General Board Meeting - United Medical Center

Transcription

General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 2015 BOARD OF DIRECTORS C. Matthew Hudson Jr., D. Min, Chairman David Small, Interim CEO Girume Ashenafi Dr. Cyril Allen Dr. Ricardo Brown Dr. Konrad Dawson Chris Gardiner Maria Gomez Steve Lyons Robert Malson Dr. Julianne Malveaux Virgil McDonald Prepared and Filed by: Yolanda Raine, Administrative Assistant Office of the Secretary of the Corporation UMC
UNIT ED
MEDICAL CENTER
our mission
United Medical Center is dedicated to the health and well-being
of individuals and communities entrusted to our care.
our vision
UMC is an efficient, patient-focused, provider of
high-quality of healthcare the community needs.
•
UMC will employ innovative approaches that yield
excellent experiences.
•
UMC will improve the lives of District residents by
providing high value, integrated and
patient-centered services
•
UMC will empower healthcare professionals live up
to their potential to benefit our patients
•
UMC will collaborate with others to provide high
value, integrated and patient-centered services.
THE NOT-FOR-PROFIT HOSPITAL CORPORATION
BOARD OF DIRECTORS
NOTICE OF PUBLIC MEETING
The monthly Governing Board meeting of the Board of Directors of the Not-For-Profit
Hospital Corporation, an independent instrumentality of the District of Columbia
Government, will be held at 9:00am on Thursday, March 26, 2015. The meeting will be
held at 1310 Southern Avenue, SE, Washington, DC 20032, in Conference Room 2/3.
Notice of a location, time change, or intent to have a closed meeting will be published in
the D.C. Register, posted in the Hospital, and/or posted on the Not-For-Profit Hospital
Corporation’s website (www.united-medicalcenter.com).
AGENDA
I.
II.
CALL TO ORDER
DETERMINATION OF A QUORUM
III.
APPROVAL OF AGENDA
IV.
BOARD EDUCATION
 Population Health: UMC’s Vision, Strategy, and Tactics – Jim Hobbs, VP
of Business Development and Physician Recruitment
V.
CONSENT AGENDA
A. READING AND APPROVAL OF MINUTES
1. February 26, 2015 – Board of Directors General Meeting
B. EXECUTIVE REPORTS
1. Dr. Cyril Allen, Chief Medical Officer
2. Thomas E. Hallisey, Chief Information Officer
3. Jim Hobbs, VP of Business Development & Physician Recruitment
4. Jackie Johnson, VP of Human Resources
5. Pamela Lee, EVP of Hospital Operations & CQO
6. David Thompson, Interim Director of Public Relations and
Communications
7. Maribel Torres, Chief Nursing Officer
Page 1 of 2
8. Charletta Washington, VP of Ambulatory & Ancillary Services
VI.
NONCONSENT AGENDA
A. CHIEF EXECUTIVE REPORTS
1. David Small, Interim CEO
2. Barbara Roberson-Thomas, Interim CFO
B. MEDICAL STAFF REPORT
1. Raymond Tu, Vice Chief of Staff
C. COMMITTEE REPORTS
1. Governance Committee Report
2. Patient Safety and Quality Committee
3. Finance Committee Report
D. OTHER BUSINESS
1. Old Business
2. New Business
E. ANNOUNCEMENT
Next Meeting – Thursday, April 23, 2015 at 9:00am in Conference Rooms
2/3.
F. ADJOURNMENT
NOTICE OF INTENT TO CLOSE. The NFPHC Board hereby gives notice that it may
close the meeting and move to executive session to discuss collective bargaining
agreements, personnel, and discipline matters. D.C. Official Code §§2 575(b)(2)(4A)(5),(9),(10),(11),(14).
Page 2 of 2
General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 Reading and Approval of Minutes • February 26, 2015 Not-For-Profit Hospital Corporation
Board of Directors Meeting Minutes
February 26, 2015
Present:
Excused:
Others:
Bishop Hudson, Chris Gardiner, Virgil McDonald, Maria Gomez, Steve Lyons, Dr. Ricardo Brown, Girume Ashenafi, David Small,
Dr. Julianne Malveaux, Dr. Konrad Dawson, Dr. Cyril Allen, Dr. Raymond Tu, Kai Blissett (General Counsel), Yolanda Raine
(Administrative Assistant)
Robert Malson
Ellen Goitia (KPMG), Xiaolei Wang (KPMG), Tingting Chen (KPMG), Christian Barrera (Special Assistant, Health Policy)
Agenda Item
Call to Order
Determination of a
Quorum
Approval of the
Agenda
Approval of
Minutes
Consent Agenda
Discussion
Discussion
The meeting was called to order at 9:22am
Quorum determined by Kai Blissett (General Counsel)
Action Item
The Board moved to approve the agenda.
The Board moved to approve the following minutes:
 January 22, 2015 – General Board Meeting
N/A
1
Executive Reports
Board moved to accept and approve the following Executive reports. Second. Passed
Unanimously.
 Dr. Cyril Allen, Chief Medical Officer
 Thomas E. Hallisey, Chief Information Officer
 Jim Hobbs, VP of Business Development & Physician Recruitment
 Jackie Johnson, VP of Human Resources
 Pamela Lee, EVP of Hospital Operations & CQO
 David Thompson, Interim Director of Public Relations and Communications
 Maribel Torres, VP of Nursing
 Charletta Washington, VP of Ambulatory & Ancillary Services
Chief Executive
Reports
David Small, Interim CEO, presented CEO Report. (Report presented to Board Members
and filed in the Office of the Secretary of the Corporation) Board moved to accept and
approve the CEO report. Second. Passed Unanimously.
David Small/Barbara Roberson
to provide rational and/or goals
for key financial metrics.
Barbara Roberson-Thomas, Interim CFO, presented CFO Report. (Report presented to
Board Members and filed in the Office of the Secretary of the Corporation) Board moved
