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FirstHealth of the Carolinas a Case Study in 'Teamwork Makes the Dream Work'
| Date Posted: 1/1/0001
- 1929-1995: The Beginning
- 1995 – Present: Bringing Care to the Sandhills
- Patient Tower Opens at MRH
- FirstHealth Fitness: Exercise is Medicine
- FirstHealth Dental Care Helps Underserved Children
- Clara's House a Home Away from Home
- Reid Heart Center
- FirstHealth Bariatric Center
- FirstHealth UNC Neurosurgery & Spine
- Hospice & Palliative Care
- Physician Leadership Academy
- Center for Provider Wellbeing
- Caring for People in 2020 and Beyond
PINEHURST, N.C. -- It’s been said that teamwork makes the dreamwork. As it celebrates 25 years as a regional health care system, FirstHealth of the Carolinas is a case study of how community members inside and outside the system band together to fulfill its core purpose “to care for people.”
The private, not-for-profit health care network headquartered in Pinehurst encompasses 5,000 employees through four hospitals in Moore, Montgomery, Richmond and Hoke counties — and much more. Extensions of care serving a 15-county region are offered through facilities for inpatient and outpatient rehabilitation, a hospice, a palliative care program, a home care program, community outreach programs, behavioral services, fitness facilities, primary and convenient care practices, a hospitality house, EMS and critical care transport services, a non-profit insurance plan, four charitable foundations and a host of other programs. The expanse of these services illustrates FirstHealth’s commitment to treating the whole patient and to providing quality health care for the entire community.
FirstHealth also benefits the community in ways outside of health care. Pat Corso, executive director of Moore County Partner in Progress economic development organization, reports that FirstHealth is a “catalyst for growth in the region.” He said that people move to the Sandhills because of the high level of quality care at FirstHealth. “You can see the proof with the Reid Heart Center and expertise in oncology, pulmonology and orthopaedics, just to name a few,” Corso said. “What we offer is equal to that of Duke or UNC Chapel Hill.”
Corso also explained that FirstHealth is typically a top employer in the communities it serves, providing well-paying jobs. “FirstHealth’s engagement with the community goes well beyond health care.”
1929 - 1995
FirstHealth of the Carolinas started out as two rural hospitals needing and receiving their own critical care.
One month after the Great Depression in 1929, Moore County Hospital in Pinehurst opened its doors with the mission to serve the people of Moore County, regardless of their ability to pay.
Times were tough for all, but residents banded together to purchase linens and layettes for the hospital, formed a motor corps to deliver groceries to needy families and transport nurses, and provided cows and chickens to make sure that parents of newborn infants would have milk and eggs. Through the decades the hospital flourished and was renamed Moore Regional Hospital to reflect its expanse.
When Montgomery Memorial Hospital opened in 1950, it was built on donated land in Troy and outfitted with supplies from Sunday School classes, community organizations and individuals. By the 1980s rising health care costs and cuts in federal funding created financial difficulties, a common situation among rural hospitals. “We are entering a time when few rural community hospitals can stand alone,” said Frank Kersey, board chairman of Montgomery Memorial Hospital, in 1995.
With strength in numbers, Moore Regional Hospital (MRH) and Montgomery Memorial Hospital (MMH) merged on October 1, 1995, creating a new entity and new opportunities for the region. “A collective goal was to make health care accessible, both in breadth of services and geographically,” said retired FirstHealth President and CEO Charles Frock. “Merging the two hospitals just made sense.”
1995 – Present
Teamwork extends general and specialized care to rural areas
In the 25 years since FirstHealth became a regional health care system, the concept of “region” has expanded to serving 15 counties in North Carolina and South Carolina. Beyond flagship facilities in Moore County, expansive facilities are also in Montgomery, Richmond, Hoke and Lee counties.
After Montgomery Memorial Hospital merged with Moore Regional Hospital, it was “immediately evident that it was the best thing we could have ever done,” said Beth Walker, R.N., retired president and long-time employee of Montgomery Memorial Hospital. “For example, instead of having to figure things out on our own, we could work with our counterparts at MRH. Also, it was not just a merger on paper. Moore Regional truly adopted Montgomery County and provided not only acute care hospital needs but wellness to the community.”
One unique aspect about MMH in the family of FirstHealth hospitals is that in 1999 it was designated a “Critical Access Hospital” by the Centers for Medicare and Medicaid Services. This federal designation allows rural hospitals to receive benefits that help them stay financially viable so they can keep essential services in rural communities. “Rural hospitals like ours keep patients close to home and reduce lengthy drive times to Pinehurst or beyond for care, which can be costly and require time off work,” said Walker in 2019.
