Case Studies

Case Study: Healthcare

Case study: Memorial Hospital of Sweetwater County

Hospital updates procedures to improve patient outcomes and staff morale

Memorial Hospital of Sweetwater County in Wyoming is in the same position as many health care facilities in sparsely populated areas of the Rocky Mountain West: It serves the health care needs of a population spread across a large geographical area.

MHSC is located in Rock Springs, in the southwestern part of the state, and it’s one of the few major medical campuses between Salt Lake City, Utah, about a two-hour drive to the west, and Cheyenne, Wyoming’s state capital, located several hours to the east.

In between lives a large portion of Wyoming’s nearly 600,000 residents, many of whom count on MHSC to serve their medical needs.

In 2011, MHSC — in particular, its Employed Physicians Group multi-specialization clinic — was not in a position to provide those services with any efficiency or effectiveness.

The clinic employed a small number of doctors, with little in the way of uniform standards and processes. There was no defined process for certifying physicians with insurance companies, billing for services or scheduling patient appointments.

As a result, the clinic was losing money, had no strategic direction and was suffering from low morale across the board among its doctors, nurses and staff.

It was an unsustainable situation for the clinic, but the clinic needed to survive — too many people were relying on it for medical services.

MHSC needed assistance to put the proper protocols and structure in place, and it needed it fast.



In spring 2011, the MHSC board and hospital president Jerry Klein contacted The Shealy Group for help with the systemic problems plaguing the hospital’s clinic.

To begin, The Shealy Group performed a top-to-bottom assessment of the clinic’s policies and procedures.

“They looked at every aspect of our clinic and how it was working,” Klein says. “When it was done, we had quite a detailed outline of what was wrong and what needed to be done in order to remedy the problems.”

The Shealy Group recommended a teardown of the clinic’s flawed and incomplete systems, to be replaced with a new operational structure. To accomplish that, the firm stationed an employee at MHSC for several months on a full-time basis to oversee the transition.

Under the firm’s guidance, MHSC installed new physician-credentialing protocols with insurance companies, new billing processes and a new scheduling system, training physicians and employees to ensure that every person working in the clinic had the same level of understanding regarding the new systems and the expectations regarding performance.

“The turnaround was simply a 180-degree difference,” Klein says. “When we started with this, we weren’t even getting the phones answered in a timely manner. We weren’t doing anything right. The Shealy Group changed all of that.”

With a defined organizational structure in place, morale began to improve as doctors and staff found a renewed sense of purpose in their work. The improved structure also aided in recruiting efforts at MHSC. The clinic was able to begin attracting new doctors, nurses and staff, and to onboard new hires in an efficient manner that allowed them to hit the ground running in their new positions. As a result, the hospital is now serving patients with the high standard of care desired by both Klein and the board.



The Employed Physician Group clinic at MHSC now employs 105 doctors and staff, nearly nine times the 2011 staff total. The additional employees have brought with them new areas of specialization, including pulmonary medicine, oral maxillofacial surgery and urology, among others.

As a result of the new areas of specialization, the clinic is playing an integral role in positioning MHSC as a destination center for medical care throughout southwestern Wyoming.

In 2011, MHSC had a 40-percent out-migration of patients to larger facilities — meaning that 40 percent of patients required care that was beyond the capacity of MHSC, necessitating referral to a larger hospital, usually in the metro Salt Lake City area.

As of early 2015, the out-migration rate had dropped to 12 percent.

“Things like premature baby deliveries, major trauma cases and complex surgeries, we won’t try to get into that,” Klein says. “We’ll ship those cases to a tertiary care facility. It’s in the patient’s best interest. But beyond that, we have really been able to position ourselves well to serve this whole region.”

Klein stresses that none of it would have been possible without the involvement of the Shealy Group and its desire to turn MHSC’s clinic into a health care management success story.

“Each and every one of the staff members at The Shealy Group really cares about what they’re doing,” Klein says. “They work with you, and they honestly become your friends. They care that much about the help they’re giving you, and about seeing your hospital and clinic become a success.”

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