Transcription:
The Outer Banks Hospital Celebrates 20 Years of Growth and Innovation with Ronnie Sloan.

Denise Schnabel (Host): Hey, everyone. Welcome back to The Outer Banks Health History, the official podcast series of The Outer Banks Hospital and Medical Group. This month marks 20 years since the hospital opened and we had been celebrating with weekly episodes that feature special guests speaking about life before The Outer Banks Hospital as well as its early years. Today, we will be looking forward. We are your hosts, Denise Schnabel.

Wendy Kelly (Host): And I'm Wendy Kelly. Today's guest leads a healthcare team of over 500 dedicated individuals. He previously served as the administrator in charge of the Swain County Critical Access Hospital and Swain Medical center, and was also the Vice President of Support Services for the Midwest Health System in Clyde, North Carolina. The Outer Banks Hospital was fortunate the day this Star Wars fan took command of the bridge on June 13th, 2011. He's the President of the Outer Banks Hospital and Medical Group and a real life Stormtrooper. Join us in welcoming Ronnie Sloan. Ronnie Sloan!

Ronnie Sloan: Thank you.

Denise Schnabel (Host): Thank you for being here, Ronnie.

Wendy Kelly (Host): You're most welcome.

Denise Schnabel (Host): So in the movies, Ronnie, Stormtroopers are evil. But we all know that you are not. So before we get to the meat of the podcast, tell us about your Stormtrooper side hustle.

Ronnie Sloan: Oh, my side hustle. Well, yeah, I work with a group of dedicated volunteers, nerds and geeks of both female and male persuasion who build costumes, exactly replicas of the Star Wars costumes in the movies. And we do a lot of work with children especially. Make-A-Wish Foundation is our national partner. And we just love to get out and have fun with the kids and raise money and have awareness for Make-A-Wish Foundation.

Denise Schnabel (Host): That's great. And you have to live Stormtroopers in your office?

Ronnie Sloan: I do.

Denise Schnabel (Host): Great.

Wendy Kelly (Host): They're models?

Ronnie Sloan: They are. Yep.

Denise Schnabel (Host): Nice.

Wendy Kelly (Host): So prior to that, or maybe not, because the Star Wars came out quite a few years ago, but when did you decide to go into healthcare?

Ronnie Sloan: When did I decide to go into healthcare? So I was in college, as a young 18-year-old, in mechanical engineering. You know, I don't want to offend any mechanical engineers out there, but I realized I'd be sitting in an office and doing a lot of work. This is before computers, I'm dating myself a little bit. Before computers came along, so a lot of drawing by hand and I'd taken a couple of years of drafting in high school at a vocational school. So I liked the drawing part, but realized pretty quickly, it was all about metallurgy and tensile strength of steel and all those type of stuff. And I happened to be dating a nurse at the time who was in nursing and I would see her come on the weekends and we'd get together. And she would talk about her day during the week and delivering a baby, saving a life, doing CPR, holding someone's hand when their family members passing away, just her compassion and the way she felt, the way it made her feel and the fulfillment she got out of that career was just amazing to me. So I started thinking about healthcare in general, because that seemed a lot more fulfilling to me than sitting behind a desk drawing all the time, basically.

And fortunately enough, I met a counselor in college. He was very smart and talked to me about different healthcare careers and introduced me into respiratory therapy. And I remember distinctly, he said, "Well, what about respiratory therapy?" And I said, "Respiratory what?" I had never heard of it. This was -- I'm dating myself again -- 40 years ago. My high school 40th reunion is coming up this year. So then he introduced me to Wanda Perry, who was the Director of the Respiratory Therapy Program in Greenville, South Carolina. And all as cliche, she could sell you oceanfront property in the middle of the desert about how great respiratory therapy was as a field. And I was still very young, about 19 years young when I got into it. And then, I started working in the clinic. I started treating patients and touching patients and, you know, going into a room with a really sick kid. I love the pediatrics as you could tell. It's still a little Star Wars stuff, right? And a matter of fact, all the therapists loved it when I was on the schedule because they knew I'd take care of the kids no matter how sick they were, no matter what situation they were in. But you'd go in and for the 20, 30 minutes you're treating the kids, you know, the parents, their shoulders would just kind of relax and they'd take it easy. And they kind of realize that somebody else had their kid for a moment and they could relax and take a break. And I got a lot of fulfillment out of that very quickly and excelled as a student, that my mother, bless her heart, asked me the question, "Are you cheating on your exams, son?"

