EMP 2011 ANNUAL REPORT
Transcription
EMP 2011 ANNUAL REPORT
EMP 2011 ANNUAL REPORT Samaritan Hospital We skate to where the puck is going to be. About EMP To Our Partners at Samaritan Hospital, We are in a unique time in history where no one is exactly sure what is coming next in healthcare. What is certain: to succeed, you need a partner that can provide innovative solutions that meet the unique challenges that the healthcare environment can bring. A partner who is looking ahead, reading the changes in our collective future, and preparing the team. As Wayne Gretzky put it, the key to success is the ability to “skate to where the puck is going to be.” At EMP, we are the change leaders. Our culture is based on values that promote high quality, the best patient experience, stable partnerships and innovation. We are excited about the opportunities that lie ahead and are committed to producing positive results in 2012 that will reinforce Samaritan Hospital as a leader in emergency medicine. We hope you’ll take the time to review our annual report. It summarizes the results we have achieved through our collaborative partnership. You’ll also discover how EMP promotes innovation and excellence through our culture, values, programs and proprietary solutions. Thank you for your support through the years and for your valued partnership. We look forward to working with you in 2012 to meet the challenges of the changing healthcare industry together. Modern Healthcare Best Places to Work Award - 2011, ‘10, ‘09, ‘08 World Class Customer Service Award - 2011, ‘09, ‘08 NorthCoast 99 Award 2011, ‘10, ‘09, ‘08, ‘07, ‘06, ‘05 Sincerely, Press Ganey Summit Award - 2011, ‘10, ‘09, ‘08, 07, ‘06 Weatherhead 100 Award - 2009, ‘06, ‘05, ‘04, ‘03, ‘02, ‘01, 2000 Dominic J. Bagnoli Jr., MD, FACEP, FAAEM Chief Executive Officer Co-Founder David Packo MD, FACEP President Co-Founder Our culture At Emergency Medicine Physicians, our culture is rooted in the core values we live and breathe every day: servant’s heart, owner’s mind, teamwork and integrity. Servant’s heart It is our privilege to serve our patients, co-workers and hospital partners. Caring for the patient is foremost in everything we do. Owner’s mind We work in a dynamic environment which presents challenges for our practice, patients and hospital partners. As owners, we are motivated to solve problems, find opportunities and create success. Teamwork We collaborate with one another and our hospital partners to provide the best quality and service to our patients. We believe success will be attained only through the integrated efforts of each member of our team. Integrity We hold ourselves to the highest standards of business and professional ethics. We insist on honest and direct communication with one another, including constructive evaluations to improve individual and collective performance. About EMP Nationwide Partnerships Nationwide partnerships Our national presence helps us attract the best emergency medicine physicians, enabling us to build Our nationalteams presence helps us attract the best emergency medicine physicians, enabling us to build exceptional for our hospital partners. exceptional teams for our hospital partners. Founded in 1992, EMP currently partners with 59 locations in 12 states. Patients Served. EMP wasPatient privileged to serve over 2.5 million patients in 2011. EMP Volume 2,800,000 2,400,000 EMP Patient Volume 2,000,000 1,600,000 1,200,000 800,000 400,000 0 When you love what you do, it shows. Your ED Physicians Steve Jobs was fond of saying, “People with passion can change the world.” We agree. Our passion for delivering the best in emergency medicine to each and every patient we serve shows. When you love what you do, and you work with people that share your enthusiasm, goals become easier to reach, work is fun, and patients get the care and experience they deserve. Your emergency department director Dr. John Janikas is the Director of Emergency Medicine at Samaritan Hospital in Troy, New York. He started with EMP in 2004. Dr. Janikas received his undergraduate training at Elmira College in Elmira, New York where he earned a Bachelor of Science in Chemistry and graduated magna cum laude. He received his Doctorate of Medicine from the University of Massachusetts Medical School in Worcester, Massachusetts and completed his Emergency Medicine Residency at Albany Medical Center in Albany, New York where he was Chief Resident. Dr. Janikas is a faculty member of EMP’s Efficiency Academy and was named Director of the Year in 2010. He serves as Chairman of the Board of Directors for Clifton Park Halfmoon EMS. Outside of the hospital Dr. Janikas enjoys spending time with his wife, Grace, and their 4 boys. He also enjoys working out and has been training in Brazilian jiu jitsu for the past 6 years. Your emergency department leadership EMP Medical Directors do not stand alone: behind every director is a team of physicians who play specialized roles in the operations of your