to accept and approve the CEO report. Second. Passed Unanimously.
Chief Medical
Report
Dr. Raymond Tu, Vice-Chief of Staff, presented the Credentialing report. Board moved to
accept and approve the credentialing report. Second. Passed Unanimously. (Report
presented to Board Members and filed in the Office of the Secretary of the Corporation)
Audit Committee
Report
Chris Gardiner, Committee Chair, presented the Audit Committee report. Moved.
Second. Passed Unanimously.
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Finance Committee
Report
Steve Lyons, Committee Chair, presented the Finance Committee report. Moved.
Second. Passed Unanimously.
Governance
Committee Report
Virgil McDonald, Committee Chair, presented the Governance Committee Report.
Moved. Second. Passed Unanimously.
Patient Safety and
Quality
Maria Gomez, Committee Chair, provided an overview of Delmarva agreement.
Other Business
Board suggested reports be
highlighted to better show
trends in hospital budget.
Motion was made to accept recommendation for Maria Gomez to sign Delmarva
agreement on behalf of the Board. Moved. Second. Passed unanimously.
Next meeting will be held on April 23, 2015 at United Medical Center in Conference
Rooms 2/3 at 9:00am.
Adjourned 10:54am.
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General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 Executive Mgt. Reports Presented by: Dr. Cyril Allen, CMO Thomas Hallisey, CIO Jim Hobbs, EVP Jackie Johnson, EVP Pamela Lee, EVP David Thompson, Director Maribel A. Torres, CNO Charletta Washington, EVP General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 CMO REPORT Prepared by: Dr. Cyril Allen, Chief Medical Officer Chief Medical Officer
Cyril Allen, MD, MSPH
Board Report
March 2015
Chief Medical Officer
Cyril Allen, MD, MSPH | 2
Chief Medical Officer Report
The beginning of spring ushers in new challenges for the Medical Staff at United Medical
Center. It is this time of year that many Medical Staff members begin taking their vacations and
deserved time off. In addition, continuing medical education requirements, extended family
duties and other responsibilities begin to assert themselves. As the hospital continues to operate,
the time management and patient care requirements are properly addressed. Call schedules,
inpatient and outpatient scheduling and all of the activities normally associated with spring and
summer, out of necessity, must be addressed by all members of the Medical Staff. Whereas most
nonmedical disciplines associate vacation time or education time as time off, the Medical Staff
must be cognizant of the responsibilities of their calling and adjust their plans accordingly.
As always, as the Medical Staff reports to the Board, this report emphasizes the essential
element of the new paradigm UMC has been undergoing for the past two years. That is that
“Quality and Patient Safety are Job One.” During every Medical Executive committee and
Medical Staff committee meetings, quality and patient safety concerns of this facility are
discussed, dissected and evaluated. The Board should be aware that the quality department of
this institution is intricately and intimately involved with the Medical Staff on a daily basis in
meetings, initiatives and assessments regarding our quality initiatives.
On March 30 of this month the Medical Staff holds its Quarterly Staff meeting and
doctor’s day celebration. It is during this time that the medical staff assesses its past quarter
performance and evaluates all opportunities for continued improvement. The Doctors Day
celebration honors particularly significant achievements of Medical Staff members as well as the
Medical Staff membership in general. All Board members are welcome and encouraged to attend
this special day.
Finally let me welcome new Medical Staff members (see Chief of Staff Report) and refer
the Board to the announcements that accompany this report.
Cyril A. Allen, M.D., M.S.P.H.
MEDICAL STAFF SUMMARY
MEDICAL STAFF COMMITTEE MEETINGS
Medical Executive Committee Meeting, Dr. Victor Nelson, Chief of Staff
The Medical Staff Executive Committee (MEC) provides oversight of care, treatment,
and services provided by practitioners with privileges on the UMC medical staff. The
committee provides for a uniform quality of patient care, treatment, and services, and
reports to and is accountable to the Governing Board. The Medical Staff Executive
Committee acts as liaison between the Governing Board and Medical Staff.
Peer-Review Committee, Committee Chairman
The purpose of peer review is to promote continuous improvement of the quality of care
provided by the Medical Staff. The role of the Medical Staff is to provide evaluation of
performance to ensure the effective and efficient assessments and education of the
practitioner and to promote excellence in medical practices and procedures. The peer
review function applies to all practitioners holding independent clinical privileges.
Pharmacy and Therapeutics Committee, Dr. Mina Yacoub, Committee Chairman
The Pharmacy and Therapeutics Committee discusses all policies, procedures, and forms
regarding patient care, medication reconciliation, and formulary medications prior to
