Hospital board approves needs assessment

Tuesday evening, the Hot Springs County Memorial Hospital Board of Trustees accepted the Community Needs Assessment as presented by Marketing Director John Gibbel.

According to the report, which includes all of Hot Springs County - as it is the hospital's service area - 21 percent of people do not have access to health insurance. These people fall under the Medicaid expansion that the Wyoming legislature refused to pass. They don't make enough to qualify for subsidies under Enroll Wyoming. They are Hot Springs County's working poor, and go without insurance.

Thirty-five percent of people don't have access to health care education for their medical issues, and only 65 percent have regular diabetic monitoring. This also increases factors for low birth weights, as people don't get necessary education prior to the first visit to the doctor.

Thirty-eight percent of school age kids are eligible for free or reduced price lunch. These kids tend to belong to lower income and less educated families that would benefit from additional health education.

Gibbel met with former mayor Bill Malloy, Jane Norskog of the HOPE Agency, public health nurse Marie McDougall, landowner and pastor Frank Robbins, and community prevention professional Becky Mortimore. Additional review was also sought from Allan Braaten of the Hot Springs Counseling Center.

Gibbel noted Wyoming Health Matters was chosen a gauge to measure how the county is doing in various lifestyle choices. Using this gauge, as well as the socio-economic factors noted, Gibbel explained, they looked at things the hospital could affect.

Areas identified as those the hospital can impact and create measurable change include: mothers who smoked during pregnancy, babies with low birth weight and adults who visit the dentist/adults 45-plus with major tooth loss.

Gibbel noted the hospital has the partnerships in place to really affect some positive change in the identified areas of concern. From the board's approval Tuesday night, there is a period of four-and-a-half months, Gibbel said, to generate an implementation plan.

In other action, the board approved the Terminating the Provider-Patient Relationship policy for Big Horn Clinic. The policy lays out the circumstances that can result in termination, including, but not limited to, noncompliance with provider-recommended treatments, failure to pay, consistent failure to keep appointments, threatening or abusive behavior, violation of the controlled substance contract, or deception by the patient.

CEO Robin Roling pointed out the termination of the provider-patient relationship is not an uncommon practice.

The Cardiopulmonary Resuscitation (CPR) policy for the hospital was also approved. This policy requires adequate training for all personnel in American Heart Association Basic Life Support (BLS). Non-direct health care providers have six months to obtain BLS certification after employment, and direct health care providers have 30 days.

All staff have 30 days to get recertification after expiration of current certification, and all staff not currently certified have six months from implementation of the policy to get certification.

The Board also approved the annual report 2015 of the infection prevention program.

An issue that continues to be addressed is hand hygiene compliance. She said there has been a lot of work regarding scrubbing in and out procedures, and hand sanitizers have been placed by the door of every patient rooms.

Other areas being addressed include: judicious use of catheters - when they are necessary - to prevent urinary tract infections, reduction of healthcare associated infection, improved antibiotic stewardship, awareness of trends in organisms in the community and educational in-services.

Roling noted there is a lot of work being done behind the scenes to be diligent stewards for the patients and eliminate infections.

Banking signature card resolutions were approved for Margie Molitor, FACHE, who will become the interim CEO beginning June 6.

A motion for replacement Bilirubin lights was approved. Chief Financial Officer Shelly Larson noted the lights the hospital currently has are not working, so they are borrowing a set. The total cost of the lights, which are used to treat infants with jaundice, is $3,806.

Roling pointed out there is support from the Economic Development Council regarding the Specific Purpose Tax and Hospital District initiative, and there appears to be support from the Thermopolis Town Council. A public hearing regarding the tax and the initiative is scheduled for June 21 at the county annex building.