Phased Building Projects: making them work in rural hospital environments


Just like economics, the culture of rural health care is unique. From inter-departmental relationships to decision-making dynamics, the culture of critical access health care is characterized by several key attributes.

  • CAH departments tend to collaborate and back each other up more intensively than in their urban counterparts. For example, when four people are on staff at midnight and a multi-vehicle car accident happens on a rural highway, all four of those people help care for accident victims, regardless of their daytime departmental assignments.
  • Decision-making in rural health care facilities happens differently. Consensus is built over informal table talk, just as much as in the boardroom. Where communities are small and tightly knit, effective health care leaders understand that community support is vital for hospital building projects. This support is often built through conversations in coffee shops and church fellowship halls as much as in more formal settings.
  • CAH leaders are held accountable to stringent financial stewardship responsibilities. Community stakeholders expect that leaders will provide for the medical needs of the community with minimal waste, bells or whistles. While people appreciate comfort, they are unlikely to support facility improvements that appear ostentatious or flashy.