submitting to the Medical Executive Committee for approval.
Credentials Committee, Dr. Barry Smith, Committee Chairman
The Credentials Committee is comprised of physicians who review all credential files to
ensure all items such as applications, dues payment, etc. are appropriate. Once approved
through Credentials Committee, files are submitted to the Medical Executive Committee
and the Governing Board.
Medical Education Committee, Dr. David Reagin, Committee Chairman
The Medical Education Committee was formed to review all upcoming Grand Rounds
presentations. The committee discusses improvements and new ideas for education of
clinical staff.
Performance Improvement Committee, Dr. Gilbert Daniel, Committee Chairman
The Performance Improvement Committee is comprised of 1-2 representatives from each
department who report monthly on the activity of each department based on standards
established by the Joint Commission, the Department of Health, and the Centers for
Medicare and Medicaid Services (CMS).
Bylaws Committee, Dr. David Reagin, Committee Chairman
Members include physicians who meet to discuss implementation of new policies and
procedures for bylaws, as it pertains to physician conduct.
The Medical Staff Bylaws, Rules and Regulations have been revised in preparation for
the upcoming Joint Commission inspection. The changes were reviewed, discussed and
approved by the Bylaws Committee and will be forwarded to the Medical Executive
Committee and then the Board of Directors for review and approval.
Physician IT Committee,
Members include physicians who meet to discuss the implementation of the new hospitalwide Meditech upgrade, as well as the physician documentation for ICD-10.
Physician Champions Meditech Program
Cyril Allen, MD
Julian Craig, MD
Mina Yacoub, MD
Russom Ghebrai, MD
Raymond Tu, MD
Cynthia Morgan, MD
Gilbert Daniel, MD
Deborah Wilder, MD
DEPARTMENT CHAIRPERSONS
Anesthesiology .............................................................. Dr. Amaechi Erondu (Medical Director)
Critical Care ........................................................................................................ Dr. Mina Yacoub
Emergency Medicine ..................................................................................... Dr. N. Adam Brown
Medicine .............................................................................................................. Dr. Musa Momoh
Obstetrics and Gynecology................................................................................ Dr. Victor Nelson
Pathology ............................................................................................................. Dr. David Reagin
Pediatrics ....................................................................................Dr. Marilyn McPherson-Corder
Psychiatry ............................................................................................................. Dr. Lisa Gordon
Radiology ............................................................................................................. Dr. Raymond Tu
Surgery .......................................................................................................... Dr. Gregory Morrow
DEPARTMENTAL REPORTS
ANESTHESIOLOGY
Dr. Amaechi Erondu
For the month of February 2015, the Anesthesia Department performed 171 procedures,
intubations and OB cases.
Special Projects/Joint Commission Projects
The Anesthesia Department continues to emphasize compliance with Core Measures.
We have developed a Surgical Care Improvement Project (SCIP).
Changes in Department
All Anesthesia providers are now proficient with the UMC EMR (Electronic Medical Record).
The Department continues with the transition to improve the efficiency and utilization of the
service. We have reduced the number of non-emergent after hour elective cases as we increase
the service utilization.
We are increasing the number of anesthesia providers to support growth of the Department. We
have added two (2) additional full-time Anesthesia providers.
CRITICAL CARE MEDICINE
Dr. Mina Yacoub
For the month of February 2015, the ICU census had slowed down compared to the prior month.
ICU length of stay continues to be an area we are working on to improve. February ICU length
of stay has decreased from the prior month and we are working to continue the downward trend
and monitor performance closely. For February 2015, the ICU had 295 patient days and 64
admissions. Average ICU length of stay was lower in February at 4.6 days.
For the month of February, there were no central line associated blood stream infection rates and
no ventilator associated pneumonias. We are continuing to implement safe practices and
monitoring performance with Infection Preventionist. Results and findings are reported regularly
to National Healthcare Safety Network.
ICU had two cases of successful organ donations for transplant. We worked in close
collaboration with the Washington Regional Transplant Consortium. Multiple patients on
transplant lists received life-saving organ transplantations.
ICU continues to monitor performance and report on Rapid Response Team interventions
throughout the hospital.
Plans for placing doors on ICU rooms are in place. We are looking forward to implementation