FirstHealth’s work in Montgomery County continues to evolve, particularly as the organization earned a $350,000 grant from The Duke Endowment in 2019 to develop a robust plan for the health care continuum in the county. Funds from The Duke Endowment will enable FirstHealth to undertake the Montgomery County Healthcare Reimagining Project, a collaborative process allowing the community to envision what the Montgomery Memorial Hospital of the future will look like and how it can turn that vision into reality.
In 1945, a team of Richmond County leaders initiated the charge to build a non-profit community hospital. They raised $150,000 in a fund drive, successfully promoted an election to issue $250,000 in bonds and gained $400,000 in federal and state funding. Mrs. B. F. (Blanch Shores Hinson) Palmer and her son Marion Lee Hinson donated a 20-acre plot of land in Rockingham. Construction started but was delayed because of the Korean War. Nevertheless, teamwork and persistence paid off and the first patient entered the three-story, 50-bed hospital on November 19, 1952. The community continued to rally behind the hospital and gained funding to add more beds, more specialty services, and surgery and outpatient centers.
Through the years, leaders realized they needed a new type of teamwork for the hospital to thrive. FirstHealth assumed management of Richmond Memorial Hospital in 1999 acquired it in 2001. The facility opened an emergency department in 2003, closely followed by a state-of-the-art fitness center, a sleep lab, imaging center, wound care and hyperbaric center and a renovated intensive care unit. FirstHealth continues to expand services to Richmond County, including family and internal medicine, surgery, cardiology, nephrology, orthopaedics, cardiology, urogynecology, gastroenterology, outpatient and pulmonary rehabilitation, behavioral services, sleep disorders and more. The facility is now called FirstHealth Moore Regional Hospital-Richmond.
“Joining forces with FirstHealth allowed Richmond County residents and nearby neighbors to receive high quality, specialty care without leaving the area,” said John Jackson, president of FirstHealth’s Southern Region and administrator of Moore Regional Hospital-Richmond. “Like other rural hospitals, we could not have done that alone.”
In 2016, FirstHealth acquired Sandhills Regional Medical Center in Hamlet and renamed it Moore Regional Hospital – Hamlet. However, a shift in patient visits to FirstHealth’s hospitals in Rockingham and Pinehurst required a consolidation of all hospital-based clinical services on the Rockingham campus, closing the Hamlet facility the following year. FirstHealth still has a strong presence in Hamlet with family and internal medicine, convenient care, gastroenterology and urogynecology.
At one time, Hoke was the largest county in the state that did not have a hospital. FirstHealth changed that with the 2013 opening of the all-new FirstHealth Moore Regional Hospital – Hoke in Raeford. “This achievement is nothing less than a dream come true for all of us,” said Julian King, Raeford resident and then-chair of the FirstHealth of the Carolinas board. “Hoke County residents have depended on outside-the-county hospital care for too long. Now we are assured of the same splendid care we received in Pinehurst but here at home.”
The campus opened with an eight-bed hospital and 24/7 emergency department and soon after included cardiology; primary care; ear, nose and throat; head and neck; orthopaedics; imaging technology and surgery.
FirstHealth expanded its service in Lee County with the 2018 opening of a multi-story medical office building and a state-of-the-art fitness center. The facility houses the county’s second FirstHealth Convenient Care clinic as well outpatient imaging, an outpatient lab, and specialty services, including back and neck pain, vascular and vein, neurosurgery and orthopaedics. These services complemented a previous partnership with FirstHealth of the Carolinas and Pinehurst Medical Clinic to provide cardiac services to residents in Lee County.
David J. Kilarski, then chief executive officer for FirstHealth of the Carolinas, said in a 2017 press release, “This project will provide us with the opportunity to serve our current Lee County patients in a new capacity while introducing new residents to our exceptional services.”
Expanding care through Convenient and Primary Care Clinics
Since 1995, FirstHealth has expanded care throughout the region in the form of Convenient Care and Primary Care centers. Convenient Care clinics are just that – clinics in convenient locations offering convenient times to receive treatment for urgent, but non-life-threatening, illnesses and medical care needs. These clinics are in Asheboro, Hamlet, Lake Tillery, Pinehurst, Raeford, Sanford, Tramway and Whispering Pines. Primary Care Clinics encompass Family Medicine and Internal Medicine and are in Biscoe, Candor, Carthage, Ellerbe, Hamlet, Pinehurst, Raeford, Robbins, Rockingham, Sanford, Seven Lakes, Troy, Vass and Whispering Pines.
Technology enables care almost anywhere with FirstHealth on the Go
Now health care knows no geographic bounds with the 2019 launch of FirstHealth On the Go. This telehealth option provides 24/7/365 access to board-certified providers through virtual visits on a computer, tablet or smartphone.