ED. Some physicians or midlevel practitioners have taken on leadership roles in specialized areas of ED management under the guidance of the Medical Director. Assistant Director Bruce Ushkow, MD, FACEP Chairman of Department John Braaten, MD, FACEP Quality Director Katrina Kardos, MD EMS and ED Critical Care Director Bruce Ushkow, MD, FACEP Dr. Janikas is board certified in Emergency Medicine and is a member of the American College of Emergency Physicians. Emergency department schedule The Emergency Department is fully staffed by Emergency Medicine Physicians, providing 43 hours of coverage per day. There are also 12-16 hours of midlevel coverage in Fast Track each day. Scribes are utilized for all Main ED shifts (24 hours of coverage each day). John Janikas, MD Medical Director Your emergency department clinicians The doctors and midlevel practitioners who serve on your EMP emergency department medical team are a highfunctioning group of clinicians with expertise in emergency medicine. They consider themselves fortunate to become partners with your hospital staff in creating an ED of excellence. EMP recruits to hire only emergency medicine residency-trained, board-certified physicians. Certified midlevel practitioners, employed at some of our EMP sites, come with experience in emergency medicine and help move operations in busy EDs to the next level of performance. Physicians John Braaten, MD, FACEP Michael Ciccarelli, DO Susan Collemer, MD Alexander Grinshpun, MD Midlevel Providers Stephanie Bisson, PA-C Laney Comitale, PA-C Jena Gregware, PA-C Robert Smith, PA-C John Janikas, MD Katrina Kardos, MD Bruce Ushkow, MD, FACEP Jacqueline Weaver, MD Meet Alexander Grinshpun, MD Emergency Physician, Linguist, Book Reader by Van Leeuwenhoek and of vaccines by Louis Pasteur, and imagined the thrill of being among those pioneers of medicine. My grandmother, who practiced laboratory medicine in communist Russia, encouraged my interest. At 11, I left Russia for Boston. I worked as a hospital interpreter in high school, and discovered a deep desire to help people and to study medicine. From the time I entered medical school at McGill University, I was drawn to the specialty of Emergency Medicine. I relish its intensity and the diversity of patients and problems I encounter every day. My professional areas of interest, cultivated during my residency at Beth Israel Medical Center in Manhattan, are bedside ultrasound and pain management. I find that the emergency room fosters a unique sense of teamwork, as a critical case brings everyone seamlessly together on a moment’s notice. As an attending physician at Samaritan, I’ve come to appreciate how each individual gives his or her best in the care of every patient. Every day I can leave my job knowing that I have made a positive impact on someone’s life. Growing up in my Moscow apartment, I devoured books from my grandmother’s library about major medical discoveries. I was fascinated by bold and radical innovations such as the discovery of microbes In addition to being fluent in Russian, I speak Hebrew and French. I enjoy travel, spending time with my wife and two daughters, as well as being left alone with a book or working in my garden. Your ED Physicians Michael Ciccarelli, Jr, DO Jack Braaten, MD, FACEP Emergency Physician, Key Listener Emergency Physician, Ski Buff, Chairman of the Department of Emergency Medicine For as long as I can remember I wanted to be a physician. I don’t know what drew me to this profession. During my high school and college years, I worked in a nursing home. It wasn’t the job that brought me satisfaction, but rather, the interactions that I had with the residents, listening to their stories and making them smile when they felt all alone. I think this experience influenced my decision to pursue medicine. In the ED, I see patients from all walks of life, but what they all share in common is fear or anxiety about their current situation and the desire to tell you their story. I feel that my listening and communication skills, instilled upon me early in life by my family, have carried with me so that I can make a difference. I have been married to Nancy for 31 years and have 3 wonderful children. Running has been a passion since college. This summer the family all participated in the Lake Placid Half Marathon, raising money for The Leukemia and Lymphoma Society. Golf and skiing are also favorite diversions. We have a Wednesday Doctor’s ski group at Samaritan Hospital and are always in search of powder, tree skiing and the gnarliest of ski terrain. I was born and educated in Troy, NY. I then went on to Virginia Tech and obtained a BS degree in Biology. I attended medical school at New York College of Osteopathic Medicine and completed a residency in emergency medicine at Albany Medical Center. I met my wife, Amelia, while in residency. We currently reside in West Sand Lake, NY, where we enjoy outdoor activities and travel. I have been employed by Emergency Medicine