soon. This would improve on infection control, patient privacy and patient satisfaction.
EMERGENCY MEDICINE
Dr. Norman Brown, M.D.
For the month of February 2015, the emergency department at United Medical Center had the
following metrics:
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Total Volume: 3845
% Left without Being Seen: 3.7%
Average Admission: 11%
Ambulance Traffic: 1091
% of Ambulance Traffic Total Volume: 28.4%
Updates:
On May 15th, 2015, EmCare will end their relationship with the emergency department at United
Medical Center. Despite the change in management and leadership in the ED, we are proud of
the many positive changes made in our department over the past few years and wish the new
management group well in their endeavors.
PATHOLOGY
Dr. David Reagin
The laboratory continues to make progress in implementation of two instruments. The I-STAT
is on schedule for a May start date. Testing on the Panther by Gen Probe is slated start on March
16, 2015.
PEDIATRICS
Dr. Marilyn McPherson-Corder
For the month of February the Department saw 24 babies. Dr. Corder met with the Nursing and
Pediatric staff regarding WIC (women infant children) program’s daily presence here at UMC.
Instead of the limited once a week visit from the van, Dr. Corder emphasized that it is important
for the pregnant patients and their babies to have improved access to this most necessary
program. Both the WIC representative and the Nursery staff are excited about the improved
collaboration. The training of the nursing staff to become certified lactation specialist is in
progress.
The month of February was filled with reports of the measles outbreaks. Dr. Corder spoke on
the measles topic as the medical expert on TV One with Roland Martin, WHUR on the Daily
Drum, WOL Radio One. She was asked to speak to various groups in the community about
measles.
The physicians and the nursery staff continue to educate the mothers on the importance of On
Time vaccinations starting with the Hep B at birth here at UMC.
The Department continues to meet 100% of its common core goals.
PSYCHIATRY
Dr. Lisa Gordon
For the months of February, the Behavioral Health Department admitted 90 patients. Of these,
48 were involuntary. There were 33 patients accepted from CPEP and 47 from the UMC ED.
Five patients were transferred to St. Elizabeth’s Hospital for longer term inpatient treatment. We
participated in two court cases out of 10 Probable Cause Hearings called. Our average length of
stay for February was 5.38 days. We continue to see patients as consults on other units including
follow-up and new residents on the Skilled Nursing Facility.
We welcomed Mrs. Sandra Williams, RN to our team as the new Nurse Manager. She brings
with her 25 years of experience in the Behavioral Health field, over 10 of which have been in a
managerial capacity. We look forward to all she will contribute to our program. We have hired
one Counselor and one Tech and are awaiting the arrival of two Social Workers and one
Psychiatrist to round out our staffing. We strive to continue to add to our therapeutic
programming to provide our patients with the best experience possible.
We continue to work on positive and productive working relationships with outside agencies and
our patient’s families as this promotes continuity of care for our patients. We recently received
an email from a patient’s lawyer, thanking us for the high quality care that patient received.
RADIOLOGY
Dr. Raymond Tu
For the month of February 2015 the Radiology Department performed 3608 procedures.
The department is currently working on transition to a modern PACS system. We were selected
by the Food and Drug Administration’s Center for Devices and Radiological Health for a site
visit, chosen for our excellence and most experience with MicroDose mammography in the US.
Dr. Tu is working on radiology quality enhancements. Dr. Tu presented to Quarterly Staff on
Quality.
Performance improvement initiatives have been met with 100%.
CARE MANAGEMENT
Adam Winebarger, MSN, RN, CCM
UMC Care Management Monthly Report
February, 2015
AVERAGE LENGTH OF STAY
(Based on acute care discharges and does not include BHU or SNF)
7.0
6.0
6.6
5.7
5.0
5.3
6.2
5.7
5.6
5.4
Oct
Nov
Dec
5.6
4.7
4.0
3.0
2.0
1.0
0.0
June
July
Aug
Sept
Jan
Feb
February continued to be a challenging month for the team, especially related to patients with
complex discharge planning needs. To highlight a few, 6 patients had lengths of stay > 20 days
because they were new guardianship cases. Also, we had several patients that required out-ofstate facility referrals based on either comorbidities or substance abuse issues, thus delaying the
approval process. While an overall positive metric for the hospital, increases in acuity (case mix
index) often translate into higher lengths of stay. CMI rose favorably from 1.15 in January to
1.21 for February. We continue to work with our physician partners to increase communication
and collaboration regarding these complex patients in an effort to transition them to a more
appropriate level or care sooner in the hospital course where appropriate. Additional emphasis
has been placed on the need to provide appropriate discharges with social issue awareness.
DEPARTMENT HIGHLIGHTS