Care expands by 250,000 square feet with new Patient Tower at Moore Regional Hospital
Responding to rapid growth in the Sandhills, particularly an influx in retirees, Moore Regional Hospital opened a $60 million patient tower in 2000. Adding 250,000 square feet, the five-story tower was designed to house:
- An expanded Emergency Department with an additional 25,000 square feet to expand the capacity for emergency care
- Comprehensive Cancer Center offering streamlined care with one location for diagnostic testing, physician visits, treatment and support. The title “Comprehensive Cancer Center” is a designation earned from a rigorous evaluation from the American College of Surgeons Commission on Cancer.
- 131 additional private patient rooms
- Sleep Disorder Lab
- Health Information Management Services
Also included was a three-story, 550-space parking deck and additional parking lots. Opening a year earlier but still included in the $60 million expansion project at MRH was the Outpatient Center on Page Road. The 24,000-square-foot facility consolidated services offered throughout the hospital, streamlined the patient flow process, and eliminated the need for patients requiring outpatient services only from entering the main hospital.
“We listened to our patients, the community and to our health care providers to determine where and how we should expand our facility,” said Frock when the tower opened. “Our main goals were to provide high-quality, technologically advanced health care while emphasizing quality, convenient patient care that is close to home.”
Teamwork delivers care through fitness
FirstHealth holds the position that instead of waiting for people to get sick, the better path is to help people maintain their health while they are well—and one way is through fitness. Moore Regional Hospital opened a small exercise facility in Southern Pines in 1987 to help rehabilitate patients with heart issues. It was so well received that in 1995 FirstHealth opened a state-of-the-art fitness center in Pinehurst, 63,000 square feet of continuous motion. The Pinehurst facility is one of six FirstHealth Fitness centers in Southern Pines, Raeford, Rockingham, Troy and Sanford serving 11,000 members.
One difference in FirstHealth’s type of fitness? Exercise as medicine. “We believe that appropriate exercise is appropriate for everyone and that if anyone comes to us, regardless of ability, current health status or past fitness experience, we can help them take personal responsibility for their health through regular physical activity,” said John Caliri, Administrative Director of FirstHealth Fitness. From significant community support through the Foundation of FirstHealth, FirstHealth in 2010 adopted Exercise is Medicine®, a global health initiative with idea that physicians prescribe exercise as medicine, just as they prescribe pharmacy-based medications.
FirstHealth Fitness serves not only its members, but approximately 400,000 people in the community each year through various classes and events. Caliri, who started with the organization as a part-time lifeguard in 1995, said “with our core purpose to care for people, we are responsible for the health of this community and strive to deliver services in many ways to as many people as possible.”
Teamwork delivers care through Community Health Services
Not-for-profit health care systems like FirstHealth are tax-exempt and are therefore required to provide benefits such as charity care and community health services. FirstHealth views this not as a requirement but a central component of its core mission “to care for people.”
“Caring for people goes beyond the walls of our facilities,” said Chris Miller, administrative director of FirstHealth Community Health Services. “Our job is threefold: identify needs in the community, develop interventions through extensive collaboration and secure resources to help implement and expand identified intervention throughout the region.”
Community health has always been a stronghold at FirstHealth and the last 25 years have seen a proliferation of programs and identification of resources for community members as part of supporting whole-person care. Examples include FirstHealth Dental Care, school health programs, healthy living classes, tobacco cessation education, childhood injury prevention, medication assistance and a multi-sector coalition to battle opioid misuse. Additionally, FirstHealth Community Health Services offers grant writing services to all areas of the health care system to help obtain the needed funding to start new programs or bolster existing ones.
Most regional health care systems serving an area the size of the Sandhills have nowhere near the breadth and depth of community health services as those offered through FirstHealth of the Carolinas. It’s one of many differentiators for the organization.
FirstHealth Dental Care Opens Wide for Underserved Children
Hospital systems typically do not enter the dental world, but FirstHealth is different. In the mid-1990s Moore County Schools approached FirstHealth to assist with a school nurse program. The nurses found that many low-income children had no access to dental care--and it’s difficult to learn when your mouth hurts. In those days, the area’s population was primarily retirees and dental practices served them, not children. FirstHealth established a community task force with local dentists to find a solution. Three options emerged: a mobile van to travel to schools, existing dentists dividing up young patients on Medicaid or FirstHealth establishing dental centers to care for this underserved population. With letters of support from the Sandhills Dental Study Club, NC Division of Dental Health, Sandhills Pediatrics, FirstHealth Board of Directors, Moore County Health Department, Montgomery Health Department, Hoke County Department of Public Health, Moore County Schools and Montgomery County Schools, the task force decided on the third option.
