How the Closure of Rural Hospitals Affects Anesthesiology

In the quiet expanses of rural communities, the lights of hospitals are going out as facilities close. It’s a silent crisis that starkly affects both patients and medical professionals, with a serious impact on anesthesiology. As rural hospitals shut their doors, the already limited number of anesthesiologists in bigger communities is stretched thinner and they have less time to dedicate to each patient’s unique needs.

Social determinants of health (SDOH) in rural demographics — which are often correlated to heightened health risks and poorer outcomes — add layers of complexity to the problem. But in this landscape of scarcity, innovative solutions like RIVANNA’s Accuro Neuraxial Guidance device are serving the pressing needs of clinicians and patients.

By enhancing the efficiency and accuracy of spinal and epidural procedures, technologies like Accuro can fill expertise gaps, improve resource utilization, and raise the standard of patient care — even in the most underserved areas.

Supply and demand in rural areas

Since 2005, 195 rural hospitals have ceased operations, and 600 more are at risk of closure. Indeed, over half the counties in Nebraska “are defined as maternal care deserts,” according to the March of Dimes. Yet the demand for medical services doesn’t wane, leading to an intensified strain on the remaining facilities and healthcare professionals. The situation is particularly dire for the field of anesthesiology.

The effects are already being observed in rural communities across the country:

• Diminishing resources and increasing demands. With fewer hospitals in operation, anesthesiologists are often spread thin across multiple locations or must handle a higher volume of cases. This imbalance can lead to burnout and, more worryingly, decreased time and attention for each patient.
• Compromised quality of patient care. Hurried conditions and an overextended workforce mean that anesthesiologists have less time for vital aspects of patient care such as preoperative assessments, patient history reviews, and postoperative follow-ups. Each of these steps is crucial in identifying potential complications and ensuring safety.
• Elevated risks during procedures. In an environment where anesthesiologists are rushed or handling multiple cases simultaneously, the risk of complications or errors during procedures can increase. These conditions aren’t conducive to the careful, calculated approach necessary for administering anesthesia — particularly in complex cases or in patients with comorbidities.

The cascading effect of hospital closures not only burdens the remaining healthcare practitioners; it also compromises the quality of care for patients. It becomes imperative to explore solutions that can support healthcare professionals, particularly anesthesiologists, to ensure the best possible patient care standards.

Factoring in social determinants of health

Complicating the issue are distinct SDOH — such as socioeconomic status, education, and physical environment — common in rural areas. SDOH can make executing medical procedures more difficult and slow the patient’s recovery, particularly under the purview of anesthesiology:

• Prevalence of health complications. Rural areas tend to report higher instances of health issues such as obesity, diabetes, and heart disease — conditions that can complicate anesthetic care. For example, obesity can affect how a patient responds to anesthesia, while diabetes can influence wound healing and infection rates after surgery.
• Limited access to healthcare services. The social and economic environment in rural areas might limit residents’ access to regular health check-ups, resulting in late diagnoses or the escalation of preventable diseases. This scenario often leads to complex medical histories, which anesthesiologists need to consider for safe and effective care.
• Increased need for personalized anesthetic care. Given the health profiles often found in rural communities, anesthesiology calls for a higher degree of personalized care. Anesthesiologists must account for these variances to prevent postoperative complications, such as respiratory depression or uncontrolled pain, which are more challenging amid limited resources.

SDOH necessitate a more nuanced approach to anesthetic care in rural settings. Yet addressing these unique patient needs is becoming increasingly difficult. Anesthesiologists and certified registered nurse anesthetists (CRNAs) are ultimately tasked with accomplishing more while managing limited resources.

Rural clinicians need help

In constrained rural landscapes, innovations like RIVANNA’s Accuro Neuraxial Guidance device, an ultrasound-based imaging solution for spinal and epidural anesthesia, can deliver the support rural professionals need.

Accuro is transformative for anesthesiology, as it is clinically proven to reduce the number of needle redirects and identify the correct interlaminar space with a success rate exceeding 94%. This provides precise assistance in environments often marked by a scarcity of resources and specialist expertise, which saves time and alleviates stress for both providers and patients.

Moreover, Accuro is portable, streamlining procedure workflows so healthcare professionals can better manage their demanding schedules and ensure no patient is left waiting.

Consider, for instance, the women in Nebraska’s maternal care deserts. Twenty percent of them must drive an average of 80 minutes to reach their nearest birthing hospital, giving anesthesiologists much less time to work. In any hospital, every second counts — but hospitals treating rural patients have fewer seconds to spare.

In short, Accuro is more than a technological advancement — it’s a necessity. By plugging the expertise gap, enhancing the standard of care, and improving resource utilization, Accuro is a crucial solution to the crisis of rural hospital closures.

Support for the professionals who need it most

As rural healthcare grapples with significant challenges, innovative solutions like Accuro are becoming increasingly essential. These advancements are key in bridging the gaps in care and resources, ensuring every patient receives exemplary care — especially in a discipline as critical and delicate as anesthesiology. As clinicians are asked to do more with less, technology stands as a vital ally, redefining the future of rural health by turning adversity into opportunity.