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Crete Area Medical Center

  • Location: Crete, NE
  • Award: Rural Healthcare Organization of the Month
  • Awarded: March 2012

About Us

Crete Area Medical Center (CAMC) is located in Crete, Neb. We serve our patients from two rural health clinics in Crete and Wilber, as well as, a critical access hospital for the residents of Saline County and surrounding areas. We are a wholly owned subsidiary of the BryanLGH Health System in Lincoln, Neb.

Our primary campus is located in the largest city in Saline County, Crete, Nebr. Crete is a growing multicultural community with 28.8% of the population indicating an ethnicity other than Caucasian, according the 2010 census. Of these residents, 20.2% report coming from a Hispanic or Latino origin. Another reflection of our uniqueness is that nearly 20% of the population speaks a language other than English in their homes. Due to our local industry, more than 30 different languages are spoken in the workforce.

All of these components provide opportunity for us to deliver progressive and innovative health care solutions, as well as position us as a leader in the changing landscape of health care.

The Journey

Four short years ago, we began a journey to make a difference in our community and lives of the individuals we serve through compassionate and exceptional care. Our vision is to completely transform the culture and provision of healthcare at the Crete Area Medical Center resulting in the destination of choice for patients, physicians, and team members. A core of our journey hinges our team's belief in “measure-vention”, concurrent performance improvement, with four guiding principles: 1) every contribution to the team is valued and vital, 2) what we measure gets improved, 3) insanity is doing the same thing and expecting different results, and 4) we have opportunities, not problems. These phases are burnt into the hearts and minds of our team, and can be heard in our halls each and every day.

With this background, it is my privilege to share with you some of our successes:

People

Team Member EngagementTalented team members are the foundation of our success at the Crete Area Medical Center. Today's success has been made possible through our team. In 2012, our team member engagement index is at the 99th percentile nationally with a 90.1% response rate. This journey hasn't been easy. Of the original leadership team, 25% are still in their roles, 15% are in different leadership roles, and 60% have been recruited to meet the changing needs of the organization. This team has cultivated manager effectiveness and change readiness also at the 99th percentile in the nation according the Advisory Board Company. In our culture, engagement is also evident in our culture of safety results measured above the 99th percentile nationally for teamwork across departments and teamwork within departments. This level of strong teamwork creates an environment of highly reliable and safe care and service for our patients and community.

Quality

In 2009, the Crete Area Medical Center set an idealistic strategic goal to measure the difference they make in lives of their patients through high value care. Our call to action is the fact that one out of every two adult Americans have at least one chronic illness, consuming 75% of the national healthcare spending. These statistics came to life. In 2010, 627 of our patients had been diagnosed with Diabetes; 1,100 diagnosed with Hypertension; and 520 diagnosed with Hyperlipidemia.

We listened to our patients' concerns, considered the overwhelming cost of health care, and examined the overall well-being of the community in order to develop a personalized plan for managing our patients' health, chronic disease, and preventive screenings for the future. This is known as a Patient-Centered Medical Home.

In 2010, the National Committee for Quality Assurance recognized CAMC as the first and only rural health clinic to become a true Patient-Centered Medical Home and only third medical home in state of Nebraska. In March of 2011, our level of recognition was enhanced to the highest level of distinction, Level 3, due to the high level clinical results and outcome of the Patient-Centered Medical Home. Today, the results of a physician lead clinical integration, evidence based practice, and team driven care model continues to reflect our commitment to community health improvement:

  CAMC NTL CAMC
DIABETES Q3   2009
Routine Visits 1/6m 85%   68% (1/yr)
HgBA1c within 6 m 65% 24%  
HgBA1c <7 percent 58% 40%  
HgBA1c >9 percent 7% 36%  

Ntl Cost: $11,744 per diabetic per year. 2.3 times more spending than average. The occurrence rate of diabetes is 3 times higher in Hispanic adults.

HYPERTENSION Q3   2009
Routine Visits 1/yr 92%   54%
BP < 140/90 70% 29%  
ACE inhibitor 61% 40%  
HYPERLIPIDEMIA Q3   2009
Routine Visits 1/yr 84%   46%
LDL <100 mg/dl 78%    
Lipid lowering med 57%    
Ntl Cost: CVD and Stroke $5,864 per person year
ATRIAL FIB Q3    
Med mgt anticoagulant 78% 60%  
Therapeutic 82% 61%  

Savings: Therapeutic patients avoid $600 per year in testing and $1,600 per year in unneeded ER visits and inpatient admissions (CAMC).

PREVENTABLE & CURABLE CANCER* (health reform 1/1/11) 2011 Increase Impact  
Cervical Cancer
(Pap test – females 21-64)
125% 99% preventable  
Breast Cancer
(Mammogram – FM +50)
69% 98% curable with early detection  
Colorectal Cancer
(CRS +50)
282% 90% preventable w/polyp detection  

Ntl Cost: Annually, 357,916 people are diagnosed with these three cancers ending in the death of 97,838 people and Costing the nation $15.7 billion in treatments.


As you can see, the physicians, team members, leadership, and board are 100% invested in significantly bending the curve in health outcomes and the related costs within our community. The medical home embraces the unique needs of our community, and highlights our investment and accountability in our patients' health journey.

Service

Compassionate and exceptional care is our competitive advantage. We are located within twenty miles of three large full service community and tertiary hospitals. Therefore, our distinction is an environment of amazing service including interdepartmental service, physician engagement, and patient satisfaction. This environment is a highly reliable culture of caring demonstrated by pre-visit and wellness calls; a warm home-like organizational spirit; dedicated multi-discipline care teams; medical home attention to planning your health and continuum of care; encounter goal setting with hourly rounding to exceed patient and family expectations; visible mission focused leadership and physicians; and post-visit care calls to support healing.

Today, our interdepartmental satisfaction and physician satisfaction have increased 40% and inpatient overall patient satisfaction doubled to 91st (FY2010) and 98th (FY2011) percentile over a four year period. Into this healthy environment, we have recruited four physicians and 5 mid-level providers composing 90.9% of our current provider team.

This fall, our providers engaged a physician coach to help them focus on holistic view of the practice of medicine. In the past, each key success factor was monitored by discipline such as patient perception of care, quality outcome measures, peer relationships, coworker relationships, and practice growth (new patients). Now, the dashboard reflects the complete picture of practice. The coach, along with the medical home journey, continues to equip us to adapt from good to great across all areas.

Growth

Throughout our journey, the organization has grown in net revenue and primary care encounters demonstrating our community's support of the organization. This year with health care reform looming, our team shifted its focus to efficiency, measured by net revenue per FTE, using tools like lean to increase our efficiency point by 9.5%. This type of adaption to the new normal of health care has become a necessary core competency in the environment of value based care and consumer transparency.

Finance

The amazing results driven by the people, service, quality, and growth pillars have created a significant financial impact including: an average four year operating margin of 8.5% (4.07% state CAHs and .67% national CAHs) and year-to-date 8.2%, an increase in days cash on hand from 130 days to 287 days (111 days state CAHs and 61 national CAHs), and $10 million or 52% increase in net assets including $4 million of construction funded from operations.

The Crete Area Medical Center team is honored to be selected as a Studer Group Healthcare Organization of the Month. The success of our journey could not have happened without the unwavering engagement of our awesome team. Thank you again for this wonderful recognition of our accomplishments!

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