Enter Sharon Nicholson Harrell, DDS, MPH, FAGD, a young member of the task force who was asked to take the lead for FirstHealth. She forged partnerships with local schools, Medicaid and other entities to start FirstHealth Dental Care Services in 1998. Funding came from the Kate B. Reynolds Charitable Trust, the Duke Endowment and the FirstHealth Community Benefit Program.
The FirstHealth Moore Regional Hospital Auxiliary (no longer in existence) and June Gadd Memorial Fund helped develop a special children’s waiting room at the first location in Southern Pines. Local dentists pitched in then and now to provide specialized services. In addition to these sources of assistance, donors today through the Foundation of FirstHealth provide extensive support. “I can’t tell you how helpful the Foundation has been as we help our children,” Dr. Harrell said.
The department now operates in Southern Pines, at East Middle School in Biscoe and at West Middle School in Mt. Gilead. Since inception FirstHealth Dental Care Services has provided dental care to nearly 29,000 underserved children age 0-21 in Moore, Montgomery and Hoke counties.
Dr. Harrell’s vision for the future? Expanding dental care to underserved kids who still don’t have access. “We’re in our own walls and that’s fantastic, but not everyone can get to our walls,” she said. “Public health serves the community and we want to serve even more of our community. We want to expand outside our walls.”
Caring for people through hospitality
As FirstHealth’s services grew, leaders and supporters recognized that caring for people extends to affordable lodging for out-of-town patients and their families. In 2001, the dream of a facility to provide lodging, support services and advocacy for patients and families began to take shape among donors and friends of the Foundation of FirstHealth. They assembled a team and got to work.
The Clara McLean House opened its doors in April 2012 with 12 overnight guest rooms and two day-visit rooms with all the comforts of home, a beautiful Healing Garden and common areas for visiting and relaxing. It was named in memory of Miss Clara McLean, a successful businesswoman who cared deeply about the many hurdles facing patients, such as transportation and access to care. Affectionately nicknamed “Clara’s House” the 20,000-square-foot facility has expanded the meaning of hospitality and woven it into the continuum of care and recovery at FirstHealth.
Clara’s House also supports the community through numerous support and advocacy groups and as home of CARE-Net, a unique “buddy system” that matches trained volunteers with patients who need a sympathetic ear, caring heart or helping hand. It is also home base for the Foundation of FirstHealth’s Cancer CARE Fund, which provides for the individual needs of patients, including transportation, medication assistance and other related expenses.
The Clara McLean House and the programs within it are supported in large part by community donations and volunteer time.
Teamwork delivers care through specialties usually reserved for larger, academic facilities
A key component of FirstHealth’s definition of caring for people is offering specialty care close to home. In the last quarter-century, FirstHealth has built an extensive portfolio of specialty clinics throughout its region of rural North Carolina with services normally available only in larger cities.
Reid Heart Center
In the 1980s Drs. James A. Tart, F.M. Simmons Patterson, Jr., Wilson Staub, and others envisioned a comprehensive cardiac program at what is now FirstHealth Moore Regional Hospital. They recruited David Cowherd, MD, an interventional cardiologist, who performed the area’s first diagnostic cardiac catheterization at Moore Regional in 1987 and the first balloon angioplasty in January 1991. Staub also recruited John F. Krahnert, Jr., M.D. who, with his carefully curated heart surgery team, performed Moore Regional’s first open-heart procedure, a triple bypass, in 1990.
Soon after, FirstHealth Moore Regional Hospital was named one of the nation’s top 100 hospitals for cardiovascular, stroke, and orthopedics care. Concurrently, demand for heart services was high and space was limited. Thanks to the pioneering work of the aforementioned professionals and the foresight of philanthropists Walter and Betty Reid, the Reid Heart Center opened in 2011.
The Center is filled with highly trained professionals working together to provide the best in patient care with the latest in technology, clinical procedures and clinical trials. Within the Reid Heart Center are several specialty clinics:
- FirstHealth Valve Clinic is composed of expert vascular and cardiothoracic surgeons, cardiologists, and other cardiac care specialists, offering patients with complex valvular disorders high-quality multidisciplinary care in a one-stop arrangement. Here patients can receive industry-leading innovations in valve care, including the transcatheter aortic valve replacement (TAVR) and MitraClip procedures. In 2013, cardiologists at FirstHealth performed the first-ever TAVR procedure in the Sandhills region. TAVR offers hope to patients who are considered too high-risk for open-heart surgery or traditional aortic valve replacement and is recognized as one of the most important innovations in cardiovascular therapy. In June 2020, a team of heart specialists from the Valve Clinic, including cardiothoracic surgeon Stephen Davies, M.D., MPH, and interventional and structural cardiologist Sun Moon Kim, M.D., successfully performed the region’s first transcatheter mitral valve repair (TMVr) with MitraClip therapy, a minimally invasive procedure to treat a leaking heart valve.
