In an era when many rural health centers are facing tremendous challenges, Sterling Regional MedCenter has defined its own formula successfully serving a rural community—and has even been ranked among the best 50 hospitals for patient engagement by Becker’s Hospital Review. The 25-bed, acute-care hospital is located in Sterling, Colorado, a close-knit agricultural community in the northeast corner of the state. It is a level 3 trauma center and offers a surprisingly comprehensive range of healthcare services, which means area residents don’t have to travel to receive care in areas like radiation oncology.Wade Tyrrell, CNO with Sterling Regional MedCenter
A chat with chief nursing officer Wade Tyrrell revealed two powerful factors in Sterling Regional’s ability to serve its community so well: state-of-the-art telehealth technology and well-defined strategies for building an engaged nursing workforce. When Tyrrell arrived in 2014, he began to focus on recruiting nurses locally, rather than reaching out to Denver and larger communities. “You have to have the right mindset to live and work in a rural market. It is different here both geographically and demographically, so it helps with retention to recruit locally and hire people who already have established roots here,” Tyrrell says. His strategy of “providing the right opportunity for the right individual” has paid off, as the number of nurses leaving after their first year has fallen from 20 percent to zero. This allows Sterling Regional to maintain an average nurse to patient ratio of 4 to 1 or 5 to 1 based on acuity.
In 2014, Sterling Regional received the ANCC’s Pathway to Excellence® designation, which means it met 12 standards essential to an ideal nursing practice environment. “It really is a kind of seal of approval that the environment is truly supportive of nursing,” says Tyrrell. One of those standards is encouraging professional development. Sterling’s parent company, Banner Health, has a training academy for med-surg nurses who want to move into or cross-train for a specialty area like ICU, oncology, or perinatal. Training includes classroom, clinical, and simulation time. Because of this, more than half of the nurses are cross-trained in more than one clinical area, allowing for great flexibility. “When volume picks up in the ER, for example, we have the ability to move staff in that direction, to work through that higher volume,” explains Tyrrell. Nurses assigned to the birthing center can also “float” as necessary when obstetrics volume is low.
Besides cross-training, Sterling Regional also supports nurses who wish to earn a BSN or MSN degree, and Tyrrell notes that in this rural area most nurses favor the online learning environment. About 30 percent of the bedside nurse have also earned national certification in their specialty areas. “We encourage that and provide tuition reimbursement for certification. I think it brings an additional level of growth opportunities and quality to the care we provide,” says Tyrrell.
Modern telehealth technology is also creating an attractive work environment for tech-savvy nurses who are comfortable working in a virtual environment. Sterling’s four-bed e-ICU connects local nurses and hospitalists with intensivists at a larger medical center and can provide the same level of monitoring and interventions as larger, more urban hospitals. Sterling also partners with a telestroke network to ensure constant access to stroke experts via audio, video, and image sharing. And even though Sterling has oncologists on site, telehealth technology gives patients access to a larger oncology center within the state. Oncology nurses often sit in on the telehealth connection not only to provide physicians with patient status updates, but to advocate for patients, help them understand their treatment, and make sure their concerns are addressed.
Overall, Sterling Regional MedCenter is knocking down stereotypes about working in—and receiving care from—a rural health facility. The staff is challenged and engaged, working with state-of-the-art technology and growing professionally. Local residents increasingly have access to services and specialists without having travel outside of the community. “As healthcare has changed, the dynamics of the hospital have changed too,” says Tyrrell. “We’re smaller than we were 20 years ago, but we’re the right size for the community and I think we bring the right services to the community.”