Physicians at Samaritan Hospital for the past 4 years. This has been a great experience, as it has allowed me to give back something to the community that raised me. I have been practicing emergency medicine for 30 years, following residency at Albany Medical Center Hospital. Twenty-six years have been at Samaritan Hospital. Jack Braaten, MD, FACEP completed his undergraduate education at Colgate University in Hamilton, New York. He earned his medical degree from SUNY Health Sciences Center in Brooklyn, New York. Dr. Braaten completed his internal medicine residency at Albany Medical Center Hospital in Albany, New York. Dr. Braaten is board certified in emergency medicine. We never confuse effort with results. ED Performance As Margaret Thatcher once said, “Pennies don’t fall from heaven, they have to be earned here on earth.” As partners in the delivery of emergency care, we know it takes hard work, determination and perseverance to achieve results. At EMP, we never give up, and we never stop raising the bar. As your ED partner, we continually strive to improve performance, increase quality outcomes and provide the best patient experience while meeting the unique needs of your hospital. Following is a summary of results for 2011. 2011 Accomplishments Operational Category Methods Patient Waiting Time Instituted Team Triage. Average Door to Doc time was decreased to 43 minutes (from 59 minutes). Patient Satisfaction Conducted Patient First meetings. Site patient satisfaction scores remained in the top third compared to other EDs of similar size across the country. Physicians and PAs attended EMP’s Patient Satisfaction Academy. Outcome Implemented patient callback system. Left Without Treatment Rate Team Triage program. LWOT rate was 1.6%. Door to Discharge Time Team Triage program. Average door to discharge time decreased to 167 minutes (from 195 minutes). Physician Productivity Encouraged ED physicians to attend EMP’s Efficiency Academy. Six ED physicians attended the Efficiency Academy and showed an increase in their productivity. Quality/ Core Measures Conducted regular reviews of Core Measures performance, identified problem areas and provided feedback to individual providers. Achieved > 95% compliance on all CMS ED Core Measures in 2011. Your ED operational performance. Emergency Medicine Physicians’ goal is to provide exceptional operational performance in each of our partner hospital EDs, resulting in a smoothly functioning ED where patient, employee and community satisfaction are extraordinary. To accomplish this task, we are committed to developing and maintaining the right combination of leadership, measurement and execution. Left Without Treatment Rate Length of Stay - Discharged Patients 5% 250 4% 200 Minutes 3% 2% 150 100 50 1% 0 0% Less Less than 2% of patients who arrive in our ED leave without being seen. Emergency Department Volume 50,000 45,000 Door to Physician Time 100 40,000 35,000 80 Minutes 30,000 60 25,000 40 20 0 Increased Our ED volume has increased 30% since 2005! ED Performance Customer Experience EMP believes that patient satisfaction is among the top drivers for ED success. As an organization, we have devoted substantial expertise and resources to help ensure our physicians rank among the highest in patient satisfaction. In 2000, EMP partnered with Press Ganey for patient satisfaction sampling partly because of their significant market presence, currently representing over 1,000 healthcare organizations nationally, and also because of the unique and innovative solutions that we are able to provide to our partner hospitals together with Press Ganey. Benefits to our partner hospitals from the EMP–Press Ganey alliance include a rigorous and timely sampling service; access to the full spectrum of Press Ganey services which include online comparisons between ED physicians and hospitals across the country to your own. Some of EMP’s most successful advancements in our Patient Satisfaction program include: Our distinguished Patient Satisfaction Academy Monthly physician-specific rankings provided to each doctor n Monthly physician-peer discussion and education n Returned patient surveys provided to each physician for review electronically n n Press Ganey Doctors' Section Ranking 100% 90% 80% 70% 60% 50% 40% 30% 20% Press Ganey Overall ED Ranking 10% 0% 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% ED Performance EMP’s Commitment to Improve Quality and Performance EMP’s state-of-the-art Quality and Performance Improvement Program is a leader in defining and measuring quality in emergency medicine. Monthly and quarterly goals are reported centrally and annual policy and procedure recommendations are brought to the attention of your hospital leadership. EMP’s Quality and Performance Improvement Program is led by Kevin Klauer, DO, EJD, FACEP, who also serves as our Chief Medical Officer. Dr. Klauer is a nationally recognized educator and expert in risk management. He serves on the ACEP Quality Improvement & Patient Safety Committee. Dr. Klauer is actively involved in advising and collaborating with other healthcare leaders in negotiations about the nation’s healthcare initiatives. Your EMP Site Quality Director leads the Performance Improvement and Peer Review process in your ED. Among the duties of the Site Quality Director: • Conduct regular education and process improvement discussions. Oversee peer review and participation of all full-time emergency physicians. • Advocate EMP’s risk management policies and institute appropriate policies and procedures as recommended by our Risk Retention Group’s board of directors. Complete regular auditing of high-risk cases. • Ensure that sound X-ray Discrepancy and Positive Culture Policies are in place in the ED, and that all physicians understand and comply with those policies. • Conduct ongoing review of Core Measures performance, providing individualized education and auditing of identified problem areas. Our ED regularly achieved 95% or greater compliance with CMS emergency department core measures during 2011. Kevin Klauer DO, EJD, FACEP CEME EMP offers its hospital partners premier access to our national educational series in emergency medicine. Partner hospital nurses, administrators, physicians and risk managers are invited to attend all of our courses. High Risk Emergency Medicine Advanced Emergency Nursing n National Emergency Medicine Board Review n Pediatric Emergency Medicine Boot Camp n Live Ultrasound Course featuring EMsono technology n n ED Performance Goals for 2012 Specific Goal Action Plan Timeline Door to Doc time <40 minutes Team Triage Kaizen Group will meet in January to review progress and make improvements for 2012. 2nd quarter 2012 Dr. Susan Collemer attended PhysicianFirst Academy and will be the Team Triage champion. Door to EKG <10 minutes Utilize Meditech to flag chest pain patients from triage for a stat EKG. 2nd quarter 2012 Drill stat EKG process as part of the Cardiac Cath training. Door to Balloon Time <90 minutes Drill and train Cardiac Cath protocols in January. 2nd quarter 2012 Review cases to improve process in ED/ Cardiology meetings throughout 2012. Site Patient Satisfaction Score >90th percentile Improve scripting in Triage and Fast Track. Encourage physician attendance at EMP’s Patient Satisfaction Academy. Monthly review of site scores. Provide individual physician rankings and returned surveys. 2nd quarter 2012 Cardiac Cath Lab Participate in planning with Cath Lab Kaizen and committee meetings. Cath lab estimated to go live in 1st quarter 2012 Culture creates a magical experience. The EMP Difference What makes Walt Disney World the most visited resort on the planet? From the moment guests arrive, an entire team of Disney cast members make sure they have a magical experience. As Walt Disney put it, “My business is making people happy.” At EMP, our culture and highly efficient ED environment create the right patient experience that helps make patients happy with the care they receive. It also creates a work environment where clinicians and staff love to work. Culture is job one. EMP’s intensive two-day New Physician Orientation immerses EMP physicians in our culture and emphasizes the four key values that make our outstanding culture possible: servant’s heart, owner’s mind, teamwork and integrity. From day one, EMP physicians learn that culture isn’t something we just talk about, it’s something we live every day. Structured for success. Every eligible EMP physician has ownership in our private company, as well as merit-based bonus opportunities. They are dedicated to building an exceptional hospital reputation by delivering the best in emergency medicine. In addition, our physicians own part of our medical malpractice company providing added incentive to ensure the latest risk management protocols and education are in place. The magic. What is the EMP difference? It’s all the things our culture makes possible: physicians empowered to provide efficient patient-centered care; strong leadership alignment with hospital goals; a smoothly functioning ED where nurses, physicians and administration enjoy working together to reach goals; and innovative solutions that meet the challenges of healthcare reform. The EMP difference is the advantage of partnering with a group that is privately owned and managed by emergency medicine, residency-trained physicians who are driven to get results. The tools and support EM physicians need to thrive. We understand what EM physicians need to meet the challenging demands of a new healthcare era. From day one, each physician receives mentoring and support from a team that’s vested in their success. Patient satisfaction skills The celebrated EMP Patient Satisfaction Academy is a rigorous learning academy that places physicians faceto-face with patient-actors in simulated ED encounters. Human behavioral specialists and psychologists provide feedback that transforms our physicians’ interpersonal skills. Results of