- FirstHealth Cardiovascular & Thoracic Center features comprehensive care in the surgical treatment of diseases affecting the chest, including the heart, blood vessels, lungs, and esophagus. Interventions available at Reid Heart Center that are not commonly offered at a community hospital include Video Assisted Thoracic Surgery (VATS), Abdominal Aortic Aneurysm (AAA) repair and use of the Left-Ventricular Assist Device (LVAD). The Cardiovascular & Thoracic Center focuses on expanding minimally invasive cardiac surgery interventions.
- The Chest Center of the Carolinas brings together the expertise of multiple specialties in the treatment of lung cancer as well as esophageal and mediastinal tumors and benign diseases of the chest. With multiple specialities housed under one roof, patients’ complex care is coordinated in an efficient and friendly manner, without excessive visits. The Chest Center has received international acclaim as Michael Pritchett, D.O., MPH, pulmonary specialist at Pinehurst Medical Clinic and director of the Chest Center of the Carolinas, has performed more robotic navigation bronchoscopy procedures than anyone in the world. This procedure uses the Ion endoluminal robotic bronchoscopy platform (Ion), a robotic-assisted, catheter-based technology designed to access hard-to-reach areas of the body through natural openings, like the mouth. When applied in the lungs, it aims to enable early lung cancer diagnoses by accessing and sampling tissue from small nodules in difficult-to-reach areas. “Before this technology, there was no minimally invasive and reliable way to find and biopsy small lesions that often represent early-stage lung cancer,” Dr. Pritchett said. Now Dr. Pritchett trains and mentors physicians from around the country on the Ion.
FirstHealth Cancer Services
In the last 25 years, FirstHealth has grown into a regional destination for cancer care and future plans hold even more promise. From top-rated medical and radiation oncologists who offer the most advanced treatment options, to highly skilled surgeons and radiologists, to oncology nurse navigators who coordinate services and provide support — FirstHealth’s team of experts brings excellence home from screening and diagnosis through treatment.
Among several factors that sets FirstHealth Cancer Services apart from those of most regional health care systems is its extensive clinical trials program. The clinical trials program at FirstHealth started in the early 1990s with one doctor and one coordinator. Now numerous doctors oversee, and four coordinators manage, 25 to 30 active studies involving hundreds of patients.
Many of the clinical trials at FirstHealth are related to cancer and sponsored by the National Cancer Institute, so the program is housed in the FirstHealth Outpatient Cancer Clinic in Pinehurst. However, drug companies and research hospitals routinely approach FirstHealth to participate in studies involving medical conditions beyond cancer.
“FirstHealth offers a wide array of clinical trials that far exceeds the average for regional community medical centers,” said Charles S. Kuzma, M.D., institutional principal investigator of clinical trials at FirstHealth of the Carolinas. “Patients who choose to participate in a research treatment opportunity at FirstHealth gain access to new, state-of-the-art treatments before they are widely available to the public. On a broader level, the advances in medicine we enjoy worldwide today are thanks in part to clinical trials as part of medical research.”
Cancer affects not only the body, but all aspects of patients’ lives. One way the community responds is through donations to the Foundation of FirstHealth’s Cancer CARE Fund. Community members established this neighbors-helping-neighbors fund in 2000 with the goal of reducing patients’ barriers to care, including expenses associated with a cancer diagnosis: transportation costs for treatment, medications, supplies and more. Other services offered to patients as part of FirstHealth’s comprehensive cancer care include a financial navigator; various types of counseling, including spiritual care, pastoral, grief and cancer-specific; lodging at the Clara McLean House; nutrition and dietary assistance; specially trained CARE-Net volunteers, cancer survivors who provide an empathetic ear and caring heart; yoga and wellness programs; and oncology massage therapy.
FirstHealth Bariatric Center
While exercise and eating right are effective ways for many people to lose weight, it does not work for all. For people with the chronic medical condition of morbid obesity, bariatric surgery – also known as weight-loss surgery – has proven to be a successful way to lose weight and improve overall health.
Health care leaders in the Sandhills wished to provide these services for residents and recruited Kenneth Mitchell, M.D. In 1999, Dr. Mitchell performed the area’s first bariatric procedure. Twelve procedures followed that year and 40 the year after. In 2005, the bariatric surgery program, which had been based at Pinehurst Surgical Clinic, expanded into the FirstHealth Bariatric Center at Moore Regional Hospital. Now the program is under the direction of David Grantham, M.D., F.A.C.S. and Raymond Washington, M.D., F.A.C.S.
