University of Southern Indiana Indiana University (10) Health Paola Hospital is a Critical Access Hospital in southern Indiana.
II Health Paola serves a rural population and offers obstetrical (B) services. The B department offers an individualized family centered birthing setting. The hospital delivers around 130 babies annually. The mission of the B department is to offer a personalized compassionate delivery of care and provide a quality outcome for mother and newborn.
The staff on B is all registered nurses (RAN), certified in in- attain obstetrics and electronic fetal monitoring. All 14 staff members are neonatal resuscitation and advanced cardiac life support providers. 2 of the 14 Urn’s are internationally board-certified lactation consultants and have an 83% breastfeeding rate at discharge. Labor support offered is hydrotherapy, birthing ball, epidural and they also offer vaginal birth after cesarean. Six family practice physicians offer obstetrical services at the hospital and three of the physicians offer cesarean section services.
The 2012 Annual statistics for the B department reflected a primary cesarean rate of only 13% and no early elective deliveries prior to 39 weeks gestation. All Urn’s and physicians are focused on quality, compassionate care and outcomes. All standards of care and core measures for B care of followed and implemented to the fullest degree. The B Nurse Director is very passionate about quality outcomes and staying patient centered with the delivery of care, decisions and policies.
A special quality that all nurse’s and physicians possess on this unit is each patient, birth is a miracle. The opportunity to be present at this memorable time in each tangent’s life is an honor not a Job. The patient satisfaction scores and comments from [email protected] reflect this passion and commitment. In the analysis of the B department, a focus on strengths, weaknesses, opportunities and threats were utilized (SOOT). The SOOT analysis reflects opinions from staff and physicians not official data (Hillsides & Borrowing, 2013).
Methods to collect this data involved self- observation, in person interviews with some staff and physicians, email surveys and Indiana Hospital and Health Association (IHA) market share data and [email protected]
From email surveys, findings revealed; the average length of employment for nursing was 10 years and nursing staff and physicians all felt that the core values of the hospital were hard wired and displayed professionally and personally. The core values are TEAM: trust, excellence, accountability and mutual respect.
Nursing staff completes annual competencies and evaluations to measure their skills clinically and customer service focused. Patient or customer service evaluations are based on the Quinn Stupor principals of AIDED (acknowledged, introduce, duration, explanation and thank you), purposeful hourly rounding, bedside shift reporting and patient room white board use. These principals help along with patient satisfaction scores and are reflected by scenario competencies and shadowing plus the results of the [email protected] scores.
IHA quarterly releases market share data to hospitals. This data runs somewhat behind rather than current but is helpful in trending, looking at growth areas or potentials for growth or where lost to. The two main competing hospitals offering B services are SST. Vincent Dunn Hospital in Bedford, IN approximately 25 miles away and Jasper Memorial Hospital in Jasper, IN approximately 50 miles away. SST. Vincent Dunn deliveries approximately 300 babies annually and Jasper Memorial does about 1000 birth per year.
The two main differences that both competitors have over II Health Paola is they have BOB/GYM board certified physicians and pediatricians where Paola only offer family practice physicians to cover both B and pediatric care. An advantage that II Health Paola has is that it offers contraceptive measures such as tuba legations that neither Jasper or Bedford offer due to religious affiliations. In 2008, IHA showed that II Health Paola held only 35% of the market share in Orange County, Indiana. This is a 2% decline from the past two years of 37%.
Jasper Memorial has shown an increase of market share in 2008 to 18% of Orange County from 12% and 9% the prior two years. SST. Vincent Dunn has reflected a steady decline to only 6% 2008 Orange County market share from 11% in 2006. (Indiana Hospital and Health Association [IHA], 2008) Overall Jasper Memorial appears to be the main competitor for II Health Paola. Strategies to pull that 18% back to Paola could focus around what staff stated in personal interviews. Two staff nurse’s felt that Jasper Memorial advertises a lot in the Orange County newspapers where Paola lacks in advertising.
Another nurse felt that the specialty of physicians also pulled Orange County residents to Jasper; she stated “Most patients now prefer a pediatrician to assess and examine their newborn for a piece of mind. ” A plus that came across from staff in surveys and interviews was that the compassionate care and the breastfeeding support offered at Paola blows Jasper UT of contention. Staff expressed they would advertise the 1:1 personalized care and quality outcomes such as breastfeeding success.
An opportunity for growth was expressed in two avenues but from advanced nursing practice roles, midwifery and clinical nurse specialist (CANS). Nursing staff felt that the population of orange county would welcome the practice off midwife at the hospital. The Center for Disease Control released in 2009 that 1 in 8 American women with vaginal births were attended by a midwife (Graver, 2012). Staff also felt that adding in the specialty off CANS would help improve care, evidence based practice and quality outcomes.
New technology that is available to B is the Labor curve interpretation of fetal monitor tones and in uterine contractions. This tool is only to assist; it does not impose a liability risk due to not a permanent part of chart. It only works during labor and alarms with interpretation for nurse and physicians. As a novice labor nurse, I would find value in this product. The SOOT analysis concludes that self-perception is that II Health Paola B department offers excellent outcomes and compassionate care to boring mothers and their newborns.
Staff and physicians care about the patients, are skilled and certified to provide preeminent outcomes. Some data from Enriched helps support this perception but keep in mind that a SOOT is a guide not a prescription (Pearce, 2007). The size of the hospital and its lack of advertising seem to factor into the stagnant state it is in. As healthcare reform moves forward, and reimbursement becomes more of a challenge, the survivability of a small B unit dims. The good news is going into this uncertain time; the cash on hand at II Health Paola is 368 days.
This is the best in the whole II-J Health system of 18 hospitals. Hopefully they can withstand the odds and remain strong and deliver miracles every day in Orange county, Indiana. Strengths Weaknesses Opportunities Threats People Dedicated Compassion Certified Astigmatism of rural Longevity Competency Retention Turnover Recruitment Service Personalized Hydrotherapy Small in size Tuba Legation Midwifery Contraception Competition BOB/GYM and peed Quality Outcomes Breastfeeding support Small census MD support CANS Labor curve documentation Small Census Cost Days cash on hand Medicaid % CA Bundle payments Lower pricing
Growth Brand Size Specialty Midwife Pediatrics CO
Graver, M. (2012, June 25). Proportion of Midwife-attended births reaches all-time high in US. American College of Nurse-midwives. Retrieved from www. Midwife. Org Hillsides, S. G. , ; Borrowing, E. N. (2013).
Health care market strategy from planning to action (4th De. ). Burlington, MA: Jones ; Bartlett. Indiana Hospital and Health Association. (2008).
Bloomington Hospital of Orange County 2008 3rd Quarter Market Share Data. Indianapolis, IN: Author. Pearce, C. (2007).
Ten steps to carrying out a SOOT analysis. Nursing management-UK, 14(2), 25.