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Becker’s Healthcare Podcast
Rural Healthcare Reimagined: Innovation at Beauregard Health System
00:18:48
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- [00:00]
A
Hi, everyone, and welcome to the Becker's Healthcare Podcast. My name is Kathy Turner. I'm the chief Nurse executive at Meditech, and I'm excited to welcome our guest, Tracy Thibodeau, the CEO of Beauregard Health System, a rural independent healthcare provider in Deridder, Louisiana. Today we will be talking with Tracy about the organization's proactive approach to clinical excellence and how they're leveraging technology to improve patient outcomes. We'll also discuss a very important and timely topic, which is how independent rural hospitals can thrive through smart technology, adoption and collaboration, while staying true to their community mission. Tracie, thank you for joining us today.
- [00:41]
B
Oh, thank you, Kathy. It's a pleasure to be with you today.
- [00:44]
A
So I know Beauregard Health System serves a community, a rural community with unique health care needs. Can you talk a little bit about Beauregard Health System, about the region you serve and the overall population health?
- [00:58]
B
Sure. We are a 49 licensed bed general acute care hospital. We have 10 freestanding clinics, four of which are accredited rural health clinics. We serve a population in our parish or county of about 36,000. It's about a 1200 square mile footprint. So we are certainly a rural area and a HPSA designated area. We are in southwest Louisiana, so just above the heel of the boot, and it's about an hour and a half drive in any direction for our community to find a higher level of care.
- [01:40]
A
Oh, that's so important in terms of the clinical excellence that you have really embarked on for your organization. Tell us a little bit about that and how you define clinical excellence and how that's evolved over years.
- [01:54]
B
Yeah. So in rural communities, you know, we can't be everything to everybody. You know, we just don't have the resources and infrastructure for that. But what we do, we take pride in doing extremely well. And we continue to focus on how we can improve our performance in the things that we do provide. Pursuit of excellence is an exercise into perpetuity. So it'll be something that we, we do today and into the future always, but really striving to provide a consistent experience for our community and our patients. We want to be able to efficiently deliver the most appropriate care at all times. And the underlying factor in our ability to continue to serve our community well is that our community trusts that we are committed to excellence and that we are constantly looking to continuously improve in patient experience, in clinical care and in performance benchmarks. So sometimes in rural communities, hospitals and healthcare providers can get a bad rap because we are human beings taking care of Human beings and humans can be flawed. Humans make judgment sometimes. And so our goal then is to really try to take the variability out of the human aspect of health care by creating appropriately structured processes and systems that help us mitigate human error and human judgment calls and, and really provide a consistent or a high reliability organization that has very little variability in care management and care delivery.
- [03:58]
A
Well, and I think that's very evident in one of the projects that you've embarked on, that being one of your quality improvement projects, was to reduce sepsis rates. What led you to that initiative and how did you leverage Meditech, Expanse, EHR to support that effort?
- [04:15]
B
Yeah, Sepsis is one of our projects that we are very proud of. We're investing heavily into and seeing some great early returns. What led us to focus on sepsis is sort of this perfect storm of benchmarking our performance. And so our baseline data was not strong. We had a team of our leadership from the organization attend, you know, some lean Six Sigma training, and they were tasked with picking a project. And because of our performance in sepsis, our baseline of 33% detection, the team said, hey, this is an area we definitely need to put some attention and resources and tools to improving our performance. And so the team, with ER staff nurses, ED leader, chief nursing officer involved and clinical analyst involved, and our chief medical officer as our physician champion, as well as the ED physicians said, let's do this. And we established the project charter and started collecting data. And we were fortunate in this process to have, through a relationship, an opportunity to try a diagnostic tool on a pilot timeline of one year. And they were looking for a rural market to pilot this diagnostic tool. We embarked on that. We received our equipment. It's a diagnostic test that's done from a lab draw. It's called intellisep. And so that tool returns pretty rapid result and it allows our team to act more quickly and appropriately based on the result of that diagnostic. And so what it's helping us do is save time and getting the patient in the right treatment quicker, saving money, because we're not arbitrarily conducting these tests to try to rule out or diagnose. And, and it's helping us save lives because the faster we can deliver the right therapeutic to a septic patient, the better their outcome. Based on this diagnostic tool, we have tweaked our processes and developed nursing protocol that are triggered depending on the result that is returned on the sepsis test.
- [06:52]
A
Well, I have to congratulate you on being the only rural hospital in the country that has launched a sepsis protocol that really leverages new detection and response strategies. You talked a little bit about the people involved, the charter that you put together, and you've briefly mentioned technology, Expand a little bit on that in terms of what technologies and workflow changes were a byproduct of this.
- [07:15]
B
Meditech is really the backbone of the sepsis management bundle. And so when we are able to trigger this diagnostic, we receive the result. We have protocols built into Meditech that activate and guide our staff, our care team, and sometimes, you know, it's nurses that are not used to working together. We could get a physician who is new to our organization. And the value of the Meditech platform is that we've been able to hardwire these protocols through, set up the appropriate alerts that are nuanced for our workflows and our care team. And so that is the process improvement that we've streamlined and optimized so that we have the patient and their data and we know exactly what to do. The team is perfectly guided in next steps and data points and all the things that allow the physician, the ER physician, to make the most accurate clinical judgment and therapeutic pathway for the patient.
- [08:36]
A
Well, and really what a phenomenal project for your staff to be involved with. But then, as you said, you're, you know, saving patients lives. It's just tremendous what you've done there. One of the other areas that you focused on quality improvement is patient engagement, certainly vitally important in rural settings. What tools have you used there and what technologies have you adopted to really modernize patient communication and drive preventative care outreach?
