeting, is we’ve written a narrative, which is a historical sketch of the hospital and what our hopes and plans are for this phased approach,” explained Schroeder. “We are sending that out to investment bankers.”Schroeder has also asked the firm Eide Baily to begin a feasibility study. The same firm has already done a debt capacity study for the hospital, which tells them how much debt is reasonable to incur in their current financial situation.The studies will look at volumes as they currently exist, including volumes in the ER, the hospital and the clinic over a period of several years and will compare and predict what the trends will be in upcoming years, he explained. This information will be used to make decisions and finalize a plan that is in the best interest of the needs of the community.“Based on that, they (Baily) will make a determination on what will be our best bang for the buck on where our construction dollars should go and where we should concentrate our resources,” said Schroeder.If all goes as planned the newly remodeled clinic could be up and running as early as spring of next year. Schroeder isn’t expecting any services to be disrupted during the construction process.Preliminary estimates project the clinic remodel to cost $2.5 million, with the entire project coming in at around $6.4 million.At the board meeting, Schroeder also updated the board on his plans for implementing a wellness program. The program will include a monthly “mini-health fair,” reasonable costs for blood draws and a nutrition and weight loss program.The first in a series of monthly health fairs will take place on March 6, where Schroeder himself will be one of the featured speakers. Schroeder will talk about his own weight loss over the past year. The program will be held the first Tuesday of the month in subsequent months.A nutrition, fitness and healthy weight loss program will be rolled out on February 28. More details will be released soon.Schroeder also announced that he would be attending a National Rural Health Association meeting in Washington, D.C. this week, where he will have the opportunity to meet with Senators Enzi and Barrasso, as well as Congresswoman Lummis to discuss the health care needs of the community.In other matters, the board of trustees voted to re-nominate all officers on the board. The foundation board was also approved.Human Resources director Barb Shumway reported that the hospital is actively looking for a new facilities manager. Five new staff have been hired.CFO Daphne Hartman reviewed the current financials with the board.Reports from the foundation, the care center and the nursing staff were distributed.By Patti Carpenter