Van Diest Medical Center.

With Fiscal Year 2019 in the rearview mirror, Van Diest Medical Center’s administration, providers and staff are celebrating successes on several different fronts.

Chief Executive Officer Lisa Ridge, Chief Financial Officer Alice Heinrichs and several members of the staff as well as providers sat down to look how the hospital fared in the just-ended fiscal year.

Ridge said the four pillars of the organization — Growth and Community Involvement, Service Excellence, Quality Excellence and Continuous Improvement and Financial Performance — reflect the goals and core values of VDMC.

“We’re dedicated to our people,” said Ridge. “We’re driven on our core values of compassion, accountability, respect, excellence and service. Everything we do, we keep our people and our patients at the forefront.”

he said as the hospital moves into the future, the administration, board of trustees, providers and staff are committed to making decisions to that VDMC remains a financially stable and viable community hospital.

“We’re up for the challenge as health care changes,” she said. “And it changes every day. There are new regulations, new best practices and new reimbursements. As those changes occur, this hospital has to change with it to be able to serve the community.”

Financials

Operationally, VDMC has had many changes over the past several years that have positively effected the hospital’s financial standing.

“Fiscal Year ’17 alone was a huge building year for us. We on-boarded new providers, expanded and added new services. We also implemented a new EMR (electronic medical records),” Heinrichs said.

Several new lines of service were initiated at the hospital in the past year and with new or expanded services there are always additional costs, Heinrichs said, which hit the bottom line.

“With new providers, it takes time to ramp them up to where they need to be to serve the patients,” she said. Adding new services or tools can also disrupt the day to day operations until they are fully implemented and operational, she said.

Heinrichs said the organization’s leadership and staff have worked hard to make sure the changes have produced positive returns for VDMC.

“Fiscal Year ’18 actually resulted in a $2.8 million positive increase to the operating margin as compared to FY’17,” she said. As VDMC closes out Fiscal Year 2019, Heinrichs said the operating margin should further improve over the previous year.

“Our total cash has actually grown by 20 percent,” she said.

Heinrichs said with the optimization of the electronic medical records, patient accounts are being paid about 8 days sooner. Additional savings have come from group buying contracts and close inventory management.

“That’s caused a reduction in our supply costs for the facility,” she said.

Focused analysis of each service line is conducted on an ongoing basis.

“We want to make sure the services are utilized and provide value to patients,” she said.

Even with all of the growth and investment in new providers and services, the property tax asking has remained the same for the past five years — $2.10 per thousand of valuation.

New services

Dr. Benjamin Willis, a podiatrist is one of the new providers at Van Diest Family Health Clinic. He joined the staff last November.

“I practiced in Ames for three years and its been a wonderful transition to be at Van Diest,”he said.

Willis said he appreciated the cohesiveness and collaboration with his fellow physicians, something he says makes for a strong working relationship.

“My first priority is to provide conservative care. As people need additional care, it’s great to be able to provide surgical care as well,” he said. Willis provides ankle and foot surgery at VDMC.

Dr. Subhash Sahai, a family practice provider at Van Diest Family Health Clinic, said the affiliation with MercyOne offers many benefits to the medical staff.

“Access is a big thing. There’s seamless access,” he said. “To be able to get our patients the help that they need. It’s really a great extension of what we offer here .”

Willis agreed.

“I’ve had opportunity to visit with Mercy doctors about mutual patients or patients that are traveling down for care. Since we’re part of the network, they’ve got access to x-rays and test results. It’s easier for the doctor and patient alike,” Willis said.

Originally, podiatry services were only offered a few days a month, but after evaluating the service, Ridge said the clinic added Willis to its list of providers. In addition to the care he provides at the clinic, Willis also provides foot care at area nursing homes.

Mental health has been a concern across the state, and specifically in Hamilton County, it was one of the top concerns from the recent Hamilton County Community Health Needs Assessment.

“We have several different entities providing mental health services, including Senior Life Solutions and we have counseling. We had a licensed independent social worker but we really evaluated and found that we needed a practitioner. So we added Amy Larson, a mental health nurse practitioner,” said Ridge. Larson started at the clinic in February.

“She’s really serving a huge need in the community,” she said.

E-services were added last fall, giving patients the opportunity to have integrative medicine appointments wherever they may be. All that’s needed is a computer or iPhone to access the tele-health services.

A ketamine clinic was added in January of this year. The clinic offers both nasal and infusion ketamine.

“We were the first hospital in the state of Iowa to get approved to use nasal ketamine,” Ridge said. “This medication has traditionally been used as an anesthetic, but it’s really been shown to be effective for mental health and PTSD, as well as chronic pain.”

The program has grown rapidly, Ridge said, with not only Hamilton County residents taking advantage of the service, but people from outlying areas traveling to VDMC as well.

In May of 2019, the facility began to offer orthopaedic clinics twice a month. Dr. William Jacobson, a board-certified orthopaedic surgeon, specializes in sports medicine, knee and shoulder surgery and general orthopaedics with a special interest in cartilage restoration of the knee.

“That was a real void we had in the community,” Ridge said, adding, “It’s really important for service lines to evaluate and make sure we can serve patients locally.”