While surgery is a major component of this weight-loss approach, the FirstHealth Bariatric Center places tremendous importance on related support services and programs. “Our program uses a multidisciplinary approach, which includes not only surgeons but a registered dietitian, licensed clinical social worker, patient coordinators and dedicated nursing staff to assist patients through their individual journeys for long-term success,” said FirstHealth Bariatric Center Program Manager Christi Embler, BSN, R.N., CBN. “What I love best about our program is our emphasis on lifestyle modification and continuous support. We are very invested in our patients and their future, so we support them not just before surgery but for their entire lives.”
“Continued improvement is always our goal, so we regularly review our processes to ensure they allow us to most effectively care for patients and provide them with the services they require,” said David Grantham, M.D., F.A.C.S. One example is the practice of calling patients daily in the first two weeks after surgery. Their progress is relayed directly to the surgeons so they can identify problems in real time. “This has resulted in fewer ER visits and improved patient outcomes,” Grantham said.
FirstHealth Bariatric Center’s approach has received accolades. It earned the designations of Center of Excellence by BCBS of North Carolina and Bariatric Surgery Center of Excellence by the Surgical Review Corporation, a company founded by the American Society of Metabolic and Bariatric Surgery (ASMBS). In 2019 the Bariatric Center earned a three-year reaccreditation as a Comprehensive Center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP), a joint program of the American College of Surgeons (ACS) and ASMBS.
FirstHealth Orthopaedic Program
Around the same time that FirstHealth became a health care system, a concept called “service lines” was emerging in the health care world. John Ellis, M.D., often referred to as the founding father of the joint replacement program at Moore Regional Hospital, and Administrative Director of Surgical Services Scarlett Blue, R.N., thought this concept would work well for orthopaedics. “We were early adopters of this concept,” said Blue.
Within the service line framework, designed in large part by then-Moore Regional Hospital Chief Nursing Officer Linda Wallace, a representative from each department contributing to a patient’s care came together to create a “care path” for the patient. Departments included surgery, physical therapy, pharmacy, dietary services, home health, discharge planning and more. The resulting care path aligned all aspects of the patient’s experience and was shared with the patient so he or she could know what to expect when.
This approach may seem standard today – and it is – but 25 years ago it was not. Doctors had medical staff meetings about patients but other professionals providing care to patients were rarely included.
Today, this team approach still exists within FirstHealth Orthopaedics and is a strong contributor to its numerous awards. Providers treat a wide variety of conditions, including joint disorders of the knee, hip and shoulder; arthritis; neck and back injuries and disorders; carpal tunnel syndrome; fractures and dislocations; foot and ankle injuries; hand injuries; inflamed joints; osteoporosis; tendonitis; torn ligaments and cartilage; and a wide range of sports injuries. Patients can receive treatment throughout the Sandhills with FirstHealth locations in Sanford, Troy, Raeford and Rockingham. FirstHealth Fitness Centers in each community augment recovery efforts.
FirstHealth UNC Neurosurgery & Spine
In 2008, FirstHealth and the University of North Carolina at Chapel Hill forged a partnership to bring world-class neurosurgery services to the Sandhills. Neurosurgeons are on staff and considered faculty at UNC Chapel Hill (UNC) but perform services at FirstHealth Moore Regional Hospital.
This partnership allows Sandhills residents to have 24/7/365 access to skilled neurosurgeons. In local emergency situations, UNC neurosurgeons evaluate patients at Moore Regional to assess spine and intracranial injury. Many of these patients can be treated at Moore Regional, but those with more severe injuries can be transferred quickly by either air or ground to the Level 1 Trauma Center at UNC. Before this partnership, access to care was not as readily available.
FirstHealth UNC Neurosurgery physicians and physician assistants provide the latest advancements to treat cervical and lumbar disc disease / degenerative disc disease, neck and back pain, spinal stenosis, spinal arthritis, spinal fractures, herniated spinal discs, head and nerve injuries, carpal tunnel syndrome, brain tumors and hemorrhages, hydrocephalus and ulnar neuropathy.
The neurosurgery partnership between FirstHealth and UNC was not the first of its kind. “Our neonatology, infectious disease, hospital medicine and maternal fetal medicine programs got their start with physicians from UNC,” said Administrative Director of Surgical Services Scarlett Blue, R.N. “We have always been grateful for this strong connection that helps us deliver the best care close to home.”
