Excellence in Governance for small providers: Melissa Fraser of West Park Hospital

Good is rarely good enough, and opportunities for improvement are never lacking. Those are the philosophies that drive Melissa Fraser, board chair of West Park Hospital in Cody, Wyo. “We're always striving to be in a better place,” said Fraser, who since 2004 has been on a mission to make the critical-access hospital a standout.

The first project she championed at 25-bed West Park was higher salaries for nurses and lab workers. “To retain good personnel, you have to pay them what they are worth,” Fraser said. An internal review revealed excess spending on traveling nurses but comparatively low salaries for staff. She pushed for a pay bump, which she said not only helped reduce turnover, but also boosted employee satisfaction and improved quality and safety through the ability to provide consistent care.

Fraser, 62, is this year's recipient of the Excellence in Governance Award for small provider organizations—hospitals with 100 or fewer beds.

She brings a diverse background to her hospital leadership role. An intensive-care nurse by trade, she has experience as a head of a cardiac catheterization lab, a medical practice business manager and neurosurgery product saleswoman. She also was a nurse-EMT for riders at horse shows in the Pacific Northwest.

Her main focus has been establishing partnerships to increase access to care. The collaborations benefit residents of Cody, a town of 9,800 founded by William F. Cody (aka Buffalo Bill)—and also aid vacationers who might need the hospital's services. Millions of visitors annually flock to the sleepy towns of the Bighorn Basin for its dramatic canyons and extraordinary mountain views.

For example, Fraser reached out to the local community to raise $3 million to construct an eight-bed hospice house, built entirely with local donations. “It was a win-win for both the hospital and the community,” she said. Families have a place equipped to take care of loved ones at the end of life, and a partnership with the hospital's foundation further ensures money is available for those without the financial means to afford the stay.

Two questions have become essential during all board meetings, she said: “What else can we do, and how can we make it happen?” Fraser also spearheaded a partnership with Nashville-based provider Dialysis Clinic Inc. The hospital did not have the capacity to allow out-of-town patients to receive dialysis. But as the closest hospital to the east entrance of Yellowstone National Park (only 52 miles away), West Park found a solution in 2013 by adding dialysis chairs, moving the service to a larger facility off-site, and partnering with Dialysis Clinic, which employs the nurses and handles day-to-day operations.

Now tourists no longer have to worry about forgoing hemodialysis treatments if they choose to spend a day at the nearby national park.

While discussions about healthcare all too often focus on costs, Fraser “is more about the people,” said Graham Jackson, director of patient experience who also heads the hospital's foundation. She nominated Fraser for the award. “She gets out there and works together with everyone to make this a great place to live.”

The Cody population might be small, but West Park—one of the town's largest employers—continues to thrive. It has 629 people on staff, including 52 physicians. In 2014, the hospital logged 7,600 ER and more than 67,000 outpatient visits.

Fraser said her focus remains on ensuring access to quality of care for all people, regardless of income. “Somewhere over the rainbow we're all equal and have access to healthcare,” she says. “That's where we've headed with our hospital and that's where we're continuing to go.”

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