Worked closely with the Diabetic Center in establishing partnership with Food and Friends,
an organization with multiple non-profile DC partners to ensure diabetic patients receive
proper nutrition, ultimately leading to better health outcomes

We are in the initial design phase of implementing Meditech’s utilization review module.
This new module will help to automate some of our manual processes, allow for better
tracking of utilization trends, allow for more comprehensive analysis of denials and help to
standardize UM documentation. Also, we were excited that Midas/Xerox’s Care
Management platform was approved as a capital expense, which will allow us to automate
Interqual criteria and provide real-time metrics to more efficiently transition patients. This is
a shared platform that Quality Management will also use.

During February, we met with two larger Medicaid HMO payers – MedStar Family Choice
and AmeriHealth DC. Both were very productive conversations and were an opportunity for
both parties to share feedback to ultimately manage resources more effectively and help to
ensure our mutual customers receive the right care in the right setting at the right time. We
have also clarified utilization management requirements for both payers, and will be sending
fewer reviews, ultimately allowing for more effective use of the CM team’s resources.

We have met with the new SNF Administrator, Ms. Dale, and look forward to once again
referring appropriate patients to the SNF.
ANNOUNCEMENTS
Medical Staff Meetings March
April 6, 2015 at 12:30 pm
Peer Review Committee
April 9, 2015 at 12:00 pm
Critical Care Committee
April 9, 2015 at 1:00 pm
Credentials Committee
April 10, 2015 at 12:30 pm
Prevention & Control of Infections
Committee Meeting
April 10, 2015 at 2:00 pm
Pharmacy & Therapeutics Committee
Meeting
April 20, 2015 at 12:00 pm
Medical Executive Committee Meeting
April 27, 2015 at 2:00 pm
Utilization Review Committee
MEDICAL STAFF ACTIVITY
REAPPOINTMENTS
Assefa Gebreselassie, M.D. (Pediatric/Neonatology)
Mohammad Ghandi, M.D. (Emergency Medicine)
Tamara Kellogg, M.D. (Emergency Medicine)
Deborah Wilder, M.D. (Obstetrics and Gynecology)
NEW APPOINTMENTS
Ker-shi Wang, M.D. (Anesthesiology)
Nithin Prabhu, CRNA (Anesthesiology)
VOLUNTARY RESIGNATIONS
Melissa Block-Menshik, M.D. (Radiology) Teleradiology
Dierich Kaiser, M.D. (Psychiatry)
Qing Li, PA-C (Medicine) Allied Health
Stephen White, PA-C (Surgery) Allied Health
CHANGES IN STAFF CATEGORY
Zaim Bulent, M.D. (Cardiology) Provisional to Courtesy
General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 CIO Report Prepared by: Thomas E. Hallisey Chief Information Officer Information Technology and Systems
Board Report – March 2015
Current or Completed Initiatives:

ICD-10 The committee to meet these requirements has restarted and is creating the final work
plan for reviewing previous work and finishing any business left from last year’s team. We will
be retraining, reviewing financial impacts and making the necessary changes in MEDITECH.

Paperless Pay This system will allow us to have all pay stubs online only, saving printing and
distribution expenses. Files have been sent to the vendor and testing has begun. Plans are to have
this system Live in May.

Information Technology Service and Project Management Redesign Work continues on the
process redesign and the HelpStar system is planned for upgrade in April. We have also sent a
survey to department heads to gauge the current service provided to assist in improving the
service in the future.

New/Upgraded PACS System We plan to upgrade the Merge PACS system to the latest
version. This requires a complete system overhaul and all new hardware installation. Work is
underway to prepare our infrastructure to complete this project in May.

Infrastructure Updates The IT team is reviewing proposals to install a new storage system and
virtual server cluster that will allow us to much more quickly meet hospital needs as they arise.
This system is called a private cloud and will allow us far greater flexibility in increasing storage
or computing capacity as required by our expanding services and new systems.

MEDITECH EMR System The IT Application Support team in coordination with the HIM
department continues to work thorough live issues and expand and improve the use of the new
Scanning and Archiving MEDITECH EMR system. We are currently expanding the use to find
and bring into the electronic record all paper forms remaining in any areas.

Integration Updates We have started a team to look at the different vendors for a complete
Interface Engine that will allow us to put most of our integration initiatives in one manageable
system. We are also reviewing systems to integrate Patient Monitoring equipment into the
MEDITECH EMR. Ideally these systems will share the same backplane for future updates and
expansion ease.
The Application Support, Help Desk, and Infrastructure teams continue to provide ongoing operational
support of UMC’s systems. The team had 403 help desk requests and closed 387 in February 2015.
General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 Business Development & Physician Recruitment Report Prepared by: Jim Hobbs VP, Business Development & Physician Recruitment Business Development & Physician Recruiting
Board Report – February 2015
AREAS OF FOCUS OVERVIEW AND RESULTS
Physician Development /Recruiting Plan:

The chart below provides an update regarding physician recruiting based on the board approved plan:
Physician Recruiting Update
Specialty
Status
Next actions_____________
GI
Sourcing additional candidates
Internal Medicine
Accepted
Contract execution
Neurology
Accepted
Contract execution
General Surgery
Accepted
Contract execution
Orthopedic
Changes in clinic, call & surgery coverage
Locum Tenens to begin on March 30, 2015
Vascular Surgeon
Initial discussion with a local candidate
Candidate applying for Med. Staff
privileges
Grants


