Access to care means being able to get the right level of medical care when and how you need it. Without appropriate access, it may not matter how good the care is: It can be unobtainable, come too late, or cause a level of hardship that outweighs the benefits. That’s why improving access to care is one of the ten top goals of the New Hanover Regional Medical Center Partnership Exploration.
In the coming months, the citizen-led Partnership Advisory Group will evaluate a range of partnership and restructuring options to determine what would help NHRMC better serve the region into the future. Considerations around improving access include questions around the best way to support NHRMC in bringing more caregivers to serve the growing population, building new clinical sites, developing digital care options, and expanding the depth and breadth of services available.
What NHRMC is Doing to Improve Access
Improving access to care and wellness programs is a critical part of NHRMC’s strategic plan. It is driven by the need to keep pace with factors that are driving higher demands for services, including the region’s rapid population growth and the greater percentage of older residents who require more medical care. It is also driven by a need to better manage individuals’ overall cost of care as the industry shifts from paying providers for each visit or procedure to paying providers a set fee to manage a person’s overall health. This shift requires a realignment of where and how services are offered, so patients can get ongoing care in settings that are more convenient and less costly than inpatient hospitals.
Within the NHRMC system, teams of employees and providers have been working on both these fronts. At the main hospital campus, managing record numbers of patients is an ongoing focus. On any given day, NHRMC’s hospital beds are nearly full, averaging over 90% capacity, well above the state average of 67%.
To help ensure a patient can get a hospital bed when they need it, NHRMC and members of the medical staff have taken steps to reduce unnecessary delays and improve the efficiency and quality of care and treatment for hospitalized patients. These steps include changing the way caregivers make their rounds. Now, they do this as a team so each member can get timely updates and answer questions from patients and their families. This helps prepare for a safe and timely discharge from the hospital. NHRMC has also introduced a tracking system for patients, supplies, and personnel so every member of the care team knows when a patient is ready for the next step in their care.
While the tracking system helps improve the timeliness of care within the hospital, access to care outside the hospital can have an even bigger impact, helping individuals get the care they need to prevent hospitalizations, or re-hospitalizations after they have been discharged. NHRMC and physician leaders have set up a transition clinic to see patients who don’t have access to a primary care provider who can check on their recovery after they have left the hospital. That follow-up appointment is often critical to catching issues that could lead to complications and a readmission. NHRMC Home Care is also using telehealth to provide more frequent monitoring of high-risk patients through digital visits.
Throughout the region, particularly in rural areas, access to physicians is an ongoing concern. NHRMC is actively working to recruit providers to the area and has plans to offer more locations and digital options to make getting care easier and more affordable. NHRMC is also partnering with other organizations to bring wellness programs and health screenings to a range of settings, from workplaces to barbershops.
Accelerating Efforts to Improve Access
While programs underway at NHRMC are helping improve access to care, the scope and pace are hindered by what NHRMC can accomplish on its own, and within its current structure as a county-owned system. The organization needs to make significant investments in infrastructure and staffing expertise to expand services in time to meet the demands of our population. Failure to do so could result in longer waits for care, less convenience and worse outcomes.
In the coming months, the NHRMC Partnership Advisory Group will evaluate whether a change in governance structure and/or partnership could help NHRMC grow with more caregivers, clinical sites, and digital care options.
Specific questions about access are detailed in more than 30 questions in the Request for Proposals (RFP) issued January 13. Respondents are being asked what, if any, impact their proposed strategic partnership model would have on NHRMC’s ability to further develop outpatient and wellness programs, improve access to primary care, grow needed specialty services, and offer more consumer-friendly convenient care options in all the regions served by the system, including those in rural areas where care is more limited. You can see these, and the other questions in the RFP, online by visiting www.nhrmcfuture.org and clicking on “RFP” in the top button bar. “Improving Access to Care and Wellness Programs” is section 1.
Once the proposals come back and are finalized near the end of March, they will also be available on the website, so members of the public can find out exactly what each proposed partner is suggesting when it comes to improving access to care.
Members of the Partnership Advisory Group will evaluate the value of the support suggested and weigh it with other considerations, including the nine other sets of goals and objectives approved by the group, and the degrees of local control and ownership outlined in the proposals.
The Advisory Group will then publicly make their recommendation to the NHRMC Board of Trustees and New Hanover County Board of Commissioners.