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

Abstract

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. DOI: http://dx.doi.org/10.14574/ojrnhc.v15i2.366 Keywords: Critical Access Hosptial (CAH), Rural, Swing Beds