The board approved strategic plan included the objective of building capabilities to pursue grants.
We were recently notified that another year of funding for Ryan White Part A Grant was approved. The funding
level is $803,000
The graph below indicates current grant status. The area in white indicates grants that have been awarded, ongoing or
closed and not funded. The yellow shaded area indicates proposals, pending awards or proposals under development.
Grant Name
Amount
*Equiv. Gross
Revenue
Ryan White
Year 2 - $703,000
$93.5M
Part A HIV
Year 3 - $703,000
$93.5M
Ryan White
-Award Increase
$92,500
$12M
Gilead (Focus)
$287,406
$38M
Diffusion
$148,750
$20M
Expand PCC hours, increase linkage
capacity
Ongoing
Effective 3/1/2015
Purpose
Supports the operations of the Care
Center which primarily provides HIV
clinical care and psychosocial
support.
Supports a program within the Care
Center to improve retention of
patients in care
Supports HIV and Hepatitis C testing
and linkage to care within the
emergency room and outpatient
primary care clinic and other parts of
the hospital.
Status
Ongoing
Ongoing
Ongoing
CDC HIV Testing
$185,000
$22M
Supports rapid test HIV testing and
linkage to care within the emergency
room and the Care Center. In
addition, it supports the position of
reimbursement specialist.
Innovation
$495,200
$66M
Diabetic Management- "Meeting
those living with diabetes where
they are;, improving health status
Not Funded
Not Funded
Proposal Submitted
Pending Award
Build Health Challenge
$250,000
$ TBD
Advisory board, RWJ, Kresge-Planning and implementation grants75K/100K, 250K -focus on population
health
Million Hearts Strategy
Grant Program
Requested $102,000
$ TBD
Hypertension and BP management
Business development areas of focus
In support of the strategic plan, work is underway on several different services. As we have discussed previously,
we have adopted the 6 key DOH health issues identified as a result of the Community Health Assessment.
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Cancer
Hypertension
Diabetes
Cardiovascular disease
HIV/Aids
Infant mortality
As a part of our overall efforts to tailor services and approaches to our PSA (Primary Service Area), we use these 6
priorities to inform our decision making and areas of development. Also, at the monthly board meeting, I will be
presenting our approach to population health and the strategies and tactics we are implementing.
In accordance with the strategic plan, several areas are currently under development, revision, or expansion. Over the
next few months, we will highlight selected areas:
Cardiovascular Services
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Wards 7 & 8 have the highest incidence of cardiovascular disease in DC.
UMC began diagnostic cardiac catheterization last year and has expanded some additional diagnostic
modalities.
With the addition of another cardiologist, we have the opportunity to develop a more comprehensive and
robust cardiovascular service line.
Work is beginning on the development of an integrated service line including diagnostics and
interventions, both for cardiac disease and peripheral vascular disease.
Stroke Care
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Wards 7 & 8 and adjacent areas in PG County have the highest incidence of hypertension and
cardiovascular disease in DC.
Wards 7 & 8 have the highest incidence of stroke in DC.
With the successful recruitment of a Neurologist (he will join us in July), we will be positioned to focus on
the development of stroke protocols and stroke care to become a “Acute Stroke Ready” Hospital.
Discussions have already begun for program development.
Outpatient Pharmacy
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Currently, an outpatient/private pharmacy leases space in the UMC MOB.
The pharmacy does not offer full services and many of over the counter products one typically finds in a
retail pharmacy associated with a hospital and MOB.
The pharmacy operates as a cash business; therefore it is of minimal use for patients being seen by
physicians in the MOB.
The pharmacy does not accept our health insurance; therefore, our employees do not have the
convenience of being able to have their prescriptions filled on site.
Research and discussions regarding alternatives are underway.
The contemporary model of retail pharmacy can have a significant impact on several areas of the care
process.
We are researching the potential of developing a contemporary retail pharmacy that can also have an
impact on care as well through:
o Bedside delivery of prescriptions prior to discharge
o Follow-up at day 3 and 30 to insure appropriate medication usage
o Reducing readmissions
o Linking to the discharged ED patient for prescription prior to departure from the ED
Obstetrical Services
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Currently, there are 500 deliveries per year.(FY 14)
Our market share for OB Services is 15% (below our overall market share of 20%).
Our services are currently delivered in a contemporary well-appointed space.
The physician model used is 2 employed OBs and 3 OBs contracted for call.
The OB/GYN clinic sees on average 250 visits per month.
Part of our growth plan is to grow this service.
A strong OB service including clinic and delivery services will be important to the health priority of infant
mortality. It will also be an important aspect of being able to contract with and provide services through
commercial payors.
Research has begun on how we elevate the standard of women’s healthcare by delivery services that
improve the quality of care and positively impacts lives of women, their newborn and their family.
Additional information will be provided over the coming months regarding the direction and work in this
area.
General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 Human Resources Report Prepared by: Jackie Johnson EVP, Human Resources Not-for-Profit Hospital Corporation
HUMAN RESOURCES
REPORT TO
Board of Directors
Submitted By:
Jackie W. Johnson
Executive Vice President Human Resources
March 2015
HUMAN RESOURCES DEPARTMENT
March 2015

The Human Resources Department welcomes a new addition to the department, Eric M.
Johnson. Eric joins the UMC team in the role of Human Resources Manager. He will
couple his unique blend of Human Resources and Engineering skills to assist in building
a better UMC. Eric will provide support in building key business processes, driving
organizational change and delivering cutting edge business solutions that empower
employees, minimize risk and promote employee engagement and ownership. Prior to
joining UMC, Eric’s served in the role of Sr. Human Resources Manager at Ameritox,
Ltd in Baltimore, MD. Additionally, his human resources experience and background
has been shared with Alliedsignal, Inc., GE Capital Market Services and BHU, Inc.

On March 12th, Quintina Johnson, Administrative Coordinator and I had our kickoff call
with Aimee Tefft, Project Manager of Benefitfocus. Benefitfocus, in 2014 was selected
as our Third Party Administrator, for the implementation of the online automation of our
employee benefits. The kickoff addressed and identified responsible parties on each team
(UMC and Benefitfocus), details of each phase, steps and data required to implement,
timelines and completion. The implementation of Benefitfocus will provide our
employees with a paperless 2016 Open Enrollment process.
o

