Rural Texas Hospital Recovers Successfully Post Financial Crisis

Transforming Hill Country Memorial: A Journey Towards Excellence

In the heart of Texas, Hill Country Memorial Hospital has undergone a remarkable transformation over the past decade. This transformation, initiated in 2013, was a strategic response to evolving healthcare demands, aimed at improving patient care quality and operational efficiency.

Dr. Michael Williams, then the chief executive officer, played a pivotal role in this change. He studied the Toyota plant in San Antonio and hired former Toyota employee Jeff Darnaby to help implement the Toyota production system at Hill Country Memorial. This system, renowned for its focus on continuous improvement and waste reduction, was hoped to bring similar benefits to the hospital.

The changes at Hill Country Memorial were not just cosmetic. The hospital diversified its offerings to include a breast health center, home hospice care, and a wellness center. However, these improvements came at a time when the hospital was facing financial and patient satisfaction issues.

A turning point for Dr. Williams came in 2009, when a 13-year-old boy named Quinn Kott passed away. Quinn had experienced a tingling sensation in his arm and was brought to Hill Country Memorial. Unfortunately, he waited for hours in the emergency room before being examined by a pediatrician the next morning. By then, it was too late, and Quinn was rushed to a hospital in San Antonio, where he died soon after.

Quinn's death was a wake-up call for the hospital. The ER doctor at Hill Country Memorial was reportedly inattentive, callous, and decided to send Quinn home late in the evening. The Kott family, who experienced poor treatment at Hill Country Memorial seven years ago, are still haunted by the hospital's advertising campaign that claims its care as "remarkable." However, they acknowledge that the hospital has transformed since then.

Under the leadership of Jayne Pope, who became CEO in 2013, Hill Country Memorial has made significant strides. Pope attributes the hospital's success to its focus on improving patient care. The hospital's hallway lights darken during a daily afternoon quiet time for patients to rest. Even the kitchen staff made changes, reducing their egg budget in half as a cost-saving measure.

These efforts paid off. Today, Hill Country Memorial ranks among the top 100 hospitals in the country and has won the nation's highest presidential honor for excellence through innovation and leadership. Dr. Chuck Romanick, Brannies' surgeon, has helped Hill Country Memorial's hip and knee replacement program reach over 400 surgeries a year.

However, the journey is not over. Len Nichols, a health economist, suggests that rural hospitals that cannot deliver good, quality services for the lowest possible cost may need to consider converting to urgent care centers or partnering with larger regional hospitals. Emily Padula, the hospital's chief strategy officer, emphasizes that rural hospitals do not need a lot of money to improve. With continuous improvement and a focus on patient care, Hill Country Memorial continues to strive for excellence.