Emanuel Medical Counters Rural Challenges by Embracing Progress

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Prior to becoming chief operating officer of Emanuel Medical Center in Swainsboro, Ga., Damien Scott, PT, MS, OCS, had a lengthy career as a physical therapist. But he eventually tired of the overwhelming negativity toward change that trickled down from his administrators and decided to transition into healthcare leadership, hoping he could have a positive impact.

Scott previously served as chief executive officer at Candler County Hospital in Metter, Ga., but when CCH was acquired by the recently established ER Hospitals LLC, he was moved to its sister hospital, Emanuel.

Although it might seem as if transitioning from a standalone, autonomous organization like CCH to a management situation at Emanuel would be a challenge, Scott actually saw it as a relief.

“To be a standalone rural community hospital that’s struggling is a challenge,” he said. “You don’t have the resources that a larger company can bring to the table in terms of leadership. You don’t have the expertise, and there’s no way that a single person can be an expert in all areas of the hospital.”

The state of Georgia still has many standalone, independent community hospitals that are structured according to the traditional inpatient model. Scott said this model simply won’t exist in the future, and standalones lack the resources, expertise, and progressive outlook needed to speed up their transition from inpatient to outpatient care.

Modeling three solutions for rural Georgia healthcare

As a physical therapist, Scott prioritizes and identifies the problems first before establishing goals. Taking stock of the hospitals around Emanuel, he said many have closed, some are near closure, and the rest are fighting for survival.

He delineated three solutions to this dilemma, all of which are embodied in the work of ER Hospitals.

Establishing a shared service across healthcare in Georgia is the first solution, which ER Hospitals is doing through its rapid acquisition of hospitals throughout the state.

The second solution is examining which niche service lines a particular organization, such as Emanuel, can offer. The third solution is expanding telemedicine in collaboration with regional hospitals, so that outlying residents can have access to specialty services.

For Emanuel, the first two solutions are indelibly connected. Scott has determined that Emanuel is about relationships, both with its customers and other community hospitals and tertiary centers in the area. Competition is out, he said. Communication and collaboration are in.

Forming these relationships enables Emanuel to focus on niche services, per ER Hospitals’ second solution. The reality is, Scott said, his hospital simply cannot offer every medical service, but there are a few services it can perform just as well as anybody else in the United States.

One of these services is inpatient geropsychiatric, which is much-needed throughout the hospital’s patient population.

After examining the data, Emanuel’s leadership realized there are 28 nursing-home facilities within 40 miles of the hospital, comprising 2,260 beds. In addition, 15 percent of the population is over 65, which is well above the state average. And the paucity of psychiatric programs in the region doesn’t come close to meeting the needs presented by the data.

On July 1, Emanuel will open a brand-new geriatric-site program after receiving a certificate of need and completing a $1.5-million renovation.

On the telemedicine side, the governor has chosen Emanuel as one of four hospitals to participate in a pilot project for expanding telemedicine within communities by collaborating with schools, EMS facilities, and tertiary centers.

“Just putting the telemedicine equipment in isn’t going to be enough,” Scott said. “We’re going to have to have those relationships to make sure we can actually get this off the ground and work.”

He said the plan is to name a point person to facilitate communication across these partnerships.

Leveraging the dedication of the medical staff

Although rural healthcare is besot with challenges, Scott said Emanuel has one major factor working in its favor: a committed medical staff.

“They have a servant’s heart,” he said. “They love caring for patients. Even the hospitals that are really struggling love caring for patients. It’s why they do what they do.

“What’s different about Emanuel, there’s also a certain level of excitement because we’re building something. We’re doing something new and that’s not been happening in the rural hospitals. There’s been more shrinking and cutting and slashing.”

It’s not that Emanuel is special, he hastened to point out. It’s the temperament of the leadership. Too many rural administrators spend their time complaining instead of leading.

“Don’t complain about the state of healthcare today,” he said. “The staff doesn’t want to hear that. The staff wants to see a leader that’s going to take them through healthcare today, and healthcare today is not what we offered even 10 years ago. It’s got to be something different.”

Blessed are the flexible

While the basics of healthcare remain, they have to be adapted to the new paradigm, Scott observed. Healthcare workers will follow an executive who embraces change and leads in spite of the challenges posed by it.

“What they’re not going to follow is somebody that’s saying, ‘I wish we had it like it was. I hate how this system is.’ Blessed are the flexible. We’ve got to be flexible. We’ve got to be willing to adjust to what our patients’ needs and desires are.”

He believes Apple serves as an example of how a niche company was willing to think beyond its standard box and adapt to the marketplace through such groundbreaking innovations as the iPod and iPhone, becoming an industry leader in the process.

“In order to survive we’ve got to shift, and the thing that has been so exciting to me is to see how we can share those services now that we’re not a competitor with a hospital 25 or 30 miles away. I’m learning so much from those other folks that we’re able to bring into our facilities.”

by Pete Fernbaugh

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