The hospital announced months ago that the emergency department would be undergoing some operational changes beginning in January. Because of low patient volumes from midnight to 8 a.m., Hospital President and CEO Steve Heatherly said the hospital was looking to staff the ER overnight with a mid-level provider — a physician’s assistant or nurse practitioner — instead of a physician. 

However, the misperception persists that the ER is no longer open during those late night hours. 

“We have gotten hundreds of calls to the hospital from people needing emergency care who are pausing during that emergency to call and ask if we’re open,” said Lucretia Stargell, Swain hospital administrator. “Our point was that this is not a hospital issue, it’s a public safety issue. We asked the commissioners, like we are asking all of our community partners, to help us correct the misinformation.”

The problem is evident by comparing the hospital’s numbers from the first quarter of 2017 to 2016. Stargell said the numbers indicate that 100 more people from Swain County accessed Harris Regional Hospital’s Sylva emergency department so far in 2017, and 30 more people from Graham County have done the same. 

“We believe this is due to the misinformation that has persisted in the first part of this year,” she said. 

The staffing changes haven’t even been implemented yet. The ER is still being staffed with a physician and two nurses from midnight to 8 a.m. While having an ER staffed solely with mid-level providers is a common practice, Stargell said, Swain hospital is working with a staffing agency to search for highly qualified personnel. The change in ER personnel won’t happen until the right people for the job are hired.  

Heatherly said the proposed change to the overnight staffing model would allow the hospital to invest more money in other services that are needed in Swain County, including more same-day access to primary care; the latest X-ray, MRI and CT scan technology; specialized services for non-surgical and surgical acute and chronic conditions; and a place close to home with physical and occupational therapy to recover from accidents, injuries or surgeries. These investments in technology alone total more than $1.5 million.

“In addition, the best healthcare means having highly-trained physicians and staff who are focused on providing an outstanding experience for patients and families,” Heatherly said. 

Swain Family Care, the primary care physician practice at Swain Community Hospital, serves patients with same-day visits to family practice physicians Tammy Johnston and Dave Johnston; physician assistants Vicki McCormack and Angela Struna; and board-certified pediatrician Brooke Budde. A third family practice physician, Benjamin Gans, will join the practice this summer. 

Heatherly said the hospital has also scored higher than any North Carolina facility on a national patient satisfaction survey — Hospital Consumer Assessment of Healthcare Providers and Systems — when it came to nurse communication. The ranking is a result of patient responses gathered during 2015 and represents the latest data available.

By the numbers

Number of emergency room visits to Swain Community Hospital and Harris Regional Hospital January through March 2016 compared to visits in the same time period of 2017.

Overall visits to Harris ER:

• Jan. 3-March 31, 2016 — 4,250

• Jan. 3-March 31, 2017 — 4,591

• Net change — up 341

Overall visits to Swain ER:

• Jan. 3-March 31, 2016 — 2,400

• Jan. 3-March 31, 2017 — 2,094

• Net change — down 306