Teamwork delivers end-of-life care through hospice and palliative care
In 1996 Sandhills Hospice merged with FirstHealth to create FirstHealth Hospice, now called FirstHealth Hospice & Palliative Care. Since joining FirstHealth, the organization’s capacity to offer end-of-life care has blossomed.
“When I started, we had an average daily census of 30 patients,” said Ellen Willard, M.D., medical director of the organization since 1992. Fast forward to 2020, in which more than 500 people were served by the hospice house in Moore County and nearly 850 were served throughout Moore, Montgomery, Hoke and Lee counties in numerous home settings, including patient’s homes along, assisted living facilities and skilled nursing facilities. Additionally, children, teens and adults who are adjusting to a serious illness or who experienced a loss due to death receive counseling at no cost.
“Thanks to the community’s generosity through the Foundation of FirstHealth, in 2011 we moved to a beautiful, 30-acre campus,” said Tina Gibbs, director of FirstHealth Hospice & Palliative Care who started with the organization as a social worker in 1995. In addition to administrative and field service functions, the campus is home to an 11-bed inpatient, home-like environment for short-term care.
It also encompasses gardens, a lake, a walking labyrinth, an interfaith chapel and a grief resource and counseling center. Another role the community plays is as volunteers, the origin and backbone of hospice, donating thousands of hours of service each year. Gibbs noted that throughout the organization’s history, its not-for-profit status is one of its greatest strengths. “The fact that we are not-for-profit and supported by the community allows us to care for uninsured patients and secure treatments for patients who otherwise may not receive them,” she said.
Teamwork delivers second-to-none nursing care
Anyone who has experienced health care knows that nurses are on the front lines. With the belief that nurses are the backbone of patient care excellence, FirstHealth of the Carolinas continually strives to maintain and enhance opportunities for professional growth, development and support in nursing. Efforts are earning national acclaim, with designations such as Certified Primary Stroke Center, one of the best hospitals in North Carolina according to U.S. News and World Report and consistently achieving top decile patient satisfaction.
One way nursing education succeeds is through partnerships with community colleges. “At least 80% of our new graduates are from community colleges,” said Karen Robeano, DNP, R.N., NEA-BC. “We depend on the community college and our community supporting nursing education.”
“It’s very much a symbiotic relationship,” said Sandhills Community College’s Dr. Dempsey. “Community colleges are committed to training the workforce and delivering skills so students can get a job to feed their family and have a secure future. Many of our students seek to work in the medical field and that training can involve clinical work at hospitals. We are grateful to FirstHealth for giving our students opportunities for hands-on learning. Also, we are grateful for the FirstHealth Professorship in Clinical Studies that helps our students advance their skillsets.”
Equally important for superior nursing is continuing education, also supported through community efforts. The Foundation of FirstHealth offers community members a way to honor their favorite nurses and propel the practice. Financial gifts build a nursing endowment that bolsters several programs, including:
- Reid BSN and Reid MSN/DNP/PhD Scholarship Program assists FirstHealth nurses looking to further their education through a bachelor of science, master of science and/or doctorate in nursing. Since inception there has been a significant increase in the percentage of BSN nurses, from 45 percent to now almost 60 percent. This is important because research shows that hospitals with more nurses with higher education have more favorable patient outcomes. At least 30 nurses have taken advantage of the the Reid MSN/DNP/PhD scholarship program.
- The Marjorie Geri Scott Endowment and the Dr. Donald Wallace Fund supporting advancement of nurse practitioners.
- The Chulay Endowed Fundto support Critical Care Nurses in attending annual national conferences. These nurses present evidenced-based best practices developed at FirstHealth and return with new ideas.
- Nursing Leadership Academy, a one-year program designed to prepare future nurse leaders, managers and educators. So far, 32 nurses have completed this program and nearly 40 percent of them have advanced to new roles.
Teamwork through dedicated volunteers
“Volunteers are essential to our work at FirstHealth,” said Cindy Strother, administrative director of Guest Services at FirstHealth Moore Regional Hospital. “They are family to us as well as the areas where they serve.” By teaming up with patient and visitor services, volunteers supplement the activities of the hospital’s paid staff by performing duties that do not require professional training.
All FirstHealth hospitals rely on volunteers. They drive shuttles, help with mailings, serve as welcoming “ambassadors” to facilities and act as liaisons between operating room staffs and anxiously awaiting families of patients. They take pictures of newborns, deliver flowers, accompany patients to medical procedures, operate gift shop cash registers and perform preventive maintenance and repairs on wheelchairs and stretchers. They provide companionship to and engage patients at risk for hospital-induced dementia through interaction, activities and conversation. They work at home making toys, blankets, walker bags, port pillows, heart pillows, eyeglass and hearing aid cases, pediatric pillowcases and non-medical-grade face masks.
