North Big Horn Hospital District’s quest to be the best


Nurses Wendy Wilkerson and Beth Zollman take patient Pansy Buckman’s vitals during a recent hospital stay. Patti Carpenter photo
Nurses Wendy Wilkerson and Beth Zollman take patient Pansy Buckman’s vitals during a recent hospital stay.
Patti Carpenter photo

What do 24 nurses, five lab techs, 15 housekeepers, four maintenance workers, five radiologists and North Big Hospital’s CEO have in common? According to NBHH CEO Rick Schroeder, it’s the never-ending pursuit of excellence.

“I think that the quality that a hospital provides begins at the beginning of every conversation, every training, every decision and more importantly, every encounter with every patient,” explains Schroeder. “It is a relentless pursuit of no accidents.  No mishaps.  No medication errors.  No falls.  Superb communication between patients, their families, caregivers such as lab techs, x-ray techs, respiratory therapists, physical therapists, nursing and medical staff.  Answering call bells as quickly as we can.  Managing pain.  Providing a comfortable room.”

The hospital staff celebrated Patient Safety Awareness Week this week along with fellow members of the American Hospital Association across the nation. The idea behind the special week is to raise community awareness about what the hospital is doing to assure the highest quality of care and safety for its patients.

According to Quality Director Tracey Walker, patient safety is the top quality priority

“For each area of concern we evaluate our current status and work on a plan to improve and reach specific targets (generally determined by state and national thresholds),” explained Walker. “The plan varies depending on what components we find that need improvement; we involve multiple departments at times and meet and review the cause of safety related events.  Changes in process, equipment, staff education, improved resources, and communication are all frequently components of our process improvement.”

According to recent surveys conducted by Medicare (HCAHPS) and focus groups made up of community members, the staff at NBHH is right on target with that goal, but that’s not enough, said Chief Nursing Officer Tina Toner.

“We don’t want to give good care or even great care, we want to give excellent care,” said Toner. “No matter how good we are, there’s always room for improvement. We do that through education and following the best clinical guidelines.”

Some of the factors used to measure that quality of care are the number of patients falls, medication errors and readmissions rates, which are all very low compared to other hospitals.

Additionally the district participates in a random survey of patients conducted by the Centers for Medicare and Medicaid Services called HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems).

The survey asks 32 questions regarding the patient’s experience covering topics like how well nurses and doctors communicate with patients, responsiveness of hospital staff, pain management, communication about medicines, discharge information, cleanliness and quietness of the hospital environment. It also asks the patient to give an overall rating of the hospital and asks how willing they would be to recommend the hospital.

The HCAHPS survey is administered to a random sample of adult patients across medical conditions between 48 hours and six weeks after discharge; the survey is not restricted to Medicare beneficiaries.

“Our HCAHPS scores speak for themselves such as reflected on the Hospital Compare website (www.,” said Walker. “There is always more to be done in order to reach the highest quality of care possible, but we are well on our way and I believe our patients opinions are a direct reflection of the quality of care provided.”

The district also obtains feedback through focus groups, which are small groups of people who are asked to give their perceptions, opinions, beliefs, and attitudes regarding the services provided by the hospital district.

“We recently had a group from Powell that spoke to several focus groups made up of our community members regarding their satisfaction of their health care,” said Schroeder.  “The group told us that we have excellent, caring staff, our facility is clean, the food is very good, and they are surprised just how much a small hospital in a small community like ours can do.”

Schroeder said some of the quality-related goals that have been set for staff include answering call bells right away, making sure the rooms are comfortable, quiet and contribute to healing, that nurses are kind, compassionate and are truly patient advocates and that those nurses have immediate access to providers.  He said the hospital delivers more than 5,000 medications to patients every month, with the goal of making zero mistakes on the distribution of those medications.

“That takes intense training, education and awareness,” he said.

As far as complaints are concerned, Schroeder said the staff is trained and has the authority to “make things right on the spot.”

By Patti Carpenter