- The Next Era of Excellence in Healthcare
- The Four Elements
- One-Stop Care
- Growth and Changing Healthcare Dynamics
- Funding for the Next Era of Excellence
- Frequently Asked Questions
Growth combined with the desire to create a better patient experience through coordinated care is driving the need for additional space on the Pullman Regional Hospital campus. These dynamics and new ones we will face in the future require us to expand our thinking and apply the convenience we experience in other parts of our lives to our healthcare experience. We can achieve this not only for today but also for generations to come. That's why we are looking ahead towards The Next Era of Excellence at Pullman Regional Hospital.
We are proposing a measure on the April 23rd ballot to Pullman voters to help fund The Next Era of Excellence.
The Next Era of Excellence consists of four main elements:
Community-Wide Electronic Medical Record - A key feature of the Next Era of Excellence is a community-wide electronic medical record that connects medical offices and hospitals in the region and even the state of Washington. Imagine not having to fill out another form at another facility because they already have your information. The community survey administered last summer shows that hospitals and clinics being on different computer systems is a patient's most frustrating part of the healthcare experience. We are evaluating systems that provide this seamless, electronic medical record capability. Funding for this component is estimated to be $8 to $10 million. This includes acquisition of the software system, implementation, and ongoing support, along with converting physician offices to the same system as the hospital. With the proposed funding in place, our estimated timeline for purchase is 2019 and implementation and conversion in 2020.
Redesign of Current Hospital Space - We are looking to reconfigure space for some of our services to provide greater efficiencies and a better patient experience. We would move the laboratory to the second floor of the new Same Day Services building to free up space to provide expanded respiratory care and imaging, along with other medical services.
Update of Medical Equipment - Keeping pace with medical technology is vital to the quality of care we deliver. The latest in medical technology or equipment, whether in surgery, radiology or the lab, is expensive but expected by patients and providers. Every year, the hospital receives requests in capital equipment and technology averaging $4 million and can fund about $1.5 to $2 million. The Next Era of Excellence gives us the ability to provide the tools and technology for the best patient outcomes.
Community Healthcare Pavilion - To keep pace with the growth in our community, we are proposing to construct a new 45,000 square foot building called a pavilion, adjacent to the hospital. This would allow us to achieve a vision of one-stop care where healthcare professionals can work more closely and collaboratively than ever before and patients could get a variety of services for themselves and their families all in one place in a time-efficient manner.
Potential services housed in the pavilion could include:
- A Center for Women's & Children's Health for centralized and convenient services all under one roof and on one campus
- Expanded diagnostic and therapeutic services
- Physician offices and clinics
- A new medical residency program to build a pipeline of physicians for the region
- Updated and additional medical equipment located close to or in physician offices
- Room for care coordinators and navigators who can guide and make appointments for the patient
- Expanded fitness and wellness services
- A system-wide electronic medical record, an essential technology to provide a coordinated experience for patients that allows physicians to view all the patient's medical history
- Medical Simulation Training Center to keep our clinicians' skills up to date.
We believe care can be delivered in a better way - in a coordinated, efficient, and convenient manner for the patient. By housing as many medical services in one location, patients receive an improved experience, with the convenience of services being co-located right next to their physician, caregivers consulting on-site in close proximity, and centralized scheduling.
You call one person to set up all your medical appointments for one time and in one place. You are assigned a care coordinator who greets you and helps you navigate through your appointments and follow-ups. You may drop off your children at an on-site childcare center. You see your primary care provider or specialist here at the hospital and receive any diagnostic or preventive services in the same location. You speak to a financial counselor to understand what your charges and out-of-pocket costs will be before you get the bill. You may discuss your care options with your care coordinator. Your physician may consult with other physicians in the same building at the same time to discuss your case, and your care coordinator gets back to you with a proposed care plan.
The Mayo Clinic and cancer centers have been successfully operating under this model for some time and have seen the value of physicians, specialty and hospital care under one roof on one campus.
Growth in our community continues at a steady rate. The City of Pullman has predicted about 6 percent growth by 2025. This growth will put more pressure on our healthcare system and demand for medical services. At the same time, outpatient visits at Pullman Regional Hospital have steadily climbed by 21 percent over the last five years and they are forecasted to grow by another 23 percent over the next seven years. Additionally, there is continued demand for family medicine physicians and specialty care. Click here to download the Executive Summary from the community growth report from Emsi. Along with the growth of Pullman Regional Hospital, the dynamics of healthcare are constantly changing. It is no longer enough to have an excellent hospital. Coordinated care or "one-stop care" in which facilities, technology, and medical providers are all co-located by the hospital under one roof is the new model of care we aspire to provide. One-stop care is synonymous with quality care and convenience.
Components of the Next Era of Excellence include:
- Constructing a new 45,000 square foot health pavilion
- Enhancing electronic medical record technology
- Upgrading and redesigning current space for greater efficiencies
- Updating medical equipment
Our plan is to propose up to $29 million community bond to be paid for by residents of the hospital district over 25 years and approximately $11 million through philanthropy and hospital funds. This partnership between Pullman Regional Hospital and the community will allow us to bring both the hospital’s expertise and the community’s capabilities together to create a new reality for healthcare on the Palouse. The proposed tax levy is estimated to be .99 cents per $1,000 of assessed property value of your home as a resident of the Pullman Regional Hospital district.
What this means on an annual basis:
We are experienced in providing and coordinating care. This makes us uniquely qualified to develop, implement, and support the medical and technical education and training needed for a new model of care. You can trust us to take care of what we know and do well.
