The work accomplished through the Small Rural Hospital Improvement Program (SHIP), alongside the North Carolina Healthcare Foundation (NCHF), is changing patient care in rural communities.

The Small Rural Hospital Improvement Program (SHIP), a federal grant initiative administered by the North Carolina Office of Rural Health (ORH), empowers rural hospitals like Atrium Health Wake Forest Baptist Wilkes Medical Center to enhance patient safety and care quality through professional development, capstone projects, innovative partnerships and strategic support.  The capstone project is an opportunity for each participant to apply their newly honed skills in practice.

Jennifer Kreger, Manager of Quality Improvement and Patient Safety at Wilkes Medical Center based her capstone project on the community health needs of Wilkes County. Through her project, she leveraged the hospital’s community paramedicine program and peer support specialists to document meaningful, measurable improvements in patient care and community health.

Since launching in spring 2025, the paramedicine program at Wilkes Medical Center has supported more than 20 patients without a single hospital readmission. The community Narcan dispenser is used over 80 times each month. With help from peer support specialists, the team has made more than 2,000 connections and helped one patient secure permanent housing.

“I began to ask people in our hospital system, ‘What are we doing for the community?’ That’s where I learned about the paramedicine program. That’s where I learned about our peer support,” said Kreger. “I just started creating this story to share with others in hopes that they might be able to do the same thing at their rural health hospital.”

Community paramedics assist patients in their transition from hospital to home, aiming to reduce hospital readmissions and improve patient outcomes. A paramedic first meets with the patient before being discharged from the hospital, where they discuss the patient’s needs and potential challenges at home. In the following days and weeks, the paramedics visit the patient at home, ensuring they know how to take their medication, use medical equipment, and attend follow-up appointments with their doctors.

“We’re able to trend whether they’re improving or declining or staying the same. We can reach out to their care team and figure out if we need to do something different if they’re not having an outcome that we would like to see,” said community paramedic, Chad Foster.

The community paramedics work side by side with peer support specialists in the hospital’s bridge program, which helps patients with substance use disorder (SUD) manage withdrawal symptoms through Medication Assisted Treatment (MAT). Peer support specialists help place those patients into recovery programs, inpatient treatment or additional resources. They provide patient transportation as well.

“We are creating a community safety net, and we provide ongoing support, which reduces relapses and re-hospitalization. That just creates a ripple effect and makes our community stronger,” said peer support specialist, Jennifer Johnson.

As this work continues at Wilkes Medical Center, Kreger hopes it will inspire other small rural hospitals to build similar programs. She credits value-based training programs offered by NCHF to her growth as a quality leader and her confidence to train her team.

“They provide resources and perspectives we didn’t know we needed. The outside expertise and support that NCHF brings to small rural hospitals is immeasurable, it helps us build sustainable foundation for growth in education programs,” she said.

“To see the work that has stemmed from the SHIP grant into our communities is incredibly valuable—it gives our team the support they need to drive even better patient outcomes,” said Chad Brown, president of Atrium Health Wake Forest Baptist’s South and West areas, which include Wilkes Medical Center. “This continued education and skill-building is not only strengthening rural healthcare but also investing in our teammates with the resources they need to deliver exceptional care to Wilkes County and the surrounding areas.”

Atrium Health Wake Forest Baptist is part of Charlotte, North Carolina-based Advocate Health. To learn more about its commitment to sustaining and improving access to high-quality health care, visit www.advocatehealth.org/RuralCare.

For more information on the Small Rural Hospital Improvement Program, click here.