Benefitfocus is a cloud-based HR management portal that streamlines online
enrollment, employee communication and benefits administration year-round.
The program has the ability to support more than 100 types of benefits and
enforce business rules at all levels, allows UMC to present employees with the
benefit plans for which they are eligible in one cohesive, engaging flow. They
are the leading provider of benefits technology programs. As part of our strategic
initiative No. 3, the program will assist us in leveraging technology to streamline
HR service processes and improve access to employee information through a
paperless process.
Our efforts to transition UMC into a state-of-art organization continues with the March
12th kickoff training for the SWANK Healthcare Learning Management System. Maribel
Torres, Executive Vice President and Chief Nursing Officer, Tonya Ross, Nurse
Educator, Janice Akintewe, Sr. Director of Information Technology and I, attended a
training session on the SWANK e-learning system. The training addressed roles and
responsibilities, employee communications, and management/employee training, all
customized on the SWANK/UMC website. SWANK will provide training to our
Executive Team and specific system educator users onsite on April 1st.
o The Swank HealthCare Learning Management System provides a comprehensive
solution that achieves continuing education and training objectives for healthcare
professionals. The system has over 500 new accredited courses per year and a
broad curriculum across 14 distinct disciplines and professions. The curriculum,
in part, is designed to:
 help maintain annual regulatory compliance, meeting the toughest
standards of patient care and regulatory requirements
 tailor the training to meet the needs of UMC
 time-saving service that integrates content with tracking and assessment
tools

Key management recruitment efforts are as follows:
o
o
o
o

Corporate Compliance Officer
Corporate Secretary
Director of Admissions
Director of Supply Chain
Interviews underway
Interviews ongoing
Advertisement and sourcing begun
Interviews and Search ongoing
PERB has provided notification to OLRCB/NFPHC that, as of, March 11, 2015; they
have appointed David Vaughn as the arbitrator for the NFPHC/1199 SEIU arbitration.
We are awaiting a formal date to resume the discussions.
 Contract negotiations with DCNA were held on Monday, March 16th. The discussions
continued with the non-economic terms and conditions. Our next scheduled meetings
will be held
•
April 1st, 7th and 21st

During the first quarter of FY 15, Renaissance Unemployment Insurance Consultants,
Inc., our unemployment representative handled 23 claims submitted by former
employees. RUIC was successful in obtaining disqualifications in 12 of those claims.
The Hospital was protected against $51,871.00 in liability charges.

The Employee Advisory Committee suggestion boxes were well received by our
employees. The EAC is currently collecting the employee suggestions on a weekly basis.
The committee will review the suggestions; select the top 3-5, present to the CEO with
recommendations and the best approach to accomplish. Employees will be provided an
update of suggestions not selected via various forms of communication (i.e., employee
newsletter, town hall meetings, etc.). We are thankful for the EAC and employees
assisting with building a better UMC.
United Medical Center has participated in the 2015 Healthcare Council National Capital Area
Wage and Salary Survey. This survey provides market data from hospitals and other healthcare
facilities throughout the Washington Metropolitan area. Survey participants include Inova
Health Systems, Providence and Sibley Hospitals in addition to the MEDSTAR facilities
operating in our area. The Human Resource Department is committed to establishing a
competitive edge in today’s market place by attracting and retaining the most talented healthcare
professionals. The survey addresses compensation practices and the types of benefits offered by
healthcare facilities in D.C., Maryland, and Virginia. Survey results will be available in May
2015.
The completion of a mandatory labor market assessment for the D.C. Department of
Employment Services is underway. The survey provides occupational wage information on a
national, state and metropolitan scale. As we continue to strive for excellence in the healthcare
arena, Human Resources will continue to seek out and participate in surveys that provide
valuable information to assist in expanding our recruitment efforts and focusing future training
initiatives.
General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 Hospital Operations Report Prepared by: Pamela Lee EVP, Hospital Operations & CQO Governing Board Report
Hospital Operations / Quality & Compliance
March 26, 2015
Quality Management
The Governing Board Patient Safety & Quality Committee (“GBPSQ Committee or Committee”)
established and approved its charter and 2015 work plan that are now being used to drive clinical and
operational performance. The purpose of the Committee charter is to define performance expectations for
carrying out its duties of providing oversight and guidance for the delivery of high quality, safe, costeffective health care at Not-For-Profit Hospital Corporation, while the 2015 Committee Work Plan will
be used to monitor performance throughout the year. Plan components incorporate the hospital’s quality
and patient safety strategic goals, “Top 10” priorities, and staff performance goals.
In addition to approving guidance documents, the Committee reviewed the hospital’s key performance
indicators against organizational goals and industry benchmarks and endorsed management-approved
tactics aimed at sustaining current success levels and improving other key performance metrics. Overall,
significant gains were evidenced throughout calendar year 2014. See the GBPSQ Committee Report for
more information.
Operational Improvements
To better facilitate provision of clinical care, the following recent activities have occurred:






