Regional West focused on present and future

Regional West’s focus is positive: It saw growth in patient satisfaction and other metrics in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a standardized, publicly available survey used by the Centers for Medicare and Medicaid Services. The survey was administered to a random sample of adult patients between 48 hours and six weeks after discharge, and not just Medicare beneficiaries, according to CMS.

“That just tells the whole story,” McNea said of the current measures. “What’s happened over the last two years is the scores have gone up.”

McNea described some of the areas where Regional West has seen growth: overall hospital rating, likelihood to recommend, medications and discharge information. The overall hospital rating and likelihood to recommend ratings are examples of ways patients are more satisfied with their experience at Regional West. According to tracking patient survey results, significant events such as changes in visits and purchases of new beds are some of the experiences that result in patient satisfaction.

Many of the measurements in the surveys are not just about patient satisfaction, but also about quality of care. Convening nurse leaders and pharmacists has improved patient care by giving patients the chance to ask questions during their care and before discharge.

“I think the thing that stood out to me the most was the overall assessment of the hospital, the communication with the nursing staff and (the improvement in) communication with our physicians,” McNea said. “Another thing that’s been really popular is this measure of, ‘Did you understand your medications and did someone explain them to you?’ That’s taken off, and it’s because our pharmacists are in a position where they can review new medications with patients.”

Significant progress has been made in some areas, and the hospital continues to make improvements, from the implementation of a task force focused on patient satisfaction and quality care measures to the recent announcement of a Network Business Council designed to provide greater feedback to physicians and healthcare providers at Regional Western Physicians Clinic.

“Every hospital is working on this (HCAHPS), so for your score to go up by 1% or 2% is phenomenal,” he said. “In some areas, we went up by 10%,” he said, referring to a table included in this article that includes just four areas: overall hospital rating, likelihood to recommend, medications and discharge information.

McNea said he believes one of the key shifts that has led to improvements within the hospital is: “What’s really changed is the culture of the organization and the expectations of how we interact with our customers,” he said. “We have a long way to go, but culture is more important than anything else.”

Regional West strives to be consistent in providing and delivering care to patients. Regional West’s providers and staff work to solicit feedback on how to improve their interactions with patients.

“One of the things we’re erasing is people’s perception of the Regional West, and it just takes time,” McNea said. “It takes a few positive experiences for people to change their minds or their perceptions.”

Speaking of perceptions, Regional West has also made a targeted effort to solicit community feedback as part of its efforts to focus on the most pressing concerns. McNea spoke directly to the public in open forums, and Regional West took action on concerns raised during those forums and other community feedback efforts Regional West has conducted in the community. Regional West has made changes to its governance structure, including term limits that allow for greater representation of different aspects of the community on the board, he said. It has also made changes to its board structure among voting physician representation, allowing the hospital and clinics to be represented on a single board, rather than two separate boards as previously.

One of the key areas of feedback voiced by the community in open forums, social media, or letters to the editors was around billing issues at Regional West.

“We’ve been working very hard too: There was a lot of concern in the organization about billing and billing accuracy,” McNea said.

McNea said Regional West hired an employee it had previously worked with, who took the lead in resolving these issues by answering phone calls, answering questions and introducing ways for people with billing issues to reach them.

Hospital billing is already a confusing area for most people — from the billing cycle to the additional requirements if you have multiple insurers. McNea acknowledged that further complications have contributed to a frustrating experience for many of Regional West’s patients in recent years.

Regional West recently announced an area that will continue its forward momentum in billing: a move to a new electronic health records provider. According to the announcement, Regional West is partnering with UCHealth of Denver to bring the most widely used electronic health records (EHR) program in the country to its patients. The new system, called Epic EHR, will be available in October.

While the change is described as an organizational transformation, Regional West leaders say it will continue to bring improvements that patients will appreciate. Most importantly, the Epic EHR system will include MyChart, a user-friendly patient portal where patients can access and pay their bills, correspond with their care providers, schedule appointments, renew prescriptions, and view test results.

Regional West has hired 21 new healthcare providers since January 2024, including a new neurologist, two new interventional radiologists, a family physician to work at the Gering clinic and a new plastic surgeon among the new faces at Regional West this year.

McNea said one of the biggest “wins” was the addition of Dr. William Murrell, an orthopedic surgeon with sports medicine experience, to the team.

“An orthopedic surgeon with a sports medicine background was something that was lacking in the entire region,” he said.

With Murrell’s clinical expertise in sports medicine, he will work with the Scottsbluff and Gering High School athletic departments to not only address injuries but also prevent them. Regional West hopes to expand this offering to other high schools in Western Nebraska.

Other areas McNea said are needed and have been positive additions include bringing on new emergency room doctors and a medical oncologist. Regional West Medical Center will now have two medical oncologists on staff, and when McNea starts as Regional West’s interim CEO in December 2022, he will rely on interim doctors to provide services in the Cancer Care Center. There is also a growing need for emergency physicians, and the addition of three new emergency physicians will help ease the demands on the emergency department. Moving away from interim doctors and staff also helps Regional West financially, as those interim positions typically come at a higher wage.

Regional Western leadership focuses on improving quality of care, patient satisfaction and other efforts, while also focusing on the future.

As Regional West faces changes in leadership, with a search for a new CEO underway, McNea said a management action plan has been developed for 2024 and 2025. McNea’s contract expires in January 2025 and it is hoped a new CEO will be announced in December. However, McNea said the management plan will ensure a continued drive for improvement.

The hospital has also spent recent months engaged in its own strategic planning effort. In May, Regional West held a strategic planning meeting, but before the meeting, it gathered feedback from community stakeholders, regional hospital and health care leaders and physicians on areas where Regional West could make, continue to improve or develop to meet hospital and other needs. The three-year strategic plan is designed to move the hospital into the future.

“(The strategic plan) focuses on everything from ensuring the hospital’s financial stability to ensuring access to quality care,” he said.

McNea shared five goals developed as part of the strategic plan:

• Maximize your resources to maintain your long-term financial health.
• Advancing patient safety, quality and excellence.
• Create a culture that empowers and inspires people.
• To improve and expand services to exceed community and regional expectations.
• To be recognized as a trusted leader and partner in healthcare.

Each of the areas will be measurable and will provide accountability and data to guide Regional West leadership and the Regional West Board of Directors in their decision-making process.

McNea expressed optimism, saying, “We have a good plan,” and assured that Regional West will continue to remain healthy as a health leader.