Lessons Learned: A Mixed Methods Analysis of Barriers to Swing Bed Utilization in Critical Access Hospitals in Montana.

Purpose: Critical access hospitals (CAHs) provide access to care and economic stability to rural regions. At times rural populations need higher-level health care from distant urban-based acute care hospitals (ACHs), distancing them from their social network. Sample/Method: This paper evaluates pote...

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Bibliographic Details
Published in:Online Journal of Rural Nursing & Health Care Vol. 15; no. 2; pp. 88 - 104
Main Authors: Jones, Faith, Sabin, Tawnie, Roper, Karen L., Crocker, Samuel, Cardarelli, Roberto
Format: research tables/charts Journal Article
Published: Online Journal of Rural Nursing & Healthcare 2015
Online Access:View this record in EBSCOhost
Description
Summary:Purpose: Critical access hospitals (CAHs) provide access to care and economic stability to rural regions. At times rural populations need higher-level health care from distant urban-based acute care hospitals (ACHs), distancing them from their social network. Sample/Method: This paper evaluates potential barriers to transferring patients back to CAH swing beds for restorative care through formative interviews with staff from both ACHs and CAHs. Four CAHs also completed workflow analytics to identify process factors that impede timely transfer of patients from ACHs to CAH swing beds. Findings: Thematic messages included a lack of consensus about swing bed eligibility criteria and delay in response from CAHs on transfer requests. Workflow analytics identified numerous opportunities to improve efficiency in transfer requests. Results showed an average of 217.5 hours were required from time of transfer request to when the patient arrived to the CAH. Conclusions: Educational programs are underway to help address these knowledge deficiencies and process barriers.