Denise Schnabel (Host): Wow. Mom, what?

Ronnie Sloan: Yeah. "You didn't have these kind of grades in high school." You know, I could say, maybe you should cut this later, but whatever, you know, I'm proof that a solid C in high school can become president of a hospital.

Wendy Kelly (Host): You like what you do.

Denise Schnabel (Host): Yeah.

Ronnie Sloan: Right. So I got into college, got into respiratory therapy. I found my passion, found something I really loved, really wanted to put my effort towards and ended up being a, you know, honor student, all this type of things that go with it. And again, mom accusing me of cheating. I've never brought this kind of grades home in high school. So that's what I encourage every time I've talked to kids. I mean, just do what your passion, do what you like. Don't worry about the money. Don't worry about anything else. Don't worry about the status, because it all comes with happiness. You know, strive for something that really just fulfills you, period. And that's what it's all about, I think.

Denise Schnabel (Host): That's a great story. I'm glad you weren't cheating.

Ronnie Sloan: Yeah. Right.

Denise Schnabel (Host): So these past two years have been crazy with the COVID pandemic. So with your background in respiratory therapy, as well as being the leader of the organization, you have a unique perspective. What's it been like for you?

Ronnie Sloan: Yeah. You know, respiratory therapy definitely is still an unknown field to some extent. I mean, I think one thing is highlighted, respiratory therapy and the importance of respiratory therapists in healthcare in general, I think that's great for a profession. But innovation has been huge over the last several years from some telehealth to ways that we keep the environment, you know, clean and sterile to the way we treat patients from testing perspective to COVID infusions. I mean, the movement the country has made in just a couple of years through innovation and through people working together across all spectrums, it's been amazing. The hope is that we harness all that, and go forward with it and have things even better, even quicker, which is what our country is going to need, obviously.

Denise Schnabel (Host): Right.

Wendy Kelly (Host): Ronnie, last week, our podcast guest was Beulah Ashby, a former board member, and she spoke about remembering interviewing you. And that one of the things that you said during your interview 11 years ago was, "I want to grow this hospital." Do you remember that?

Ronnie Sloan: Yeah, most definitely. And I love Beulah to death. When I'd met Van Smith, so a lot of people in the Outer Banks still know Van Smith. I'd met Van Smith at a hospital conference. I was in a situation in my previous employment and I was ready for a new challenge and looked around and he was talking about the Outer Banks. I'd never been to the Outer Banks in my life. Probably one of the few team members we have who had never been to Outer Banks until we actually interviewed here. And I interviewed here because of the impact I felt that I could make personally on this community. So Van was talking about the community and just what a giving community it was. And the community pulled together to do things that were just unbelievable for a community our size. So it really intrigued me. And about a week later, I saw through a hospital email that comes out across the state, movers and shakers, well Van was a mover and shaker because he had mentioned he was leaving and going to Greenville for a senior position. And I thought to myself, "Well, that's silly. You just told me you had a great position and a great community in the Outer Banks." So I sent my application in and it was all history. You know, six months later, I was here as the president.

One of the things I did during all that time, obviously, was too a look at the market and market data and the age of the hospital system being nine years young. Matter of fact, another trivia answer, I actually interviewed, the first interview was on the day of our ninth anniversary. So I actually interviewed on one of the anniversary days, which was kind of cool. Now again, like you said, 11 years ago now here in June, I started. So I really saw a lot of opportunity for a young hospital to really grow. You know, stuff like ear, nose and throat services, urological services brought to the outer banks, the urgent care centers that we've opened. I'm not sure how we would have managed the last couple of years with both tourist volume and COVID volume without those urgent care centers out there.