- [09:06]
B
The resources that work often most closely with our patients are case management, social workers, our population health manager. And we just brought on a new patient and community engagement coordinator. And so in leveraging these very critical human resources in our health system with the technology, again with the backbone of the Meditech Expanse platform and the addition of partners like Artera who have helped with the engagement aspect. So patient reminders, text messages, appointment reminders, prompts to schedule, helping us identify through Meditech care gaps, potentially folks that are appropriate for the Medicare annual wellness visits and folks with chronic care conditions that we need to very closely monitor from a prevention standpoint. And so this platform, this Meditech Expanse, in partnership with Artera and Beauregard Health System, we've got this super team of clinicians and frontline folks near and dear to our patients. We've got the structure of the Meditech platform and the ability to, on a more personal level, really consistently engage and connect with our patients. And that has been a very powerful tool. The patients appreciate being reminded and looked after. And it has certainly helped our staff manage communications and diseases and chronic care activities and preventive activities through this technology.
- [10:59]
A
Yes. So important in those preventive activities. And I know, you know, one of the other things that you've embarked on in terms of really caring for that community that is not within driving distance of you is telehealth. You want to just mention some of those programs that you've been working on.
- [11:16]
B
Yeah. So we are a telestroke spoke of a larger primary stroke center hub and about two hours away from us. And so when we get patients where we are trying to either diagnose or rule out stroke, we have the technology, we immediately get on camera, on screen with a neurologist in this metropolitan market, and we make the determination on the ground using, you know, our. Our ER physicians, our advanced imaging and our telestroke partner to determine exactly the. The disposition and the care that each individual patient needs. And so we have the opportunity to administer thrombolytics to patients that are appropriate recipients for that therapy. Then we can transfer them to this primary stroke center. And so we've seen some tremendous results in our, in both the partnership and the telemedicine technology and our ability to really affect patients. You know, in stroke, you know, time is brain, and so the faster we can identify and act and administer therapeutics, the better the outcome for the patient, the better the quality of life, the fewer deficits oftentimes for the patient. And so that's been very impactful.
- [12:43]
A
Yeah, that's great. And I know certainly with the rural healthcare funding, telehealth has been a big piece of that and really looking for organizations to submit what they're doing there. So you're certainly in a good spot in terms of that. And, you know, I think your telehealth stroke is a good example of the affiliations that you're doing with other organizations so important in independent rural hospitals. And I know you've done a fair amount of work with grant funding and supplemental opportunities, share a little bit more about how independent hospitals can thrive without losing their community identity.
- [13:20]
B
Technology is certainly a driver of that. And these telehealth programs that we just talked about are great examples of that ways to look at applications of automation and AI to help where many organizations struggle with workforce and these technologies and systems when appropriately managed and throttled. And we've got the safety rails up for the use of AI in the organization. But we can use these tools to certainly leverage workforce leverage, technology and outreach, leverage our providers and feeding them information, diagnostic tools, predictive analytics certainly has a great application in healthcare, but technology in my mind is one of the best opportunities for the Rural Transformation Fund so that we're able to offset some of the workforce challenges where it's safe to do so and makes sense to do so. And we can have more reliable systems, more sophisticated systems, and so our efforts in our rural communities can be further enhanced and we can care for folks at home. Folks that have to travel for healthcare may often be disadvantaged from a cost perspective. When you think about time away from work and fuel and food and the cost of care in some of these larger cities, sometimes a patient is best served in their community. And we want to leverage our human resources, our technologies, the funding available through these grant opportunities to build great care systems for people right here at home.
- [15:19]
A
You know, I think your website is such a testament of that, that proudly says community owned. You know, it's such a reflection of who you are and what you strive to do for your community. Well, as you look at the next three to five years, what do you see as the biggest opportunities and challenges for advancing clinical excellence and innovation at Beauregard?
- [15:42]
B
So I'll just start with maybe the challenges and try to end on a positive note. And so, you know, obviously there's a lot going on right now with policy changes and reimbursement and how do we deliver effective care in a system that just seems to work against us. The regulatory burden, the policy burden, the constant fight for our revenue from insurance companies and all the hoops that we jump through to get paid. So that continues to be a challenge. And so I would love to see policy more aligned with the providers as opposed to other special interest groups and other for profit entities. It's sometimes very challenging to meet the requirements to pull the data, to analyze the data with the limited resources we have in rural communities. And so those are some of the headwinds. The opportunities I think are many, especially around technology. Love all the things that Meditech Expanse is doing in focusing on automation and AI in their platform, the patient portal, and developments and enhancements there are vitally important for patient engagement, patient access and transparency. The opportunity for more sophisticated automation, AI, more sophisticated predictive analytics, both in administrative settings and clinical applications, so that we can really customize care, make it more personal to each patient, but be surrounded by the tools and the data validation that we need to do this effectively. And so I think just really continuing to invest in these super teams especially in rural communities where you've got a clinical team on the ground or virtual, you've got a strong electronic health record system that performs well and plays well with others so that we can continue to optimize the clinical care, the experience and then implementation of effective and safe automation and AI where it makes sense. I think that is this trifecta of clinical care technology and the infrastructure and processes such as what Meditech Expanse provides for us.
- [18:14]
A
Well thank you Tracy. I appreciate that. And you know your passion for your community and your organization is so evident. I appreciate you sharing that with all of us. That brings us to the end of today's conversation with Tracy Thibodeau from Beauregard Health System. Thank you for joining us today and Tracy, thank you for sharing your insights and passion for clinical excellence and advancing rural health care.
- [18:37]
B
Thank you Kathy. I appreciate the opportunity. We're proud of what we're doing here and we will continue to pursue excellence into purpose, that's for sure.