The community - you - have the ability to make it possible to build the Health Pavilion and technical infrastructure to make this a reality - so that you receive the best care right here in Pullman. This exceptional partnership makes The Next Era of Excellence possible.
Learn more about the Next Era of Excellence with some of our frequently asked questions or by downloading the overview report to the Board of Commissioners.
In 2004, we opened a new state-of-the-art hospital funded by an $8.2 million bond, philanthropy, and bank financing. Since voters passed the 2001 bond for the new hospital, we have worked to be excellent stewards of our public district hospital, including refinancing the original bonds in 2011 – a district taxpayer savings of more than $400,000 over the life of the bond. This bond will be paid off in 2021.
Over the last five years, Pullman Regional Hospital has invested approximately $12 million in plant, facilities maintenance, and equipment and has used hospital reserves and philanthropic gifts to add a fourth operating room and build the new Same Day Services addition to keep up with the growing demand for outpatient care.
An electronic medical record contains your health information and history. Hospitals and physician offices use different software systems or paper records that do not “talk to each other.” As such, most times patients must fill out a form when they visit a new provider. A universal community-wide electronic medical record will serve as a central repository for patient medical records and physician offices and hospitals in the community would be connected to this repository.
The measure will be on the ballot for a vote on April 23, 2019.
The boundaries are the city of Pullman. Those residing in Pullman city limits will be eligible to vote on the bond levy.
The total project cost is estimated to be $40 million. We plan to fund this through a $29 million bond levy and$11 million through the Foundation and the hospital.
Based on the average assessed value of a home in Pullman of $250,000, in 2019 a homeowner will pay bond taxes of $83.00 per year ($6.92/month) for the original bond from 2001. If the proposed bond passes, the same homeowner will pay bond taxes beginning in 2020 of $250 per year ($20.83/month). This is an increase in hospital bond taxes of $167 per year ($13.92/month).
Note: Pullman homeowners are currently paying an M&O levy tax for Pullman Regional Hospital which will continue once the 2001 bond is retired.
If funding is approved and philanthropic support from the community is attained, the plan is to break ground on the pavilion in 2021 and expect to be complete in 2022.
Key roles in the delivery of One-Stop Care are care coordinators, transitional care providers, chronic care managers, mental health professionals, health coaches and educators. Many of these roles can be filled by licensed independent social workers, nurses and health psychologists but we’ll have need for non-licensed professionals, such as community health workers and social work extenders as well. There will be program coordinators for the Family Medicine Physician Residency program, and staff for possible childcare and adult day health services. Finally, we believe there will be a need for expanded therapies such as physical therapy, occupational therapy and speech therapy.
We continue to work collaboratively with other rural hospitals in the region to financially support expensive specialty care. We have been actively working with Gritman Medical Center and Whitman Hospital and Medical Center to bring oncology services to the region. This summer, a new oncologist will be starting at Palouse Oncology in Moscow, and a new full-time neurologist will be starting practice with Palouse Neurology this summer. Both of these practices are shared services of the three hospitals. Additionally, the three hospitals also support Palouse Surgeons, Palouse Urology and Palouse ENT/Audiology. We will continue to work together to bring other needed specialists to the area to serve our community in a cost effective manner.
As a public district, non-profit hospital, our current district boundaries are Pullman city limits. Changes to this would require a community wide effort to redistrict the voting area. Meanwhile, the Pullman Regional Hospital Foundation actively solicits private donations from residents outside the hospital district to support their community hospital.
As the hospital continues to grow and see more patients, the challenges of parking grow. Here are facts on our parking situation and things we are considering as we plan for possible expansion.
- Currently, the hospital campus has 527 parking stalls and 25 of those stalls are designated as accessible.
- It is estimated that with the addition of a possible pavilion, we will need a total of 582 stalls, or a minimum addition of 55 stalls, with 12 of those designated as accessible. Our current 25 accessible stalls exceed the code minimum of 2 percent.
- This spring we will begin a process of reorganizing staff and physician parking which will free up lots next to Sid’s Pharmacy and Palouse Medical.
- We have options for building the additional 55 spaces needed but they do not include a parking structure which is cost prohibitive. We may create more than 55 spaces but it is clear that we will create additional spaces for patients and visitors by reorganizing staff and physician parking.
- Options we are considering that would help with the parking situation and possible expansion are valet and shuttle service.
Pullman Regional Hospital is a public hospital district governed by a seven-member Board of Commissioners, all elected officials. As a non-profit, critical access hospital, we do not get paid 100 percent of the cost of providing our services. Our margin earned after expenses are paid is reinvested in to the hospital and medical services. The hospital’s margin is between 1 and 2 percent annually.
Pullman resident and City Councilwoman
The Next Era of Excellence and one-stop care is a forward-thinking idea whose time has come as we experience growth and continuing need for healthcare in Pullman. A key part of this is moving to an integrated electronic medical record that would allow hospitals and physician offices to have all the same patient information.
Dr. Gerald Early
Chief Medical Officer, Pullman Regional Hospital
The Next Era of Excellence includes continuing to ensure physicians are here to serve the Palouse today and for future generations. We are working with area partners and hospitals to build a medical residency program in Family Medicine.
Dr. Ed Tingstad
Coordinated care means a comprehensive and convenient experience for the patient. Our orthopedic and sport medicine patients could have a pre-operative teaching and instructional experience in a single visit.
Dr. Ric Minudri
If a pavilion was built, we could envision moving our Pullman office there to provide OB/GYN services as part of a women’s center that was co-located by the hospital for improved access to women’s healthcare such as, mammography, imaging, BirthPlace and surgical care.