the Academy on Press Ganey physician ranking have shown, on average, a 32% increase maintained over 18 months or more. Efficiency training EMP’s Efficiency Academy is an intensive training course based on the well-established principle that efficiency is a learned behavior and that educating motivated students can help them develop new and better habits. Utilizing data collected from thousands of ED encounters and analysis of the patterns and habits of highly efficient physicians, this powerful course is setting a new standard for post-graduate emergency medicine physician training. Results of the academy have shown a nearly one RVU/hour increase in physician productivity. Ongoing medical education EMP’s Center for Emergency Medical Education (CEME) assists physicians and other healthcare professionals in maintaining board certification and fulfilling their commitment to life-long learning and improved patient care. Our nationally recognized emergency training courses are open to all emergency professionals in the United States and include: Emergency Medicine Board Review, High Risk Emergency Medicine, Pediatric Emergency Medicine Boot Camp and our live Emergency Medicine Ultrasound Course. The EMP Difference EMP’s leadership philosophy, training and team. We believe our success in partnership with hospitals and communities begins with our physician leadership. EMP is owned, led and managed by emergency medicine physicians. EMP’s management philosophy provides hands-on mentorship by experienced physician executives who are closely involved with your site Medical Director. EMP Directors’ Meetings develop leaders Meet your EMP leadership EMP medical directors, executives, and staff physicians meet three times per year to educate, exchange ideas and connect with other leaders. Held at various locations across the country, these meetings are intense, four-day affirmations of our values, mission, goals and culture. EMP Directors’ Meetings are required for all Medical Directors, and are open to all general staff physicians as well. With their participation, future leaders are often born. Executive Leadership The EMP Scholars Program launches new leaders David Scott MD, FACEP President EMP Medical Group Led by Dr. Anita Gage, Chief Learning Officer for EMP, our Scholars Program equips future emergency medicine leaders. The curriculum spans the entire year and covers a broad range of topics dealing with self-awareness, team building, conflict resolution and leadership skills. Orion Colfer MD, FACEP Vice President EMP Medical Group Mark Slabinski MD, FACEP, FAAEM Vice President EMP Medical Group Jesse DiRando MD, FACEP Vice President EMP Medical Group Board of Directors Donald Lombino, MD, FACEP –Chairman of the Board L. Anthony Cirillo, MD, FACEP – Board Member Timothy Corvino, MD, MBA – Board Member Andrew Jenis, MD, FACEP – Board Member Jayne Kendall, MD, FACEP – Board Member Kevin Klauer, DO, EJD, FACEP – Board Member Merci Madar, MD, FACEP – Board Member Lawrence Payne, MD, FACEP – Board Member Steven Rudis, MD – Board Member EMP’s unique solutions and partnerships. Our unique partnerships and proprietary solutions achieve immediate and lasting results in key areas: improved patient experience, improved revenue and performance and decreased medico-legal risk. As we move into a new healthcare era, we will continue to be proactive in creating new solutions and programs that create success for our hospital partners. EMP’s PhysicianFirst triage model PhysicianFirst is a revolutionary concept from EMP that delivers immediate, sustainable results in door-to-physician time, walkout rates, length of stay for discharged patients, and patient satisfaction. With the PhysicianFirst model of ED care delivery, patients see a physician before they’re even registered and receive rapid assessment and initiation of care orders. The result: empty chairs in the waiting room become the norm, not the exception. Our unique triage model is in place in over 25 emergency departments across the country, representing well over one million patients. In addition to the sustainable results already mentioned, patient and staff satisfaction have improved dramatically at these locations due to streamlined intake and door-to-physician times that are consistently below 30 minutes. Press Ganey patient satisfaction scores have improved dramatically, in some cases shooting up from below the 10th percentile to the 99th percentile nationally. The EMP Difference ED Design EMP provides partner hospitals every available solution to improve their clinical operations and ED flow. When our partner hospitals elect to redesign or expand their existing emergency department physical plant, James Augustine, MD, FACEP, a nationally recognized expert in emergency department design, leads the EMP team. Computerized simulation software can optimize the ED space and flow of a hospital ED, prior to a hospital’s investments in capital, time or personnel. The specific clinical environment