Patricia Justis
Director, Washington State Office of Rural Health

How did you get to where you are now?
I have a Master’s in Counseling Psychology and got into healthcare on an inpatient psychiatric unit where I worked for 14 years. The hospital was doing Total Quality Management and I ended up working another eight years in quality improvement at a semi-tertiary center that served five rural counties. I tried my own business for a few years doing consulting, writing and photography. I’ve now been with the Washington State Department of Health (DOH) since 2009 and in my current position for two years. In my first six years at the DOH, I ran statewide and regional PCMH collaboratives. The last one was in a rural area, which got me very hooked!

What is the most important thing you are working on right now?
We are getting ready to launch a palliative care integration project with the idea that no rural community can stand up a free-standing palliative care service. We’re working on a Project ECHO type service of case consultation and exploring the feasibility of using board certified palliative care to provide direct patient telemedicine to rural communities. We want to create rural Centers of Excellence and integrate a training and technical assistance package to clinical teams to help with the culture change and how to think differently about this aspect of care. The overall goal is to minimize the use of long-term care beds and decrease transfers to tertiary centers for people who are not going to get better. We want to help people stay in their communities for care so they have the support of loved ones, which everybody needs when they are vulnerable and sick. We also consider site visiting as one of the most important things we do. Rural constituents would say we are visible and attentive and that we show we care by going to them.

What are some great things about rural health in your state?
We are a super diverse state with strong leadership and a lot of wonderful supports out there. We have only had one CAH closure. The University of Washington Research Center is near to us and we get a lot of interaction with the researchers. We also have strong partnerships with the Hospital Association and the Washington Resources Group, which is made up of the DOH, our Primary Care Association and both AHECs. We meet and lay out a calendar of residency visitations and canvas every residency across the state.

You recently hired new staff. What skill sets do SORH staff need?
I look for a sense of passion and empathy for rural communities. I look for staff who get along with others and are resilient when faced with a challenge. Instead of saying something’s too big and we can never get it done, what can we say “yes” to? We are a relatively new team, which gives us the ability to see things in a new way and make changes thoughtfully and with respect for how things have been done. We can step away from “we’ve always done it this way” and really try some new things. They are all very dedicated professionals.