Parkview Hospital: Ann Fagan-Cook, CEO and Administrator

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Last year when a bus wrecked in icy conditions on an interstate in the Texas panhandle, Parkview Hospital received 29 patients all at once. That’s a significant load for a 16-bed hospital that serves a 908 square mile service area that averages less than seven people per square mile. Within 20 minutes, the entire staff of Parkview was assembled. Dietary staff who heard on the police scanner that accident victims were coming in arrived at the hospital to fix breakfast for everyone.

“We have a true team here,” says Ann Fagan-Cook, CEO and Administrator of Parkview. “I have employees who have been here for 29 and 30 years. They have dedicated their whole work lives to this hospital.” Of Parkview’s three physicians, two have been there for more than 35 years. “That’s pretty extraordinary for rural hospitals anywhere,” Fagan-Cook says. “The average length of time for an administrator is about three years and I’ve been here almost eight. I’m only the third administrator they’ve had since 1963.”

Parkview is a level four trauma center supported by county taxes. They also have a home health agency, an ambulance service and a total of three physicians and one dentist. Seventy-seven full-time employees work for the organization.

Because it’s the Right Thing to Do

A few years ago, the little hospital was one of six in the state to win a quality improvement award from the governor of Texas. Patient safety is at the top of Parkview’s agenda.

Fagan-Cook implemented a medication dispensing system from MDG Medical for drugs shortly after she started working with the organization. “I’m a registered nurse; have been one for 34 years,” she says. “I realized we were having medication errors that I thought were absolutely outrageous, so we went to an electronic dispensing system for drugs. Our error rate was about 4 to 5% and we cut that to 0.05%.”

Well before the stimulus incentives were on the table, Parkview began working toward an electronic medical record. It is something they’ve had in mind for the last four to five years. Last year, a couple of board members went to a trustee training meeting and they came home with information from Prognosis Health Information Systems out of Houston, Texas. “We looked at it and we agreed with them,” says Fagan-Cook. “We have been very pleased.”

One obstacle has been that a lot of Parkview’s equipment is not necessarily computer friendly. “They have to have interfaces and things you don’t know about until you get into the business of getting an electronic record,” she says. “Prognosis has worked very closely with us.” The outpatient portion was up and running first and the inpatient portion soon followed. A nearby hospital also picked Prognosis, so the two have done a lot of work together to transition to the electronic record.

Making Changes in a Small Hospital Setting

“The first thing you have to do is get buy-in and commitment from the staff,” says Fagan-Cook. “If you don’t include them and convince them on the front end, it will never happen on the back end.” When introducing initiatives, she starts by distributing all the pertinent details to everyone.

“Then we have a meeting and get everybody’s general opinion about why we need to do this and whether or not we need to do it,” she says. “If there is consensus that this is a project we need to take on, someone is made head of the steering committee.”

The Parkview Board of Trustees is also a long-term group. “Some of them have been  trustees for more than twenty years. They are pretty involved in what is going on which helps a lot. There’s nothing worse than making a big presentation and them saying, ‘Nope, don’t want to do this.’ It kind of takes the wind out of your sails,” says Fagan-Cook.

The Future of a Rural Hospital

Parkview relies on its designation as a critical access hospital to keep the doors open. “We’re not branching out right now,” says. Fagan-Cook. “We don’t have any surgeons here; we don’t do any surgery, and we don’t deliver babies except in emergencies.”

Fagan-Cook says one of the keys to operating in such a rural area is to carefully decide whether or not the programs you consider putting into place are sustainable. “We’re here to provide services for the county,” she says. We really are a service oriented organization and if you don’t follow through with what you say you are going to do, the people stop coming to your hospital. We always make it our goal to do what we say we are going to do.”

-by T.M. Simmons

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