Brown County Regional Healthcare: Resource of Choice - Health Executive - Red Coat Publishing - Inside Healthcare

Since its creation in 1952, Ohio-based Brown County Regional Healthcare (BCRH) has focused on its commitment to being the healthcare resource of choice to its community. Although the hospital has gone through many changes since it opened, none have been as technology focused as those planned in 2007, which include building a laboratory addition onto the 115-bed acute care community hospital.

Micheal Patterson, President and CEO
Strategic investment
For the past 25 years, BCRH’s clinical laboratory had been housed in a modular building. When Michael Patterson arrived at the hospital in 2005, the facility was no longer capable of providing the kind of quality service the community expected. “We started on the project design in October 2007, which is also when we put out RFPs for architectural services,” said Patterson, president and CEO.
Several criteria were used in the selection process for the architectural firm, including having experience in building clinical laboratories. The hospital also looked at how many projects the firm had completed, what the firm was currently working on, and the firm’s ability to create a healing environment. By November, BCRH had found its match in Ohio-based Champlin Haupt.

“We involved our director of the laboratory, the medical technologists that would work in the department, our medical director, and our vice president for plant operations in the selection process,” Patterson said. “We expect the new clinical lab to be completed in September.”

During this time, BCRH invested $1.8 million to build a 750-square-foot modular building to house a Toshiba 1.5 Tesla MRI. Previously, the hospital had a mobile unit come to the facility three days a week, but that provided a limited number of services to patients. Although a hefty investment, an inhouse MRI will save the hospital money in the long run. According to Patter-son, the hospital expects to see savings of $500,000 over the next five years.

Because MRI services will be available seven days a week, patients will no longer need to travel to Cincinnati, roughly 40 miles away. And the additional modalities available with the Toshiba MRI will allow the hospital to perform specialized studies it currently refers to other MRI facilities. The county is projected to grow by nearly 18,000 people before 2010. If those projections are correct, the hospital will experience significant volume increases.

“It’s a cost saving initiative, a revenue initiative, and an improvement of the quality of care available to our community of patients,” Patterson said. “The Toshiba MRI has capabilities the current mobile unit does not have, which means we’ll be able to perform cardiac and breast MRI studies.”

Similar to the process used in choosing an architect for the lab, BCRH used RFPs to choose a vendor for the MRI. The scorecard was based on cost, availability, quality, and service ratings from the industry comparing the various MRI vendors. Toshiba ranked the highest in all areas.

“Our decision wasn’t just based on service,” Patterson said. “It was also on the quality of the images and industry information from users currently using Toshiba versus other manufacturers.”

Staying focused
As with many hospitals, one of BCRH’s greatest challenges is declining reimbursements coupled with rising costs for operations. More than 50% of the Brown County population is at or below the federal poverty level, and with the nationwide nursing shortage and the hospital’s close proximity to a major metropolitan area, BCRH has its work cut out for it.

“People generally don’t live in the city and drive out to the country to work, but people from the country will drive into the city to work,” Patterson said. “One of the challenges we’ve had is attracting and retaining our local professional healthcare staff.”

The administration began by looking at its pay scale for all positions in the hospital compared to local markets, particularly the Cincinnati metropolitan area, which tends to pay higher wages. In 2007, BCRH’s HR department began a recruiting campaign by visiting the nursing programs at local universities and colleges. Then, using zip code data, the hospital sent a letter to nurses in Brown County and surrounding counties and held a recruitment fair at the hospital. Only 14 people showed up, but Patterson considered it a success because the hospital hired five people at the cost of one.

“I was there as the CEO. The HR director was also there with all the nurse managers, including ED, OB, med/surg, and OR, to talk to the nurses that came to visit to see what our openings were, what the shifts were, and what the jobs entailed,” Patterson said. “We no longer have any agency nurses or contract nurses—the first time that has occurred in three years.”

As for the ongoing battle of bad debt from a high uninsured and underinsured population, the hospital is actively recruiting physicians for new services. In 2008, the hospital started a pain management program with its anesthesiologist, and many other services are in the works. The challenge, Patterson said, will be whether or not BCRH can add programs while stabilizing the free care it provides, a challenge for hospitals across the US.

“We’re seeing that in all parts of the country,” he said. “But our vision has always been and continues to be a commitment to being the resource of choice to provide excellence in community healthcare.”

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