A Small Town Hospital With A Wide Range Of Services

By VERNON ROBISON

Moapa Valley Progress

Mesa View Regional Hospital in Mesquite has been ranked as one of the top hospitals of its kind in the state and across the country. In 2012 and 2013, it was recognized with Top Performer status by nation-wide hospital accrediting organization Joint Commission for Surgery and Pneumonia. The hospital is the only hospital in the state of Nevada to receive the HealthInsight Quality Award for four consecutive years including 2009-2012. Mesa View received the Press Ganey Summit award, which recognizes top performing facilities sustaining the highest level of customer satisfaction, in 2012. And the hospital regularly maintains high scores for patient satisfaction. In the first quarter of this year, Mesa View was #1 in southern Nevada for overall patient satisfaction with a score of 73%, where the average is 59%.

But despite all these high achievements, and all the recognition they have brought inside the health care industry, the hospital still faces difficulties in communicating the scope of services to local residents. According to hospital CEO Patty Holden, hospital staff is continually trying to get the message out to the community on the role that the hospital can and does play in its service area which includes both the Virgin Valley and Moapa Valley communities.
“One of our ongoing challenges has been just making the community more familiar with the hospital and what we can offer,” Holden said.

Mesa View Hospital is a Critical Access Hospital (CHA). A CHA is certified under a specific set of conditions set by the federal government. First, a CHA must be relatively small. It can have no more than 25 inpatient beds. The length of inpatient stay in the hospital can average no more than 96 hours for acute care. A CHA must also offer 24 hour, 7 day a week emergency care in its community. And, finally, it must be located in a rural area that is at least 35 miles away from any other hospital.

These factors allow CHAs to focus on providing care for common conditions and outpatient procedures, while referring more serious conditions to larger hospitals.
“As a critical access hospital we have some real strengths; things that we do really well,” said Holden. “But we also have some limitations.”

For example, a CSA is not likely to have a full-blown stroke center, Holden said. Also, a CSA wouldn’t be equipped or staffed to handle acute heart attack patients, where a full heart catheder lab and/or open heart surgery might be required.

“But we do have great relationships with facilities in St. George and Las Vegas,” Holden said. “So if we have a patient who has had a stroke or some other serious problem, we are right here. We can stabilize the patients and get them to the right place.”

Holden explained that Mesa View has agreements in place with just about every hospital in Las Vegas and St. George. So when hospital staff refers a patient, there are plenty of options.
“We definitely take into account where the patient prefers to go,” Holden said. “We are not just going to send them off to St. George when they want to go to Vegas or vice versa. And we can usually accommodate them on whichever specific area of Las Vegas they want to be treated. We will accommodate their requests as long as we can get them to a hospital facility that will meet the needs that they have.”

Despite its limitations, there is a long list of services in which Mesa View truly excels, Holden said.
First off the hospital keeps an excellent emergency room. The ER wait time at Mesa View averages only about 10 minutes to first be seen by a doctor. And Mesa View is one of the only critical access hospitals in the state that has a physician on duty 24 hours a day, seven days a week.
“Many small rural hospitals will have a physicians assistant or nurse practitioner come on at night,” Holden said. “But we have a full physician there all the time.”

Mesa View also excels in its orthopedics treatment. The hospital has several specialists taking care of patients in that department. They are able to repair a host of injuries from sports-related problems to ATV accidents. Surgeries like hip replacements, knee replacements and more can also be done in house.

Earlier this spring, the hospital opened its all new wound care center equipped with a state-of-the-art hyperbaric chamber. This equipment is built for treating just one person at a time, unlike larger hospitals where many patients might be treated in the same chamber. Thus Mesa View offes added privacy and comfort to its patients, Holden said.

The hospital has podiatrists on staff for treatment of foot conditions. Holden pointed out that Mesa View sponsored a free foot evaluation clinic last week which drew a lot of new patients from the community to get answers to questions about problems they were having. “It was quite a successful event,” Holden said.

In addition, Mesa View now has a cardiologist on staff, Dr. Mekdelawit Aschenaki, who can do all of the non-interventional diagnostics for identifying and monitoring heart conditions. These include things like nuclear stress tests, echo cardiograms, heart monitoring, rhythm monitoring and more.
In the field of OB/GYN, Dr. Edward Ofori has been providing service through Mesa View Hospital for many years.

In the surgery department, the hospital offers a wide range of surgical procedures performed by its on staff surgeon Dr. George Hahm. These procedures include anything from hernia procedures, gall bladder removal and appendectomies to routine colonoscopies.

For urological treatment, the hospital brings in a specialist from St. George, Dr. Brian Ellsworth, who sees patients in Mesquite once each week. Many surgeries associated with urology, such as prostate surgery for men or bladder support slings for women, can be done right at the hospital. Procedures needing more advanced equipment may be done by Ellsworth at Dixie Regional Medical in St. George.

Holden said that she would love to recruit even more specialists to provide lines of service at Mesa View. But recruiting is an ever-present challenge, she said.
“In general, there is a limited number of doctors out there and there is this great big need for them all across the country,” Holden said. “So it is a bit of a sell to bring them to a small town in southern Nevada.”

But there are a few doctors out there who actually want to have a small town experience, Holden said.
“They want a better work-life balance than they might have in a much busier facility,” she said. “And they are willing to take a little less pay to get that.”

The lower volume is not only good for the doctors. It also can be a benefit to the patients. For example, Mesa View has 25 inpatient beds available. During the busy season of the year, Holden said that the hospital averages only around 18 or so patients at a time. During the slow summer months that number is more like five or six. That means there is more quality of individual care in the small facility.
“We base our staffing on our patients and how sick they are,” Holden said. “But even if there are only 3-5 patients, we have a nurse and certified nursing assistant who are doing hourly rounding. We are focused on quality and that is what we have become known for.”

“In a small facility like this, we are working with our neighbors and friends in the community., Holden added. “So there is a chance for us to develop close, ongoing relationships with our patients. And that is good for both our staff and our patients.”