is created in a virtual model to demonstrate and test statistically and accurately what will happen when changes are made in the real environment. The proprietary software is part of the strategy used by ECHO Management and Consulting Group, LLC, an EMP Holdings partner. EMP hospital partners who have invested in ECHO Consulting have achieved remarkable results in process improvement, increased patient satisfaction and revenue enhancement. The EMP Difference Risk Management EMP has built a powerful Risk Management Program that is led by our Legal Counsel, Mike Frank, MD, JD, FACEP, FCLM. EMP physicians are sued about half as often as the national average. We credit this noteworthy accomplishment to our careful selection of quality physicians, education in high-risk areas of emergency medicine, participation with risk reduction practice guidelines, and routine interaction with our proactive legal department. We own our professional liability insurance company, Physicians Specialty Limited Risk Retention Group. Your risk is lowered because every physician in our group participates in the robust Risk Management Program. Robert Broida, MD, FACEP, serves as Chief Operating Officer of PSLRRG where he oversees the management, investments, and physician education programs for the insurance company. Michael Frank MD, JD, FACEP, FCLM EMP sponsors nursing education and development. Emergency Medicine Physicians is thankful to partner with specialized emergency medicine nursing personnel across the country. In fact, we consider that partnership so critical to our operations that we have created numerous opportunities for advanced education for nurses who work in emergency departments. Advanced Emergency Nursing Course ED Nursing Leadership Summit This course covers current, cutting-edge topics that impact emergency nurses on a daily basis and provides real-world solutions. Attendees include emergency nurse administrative and clinical leaders and staff nurses. Nursing professionals and EMP leadership meet to share ideas and collaborate with nursing colleagues across the country to improve emergency department performance. Patient Satisfaction Academy for Nurses Nationally-recognized experts in emergency medicine and medical malpractice present vitally important emergency department risk management strategies. EMP encourages all nursing staff, risk managers and hospital employees involved in performance improvement to attend this informative course. Developed and led by the same dynamic team that created the Patient Satisfaction Academy for EMP physicians, this powerful course gives nurses skills and tools they can use to improve the patient experience. High Risk Emergency Medicine The EMP Difference At EMP, we welcome the future of healthcare. As change leaders, we enjoy skating to where the puck is going to be. While other groups are just beginning to grapple with healthcare reform challenges that demand improved outcomes, lower costs and an even better patient experience, we’ve been addressing these issues with innovative solutions for 20 years. We know what it takes to succeed. Improved patient outcomes The transition of care from ED patient care to the primary care physician is vital to patient outcomes. EMP physicians take ownership in the critical role they play in this process and are given the technological resources and physician communication tools they need to make a difference in the health and well being of the residents in your community. Improved patient experience For a decade, EMP has developed programs and solutions to help our physicians provide the best patient experience. Technological advances increasingly allow us to “know” our patients even as they walk into the ED. Institutional memory of the last time they came to the hospital provides the patient with a better overall experience. We’re dedicated to the idea that each patient deserves the best experience, every time. Decreased costs We don’t leave the cost of healthcare on the table for our hospital partners, or for our patients. Regular peer reviews are conducted to ensure EMP physicians are practicing evidence-based medicine. Our utilization review process aims to reduce waste in all forms, particularly by decreasing unnecessary procedures and tests. The individual actions of each physician are our responsibility and our mission. We take our part in reducing the per capita cost of healthcare in the nation seriously. We won’t rest. It is an honor and privilege to serve your hospital and community with the best in emergency medicine. As we celebrate the goals we’ve achieved together this past year, we’re skating forward with a passion to achieve our goals for 2012. Thank you for partnering with EMP. Environmental Benefits Statement EMP Annual Report interior pages are printed on 10% Post-Consumer Recycled Paper. EMP is committed to environmental stewardship and supporting responsible use of forest resources. 4535 Dressler Road, NW., Canton, Ohio 44718 800-828-0898