In the hospice and palliative care world, volunteer options can include providing companionship and emotional support for patients, their caregivers and their families. At Clara’s House, volunteers serve inside the house, in the Healing Garden or through the CARE-Net program.
“Many years ago, a very wise volunteer, who worked transporting patients via stretchers until he was 93, taught me a valuable lesson,” said Strother. “He reminded me to expect volunteers to do great things for our hospital and then allow them, train them and give them the resources to do just that--great things.”
Teamwork through giving
One of the most impactful ways the community comes together to make the dream work is through charitable giving. Gifts prudently managed by the Foundation of FirstHealth Board of Trustees are pivotal in helping the organization deliver on its core purpose: to care for people. In the 25 years since Moore Regional Hospital and Montgomery Memorial Hospital joined forces, the Foundation has distributed more than $70 million while averaging a $60+ million invested portfolio.
Through the Foundation, the community has funded numerous brick-and-mortar enhancements to FirstHealth, including the Reid Heart Center, the FirstHealth Hospice House and the Clara McLean House. It also funds patient-facing efforts such as the Cancer CARE Fund, Life Vests for heart patients, breast pumps for new mothers and mammograms.
However, residents of our region may not know that the Foundation is also the driving force behind programs that patients can’t see but can certainly benefit from, namely nursing and physician enrichment programs. These equip clinical providers to be leaders at the forefront of health care – while enhancing work-life balance, career satisfaction, clinical performance, and personal health and wellness. The result? The ability to attract and retain world-class talent to build a world-class health care system.
Physician Leadership Academy
Traditional medical training does not teach the leadership and personal management skills physicians need to stay on the cutting edge of today's demanding health care environment. The Physician Leadership Academy, funded by the Foundation, fills the gaps. Each participant is assigned an executive coach to help develop competencies and mentor them through the process. Local and national experts teach monthly classes featuring topics such as communication, leading change, executing results and financial management.
FirstHealth Center for Provider Wellbeing
Anyone who has flown on an airplane has heard the guidance to put on an oxygen mask before helping a fellow passenger. That notion of caring for self to best care for others holds true in health care, too. Burnout among health care providers has never been higher and the Foundation of FirstHealth seeks to mitigate it through the Center for Provider Wellbeing. Established in 2016 the FirstHealth Center for Provider Wellbeing is an innovative and comprehensive benefit for physicians, nurses, other medical providers and their families with the intent to promote wellbeing, prevent burnout, increase resilience, restore health and foster intentional engagement.
Teamwork to care for people in 2020 and beyond
FirstHealth of the Carolinas President and CEO Mickey Foster started his health care career at Moore Regional Hospital in 1995, the same year the new FirstHealth entity was created. His leadership experience at numerous health care systems informed and refined his three goals for FirstHealth: make FirstHealth the best place to work in health care, create a culture resulting in zero harm to patients and build the new FirstHealth Comprehensive Cancer Center.
“Research has shown that high employee engagement is a significant factor in a great patient experience,” said Foster. In his work to create the best place to work in health care are numerous channels for open communication, including town halls and a weekly “Mickey’s Message” email to the board and employees. When possible, he also works alongside employees on “Walk in My Shoes” days and hosts “Meals with Mickey” to gain employee feedback.
Similarly, when employees are happy they produce quality work, said Foster. That contributes to zero harm, a term used in health care that means zero patients are harmed as a result of their interactions with FirstHealth. “We want to be a system with zero falls, zero injuries and zero infections,” said Foster. “My grandfather died of a preventable medication error and I am steadfast in my commitment to zero harm and continuing FirstHealth’s long-standing history of high-quality, safe health care.”
Foster’s third priority is the 2023 opening of the FirstHealth Comprehensive Cancer Center. Right now, patients must travel to multiple locations on the Moore Regional Hospital campus for cancer services. In the new, four-story, 120,000-square-foot outpatient facility on Page Road across from Reid Heart Center, patients will have one-stop access to FirstHealth’s full continuum of cancer care. Enhanced support services and patient navigation are also part of the new center. Patient comfort will be at the forefront of design; for example, patients receiving chemotherapy will be able to look outside at a beautiful healing garden. “A new comprehensive center will allow more local residents to receive their cancer treatments close to home instead of going elsewhere,” said Foster.
The community collaboration over the past 25 years that helped turn two rural hospitals into a health care powerhouse will be the same force needed to advance FirstHealth of the Carolinas through the next 25 and beyond. Can it be done? In the Sandhills, it can. Teamwork makes the dream work.
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