After one year in operation, the Strickland Cardiopulmonary Rehabilitation Clinic at Evans Memorial Hospital in Claxton has yielded measurable improvements in health and quality of life for patients who have experienced events such as heart attacks or been diagnosed with heart disease or trouble breathing, reports the hospital and CareSource Georgia.

The clinic is also showing promise as a part of the rural hospital's ongoing efforts to remain viable and relevant to its community, said Evans Memorial CEO Bill Lee. CareSource Georgia, a nonprofit managed care plan health insurance provider, contributed $25,000 toward creation of the Cardiopulmonary Rehabilitation Clinic. Another $25,000 contribution came from the Strickland Foundation, a longtime EMH benefactor organization created by the late George W. "Jack" Strickland Jr. and his estate. Not to be confused with the longer-established Jack Strickland Rehabilitation & Wellness Center across the street, the clinic was set up inside a recently underused space, which once housed nuclear-medicine equipment, inside the main hospital.

"We really felt like it was an opportunity to meet a need in the community that wasn't being met, in opening the Cardiopulmonary Rehab Center. …," Lee told the Statesboro Herald. "It is a rehab program that is geared to people that have cardiopulmonary issues or diagnoses, and part of their treatment post-hospitalization or post-diagnosis would really be to use monitored equipment, whether it be ellipticals, whether it be treadmills, various machines that we have in that area, and it's  monitored and supervised by a technician."

The technicians monitor patients' vital signs such as heart rate and blood pressure. This is done in an effort to keep the patient safe, "but  also stress you and stretch you to exercise and rebuild some of the deficiencies that you might have with your heart or lung capacity," Lee said. "Really, it's more around endurance and helping you get back to a baseline that would help you in your daily living."

In addition to guided exercise with state-of-the-art monitoring, the program provides patients "lifestyle education," on nutrition, exercise, and topics such as smoking cessation.

Patient graduations

The hospital currently has 25 patients enrolled in the cardiopulmonary rehab program and has "graduated over a dozen," Lee said.

A physician typically prescribes either a six-week or a 12-week program and then oversees the patient's progress. 

"They have to hit certain milestones, and once they complete that, they get to graduate and ring the bell, and we have a little certificate and a ceremony for them, just to recognize their good work and efforts," Lee said. "We've had multiple graduations, and we continue to enroll people in the program and hope for continued success."

According to some rough statistics cited by a public relations firm in a release for CareSource Georgia, 70% of participants improved their cardiovascular fitness, 40% of patients who previously required supplemental oxygen no longer need this therapy and over 75% of patients "experienced notable health benefits" such as reduced resting and post-exercise blood pressure. These numbers reflect the experiences of the program graduates, Lee agreed.

Evans Memorial, he said, is the only provider in its region that has a rehab program specifically for cardiopulmonary patients.

"And so we're very excited about that, and especially when you serve the counties in Georgia that we do, it's great to have that, so people don't have to travel to Savannah or to a larger city, and some go to Statesboro, but it's not always as easy to get in at East Georgia Regional," Lee said.

He added that he is friends with Stephen Pennington, CEO of EGRMC, and was not implying anything negative about the Statesboro hospital, but only meant that "it's just a little busier over there."

EMH resurgence

Evans Memorial, a not-for-profit, public hospital overseen by the Hospital Authority of Evans County, is licensed for 49 in-patient beds but currently operates 25 beds, a number that has rebounded after cutbacks in staffing a few years ago.

EMH now has a pulmonologist and a cardiologist on its medical staff, and the pulmonologist, Dr. Adewumi Oguntunmibi, supervises the rehab clinic program.

Developing an outpatient specialty area, such as a cardiopulmonary rehab clinic, is also something struggling rural hospitals do in their efforts to draw more patients and revenue and stay in business. In recent years, Evans Memorial has taken a number of other steps that appear to be paying off. It has also added plastic surgery and orthopedics, as well cardiology, Lee noted.

"In 2020 when I came it was on the hospital closure list for the state of Georgia, and now we have actually grown our volumes by 30 to 40 percent, we've increased revenue, we've had positive bottom lines for the past three financial years," he said. "We are really trying to make sure that we are being smart but also being relevant to the community."

That 30% to 40% growth in volume was from a combination of inpatient and outpatient visits and surgeries.

Since 2010, nine rural hospitals in Georgia have closed, placing the state among those with the highest number of closures nationwide, CareSource noted in its release. CareSource has invested $5 million in a special loan program to provide bridge funding to hospitals with cash-flow issues.

But the $25,000 contribution to Evans Memorial won't have to be repaid. Dr. Minh Nguyen, chief medical officer for CareSource Georgia, said the Cardiopulmonary Rehabilitation Clinic was Lee and the hospital's idea, but one CareSource was proud to support. Cardiovascular disease is the leading cause of death in Georgia, accounting for more than 28,000 deaths annually — about 1 in 3 deaths overall, and he said access to rehabilitation programs can make a real difference.

"As a nonprofit, managed care organization, we're committed to strengthening rural health systems by investing in these innovative programs," Nguyen said. "These programs existed a lot more in the metro-Atlanta area or bigger cities. However, in the rural communities, access to something like this is very challenging for patients. People may have to travel hours to the next county that would have something like this, so in this area to have a clinic of this size, and state-of-the-art, and treatment with clinicians well trained is extremely helpful for these communities, so we love supporting clinics like this."