The Role of the Nurse Executive in Rural Hospital Closure

Abstract

Between 2010 and June 2016, 75 rural hospitals closed, and more than 250 more are at risk of closure. Nurse executives need to be prepared for this eventuality. There is a need for formal direction on how to close a highly regulated healthcare facility.

“It's not right”: Nurse perspectives on rural hospital closures: A qualitative study

“…Prior to and during the process of closure, participants expressed lacking input into hospital‐level administration decisions, similar to Warden's and Probst's (2017) finding of nurse executives reporting exclusion from the decision to close and not feeling prepared for the administrative aspects of a closure once the decision was made. Participants of the present study indicated that nurse executives were burdened with the knowledge of a high likelihood of closure before staff nurses but were unable to share that information immediately.…”

“…Community characteristics (i.e., more residents over age 65) have contributed to increased odds of unprofitability for rural hospitals (Kaufman et al., 2016). However, studies providing in‐depth reasons for closures from a qualitative perspective (Hart et al., 1991), and community‐level recommendations regarding preventing closures (Harmata & Bogue, 1997), are dated, and nurses’ insight about closures is limited (Warden & Probst, 2017).…”

“…Rural nurses can provide care in under‐resourced environments (Schlairet, 2017), and serve as expert generalists (Knight et al., 2016). The processes of rural hospital closure, including exclusion from decisions to close the hospital, can influence how nurse executives lead through change (Warden & Probst, 2017). Despite the central role of rural hospital nursing, there is limited information about the subtle aspects of rural hospital closure, including antecedents, intra‐organizational process, and long‐term impact of the closure through a rural nursing lens including rural nurse staff and nurse executives.…”

Isolated, small, and large hospitals have fewer nursing resources than urban hospitals: Implications for rural health policy

“…Results add to few published studies we identified about differences between rural and urban nurse education and work environments (Baernholdt & Mark, ; Skillman et al, ), and extends knowledge by describing how, as hospitals became more rural, there were fewer nurses with a BSN, fewer RNs, and higher patient‐to‐RN ratios. Fewer nursing resources in isolated hospitals represent another worrisome facet of rural population health care access given increasing U.S. rural hospitals closures (Kaufman et al, ; Warden & Probst, ). Results highlight the need for rural health policies to allocate nursing resources to under‐resourced rural populations, who face greater chronic disease that contributes to poorer health compared to urban populations (AHRQ, ; NASEM, ).…”