Jon Applebaum outlined plans designed not only to improve patient care and safety, but to make Twin County Regional Hospital a facility that can take care of all area patients’ needs during a Community Advisory Group meeting on Jan. 3.
Applebaum, Twin County Regional Healthcare’s CEO, said, “We decided to join Duke LifePoint Healthcare so they could help us with innovation and designing new services, so local people could stay here for health care. We think we’ve definitely chosen the right partner.”
Twin County became a part of the Duke LifePoint Healthcare system on April 1, 2012.
During the first quarter of 2013, Applebaum said plans include initiating a patient safety and clinical quality monitoring and reporting structure, which “Will help us evaluate patient care and safety.” In addition, Twin County is forming new committees focusing on patient safety, clinical quality and patient experience, and launched a safety attitudes questionnaire on Jan 2.
“We asked everyone involved in patient care what areas we need to work on to improve patient safety,” said Applebaum of the questionnaire.
He also announced that Twin County’s primary care base is expanding. Already a physician, Djeunou Tchamba, is in place at Hillsville Family Care, while a physician has been secured for Independence Family Care beginning Feb. 18. Negotiations are presently under way for a physician to staff Galax Family Care.
During the second quarter of 2013, Applebaum said action plans based on a community insights survey and a safety attitudes questionnaire will be considered and implemented. The hospital will also establish pain management services and evaluate medical/occupational health opportunities with area employers, who are looking for ways to “keep their (health care) costs down.” A feasibility assessment concerning new medical office space will also be conducted.
While first quarter plans are focusing on primary car, third quarter plans will look more closely at specialty care, said Applebaum, especially cardiology.
“A strong cardiology department with a full-time presence is our top priority,” he said.
Hospitalist medicine/tele-intensivist capability, other medical and surgery specialties, and behavioral health will also be emphasized.
Through tele-communication, Applebaum said hospitalists “will have the ability to access a physician who is trained in a critical care specialty.”
Hospitalists, said Applebaum, are physicians who work solely in the hospital. They confer with a patient’s family doctor after the patient is admitted to the hospital. Following treatment, the hospitalist contacts the patient’s family physician to inform him of the diagnosis and treatment the patient received.
“It’s a relatively new specialty, only about 10 years old. They spend all their time in the hospital, diagnosing and treating patients. Most are internal medicine trained,” he said.
Twin County currently has two hospitalists, who work alternating weeks, from 7 a.m. to 7 p.m. each day. Nurse practitioners tend to patients from 7 p.m. to 7 a.m. However, if a problem arises during the evening or night, the practitioner calls the physician working that week.
“There is always a physician on call to see patients,” noted Applebaum. “Generally, they’re seeing about 40 patients a day, discharging five to 10 a day and admitting five to 10 a day.”
Fourth quarter plans call for capital investments, such as a new CT Scanner, other clinical equipment, facility upgrades and an electronic health record system. The CT Scanner is particularly important, according to Applebaum.
“It is the most heavily used piece of equipment in the hospital. It is used over 600 times a month or about 20 times a day,” he said.
Applebaum also recapped the changes made in 2012, pointing to a $3 million investment in new clinical equipment, such as digital mammography and endoscopy systems, and facility improvements, such as nurse call and wireless communication systems, as the major investment during the hospital’s first year in the Duke LifePoint Healthcare system.
“That’s four times than what it had been in the past. It was a major investment,” said Applebaum.
Another major accomplishment was Twin County receiving a Joint Commission Primary Stroke Center certification. “We are the only hospital in the area and one of the few in the Duke LifePoint Healthcare system to have received the certification,” noted Applebaum.
During a question and answer period following the presentation, the flu was a topic of conversation.
“Thirty-four percent of all suspected flu cases turned out to be the flu. That’s a pretty high level,” said David Southerland, chief operation officer. “We’ve had an early flu season and a pretty hard one.”
As one might expect, the hospital’s admissions were also up. Applebaum said admissions “exceeded our projections for November and December. We had more admissions (310) in December than we had any other month.”
The emergency room experienced an “all-time high” in December with 2,361 people seeking treatment.