Stonewall Memorial Hospital: Nathan Tudor, CEO

by HCE Exchange on August 19, 2010

In central west Texas, the population is sparse and there are a lot of miles between cities. That hasn’t stopped Stonewall Memorial Hospital (SMH) in the town of Aspermont from leading the way for rural healthcare. SMH is a 20-bed, critical access hospital with an 80-bed nursing home, a rural health clinic and an ambulance service. It is also able to offer a full complement of therapy services including physical therapy, occupational therapy, and speech therapy. The hospital is staffed by two medical doctors, a nurse practitioner, and approximately 130 total employees.

“One of the things I’ve always appreciated about rural healthcare is that we have a really dedicated staff that reflects the values of rural America,” says Nathan Tudor, CEO and hospital administrator. “You’ve got people taking care of their friends and neighbors. It becomes a little bit more personal when you are taking care of the people you see at church, the people you see at the grocery store and the people you see at the football games on Friday nights.”

Small, but Leading Change

SMH is one of four rural Texas hospitals working together to bring an electronic health record into operation. “We have formed the first rural health information exchange in the country,” says Tudor. “If we weren’t able to work together, none of us would have been able to have an electronic health record, but by combining forces, we’ve been able to do something incredible.”

The joint effort has given the small hospitals involved a leg up in regards to technology. Together they could afford a system which will help them meet government mandates, but better yet, improve healthcare for their rural patients. The upgrade, which is expected to be online by November of 2010, includes billing and financial system improvements. SMH has also completed upgrades to its nurse call system and imaging capabilities. “We’ve implemented a lot of telemedicine with regard to mental health, which oftentimes is overlooked, especially in rural areas,” says Tudor.

The formal organization that has emerged from this group effort is called the Texas Midwest Health Information Exchange. “Basically, each patient that is seen in my clinic, if they were to end up in the emergency room of another clinic, their medical record would be available for that physician. As a region, we thought that was the most important thing. How could we help people here? How could we provide a tool like this to serve our patients?”

Patients First

“I’ve had a lot of great mentors in healthcare,” Tudor says. “But one of the things I was told early on that has stuck with me is that the first priority is to take care of your patients. Everything else can wait till morning.”

In the fifteen months since Tudor joined the organization, they’ve implemented 52 new policies on safety and compliance issues. One of the items they’ve been tracking, for instance, is diabetes management in their patient population. “The EHR is giving us the ability to track a lot of data,” says Tudor. “That’s one of the things we’re working on to continue to meet core measures as far as how we take care of our patients and how we treat them.”

Emphasizing Community in Rural Healthcare

Tudor admits that attracting and keeping talent can be difficult. “Not everybody is cut out to be in a rural hospital because there are so many challenges,” he says. “Obviously, cash and access to capital dollars are a struggle for every rural hospital, but we do the best we can here. We’ve been able to remain strong, financially, and have made great strides to improve our standing in that area. We’re very secure as an organization right now from a financial perspective.”

“I like to give my people the tools they need to be successful. I think it’s important in a rural area that you are actively engaged in the community and you are seen in the community. One of the things I like to do is called management by walking around. That’s one of the things nicer about being in a small facility. I can round on the patients twice a day, check in on them, and check in on their families. I think that’s important,” Tudor says. “Same with my employees. I go every day and say good morning. I keep an open door policy and employees are allowed to come in at any time and share their ideas with me. Being more of a listener is essential because employees have the best ideas and finding ways to implement them is something I see as crucial.”

“Obviously, in a rural facility we can’t do everything. We can’t be all things to all people, but we can focus on our core business and that is taking care of patients. We can do that as well as any hospital in the country.”

-by T.M. Simmons

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