Knox County hospital among nation’s rural Top 100

Feb. 27--Patient satisfaction has been a buzz phrase in the health care industry for a number of years as physicians, clinics and hospitals strove to learn how well they were providing medical services for its patients.

A variety of metrics are measured to gauge how well different levels of care are performing when it comes to administering patient care. The National Rural Health Association's Rural Health Policy Institute, iVantage Health Analytics and The Chartis Center for Rural Health are organizations that look at that data to determine a facility's ability to manage risk, achieve a higher quality of care, have better patient outcomes, increase patient satisfaction and operate at a lower cost than their peers. Their review has placed the Knox County Hospital District among the Top 100 Rural and Community Hospitals in the country.

While the staff and administrators at the district certainly look to excel in providing healthcare to its patients -- whether it's in the hospital, two clinics, retail medical equipment location, home health, assisted living facility and more -- there is more to what drives this top rural hospital in Texas: Family.

Stephen Kuehler, administrator of the hospital for the past 16 years and near-lifelong Knox County resident, said he was surprised to see KCHD make the Top 100 list, but the high quality of care they provide isn't surprising to him and isn't used to win awards. It's to provide that top-notched service to family, friends and neighbors they're most likely to treat in the county of less than 4,000. He said they, like other medical facilities, have had patient satisfaction training because that is one of the measurables insurance companies and government health programs use for reimbursements and payments, but what they do goes beyond that.

"I still go back to the reason we're on the list is because we have more people who grew up here who work here who know those people who walk through the door," he said. "It's more like a family atmosphere. I think each one of us spend more energy taking care of our own family than we would taking care of someone we didn't know, so I feel like that's what sets us apart more than anything."

Stephen's wife Sheila Kuehler, the director of nursing at the facility for roughly 16 years and the trauma coordinator in the 1990s, said it's their responsibility to treat everyone who comes through their doors as if they are family.

The first medical doctor came to the agriculture and oil and gas county in the early 1900s to practice horse-and-buggy house-call medicine for its residents. The first hospital was soon established about a block or so northeast of the existing facility, which was built in the 1920s and added onto in the 1940s and 1960s.

The community went without a hospital for a brief nine-month period in 1987 when voters in the county decided to close the financially struggling facility. Voters relatively quickly decided to bring back the hospital district, but services such as surgical and labor and deliver were no longer offered.

Now, the 14-bed hospital provides Level IV emergency room, laboratory, radiology, physical and speech therapy, cardiac rehabilitation and an ambulance service. Stephen Kuehler said while they continue to look for new services to bring to the facility and provide the community, they've also expanded their footprint in the region to include a new clinic in Knox City across from the hospital, a clinic in Munday, a nursing center in Seymour and retail pharmacy and medical equipment services. They also have a mobile MRI and CT unit come to the hospital for those diagnostics.

Sheila Kuehler said the mission of the hospital is the continuum of care, to stabilize and transfer the sickest of the sick patients who exceed the acuity of care for the Knox County facility.

"We get several swing-bed patients -- that's where they come back here for rehab, (for example). They don't need acute care, but they need some skilled nursing such as physical therapy or IV antibiotics," she said. "We do have our acute care. We can keep the pneumonias and flus. If you need a ventilator, you're going to be going" to a higher level of care.

Patients, depending on the family's request, are typically transferred to Wichita Falls, Abilene or Lubbock.

Another ingredient to KCHD's success is having homegrown products, such as the Kuehlers and administrative assistant Lisa Myers, return and take care of the people they grew up knowing. Stephen Kuehler said they have a program in place to assist residents receive their medical education and return home to provide care. Dr. Ezekiel Duke, a graduate of Benjamin High School in Knox County, is an example of the partnership between the hospital and high school students. But, Stephen Kuehler said, they have to have "skin in the game" and commit to returning home to put their newly learned skill to work.

Stephen said KCHD is night and day from where it was when he returned home roughly 16 years ago to where it is today, and he's not finished. He said they have remodeled portions of the hospital over the years and will continue to improve the facility, hopefully with a new emergency room in the future. He said they've been able to secure grant funding over the past several years to the tune of about $1.5 million.

Sheila said having a hospital in a rural community that could be almost an hour from the next hospital is sometimes the difference between life and death.

"How important is life?" she asked. "If you have a heart attack, we can give you (the medications) and get you on to where you need to be. If you're not breathing, we can get you intubated."

She said their nursing staff is trained in provided trauma and life-saving care to get patients stable before sending them out.

For more information on Knox County Hospital District, visit knoxcountyhospital-texas.com or call 940-657-3535.

Follow John Ingle on Twitter at @inglejohn1973.

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