Rush Foundation Hospital: Christopher Rush, Administrator

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Rush Foundation Hospital, a rural acute-care facility in Mississippi, is in a period of growth, a factor that is uncommon for many community-based hospitals. The 215-bed hospital is part of Rush Health Systems, which serves communities in East Central Mississippi and West Central Alabama.

The patients seen at Rush are from rural communities with limited access to care outside of the facilities Rush Health Systems provides, and about 50 percent of the hospital’s payer mix is Medicare and Medicaid. Despite challenges in reimbursement, the health system’s growth is enabling it to better service the surrounding counties.

Expanding within rural areas

Rush Foundation Hospital also has a 49-bed long-term acute-care facility on the first floor, and the health system operates rural-health clinics, a physician-management company, two multispecialty physician entities, and five critical-access hospitals. Rush Health Systems recently added a 25-bed critical-access hospital in Mississippi and another 25-bed critical-access hospital in Alabama.

“It is a tough time to be in a period of growth, but we are trying to take care out to rural communities,” said Christopher Rush, hospital administrator and executive vice president of the health system. “Patients in these areas often have transportation issues, and we are trying to have a network of facilities solidly in place throughout our service area.”

In addition to new hospitals, Rush is also implementing an electronic health record (EHR) throughout the system. The organization is in its second year of a three-year plan to bring all Rush Health Systems entities, including clinics and physician practices, online with the EHR.

“Ultimately, we want a patient to be able to come into any facility and be able to send information seamlessly to other hospitals, clinics, emergency departments, or physicians within our system,” Rush said.

Rush Hospital was founded by surgeons and still remains largely a surgical hospital, accounting for about 60-70 percent of its services. During the past three years, the hospital has built its minimally invasive surgical program and invested in two of the latest da Vinci Si Surgical Systems. The hospital has already performed more than 1,000 cases.

“Our robotics program began with a gynecologic surgeon, but has encouraged our entire surgical department to look at capabilities for minimally invasive surgery in other areas,” Rush said. “We have begun some heart surgery and are looking to add urological surgery with the robot.”

Managing challenges along with growth

As with all healthcare facilities, Rush Hospital is looking at ways to provide lower-cost care. Rush said the health system is looking at ways to position patients in the proper facilities to get quality care at the lowest cost. For example, some patients may be treated in a smaller hospital in a swing-bed program at a lower cost than at the flagship hospital.

“We are coordinating as a system to make sure patients move from a higher-cost setting into a lower-cost setting and receive the appropriate care,” he said. “We are also working on cost control in terms of length of stay.”

Rush is employing other methods as well. With more people coming into Medicare and Medicaid, Rush said managing length of stay and capacity will become even more important. The system is also working on ways to link clinics and physician practices to ensure patients are receiving care once discharged from the hospital in order to avoid readmissions. Rush said the system is evaluating ways to provide as much care as possible on an outpatient basis to limit readmissions and maintain the surgical volume at Rush Foundation Hospital.

Another important area that Rush is evaluating is using mid-level practitioners in light of a physician shortage. The nation is facing this physician shortage in all specialties, and rural hospitals have always faced even greater struggles in recruitment. Rush said using nurse practitioners more and establishing a team of nurse practitioners with physician oversight is a future initiative.

Keeping it in the family

Many community-based hospitals have close relationships with staff and the communities they serve, and Rush is unique in its family history. The hospital was founded in 1915 by Dr. J.H. Rush, Christopher Rush’s great-grandfather. Dr. Rush’s sons joined the staff shortly thereafter, and Christopher’s father was also a surgeon at the hospital. Today, the hospital is a nonprofit facility with no family ownership, but the Rush family has always remained involved. Christopher Rush’s brother serves as a surgeon at the flagship hospital.

“Having the hospital carry your name does have meaning on a personal level in terms of your view of how you think about providing care and whether you are fulfilling the mission to the community,” Rush said.  “I am constantly aware of a higher standard than just being the administrator of a hospital.  There is a history of my family’s values and life work that I carry forward every day in guiding the hospital. It is the biggest privilege of my career so far.”

The values or “House Rules” at Rush Hospital also reflect a family atmosphere. These values include guidance on how to treat others, such as showing respect, addressing people by name, being patient, being prompt, being professional, and helping others. The main driving force of these rules is the hospital’s mission, penned by the Rush family, to be their “Brother’s Keeper” in providing care.

Continuing this in light of reform, Rush is focused on improving patient-satisfaction scores.

“Focusing on our mission to be our Brother’s Keeper is proving true in our patient-satisfaction scores, which will be very positive under the new reimbursement models in healthcare reform,” Rush said.

In all of this, Rush continues to implement growth strategies and evaluate the most cost-effective way to provide care while not losing sight of the patients in the communities it serves.

-by Patricia Chaney

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