The clinic also added additional primary care providers in Fiscal Year 2019 — Mari Kait Keane. PA-C, and Amanda Langford, ARNP-C.

“We are continually recruiting for another family practice doctor or internal medicine provider,” Ridge said.

“The whole idea is that we’re serving not only Hamilton County but the surrounding area, too, with many different services. We want to meet the standards that are required of us. And I think we not only meet but exceed those standards in many areas,” said Sahai.

Volunteers

Chris Wright, service excellence manager for VDMC, said volunteers play an important role at VDMC and assist in many areas of the hospital.

“We have an amazing group of men and women here who donate their time and talents to help us deliver care in a much better way,” Wright said. The volunteers are considered non-clinical care givers.

Many of the volunteers are involved in the hospital auxiliary. The group meets every other month to work on blood drives, fundraising events, and events. The hospital gift shop, is an extension of the auxiliary and is also operated by volunteer staff. The auxiliary also provides two scholarships to students planning to pursue health care careers.

Several volunteers work the greeter desk at the hospital entrance.

“Along with our admitting staff, their friendly faces are among the first you see when you arrive at VDMC,” she said.

The bedside volunteer program is new and Wright said the first year has been a building and learning year for the program. Additionally, a comfort menu has been added to help offer items of comfort to patients.

The comfort menu was developed by VDMC employees and the employee advisory committee. Examples of items on the comfort cart may include gum or mints, crossword puzzle books, hair ties, music, and other things that bring comfort to those in the hospital.

“The comfort cart has been an excellent tool for us to really deliver exceptional care,” Wright said.

Improved patient satisfaction scores reflect the importance of each department of the hospital and the volunteers, as well, according to Wright.

Anna Anderson, director of quality management, concurred, pointing to the strength of the organization’s teamwork.

“There’s always been this desire for kindness,” she said. “The programming has really allowed us to shine in that respect, too.”

Anderson talked about one of those programs. The continuity of care team works with those patients who have had at least four unplanned visits to the hospital. Those visits would include unplanned admissions or trips to the emergency department over a period of about six months.

“We partner with the clinic, with our specialty clinics, local agencies that also provide care for that person,” she said. “We communicate a lot back and forth and meet about every two weeks. The folks who are identified kind have a little case report. How are they doing and what are we doing for these folks?”

In the first six months of the program’s existence, none of the patients were readmitted to the hospital. Anderson estimated that there was about $250,000 in cost savings to the patients — about $8,000 each.

“We’re really looking at individualized needs. I think that’s the transition of the future. People just don’t just need to pick up their prescriptions and go home. They may need a ride back to the doctor. They may need individualized time with a pharmacist,” she said.

One way VDMC reaches out to patients who are leaving the hospital is through its EMS team home visits. A couple of days after the patient goes home, an EMS team visits to see how they are doing. The team assesses the patients condition, checks incisions, makes sure they understand medications and other post-hospital instructions.

Anderson said staff members also have actively worked to find solutions to help patients, including preventing falls. She said because of those efforts, there haven’t been any falls at the hospital in the past six months.

“Before that time, during my tenure, the longest we had gone was two months without a fall,” she said. “And to our aging population, falls can mean a lot to their quality of life and life span going forward. We want to prevent those in the hospital and at their homes as well.”

Mari Jo Timmons, inpatient nurse manager, has a wealth of health care experience, but is relatively new to VDMC.

“I felt like one of the family since I came through the door,” she said. “We have a very well-versed staff. We take care of a lot of things here — we’re a very busy critical access hospital,” she said. She added that employee appreciation efforts offered by VDMC is helping to drive a strong morale at in the organization.

“We not only want this to be a wonderful place to work, but also a place that the staff provides quality care,” she said.

She said one of her goals is to find ways to “work smarter, not harder” — having everything the staff needs right at their fingertips.

Community engagement

Lori Foster, director of public relations and marketing, said in the past year, the staff been encouraged to get involved and give back to the community.

“We are a community hospital, but let’s take it beyond our walls where we can positively impact people’s lives where they live, work and play,” she said. “We set a goal to complete 500 community engagement hours and they far surpassed that goal in Fiscal Year 2019.”

That goal has been increased for the coming year, and the staff has embraced the challenge, she said.

Some of the ways the hospital staff has contributed to the community include serving as a sponsor for the Hamilton County Fair, helping to sponsor Relay for Life, working with the police department for their BLUE program and Christmas at the Bridge.

“We brought back our community Halloween event, providing a healthy event for hundreds of kids,” she said. Two teams participated in Warm Hearts, Warm Homes, and partnered with the City of Webster City to do community cleanup and mulching during National Hospital Week. A Walk with the Doc program gets community members out and walking along one of the area trails with one of physicians from the hospital.

Staff members contribute to the nonperishable goods drive, which are located on tables throughout the facility. The ongoing service allows those in need to pick items they may need.

“They can take whatever they need and we encourage that,” she said.

New this year was the Boone River Run, a 5K event at Briggs Woods Park. The proceeds from the event went back to Hamilton County schools, according to Foster.

VDMC also offers many community educational opportunities throughout the year, she said.

“We want to help people live their best lives,” she added.