Cancer services, I took a look at the cancer services in the community, which weren't really grown where they are today, obviously. And mortality, there's a Robert Wood Johnson Health Status Indicator report that comes out every year. If the community doesn't know, out of a hundred counties in the state, you know, we've ranked 5th to 11th over the last 10, 11 years. And one of the indicators on that status report is around cancer mortality and screening, mammo screening, prostate screening, lung cancer screening, those type of things. And that's where we were not doing that well as a community. We were diagnosing cancers really late in stage with poor outcomes and we were not screening women and men enough for cancer services. So I knew that had a real big hole as well that we could work on. So that kind of stuff really excites me. I had a leadership meeting a few months after I started and I used the analogy that we all use a lot, spaghetti on the wall, because you know I love throwing spaghetti on the wall and some of it's going to stick and some of it's going to fall right off, where I go, "Dang. That didn't work. That's okay. We'll keep moving." The interesting thing here is probably 90% has stuck and it's really amazing at this community because without the community, there's no way we'd be this successful, obviously. It was also why we started the outreach department really early on to really connect in this community because we needed the community to go with us on this journey. We really couldn't do it alone.

So yeah, just the whole excitement of the potential here, as I tell people, please nobody send me hate emails, you know, I don't go to the beach. I hardly ever go to the beach. You know, my wife, my family loves it here, loves this community, but I could do this anywhere in America as long as I knew I could have this kind of impact on a community. That's what drives me. That's my passion. And to think that we've decreased mortality in cancer alone 11 years ago, being above state average in all cancers, including breast cancer mortality in five years to now decreasing it by over half in breast cancer and now being 67% below state average, it's just amazing the lives we're saving and the work that we're doing. I could just take the whole podcast, just keep talking, but I know you may want to ask some questions. I'm always asked a few questions, but what great opportunity and, you know, why would you leave an organization that you've been with for 20 years to go do nothing or to go do something less? And the ability to lead this organization, it's just been an honor and I'm pretty humbled by the whole thing.

Denise Schnabel (Host): That's great. So you've mentioned the cancer and you've mentioned the urgent cares. What other innovations have been most notable for the hospital?

Ronnie Sloan: I think stroke care is really large. Eleven years ago, we weren't giving the clot-busting medication to help with stroke patients. We didn't have neurologists on site, which you need to read the studies to make sure that you're giving it appropriately. Because if you give the clot-busting medication to individual patients who don't need it, who aren't having a stroke or other symptoms that are similar, then you can really hurt the patient. So we would ship people as quick as we could, who might be having a stroke in Chesapeake or Albemarle, where others would decide if they were having a stroke or not. So we were at a contract with a teleneuro company who does telehealth. People talk about telehealth a lot. And we talked about it tremendously the last couple of years through COVID. But really, we started using telehealth about nine years ago for a program that really makes a difference. And as soon as you come into hospital with potential stroke signs and symptoms, then the neurologist gets on the computer as well as our ED physicians. And they're all seeing the CT scan immediately and determining by an expert if we should give the clot-busting medication or not. And now, we're doing it very routinely, very regularly. I think we all know Diane Denny here in the community who is a great leader in this community, especially now her recent work with the Alzheimer's Coalition locally, and the impact it made just on her and her life and her quality of life is just one great example because what we think about when we do these type of enhancements, you know, we think about our patients and our community. So yeah, stroke care has just been tremendous over the last number of years.

Denise Schnabel (Host): And we just went through our recertification for our stroke program.

Wendy Kelly (Host): And another item might be Dementia Friendly.

Ronnie Sloan: Yeah. The Dementia Friendly is pretty cool as well. And again, it's one of those things that came out of this community first and through the Healthy Carolinians' work and health department's work and our tri-annual needs assessment, community health needs assessment. So we were given the challenge pretty quickly by Diane. A matter of fact, this hospital, what if it became totally dementia friendly, the first hospital in the state to do it? And Marcia Bryant, our Chief Nursing Officer, you know, took that up as a challenge and she did it. And so we did become the first hospital in the state to become Dementia Friendly. And, you know, what does that mean? Well, it means that, you know, our food service workers understand that dementia patients, if they see all white plate, eating mashed potatoes and all white chicken, they lose their food and they don't eat. But if you make it colorful and you put it on colorful plates and you mix and match it somewhat, then they eat better. It also allows your facilities worker, when they go in to change a light bulb or to work on an air conditioner, that they understand and get trained on how to treat a patient, how to approach a patient, how to be conscious to have a better patient reaction to those folks who may have some sort of dementia. So we marked that on the door in a unique way with a seahorse. So all of our staff, a hundred percent are trained and Marcia Bryant's been fortunate enough and Lisa McGaha as well, our med surge director to be on panels throughout the state, to work with communities outside of the state even in United Kingdom, pushing this forward Dementia Friendly. It seems like it's something that we all should know when you're in healthcare. So you should not treat dementia patient, just not the case whatsoever. Unfortunately, witnessed firsthand, mom passed away a couple of years ago with frontal temporal lobe dementia. And when I was with her at a rehab hospital after a shoulder break, you could tell pretty quickly that people just didn't understand how to deal with patients who were angry, who were cussing, who were, you know, in dementia stages and they just thought, "Well, they're just a mean old person, right?" And it's like, "No, they have a condition and we need to know how to handle them." And just by saying a few kind words, by sitting low with them, not hanging over them, by not touching them until they're okay for you to respond that way, just really means a tremendous difference in their care. But it also means a tremendous difference in their loved ones. When they see the staff interacting with their loved ones that way, and more of a compassionate way versus just kind of as a patient number. I can get on that soap box for a while, because mom went through it.

