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Mercy Hospital Gaining, Losing Under ER Plan

February 6, 2013

Keith Heuser

Valley City’s Mercy Hospital is losing all its physicians assistants at the same time it has reached an arrangement so that a physician will be in the building at all times to ensure full care in the Emergency Room, said Keith Heuser, hospital administrator, Tuesday.

Heuser said that Mercy has decided to contract with a specialty ER coverage service. This service will provide doctors trained in emergency services in the Mercy ER 24 hours a day, seven days a week, 365 days a year. This, in conjunction with the electronic/video system that links the Mercy ER with emergency room specialists in Avera Health, Sioux Falls S.D., will provide a more updated response in the ER.

Heuser said that few people realize that Mercy hospital is a Level IV trauma center. This designation places greater responsibility on the facility to ensure that specific trauma treatment training of all the Emergency Room nurses takes place, that the ER is staffed by physicians and that specific response times in the ER are met. Until recently, the level IV physician requirements have been filled and met by the local medical staff.

“The residents of Barnes County and surrounding areas do not realize how fortunate they have been to have as committed a group of physicians as we have in Valley City. They have sacrificed their personal and family time to provide top notch care in our Emergency Room at no cost to the hospital or community,” Heuser said.

Heuser said things are changing partially in response to the demands of emergency room coverage on a smaller medical staff. He said the change will give the medical staff time away from worrying about ER coverage and to ensure that there is 100 percent coverage of the ER by a physician. The move is also a reflection of the responses received as part of Mercy’s patient satisfaction system. “Patients in the ER have expressed a desire to see the physician more quickly and to better understand the care they receive in our ER. This is a major step to meeting and exceeding those expectations.”

Heuser said moving away from the model that allowed the hospital to use physician assistants is the most difficult part of the change. “These midlevel providers were a great asset to the hospital and very highly regarded health care providers in the community. Their commitment to this community and to exceptional healthcare services was invaluable. They were the core of our Emergency Room treatment team and we are extremely grateful for their service here.”

However, said Heuser, “In the long run it (the change) will be very positive for the medical staff.”

The target date for getting the new arrangement into to operation is May 1. Heuser said all Mercy physician assistants were told about the plans early, and all were offered other employment within the CHI system, the corporate parent of Mercy Hospital. Heuser said no Mercy physician assistants decided to accept the offer.

“By providing the ER coverage using a contract service it allows the local physicians to spend more time in their clinics seeing their regular patients. This improves their responsiveness to their own patients and patient satisfaction. It also improves the quality of life for the local physicians and improves recruitment of outside physicians to our community because they don’t have to take call. This is a major source of dissatisfaction for physicians in smaller communities that cannot afford the more expensive ER contract services. Physicians who are looking to make career changes often look for communities that do not have an ER call commitment. This is a very exciting change for the hospital and demonstrates its commitment to the medical staff and to improving services and responsiveness to the community.”

Comments

NOT a Positive change

February 6, 2013 by VC Citizen (not verified), 1 year 10 weeks ago
Comment: 17649

This is a ridiculous move by the hospital. First off it makes it sound as if the PA's were all offered jobs and everything was just laid out so kindly for them, NOT the case. They were NOT offered jobs. They were informed that other CHI hospitals had openings, but not a single one of the 3 were given an actual job offer to accept or deny.

Secondly the town physicians will not be helped out by this as much as the article leads you to believe. These doctors will still have to be on call for the nursing home facilities as well as their individual practices and their respective patients in the hospital. So, it won't be giving them all this "free time" with their families. Not to mention that the company the hospital is trying to use to outsource to, is wanting to employ our local physicians to take call and back-up for them. So, exactly how is this helping anyone?

Being a trauma center is important. But the difference between a level IV and level V trauma center is that level IV requires a physician to respond with in 20 minutes and a level V requires a physician, physician assistant or nurse practitioner to respond within 20 minutes to a trauma. Currently traumas brought in from 5pm-7am and on weekends are seen immediately by the PA on duty and then a doctor called in to respond within 20 minutes. In both cases, our hospital is a stabilize and transfer to higher level of care. The majority of Critical Access Hospitals in North Dakota are level V.

This new plan is taking jobs away from people who are a part of this community. Not to mention as stated in the article "smaller communities that cannot afford the MORE EXPENSIVE ER contract services." So, if this service will be costing the hospital more money what makes it such a good plan?

I don't know ALL the patient satisfaction results, but I cannot imagine wait times being a serious problem as critical access hospitals require a provider to see the patient within 30 minutes. I would imagine the longest response times are during the daytime hours of 7am-5pm when the community doctors are covering their clinic and the ER. The response time could be easily dealt with by hiring one more PA to cover the day time hours Monday-Friday. This not only would help response times, but would also free up the physicians to take better care of their patients in the clinic. It would also bring in another person to the community, not get rid of 3 valuable PA's and their respective families.

I do NOT understand how outsourcing our emergency room coverage to an out of state company, will ever be a positive change!

Mercy Hospital is a BUST

February 12, 2013 by citizenVC (not verified), 1 year 9 weeks ago
Comment: 17771

In reading this article, it is clear that with in the next few years Mercy Hospital will be one of the many hospitals that will close its doors for mismanagment, and financial loss.
1. It does not require a rocket scientist to know that when you outsource for a physcian it is going to be considerablly more expensive then employing your own.
2. Mercy Hospital is slowly losing ground, it lost it's OB department a few years back, and eventually the ER will not be financially feasible either. Once the ER is gone, the hospital will not beable to opperate as a Critical Access Facility, therefore making it unable to collect Medicare payments or insurance payments.
3. Mercy Hospital seems to not understand the "community hospital" image. It currently contracts for the majority of its nurses, and now it is going to lay off 3 PA's and replace them with doctor's from some organization that the community is unaware of???? That does not make sense to me.
4. Are you telling me that if I am hospitalized, that my PRIMARY CARE PHYSICIAN will not make rounds, and I will be seeing some internal doctor???? Or is my Primary still going to be responsible for my hospitalized care, while this substitute is only going to see me in the ER????
5. I always knew that when I went to the ER, I may not be able to see my own personal physician, but at least had some level of trust in the physician I would be seeing. The physician's came from this community, and could access my medical records if it was necessary or could access my physician if necessary. Now that is not going to be available.
6. Somehow I am suppose to feel at ease because if the doctor needs to link with a larger hospital it can link with Avera in Souix Falls??? What about Sanford or Essentia in Fargo, where care that could not be met at Mercy would be continued????
7. Basically what Ken has said is "In a small town like Valley City, you are going to become a number, when you have a medical emergency. You are not going to be seen by someone who not does not know you, they do not know your children, parents, grandparents, aunts, uncles, cousins, nieces, nephews. Typically they do not know you for the person that you are, they KNOW you as a number that walked into the ER that day.
8. I guess if that is the kind of care Mercy Hospital wants to provide, I will bipass Mercy, and go to Fargo. At least then I will know that if I require hospitalization, they will have access Sanford/Essentia medical charts, and will at minimum be able to know my history

BAD and SAD move for a "Community Hospital" that no longer wants to serve the community.

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