Latest COVID vaccine now available at hospital

The North Big Horn Hospital District Board of Trustees meeting took place on November 21 at 7 p.m. 

The budget was the first item of business. Eric Connell, CEO of North Big Horn Hospital District, said that operating expenses year to date have been $8.9 million while the yearly budget is $9.6 million. The hospital is currently trending under budget. A motion was made and passed to approve the payables. 

The latest COVID-19 vaccine is available for Big Horn County residents, said Amber James, North Big Horn Hospital clinical manager. Anyone who received the original vaccine can call the clinic to schedule an appointment for the new vaccine. 

The next item of business was the New Horizons Care Center report. Connell said that four employees have tested positive for COVID-19. To mitigate the COVID-19 risk, doors to the care center are closed. 

For those wanting to spread Christmas cheer, they can grab a stocking and sponsor a care center resident with a Christmas gift. Additionally, care center residents will be recording Christmas greetings for the radio.

The OR manager for the hospital is transitioning to working part-time in February, which leaves little time to replace her, Connell said. So far, there is only one applicant.

“I think the correct wording is little time, because the position that will be replaced as OR manager, I’d like to have them have some overlap for some of that training,” Connell said.

The hospital is ranking better than average on various metrics compared to other rural and critical care hospitals nationwide, Connell said. Overall, they are ranked in the 94th percentile on all metrics measured.

At their best metric, the hospital ranks in the 100th percentile for quality. At their worst metric, the hospital is ranked at the 10th percentile for cost.

The area where the hospital ranks lower than average is cost due to the rural nature of the hospital as well as cost associated with the nursing home, he said. 

The hospital participated in cybersecurity training in Missoula and upgraded their cybersecurity that was geared toward healthcare leaders, Connell said.

Cybersecurity threats are one of the biggest risks for every hospital across the country, said Clint Seger, CEO of Billings Clinic, who was visiting the hospital district meeting. 

“There’s not one hospital or healthcare system in the country right now that that’s not one of the top things around risk,” he said. 

It is important that anyone in a hospital who is in a leadership role is connected to making sure that the hospital has a top-notch cybersecurity team, he said. 

Ambulance director Scott Murphey presented on a special opportunity to buy an ambulance more cheaply and save up to $100,000. One of the hospital’s three ambulances needs the chassis refurbished, Murphey said. 

With the mountainous and wintery conditions of the area, a specific type of vehicle is needed, Murphey said. One option is to use a new chassis and remanufactured box, the area in the car where the patients go. The other option is to purchase a completely new ambulance, he said. 

Although the purchase of a new ambulance may not be in the current fiscal year’s budget, a company was found that could float the needed money until the next fiscal year. The decision to buy the ambulance was shelved for a later date. 

Next, a motion was made and passed to reappoint medical staff privileges for Mark Ryzewicz, MD and Patrick Cobb, MD. A motion to request medical staff privileges for Troy Graybeal, MD also passed. 

The hospital received a grant to buy two ultrasound equipment, Connell said. The machines are being sold at a lower price due to a promotion from the vendor. The hospital wants to buy two point of care ultrasound machines called the Trophon2.

A motion was made and passed to pay for the ultrasound equipment. After that, a motion was made and passed to continue the professional services accounting agreement with the Billings hospital. 

The last item of business was a presentation on a potential robotics program by surgeon Michael Hill. Using robotics to aid in surgery results in improved surgery outcomes, lower length of stay, lower complication rates and less prescription pain medications needed, Hill said. 

One area in which robotics are helpful is during a colectomy, he said. In the past, a surgeon would just look at where they think the blood supply is and use their best judgement to remove the needed part of the bowel. While surgeons normally guess accurately, you can now see exactly where the blood supply is and know you will have adequate blood supply to put the bowel back together. 

The robotics would mainly be used to enhance surgeries that are already happening instead of doing the entire surgery, Hill said. One service that would now become feasible for the hospital to do with robotics would be tubal litigations, hysterectomies and prostatectomies. 

The robots would be paid off over a five-year period, Connell said. Based on current projections of how the robots would be used for surgery, it would be a financially viable investment for the hospital based on the services they provide, he said. 

While the board did not authorize an agreement with the robotics program during the meeting, they authorized Connell to start negotiating with the robotics company. A special board meeting was scheduled for November 30 at 6 p.m. to discuss the issue further and allow Connell time to put together the negotiations.