Wendy Kelly (Host): The beauty of that was the decision to have a hundred percent of the team trained in it because being in a department other than clinical, I had the opportunity to actually employ it in an airport one time and I never would have done it had I not been trained in it. So you pass it on. It's synergistic, I think.

Ronnie Sloan: Yeah, the hospital's really proud of that. The North Carolina Healthcare Association began giving out an innovative award. It's called the Highsmith Award and their inaugural year several years ago, they actually awarded it to our hospital for the Dementia Friendly movement that we've made. And I think as I told them during the acceptance, it was a real brief acceptance speech. It really just goes to show it doesn't really matter the size of the hospital. It's all about the size of your heart. And that's kind of like how we lead our organization

Denise Schnabel (Host): And what's really cool that businesses here on the Outer Banks, restaurants, et cetera, also became dementia friendly, and taught their team how to engage in the same approaches. I thought that was pretty cool.

Wendy Kelly (Host): It all started here. It's really amazing to be proud about.

Denise Schnabel (Host): Yeah, it's amazing.

Wendy Kelly (Host): Other innovative projects, when did the idea come to you or the dream about starting a cancer center?

Ronnie Sloan: Oh, wow. Sometimes it takes a long time for dreams to come true. Probably four or five years ago, we really started thinking seriously about a comprehensive cancer care center. We had hired our first director of cancer services, was a first new position I created when I arrived 11 years ago. Again, based on previous things I've mentioned already in this podcast, but who knew one day we would grow big enough hopefully to need a comprehensive cancer care. We need to be accredited first, which we've now been nationally accredited several times over now. One of eight hospitals our size in the nation with such accreditation. Same accreditation, not to pick on any one, so I'll be across the board, Sentara, Norfolk, Vidant Medical Center, same exact standards, and whether you're accredited or not, it doesn't really matter. Really, because this is the right roadmap to do the best by your patients. And that's really what accreditation means. It really gives you the standards you have to uphold to do best by your patients and by your community.

So as we began to become accredited and say, "Well, we really are growing," we have chemotherapy at the hospital, hematology in the medical office building. We have a radiotherapy center down the road. So I started looking about four years ago really for sites. What happened over the first couple of years was our linear accelerator, our radiation therapy center in nags head was aging out and need to be replaced. And when you replace something like that, it ends up being a six-month process to pull the old one out and put the new one in. You know, the vault that it sits in is bigger than a bank vault and thicker, it's eight-foot thick all the way around in concrete. So we knew we had to go ahead and put a new LINAC in, the piece of equipment that treats the radiation therapy. So we started a new location for it, hoping one day we could expand it. We also did that, so the community wouldn't be down for six months and need to travel four or five days a week for radiation therapy services. So we built the new radiation therapy center, closed one down on Friday, opened one up on Monday, so the patients weren't inconvenienced. And then started working towards the plan to expand that center. Because really, I mean, we have a great service. We have proof this is a great service. We have proof that we've decreased mortality greatly over the years as well. But still for the best care possible for our community, to have all those services in one location and you go, "Why?" Well, the caregivers in hematology-oncology, the caregivers in chemotherapy, the nurse navigators, the social work, case managers, nutritionists, the caregivers in the radiation therapy center, they all see the same patients at the end of the day. And there's a lot of communication that goes back and forth. And when you're on three different floors and across the street, some of that communication can be jumbled at times. And that's not a mistake we want to make. So to have everybody in the same building, have daily conferences on patients who may be getting treated multiple ways in the same day or the same week at the same time, just makes the best sense and the best way possible for patients to have the best care possible. It's also nice and convenient for the patients obviously, because they just go into one shop and they don't have to go across the street or back and forth. So that's convenient, but really it's all about the coordination of the care, delivering the best healthcare for our patients.

