Jefferson County Health Center: Deb Cardin, CEO and Chief Administrator

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Starting with the oldest hospital west of the Mississippi River, Jefferson County Health Center underwent a large project a few years ago to build a replacement facility. Located in Fairfield, Iowa, the health center faced unique challenges with a diverse community and a difficult facility location.

The original hospital facility was landlocked in a residential area, leading to the decision to build an entirely new facility on the edge of the Fairfield community. The new facility opened in 2009 and features many natural elements conducive to healing as well as to green initiatives.  The project included the 120,000 square foot, 25-bed critical-access hospital, an attached medical office building and a 10-bed dialysis unit on campus.

“Our new hospital sits in a tranquil setting at the edge of the community flanked by three recently restored barns,” said Deb Cardin, Chief Executive Officer and Chief Administrator. “The campus has a courtyard garden, walking trails and a pond. Patient rooms have views of the barns, adjacent meadows and the pond.”

Engaging the community and staff

Fairfield is a town of about 9,000 residents in rural Iowa. Fairfield is also home to the Maharishi University of Management (MUM), which attracts students from more than 80 countries. Numerous businesses in the community are also associated with the university.

Following the lead of many of the new buildings on the MUM campus, which incorporate the principles of Vedic architecture, east entrances were chosen for the new health center. “Now our front door and even our emergency department, which is on the north side of the building, have entrances that face east.”

In addition to the MUM and Fairfield communities, Jefferson involved all staff in the design, making the final result extremely functional for staff and patients. Nursing units are arranged so there is a pod outside every two patient rooms with a computer, medication and supplies. Each room has a patient lift that moves in all directions and can lift patients anywhere around the room. Being a critical-access facility with limited staff, employees need to be multipurpose, which also affected design.

“Our staff needs to be able to work in more than one unit,” Cardin said. “We made all nursing units adjacent to each other, so if one gets busy, we can easily pull from one to another.”

Incorporating green initiatives

In 2008, Fairfield developed a “Go Green” plan to encourage green business practices; the MUM community also wanted to see more sustainable features. The replacement facility was a pilot project for the Green Guide for Healthcare, a best practices guide for healthy and sustainable building practices. Jefferson implemented many sustainable features including low VOC interior finishes and paints; tiles using significant recycled content; low-maintenance grass, eliminating the need for irrigation; and broad expanses of windows, reducing reliance on artificial lighting.

The hospital is also wireless and is working toward a complete electronic health record. The health center started CPOE in 2005, helping its vendor improve their system.

Building the organization’s values

Cardin has been with the organization for 12 years, but took over as Chief Administrator about two years ago. When she began, the hospital had previously not had organizational goals or a recent strategic plan. She also had work to do to improve the relationship between administration and physicians.

“My first order of business was to establish organizational goals,” she said. “We developed these with input from medical staff and the Board of Trustees. Then we rolled them down to departments and employees.

“We have seen progress, including a 31 percent reduction in adverse events, increases in patient, employee and physician satisfaction scores. We recently completed a physician satisfaction survey, developed with help from the physicians to comprise every department, and our overall score was a 4.5 out of 5. We just had 97 percent overall patient satisfaction scores in both the emergency department and inpatient.”

Cardin said she credits the success of Jefferson to the employees. Her key to success as an administrator has been communication–communication with the community, physicians, nurses, leadership and staff at every step of the project. Jefferson County Health Center has shown all stakeholders that it listens by incorporating their values and needs into the health services it offers.

-by Patricia Chaney

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