RCHC Community Project Abstracts

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Access to Specialty Care Services in Curry County
Date of project: 10/12/2009

The limited availability of local specialty care services in Gold Beach, Port Orford, and Brookings, Oregon is a significant barrier to accessing adequate health care for patients in Curry County. Patients frequently have to travel to other cities in order to obtain necessary care, incurring additional costs related to transportation/travel, lost work hours, childcare, and direct health care costs. This project aims to illustrate potential barriers to accessing care, delineate where providers are currently referring patients for specialist services, and quantify the costs (time and monetary) of travel for the purpose of accessing such services. Demonstrating the challenges associated with utilizing specialty care services as they currently exist provides insights into potential solutions for addressing these issues in Curry County.

Public Perceptions Regarding Adult Obesity and Treatment Options in Gold Beach, OR
Date of project: 9/7/2009

Obesity is a nationwide problem associated with many well-known effects on physical and emotional health. Gold Beach is a small, coastal community in the southern portion of Curry County, OR. It is not currently known what options exist regarding obesity in this rural area, and what local public perceptions are regarding both the problem of obesity and the treatment options available. This qualitative project was designed to explore regional views on obesity and therapies available both from patients and physicians in the area. These were conducted via personal interviews with many members of the community. In addition, a literature search was performed to explore evidence-based data available on other treatment options that have been explored. Results showed many areas of frustration with diet and exercise, as well as success with mainly surgical therapies. Interestingly, many behavioral and group therapies had not been tried in this smaller community. Based on the perceptions gathered from patients in Gold Beach, failures and successes reported, and the literature search performed, recommendations to help physicians and patients achieve weight loss outside of medical and surgical management were created.

Advance Care Planning
Date of project: 8/3/2009

Gold Beach has a large percentage of elderly population. The largest age group is 45-64 at 33.5%, above the 27.1% of the Oregon average. The group of 75-84 year-old is at 9.1%, double the Oregon average. Heart disease, cancer and chronic lower respiratory disease are listed as the top three causes of death in Gold Beach from 2001-2005. Advance care planning seems to be more pressing in a small town with a higher elderly population. POLST and Advance Directives are available to facilitate the discussion of advance care planning. After witnessing two patients pass away in the ER with a POLST and DNR during my first week, I want to explore how the hospital and the providers in a small town manage advance care planning. How is Curry General Hospital incorporating POLST and Advance Directives into the care of their patients? The project involves chart review of recently hospitalized patients in 2009 to obtain a baseline of the number of people with and without such forms. Interviews were then conducted with the nursing, medical, and administrative staff to understand how the hospital manages these difficult issues. Recommendations were made based on the chart reviews and discussion with the staff.

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