Wendy Kelly (Host): And it is coming true. It's very exciting.

Ronnie Sloan: It is. It is coming true.

Denise Schnabel (Host): And remind our listeners where that cancer center is going to be.

Ronnie Sloan: It'll be across from the main hospital campus in Nags Head. The urgent care center in Nags Head, if you haven't noticed by now, our color just went up on the old Applebee's. So you go, "That must be a hospital because it's the same blue." But what is it? That will be our new urgent care center in Nags Head. So we're moving into that building, leasing that from the Rosemyr Corporation who leases the mall there. And we're going to be tearing down the urgent care center in Nags Head and adding about 10,500 square feet to the radiation therapy center. And it would be a two-storey building. And it will indeed have chemotherapy, hematology-oncology, the nurse navigators, areas for nutrition counseling for symptom management clinic and everything that we do now, but just all in one nice location.

Denise Schnabel (Host): It's going to be amazing. I cannot wait.

Wendy Kelly (Host): We can't wait.

Ronnie Sloan: We hope to break ground June-ish and have some other great announcements too with groundbreaking. So, if it works out, I think it's shooting to be done by August, September of next year of '23.

Denise Schnabel (Host): That's amazing. So great for the Outer Banks.

Wendy Kelly (Host): Stay tuned.

Denise Schnabel (Host): So, Ronnie, I know you are humble. And I tell people all the time, no disrespect to anybody, that you are the best thing that's ever happened to this hospital. So with that being said, what are your hopes for the future of the Outer Banks?

Ronnie Sloan: Wow.

Denise Schnabel (Host): If you had a crystal ball or your dreams?

Ronnie Sloan: I think we've done a fantastic job over the years, bringing in services that really a small facility can do safely, effectively and expertly. That's one of the things. I think a lot of times in the community folks either think if you're a small facility, you're kind of a Band-Aid station, or you should do heart surgery. I mean, that's just what we hear in the community. "Ronnie, why don't you have a trauma surgeon? Why don't you have a neurosurgeon? You know, why don't you have a heart surgeon?" And we'll just never do those types of things because it's just not the right thing to do in a small facility. You really want somebody that does a hundred cases a month when you have your heart surgery, not somebody who does 10. So this time, I think from a standpoint of good community services for this community, we're close to where we need to be. I think some neurology services would be great to work on, but not neurosurgery, for example, that type of thing.

You know, I think when you asked about the future for me right now, anyway, it's just a moment in time, you know, but it's probably not as much about changing healthcare, growing healthcare, but it's about maintaining what we have. We all know where we sit in this community when it comes to our environment right now, when it comes to team member shortages, when it comes to housing shortages, when it comes to cost of living in the Outer Banks. So right now, almost all of our strategic thought is being put in how we maintain what we had to go to the next couple of years. And obviously now locally with gas prices just recently, does the helping as well. So I think the future of us is innovative ways that the community works together and looking at essential housing. We have to. I mean, it's so critical. It is the number one critical thing across the board no matter what service line you're in the Outer Banks, because negative feelings towards the Outer Banks kind of will affect everything at the end of the day.

Wendy Kelly (Host): You're not the first podcast guest to say it.

Ronnie Sloan: Yeah, reading a lot of stuff from folks in the west coast as well. We're not unique. There's a lot of small tourist towns in America that are going through the same thing that are, you know, million dollar for houses at a start. You know, we're at probably about 500,000 or so in our sales, but there's some that are in a tougher situation that we are. A lot of those are unique because they have just one or two towns and they do a lot of things closer together. And, you know, we're pretty spread out and a lot of coastline. It's a challenge, but I really hope we pull together as a community and figure it out obviously.

Wendy Kelly (Host): Well, if the past is any indication we're going to do it, we will.

Denise Schnabel (Host): We are.

Ronnie Sloan: Yup.

Wendy Kelly (Host): Persevere.

Denise Schnabel (Host): So if you've enjoyed this podcast, share it on your social channels. To hear more Outer Banks Health History, check out the library at theobh.com/podcast. This is your host, Denise Schnabel. Stay safe.