Rural Health

Decatur Health achieved success in 2023, earning recognition as a Chartis Top 100 Critical Access Hospital. Key initiatives, driven by staff collaboration, included projects on severe sepsis, fall reduction, community integration, patient engagement and antibiotic stewardship.

Their initiatives have significantly improved patient outcomes and reduced disparities. Key achievements include a 78% decrease in sepsis mortality across both emergency and inpatient departments; recognition as a top performer in an 8-state area; only 5 falls in 2023, with no major injuries; and a 97% improvement in antibiotic stewardship, reducing the error rate from 4.47% in 2022 to 1.55% in 2023. In addition, Decatur Health’s Patient and Family Advisory Council was created, consisting of health care staff, community advisors and patients and family members, who work together to improve the quality of the hospital’s care based on their experiences.

Blue Ridge Medical Center (BRMC) serves rural areas in Georgia, Tennessee and North Carolina, where socioeconomic challenges significantly impact community health. Since 2017, it has transitioned from an acute care hospital to a rural emergency hospital, and now to a critical access hospital. To improve access and quality of care, BRMC has expanded services to include orthopedics, gastroenterology and ophthalmology. They started an outpatient antimicrobial stewardship program (ASP) and maintained the inpatient ASP. BRMC re-opened as a Critical Access Hospital on October 1, 2024, established new transfer agreements with nearby hospitals and initiated a Hospitalist program.

Despite changes in ownership, leadership and hospital designation, BRMC staff stayed dedicated to quality care. Achievements include zero surgical site infections or returns to surgery after GI procedures in a year, improved ED admit-to-discharge time from 197 minutes (Q2 2023) to 80-90 minutes and continued ongoing collection of Critical Access Hospital quality and safety measures, such as patient satisfaction and antimicrobial stewardship.

Bland and Wythe counties in Virginia have poor health outcomes, with high rates of diabetes and heart disease. Brock Hughes Medical Center (BHMC) serves these communities, focusing on chronic conditions, but lacked a formal, coordinated approach. BHMC implemented Chronic Care Management (CCM) to improve diabetes and hypertension care, enhancing patient engagement and medication adherence. A four-month pilot showed positive results, prompting an expansion of services.

CCM services at BHMC improved diabetes and hypertension management through home tracking calendars, CGM devices and blood pressure monitors. Targeted interventions were delivered based on EHR reports, allowing for personalized care adjustments. Despite challenges like Medicare Part B authorization barriers and new EHR software issues, the program focused on continuous improvement, with staff using the Plan Do Study methodology to refine patient outcomes and advance quality measures.