Southeastern Regional Medical Center: Andrew Schwartz, MS, MD, FACS, FCCP, Vice President of Medical Affairs and Chief Medical Officer

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As a rural hospital, Southeastern Regional Medical Center (SRMC) has made significant advances in the care it provides to its community despite noteworthy challenges. The medical center has 452 licensed beds and offers acute care, intensive care, and psychiatric services. It has a freestanding hospice house and long-term care facility.

SRMC is located in Lumberton, N.C., a rural area in the southeastern part of the state, about 40 miles south of the Fort Bragg Army base. According to Andrew Schwartz, vice president of medical affairs and chief medical officer, the patient base presents unique challenges in terms of providing wellness care and reducing readmission rates. The community has a fairly high illiteracy rate and many patients with limited education, along with a high proportion of obese patients and many smokers. Lumberton is in one of the unhealthiest counties in the state and among the unhealthiest in the country.

“We have case managers and social workers involved in the discharge process, but many patients don’t understand their follow-up care,” Schwartz said. “With the education level of our patients, there is an overall lack of compliance. We are highly focused on our discharge processes.”

Coupled with the health-risk factors of its patients and being one of the poorest counties in the state, SRMC’s patient mix is about 75-percent Medicare/Medicaid and self-pay. But despite these challenges, SRMC offers a wide range of services, including cardiology, and is steadily adding more.

SRMC has full cardiovascular capabilities, including invasive and non-invasive cardiology and cardiac surgery. It has received recognition from HealthGrades for cardiac care and patient satisfaction, as well as achieving Magnet designation.

Southeastern received the HealthGrades 2012 Distinguished Hospital Award for Clinical Excellence. To be considered for this award, hospitals need to be ranked in the top 5 percent in the nation in terms of in-hospital mortality and complications. It has partnerships with Duke Medicine to provide medical oncology services and with UNC-Chapel Hill to provide teleneurology care.

Reaching out to provide community care

As in many communities with a similar patient population, SRMC sees many patients in the emergency department–nearly 80,000 contacts per year. The emergency room has 45 beds, but, with a daily census sometimes reaching over 200, wait times have been an issue for the hospital. Therefore, SRMC has an urgent-care facility in the works along with other community clinics to help alleviate the burden on the ER of patients coming in with minor issues.

In addition to the hospital, SRMC has 29 outpatient clinics that provide primary care, general surgery, and specialty services. The medical center has undergone a multi-million dollar project to build a Southeastern Health Mall complex at a local mall. This year, the complex will open a Weight Loss Center, an Express Lab, Pharmacy Care Clinic, and Community Health Services/Diabetes Education Community Center. A surgical center will open in March, and an urgent-care center and retail pharmacy are also planned for the facility.

“The complex will provide patients the convenience of receiving multiple services in one location,” Schwartz said. “We are also hoping the urgent-care center will reduce some of the burden on our emergency department and allow us to lower those wait times. The hospital is just down the block from the complex as well.”

An ambulatory surgery center is also in the works for SRMC, to be opened in 2013. To expand its reach outside the primary service area of Robeson County, SRMC continues to look for opportunities in areas beyond Robeson County.

Because many patients coming to the hospital don’t have a primary-care physician, the clinics are a necessity to see patients early and try to reduce hospital admissions. For patients in the hospital, SRMC has paid special attention to its hospitalist program over the past four years and has instituted a full-time intensivist program.  Furthermore, Southeastern is able to go into underserved areas with its Mobile Medical Clinic.

Making gains in employee satisfaction and quality

Recruiting a solid workforce in a rural area is challenging for any organization, but SRMC maintains about a 12-percent turnover rate after the first year of employment. To help keep this low, the medical center is a Studer facility, following the Studer Group principles for creating a culture of excellence.

In the previous fiscal year, the hospital brought on 13 new providers, including three orthopedic surgeons. These new providers have expanded the services the hospital provides, adding hand surgery and minimally invasive shoulder surgery.

“Part of our growth plan is to make sure we identify and secure physician leaders,” Schwartz said. “When I came on board in January 2011, my primary focus was to facilitate relationships and grow partnerships between the medical staff and the hospital. I believe these partnerships are becoming stronger.”

SRMC employs the majority of physicians on staff, and Schwartz has to help ensure that the physicians are engaged and aligned with the medical center.

“We have to go forward as partners,” he said. “If we don’t bring physician leaders into the boardroom and share in leadership and strategic development, we won’t be successful.”

Before moving into administration, Schwartz was a practicing cardiothoracic surgeon, a background that, as an executive, allows him to empathize with physicians.

In addition to maintaining a happy medical staff, SRMC is focused on providing quality care for patients. The facility participates in numerous databases for quality benchmarking, as well as following core measures, medication safety, medication reconciliation, and HCAHPS scores.

The electronic medical record is a large part of SRMC’s future strategy. It plans to launch CPOE this year and is on track to meet meaningful-use criteria. Looking forward, Schwartz said SRMC is focused on growth and positioning itself in the marketplace as a healthcare destination.

“We will continue to explore how we can be competitive and continue to recruit subspecialists and grow our services and bring new approaches to healthcare to the communities we serve.”

-by Patricia Chaney

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