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Business Excellence Award nominee: CRMC points to growth

CROSBY - At Cuyuna Regional Medical Center in Crosby, building projects have been the norm in recent years. The medical center recently hosted an open house for the opening of its multi-specialty clinic in Crosby. The completion of the clinic bri...

Adam English, Nurse Practitioner in Orthopedics, talks to a tour group during the Cuyuna Regional Medical Center’s Multi-Specialty Clinic Open House in Crosby. (Kelly Humphrey, Brainerd Dispatch)
Adam English, Nurse Practitioner in Orthopedics, talks to a tour group during the Cuyuna Regional Medical Center’s Multi-Specialty Clinic Open House in Crosby. (Kelly Humphrey, Brainerd Dispatch)

CROSBY - At Cuyuna Regional Medical Center in Crosby, building projects have been the norm in recent years.

The medical center recently hosted an open house for the opening of its multi-specialty clinic in Crosby. The completion of the clinic brings full circle a building project with origins as far back as 2006, when room used largely for cold storage became the shell for a 33,000-square-foot lower-level expansion for surgical space at CRMC.

Construction on the surgical expansion project began Feb. 3, 2014. The first phase of the $13 million project was completed in February of this year, allowing the hospital to go from four operating rooms to seven. The year-long renovation expanded CRMC's surgery capacity by 45 percent. Five operating rooms opened with the surgery center in February.

The surgery center includes an eye procedure room and six eye recovery bays. It has a registration and waiting area along with private consultation rooms and offices. There are three endoscopy procedure rooms with six recovery rooms along and multiple recovery beds for post-anesthesia care.

The surgery clinic encompasses 19,000 square feet with a 2,000-square-foot laboratory, digital X-ray room and orthopaedic area with seven exam rooms along with a procedure room and five offices. The multi-speciality clinic has general surgery, obstetrics and gynecology, bariatric, reflux and heartburn, orthopaedics, podiatry, urology, dermatology, ear/nose/throat, pulmonary/sleep, nephrology and electromyography (which checks the health of muscles). The multi-specialty clinic has 24 exam rooms, five procedure rooms and multiple offices and a conference room. Orthopaedics has seven exam rooms and a procedure room along with office space. The multi-specialty clinic entrance is down the hall from CRMC's main entrance reception area.

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Nor-Son served as construction manager on the $3.6 million multi-speciality clinic with $792,000 in equipment and furniture, much of that was for the digital X-ray machine ending the need to wait for film development. Construction started in March. The clinic opened Sept. 14.

Amy Hart, chief operating officer, said in addition to the construction projects, CRMC has focused on recruiting physicians. Since the spring of 2013, CRMC recruited 22 physicians, including specialities such as pain management and a hand surgeon.

Hart said the projects have been like dominos building upon each other beginning with the expansion into the Brainerd/Baxter area with the clinic on Isle Drive in Baxter near Wal-Mart. Next came the surgery center addition. As those services moved downstairs, Hart said consideration went into what to do with the vacated space, which created room for additional services.

"We also wanted to take advantage of the architecture we had," Hart said. She noted the small waiting room next to the clinic and the larger open space in the hallway with the nearby lounges, and coffee/snack area.

"One of the things you want to do when you are trying to do the best for the patient is lower their anxiety," Hart said.

Hart said one of the goals in the small waiting room was designed to do just that, both in improving flow to reduce wait times and an effort to move patients out into an open more relaxed setting. Hart said reducing patient anxiety affects how patients hear medical news and may even increase the likelihood they will follow recommendations such as taking medications. Nearby the new multi-specialty clinic entrance is a nod to the past, both in CRMC's heritage timeline along one wall and a section of exposed brick on another. The brick showcases what was once the hospital's exterior wall circa 1964.

A waterfall, which once stood nearby along with an ornamental tree in the medical clinic were removed, Hart said, because of concerns for allergies and the ability to clean those attractions for a clinic and hospital setting.

Changes on the technology side also had an impact on the patient experience. In the past, the medical clinic and the hospital operated on two separate computer systems. Hospital patients checked in a separate area than those in for a checkup at the clinic. An investment was made for one integrated computer system with people able to register without those previous restrictions for one side or the other.

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Hart noted changes to meeting space that may seem small but are designed to improve the patient experience. A consultation room minus the exam table or equipment allows medical staff to talk to patients in a setting designed to be more relaxed and less formidable.

An exam room is connected to a room for group sessions, such as diabetes education. The adjoining procedure room allowing a doctor to provide private foot exams on patients. After the procedure, patients can then return to the support group. Hart said the group interaction can play an important role in getting patients to arrive for appointments.

Tidbits

• During recent tours of the new clinic spaces, Hart was able to give a glimpse of doctors' work spaces as separate small cubicles in an open, relatively narrow room - not private offices as she said many people expect.

• The subspecialty area has 10 exam rooms and up to three subspecialists working at one time. Hart said having the specialities present allows people to stay local.

"That's what's going to make places like us much different because of a lot of hospitals years ago pieced all that off," Hart said, noting now with changes in health care the goal is to provide a continuum of care.

• One of the new wrinkles, Hart said, is recording surgeries on discs to give to patients. In the past, doctors may have given patients photos of their surgical procedures, now they can have the video version to show family, keep for their records, or even post on Facebook.

• An educational conference room's technology allows surgeons to communicate with a hospital in Haiti and view procedures.

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• To accommodate the flow of orthopedic patients with surgeons seeing 40 to 60 people in a day, patients check in and use a locker room to change into shorts provided by the clinic and then proceed to the waiting room.

Adam English, nurse practitioner at CRMC's Minnesota Center for Orthopaedics, said the goal is to publish between four and five studies in a year. He noted Dr. Erik Severson's presentation to 10,000 surgeons on rapid recovery knee replacement and a 2014 presentation on hip data in Dallas. Those efforts are getting CRMC's name and brand out on the national stage, English said. It's "letting them know our hospital here is leading the way across the country," he said. Hospitals in Kentucky and Washington are looking at what CRMC is doing to learn from the medical staff in Crosby.

Innovation is what's bringing people to CRMC, Hart said, adding "it's not just if you build it they will come." Medical professionals are coming from other parts of the country because of the services available and because of the lifestyle and natural resources moments away, without metro traffic congestion.

Hart said CRMC is trying to connect the services that are part of the new health care.

"We want to be a model of the other 1,700 critical access hospitals in the country," Hart said. "You can be successful. You can remain independent."

CRMC by the numbers

3 outpatient clinics: Crosby, Baxter, Longville.

18 average daily census for patients.

25 critical access beds in the hospital.

$40 million in annual payroll.

41 doctors - 14 primary care/27 specialists.

62 providers.

117 care center beds.

260 births annually.

947 employees.

2,200 inpatients annually.

72,000 clinic visits.

9,340 emergency room visits.

150,000 outpatients annually.

$110 million net revenue annually.

RENEE RICHARDSON, associate editor, may be reached at 218-855-5852 or renee.richardson@brainerddispatch.com . Follow on Twitter at www.twitter.com/Dispatchbizbuzz .

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