Small Size as an Advantage for Rural Hospitals: Providing Individualized Patient Care is Easier to Achieve


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This article is part of the Dexur's Rural Health Newsletter, which is focused on Rural Healthcare’s operations, technology, quality, safety, risk, compliance and learning topics. Please email DexurRuralHealth@dexur4.com to join this newsletter and receive updates (not more than once per week)

The capacity for individualized patient care is a significant metric for healthcare quality and outcomes. In smaller rural hospitals, the scale of operations lends itself to a more personalized approach, particularly when managing chronic conditions such as heart failure (HF), acute myocardial infarction (AMI), pneumonia (PN), and chronic obstructive pulmonary disease (COPD). For these conditions, a typical rural hospital may see fewer than 200 patients over three years as per Centers for Medicare & Medicaid Services (CMS) measures, averaging about five patients monthly. This volume is distinctly manageable compared to larger systems, which often struggle to provide individualized follow-up care due to higher patient numbers.

Personalized patient follow-up is critical because readmission and mortality are metrics is a game of inches where every single percentage point matters. The difference between being in the bottom 10th percentile or the top 90th percentile often hinges on each case of readmission or mortality prevented.

Consider a rural hospital initiating a Post Discharge Follow-Up Program aimed at reducing readmission and mortality risks. Targeting the five patients a month who influence these measures, the program could involve four follow-up actions per patient within 30 days of discharge—one follow-up per week. This amounts to approximately 20 actions in a month. Such a workload is not only feasible but could be efficiently managed by a part-time nurse or discharge planner.

This scale of operation, where a health professional can feasibly conduct follow-ups daily, is not just manageable; it can also be deeply impactful. It allows for the tailoring of care to individual needs, the addressing of potential issues before they escalate, and the fostering of a relationship that can lead to better patient compliance and satisfaction.

Furthermore, Dexur’s Unified Quality and Incident Management System offers an out-of-the-box form specifically designed for a 30-day post-discharge follow-up plan. This tool is invaluable in ensuring a standard quality of care is maintained across each patient interaction. By leveraging such a form, rural hospitals can systematically address the needs of each patient, track the effectiveness of follow-ups, and integrate this data back into their care protocols.

The advantage of smaller patient numbers is the opportunity for a high-touch, detailed approach that large hospitals often cannot provide. By focusing on the manageable scale of patient flow and utilizing efficient tools like Dexur’s platform, rural hospitals can turn their size into a strategic advantage, ensuring that each patient receives the attentive care that can make a tangible difference in outcomes.