Tribes say decreasing ER wait times top priority
Throughout the 20-year history of YKHC Tribal Gatherings, dissatisfaction with long waits to be seen at the Bethel Hospital—outpatient clinics as well as the Emergency Room—has been among the top 10 priorities for change listed each year by delegates representing the 58 Tribes that make up the YKHC service area.
This year the delegates voted decreasing ER wait times their number one priority.
The issue has not been ignored; YKHC leadership and hospital administrators have initiated new appointment procedures in the ER and outpatient clinics, such as Fast Track (see “Tired of Waiting?” below) in recent years and wait times have improved. Patients coming to the Emergency Room, however, are seen according triage—those whose needs are most dire are seen first. A patient whose illness or injury can wait, sometimes will have to wait. Nevertheless, YKHC’s leadership teams will be taking a good hard look at how to make improvements.
Also on the tribes’ priority list: service improvements at the hospital and the subregional clinics, more cancer screening and research, support for Health Aides, and funding for village sanitation projects (see “Top Ten”)
The YKHC Board of Directors, meeting just a couple weeks after the Gathering, consolidated the priorities list to three main areas for focusing improvement efforts in the coming year: Work on reducing the ER wait times, increase provider travel to subregional and village clinics to provide more services, and increase cancer screening and prevention/education efforts.
YKHC Medical Director Dr. Joseph Klejka, who presented the Tribal Gathering report to the Board, acknowledged that increasing services will be especially challenging in the coming year because of federal budget cuts, so it’s important to choose our “targets” wisely.
Why we “Gather”
YKHC’s annual Gathering serves a two-fold purpose. The corporation reports on the status and progress of programs, facilities and services; the Tribal representatives identify health care concerns and determine their priorities for making improvements.
Many changes have come about as a result of Gathering priorities. Most recently, the skilled nursing facility now nearing completion in Bethel and a new Prematernal Home under construction. Add to the list: CT scanning at the hospital, regional medevac services, a Sobering Center, subregional health clinics and many service improvements designed to bring culturally relevant health care closer to home.
The Three-Day Gathering
Following last year’s listing of Behavioral Health concerns such as suicide prevention and alcohol treatment at the top of the list, this year’s Gathering included an extra full day devoted to YKHC’s Behavioral Health programs and services.
Keynote Speaker Dr. Clyde McCoy of the University of Miami emphasized the importance of accounting for culture in scientific studies and medical research, and programs developed as a result.
Cultural relevancy is central to YKHC’s vision, and is embraced whole-heartedly by Behavioral Health programs. The McCann Treatment Center’s subsistence-oriented education component is a prime example. The program’s clients, Alaska Native boys who struggle with drug abuse and alcohol in addition to severe emotional trauma and behavioral difficulties, learn subsistence skills such as fishing and hunting in addition to the usual academic classes in math and science.
Traditional Yup’ik ways—ancestral wisdom and knowledge, skills, ceremonies, and subsistence living—are the basis of Behavioral Health’s Preventative Services’ approach to community and individual healing.
Behavioral Health’s day at the Gathering included informative explanations of YKHC’s varioius residential services, outpatient, counseling and emergency services. Links to the slideshows for these and all the other presentations shown at the Gathering are on the YKHC website at www.ykhc.org/tribalgathering.
The second day’s reports included a look at the region’s overall health status, an update on clinic and hospital construction projects, care costs associated with the new nursing home, and the importance of vaccinations and prevention of disease.
YKHC’s biggest project of the preceding year was the electronic health record implementation—RAVEN (Records And Verification Electronic Network). President/CEO Gene Peltola said the $13 million cost of the project, mandated by the Affordable Care Act (Healthcare Reform of 2010), was drawn from operations profit of preceding years, not from YKHC’s savings funds. Over the past two years, nearly 1,000 employees have been trained with 14,000 staff time hours going into the effort.
The region-wide system went on-line on January 28, 2013, as scheduled. It turned out to be a smooth transition, with few problems. With RAVEN, all providers in all facilities, from the clinic to the hospital, have access to the same patient record; the record is legible, the information is secure, the patient’s history and all medications are listed and possible drug interactions are flagged.
The third day of the Gathering was dedicated to Tribal priority-setting and voting on the top issues for the coming year. See the results of the overall voting below. The complete listing of each election unit’s priorities is on our website at www.ykhc.org/tribalgathering.