It’s one thing to facilitate customer co-design efforts for and with clients. It’s quite another thing to be in the midst of one that greatly impacts me, personally! For the next few months, I plan to chronicle my own rural community’s grass roots efforts to re-claim, revitalize, and re-invent our local community hospital as a vital center of health, wellness, and acute care serving our community. In late July, the people in the four towns on our peninsula in Maine (Boothbay Harbor, Boothbay, Southport, Edgecomb) were informed that our 80-year old community hospital would be shut down and converted into a day-time walk-in clinic.
St. Andrews Hospital, Boothbay Harbor, ME (aerial view) Note access by sea, land and helicopter!
Like many
crises that spawn community activism, ours has a deadline. On April 1,
2013, our local hospital will lose its certification as a Critical
Access Hospital and will close its emergency department and lose its
hospital beds.
As you can imagine, this was unwelcome news to members of the community, many of whose lives have literally been saved by this local hospital. Although there are other hospitals within an hour as the crow flies, we are at the foot of a long peninsula which is served by a single road that becomes impassable in snow storms and clogged with traffic in the summer. So, easy access to an emergency room and a hospital is important both to locals, to our year-round retirees, and to our many summer residents who are prone to boating, fishing, and auto accidents.
There are two big issues:
1. How did this decision come to pass, can it be reversed, and who is to blame? That debate has generated a huge amount of debate and discussion. The best analysis of how we got here can be found in two posts in the Scientific American blog network by Dr. Judy Stone, a respected clinical physician and medical researcher who summers here in Boothbay Harbor, Maine. For Judy, what’s happening in Maine is “déjà vu” to what happened to the community hospital in which she served in rural Maryland: Hospital Merger Deja Vu—Scientific American blog network which, like our community hospital was subject to decisions made by a parent company without seeking any input from local citizens. She cautions that other rural hospitals need to be vigilant to keep the same thing from happening to them, as top down decisions are made without the involvement of community members.
Angry citizens hold 1st ever 4-Town Open Meeting
2. Where
do we go from here? Assuming that we can wrest back control of our local
hospital and elect our own board, what services do we want it to offer
and how can we make it viable from both an economic and a quality of
care standpoint? That’s the part of the initiative that I find most
compelling. So I have thrown my hat into the ring to help facilitate the
community-based families/physicians/community/insurers co-design efforts.
What I
can report so far is that there’s an outpouring of energy and
self-organizing initiatives underway. It’s truly inspirational to see a
small New England town spring into action. This is where the deep-rooted
tradition of open discussion and debate in town meetings is serving us
well, supplemented by local cable TV, an excellent local newspaper
editor and staff, and, of course, the Internet.
What’s
surprising to me is that by engaging the community early in helping to
shape the future of its rural hospital, the management of MaineHealth
could have tapped into the creativity and expertise of its residents,
who include, by the way, many renowned genetic researchers.
In her second post, Big Fish Eats Little Fish: Warning to Rural Hospitals,
Dr. Judy Stone discusses the role of telemedicine in enabling rural
hospitals to provide high quality emergency care. That’s definitely one
of the plans on the table. Our goal is to have a viable business plan
and strategy in place by early January. I’ll keep you posted on our
progress as our community co-designs better healthcare and wellness
options for its 6,000 year-round and 20,000+ seasonal residents.
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