When Alan Kent came to Meadows Regional Medical Center in Vidalia, Georgia six years ago, the facility was the largest community hospital in the rural Georgia area. The facility is almost 50 miles from any large urban hospitals and 90 miles from two major medical-trauma centers. Kent realized the geographic position of his facility made it a prime candidate to become a referral center for primary-care physicians. This recognition changed the focus and the future of the non-profit community hospital forever.

“We realized there was a satisfactory amount of primary care in most of the surrounding small rural communities,” said Kent. “Rather than growing the primary care business and depending on our primary care physicians to tell us when they needed a specific specialist, we changed our focus to specialty care.”

The administration embarked on a mission to develop the medical center around a specialty care model, recruiting more OB/Gyn, urology, ENT, pulmonology, and cardiology physicians. Some of the specialty physicians then established satellite clinics in other communities, taking care of office visits and then referring patients back to Meadows Regional for follow-up care or surgery.

“Our model progressed to one that centers on the development of specialty-care physicians,” said Kent. “Complementary to that, we found ourselves lacking in technology. We decided to make a large investment in the facility and equipment, and we started buying upgraded X-ray equipment and cardiac monitors, and added dynamaps to every nursing area.”

The administration started equipping specialists with the technology that enabled them to compete with physicians in the larger centers. Five years ago, Meadows Regional became one of the first rural hospitals in the region to have a fully integrated PACS system. After installing it at Meadows Regional, the administration installed PACS in each of the partner doctors’ offices throughout the region. “They can now follow up with radiology and see the X-rays themselves rather than having to depend on the patient to bring the film back and forth,” said Kent.

Moving ahead
Over time, the range of specialty care at Meadows Regional increased to include ENT surgery and medical oncology. Although it would be easy to say a strategic growth plan was in place in deciding which specialties were developed, Kent said the deciding factor for many of these services came from the availability and compatibility of physicians.

“If I’m recruiting among six specialties and I’m successful with a cardiologist first, then cardiology becomes more of a focus,” he said. “When you have needs in multiple specialties, sometimes availability establishes that priority.”

Specialty focus is not, however, decided on a whim. Medical staff leadership, board leadership, and management leadership teams work together to establish which priorities are appropriate for the rural hospital and which are not. The administration’s overall vision is to become the first choice for medical care in the region. During the past six years, the medical center has seen an increase in revenue from $47 million to its current budget of $161 million. Kent said this change is a natural outcome of the growth process and the focus on specialty care.

“Since we purchased technology such as a 1.5T MRI scanner and a 64-slice CT scanner, more people are turning to us for imaging as opposed to going to the larger trauma centers,” he said. “We’ve also developed five sleep centers. We have the only accredited sleep center in this part of the state.”

The sleep center revenues are a big component of growth, yet without the ability to recruit a pulmonologist and develop sleep medicine as a subspecialty of pulmonology, the centers would not have been possible. When Meadows Regional started down this path, it had only one sleep center. The administration quickly realized there was a need in surrounding communities.

“One of the things we identified was a need for pulmonary care not only in our community but also in several of the referral communities around us,” said Kent. “Because the first location was so successful, we looked at expansion. We went to another community, met with physicians, looked at the referral base, and proceeded to open four additional facilities.”

Growth from within
When looking at the structure of an organization, outgrowth is only possible with a strong core. For Meadows Regional Medical Center, the same holds true. In 2003, the administration adopted a philosophy known as Open Book Management that thrives on a transparent management style. Each employee is taught how to read the organization’s financial statements and is required to complete 30 hours of education per year.

“There are programs in infection control, nursing skills, and critical clinical thinking, but we also offer courses in customer service, customer relations, hospital finance, operational improvement, and performance improvement,” he said. “We want our employees to understand the medical aspects of improving their professional development as well as the aspects of business development so they can understand what it takes for a hospital to remain successful and profitable while improving quality.”

Last year, Meadows Regional Medical Center received Solucient’s Top 100 Hospitals Award. Only three hospitals in Georgia won the award that year, and Meadows Regional was the only one in the under-100-bed category. As a self- sufficient 501(c)3 non-profit community hospital, Kent is proud of his organization’s accomplishments. “Every day we continue to focus on our employees, our physicians, and our patients. When you focus on those things, everything else becomes clearer.”