When you choose a career in health care, you learn quickly that there are some key attributes one needs to ensure success – both for the organization and for you as an employee. First, you need to be passionate about helping people and your communities. Second, you need to be agile and prepared to face anything thrown at you with little (and sometimes no) time to prepare. Third, you need to be committed and connected – to your community, to your health system and to everyone’s well-being.

Never have these attributes been more necessary than today, as our world faces one of the deadliest pandemics of our generation.

In one rural Missouri community nestled between Kansas City and Columbia, Mo., Fitzgibbon Hospital and its leadership epitomize these attributes and can teach all of us about how to face challenges like COVID-19 head on.

Fitzgibbon Hospital: COVID-19 Journey

Fitzgibbon Hospital is a 60-bed, non-profit hospital, located in Marshall, Mo., a rural town in Saline County with a population around 15,000. Due in part to infections spreading at two local plants, the county recorded the most COVID-19 cases per capita in the state of Missouri during the first wave. In just six weeks (mid March-May), Fitzgibbon staff tested nearly 2,500 people; to date, more than 5,600 patients have been tested. 

So, how was Fitzgibbon prepared to handle such a surge of patients in such a short period?

Be Prepared; Plan Ahead

Fitzgibbon leadership knew that there was always the potential for a surge in patients, whether from a natural disaster like a tornado or from an unknown circumstance in its community like a previous school bus crash in 2017, which tasked its emergency responders and emergency department. As such, Angy Littrell, president and CEO, placed a high priority in staff training and leadership involvement in the community to be prepared for any such occurrence. 

One example is Fitzgibbon chief information officer and emergency preparedness officer Tom Jones. In addition to his leadership role at Fitzgibbon Hospital, Jones chairs a regional planning council, his county’s health care council and a local emergency planning committee.

Emergency preparedness planning occurs at not only the hospital level, but across the Marshall community. Police, sheriff, highway patrol, fire, emergency medical services, emergency medical dispatch, long-term care facilities and Fitzgibbon Hospital all participate in regularly scheduled community-wide drills.

Respond Quickly; Adapt to Community Needs

When others were just realizing that COVID-19 was going to escalate to a national pandemic, Fitzgibbon Hospital was already putting its plans in place. When Saline County and its surrounding counties became a hot spot, the hospital was able to provide its community access to COVID-19 testing almost overnight.

“When we became aware of cases, we quickly ramped up testing and removed potential barriers to access,” said CEO Littrell.

“We’re the only organization in the area, that we know of, to offer 24/7 curbside testing,” added Jones. “During the first three months, we often had 30 to 50 people show up for testing at night. We’ve had people from 36 Missouri counties and 25 counties from 11 other states come here to get tested.”

Foster Relationship with Neighboring Health Systems; Leverage Technology

As a rural 60-bed hospital, Fitzgibbon Hospital recognizes that it will not be able to manage a high number of critical cases. In anticipation, Fitzgibbon forged strong partnerships with Boone Hospital and the University of Missouri (MU) Hospital system in Columbia, Mo., and St. Luke’s Hospital in Kansas City, Mo.

As part of its COVID-19 response and treatment, multiple patients necessitated a transfer to one of these hospitals for more aggressive treatment and ICU monitoring. Leveraging its Cerner Millennium® Electronic Health Record connection to the Cerner/Tiger Institute Outside Records, the CommonWell network, and, in turn, the Carequality Infrastructure, the patients’ data was immediately accessible to hospitals like Boone, MU and St. Luke’s, including orders, results and clinical notes taken prior to and at time of transfer. Likewise, Fitzgibbon can receive updates to those patients’ health records, providing continuity of care when they return home.

“With a simple click in a patient’s health record, our clinicians can see where a patient has received care and what the outcome of that visit was, helping to inform our treatment of the patient,” Jones expanded. “We have also been able to leverage the Tiger- and CommonWell-accessed data to see patients’ COVID-19 testing results from other providers.”


There is no doubt that the Fitzgibbon leadership and staff are passionate about the community they serve. Their approach to COVID-19 was agile, innovative and coordinated.

As of July, Saline County had dropped off the Missouri trending chart of increases in cases. In fact, they had one of the smallest percent increases in the state. While much analysis is still to be completed once the pandemic has passed, it’s reasonable to assume that the Saline County coordinated approach and the preparedness of Fitzgibbon Hospital, the Saline County Health Department and its fellow community partners played a critical role in their success in slowing the curve.