Environmental Services—In addition to stabilizing Environmental Services (“EVS”) leadership
and workforce, several actions are being taken to promote hospital cleanliness. To promote
consistency, managers and staff are geographically assigned. Low-maintenance flooring is being
installed throughout the hospital where renovations are occurring, resulting in the ability to shift
resources from extensive floor care to point-of-care cleaning. A High-Profile Cleaning (“HPC”)
technician has been assigned to work directly with staff to role model and reinforce cleaning
expectations. Cleaning schedules are being refined to better coordinate cleaning activities. EVS
managers are routinely rounding with department, unit and executive leaders to assess
performance and respond to organizational needs.
Telecommunications—Use of hands-free Vocera communication technology has been expanded
to the Division of Patient Care Services and the Department of Facilities. The technology
facilitates immediate staff communication needed for provision of patient care and support
services.
Health Information Management—Electronic health record scanning and archiving functionality
was recently implemented.
Emergency Management—Staff has collaborated with the District of Columbia Healthcare
Emergency Management Coalition (“DCHEC”) to obtain additional Ebola-related equipment and
supplies. Ebola preparedness drills and other preparatory activities continue.
Safety & Security—Several safety and security enhancement projects are in process or have been
completed over the past several months: (1) Implementation of an electronic visitor management
system to enhance visitor screening and issue temporary identification badges; (2) Installation of
LED lighting throughout the hospital campus; (3) Installation of Code Blue communication
devices in strategic locations throughout the hospital campus to alert Security of patient, visitor or
staff emergency situations (in process); (4) Upgrade of campus-wide security camera system; and
(5) Expansion of elopement detection technology within the skilled nursing facility.
Food Service—Various programs have been initiated to improve the health of patients, visitors
and staff: (1) Increased “better for you servings” within the cafeteria retail area to 50% of food
1




served (goal = 100%); (2) Implementation of a new retail menu; (3) Implementation of “Always
Available” menu sampling to SNF residents to better obtain input into meals served; and (4)
Reconfiguration of work flows to improve efficiencies with serving patient meals.
Biomedical Engineering—Clinical equipment have been added to the existing fleet to enhance
patient care (EKG machines, defibrillators, interventional radiology light source and steam
sterilizers).
Admitting & Registration—Continued efforts are being made to improve service and efficiency
within the Department of Admitting and Registration: (1) Improved registration efficiency by
implementing Meditech scanning functionality to input demographic and other data; (2)
Expansion of Centralized Scheduling to include physical therapy and cardiology; and (3)
Transition to a new insurance verification and authorization system (Relay Health) (in process).
Facility Enhancements—Progress continues to be made with hospital renovations and
enhancements. The Memorandum of Understanding between the hospital and DCHCF was
signed and therefore the required paperwork to begin budgeted capital projects has now been
processed. Project schedules have been updated to reflect new timelines since MOU process
delays. See Attachment I (Project Status).
Supply Chain—The GPO contract with MedAssets will be finalized soon. Contract deliverables
will enhance staff access to technological tools that will be used to enhance visibility into
spending patterns, better identify cost savings, more effectively control expenditures and facilitate
use of additional resources for managing the hospital’s supply chain process.
Most Recent Facility Enhancements
Project
Status
1. Pipe insulation project
Complete
2. Compression of Purchasing
space to accommodate
relocation of Centralized
Scheduling and re-opening of
the Gift Shop
3. Enhanced parking signage
In
progress
4. Replacement of elevator
flooring
5. Steam valves & pipe repairs
and replacements
6. Building automation system
7. Creation of space for
Purchasing staff
8. Creation of SNF annex space
9. Creation for locker room for
SNF staff
10. Replacement of blow down
tank
11. Cooling tower cleaning
12. Repairs to domestic hot water
circulating pumps
Complete
In
progress
Complete
In process
Benefit / Result
Reduction of ceiling leaks & stained tile. More
efficient HVAC system. Cost savings.
Improved patient experience with access to a first
floor gift shop.
Additional parking signage added to recognized high
performing staff (“Employee of the Year”, “Manager
of the Year”), and to better control facility access in
restricted areas.
Improved hospital image. Reduced maintenance
activities. FTE reduction.
Greater efficiencies. Cost savings.
Complete
Better temperature controls throughout the facility.
Energy cost savings.
Interim space planning moves to increase operational
efficiency
Created space for SNF residents’ medical records,
physical therapy and storage of personal belongings.
Reduced clutter within the nurses’ station
Complete
Increased efficiency with boiler functionality
Complete
Complete
Increased HVAC efficiency
Increased efficiency and backup to circulating hot
water
Complete
In process
2
UMC 2015 Projects Status
As of March 17, 2015
Project
Current Status
Construction
Start
Complete
Behavioral Health (4th Floor Renovation)
Design &
Engineering
May 15, 2015
August 6, 2015
Patient Refresh 5th & 8th Floor, ICU Doors and
Exterior Windows
Design &
Engineering
May 15, 2015
August 6, 2015
Programming
June 24, 2015
October 6, 2015
Operating Room Renovation
(4 OR’s)
Interim Projects:
1. Centralized Scheduling/Employee Health
Design/Permitting April 21, 2015
June 1, 2015
2. QC, Risk Mgmnt, Comm, ICRA, Case
Mgmnt,
Design/Permitting May 19, 2015
July 13, 2015
3. Emergency Department Behavioral
Health Suite
Design/Permitting May 19, 2015
July 13, 2015
4. Patient Experience
5. Patient Accounts
6. Healing Garden and SNF Lounge
Design &
Engineering
June 24, 2015
August 18, 2015
Design/Permitting June 24, 2015
August 18, 2015
Design &
Engineering
July 23, 2015
September 29,
2015
ATTACHMENT i
General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 Public Relations and Communications Report Prepared by: David Thompson, Interim Director, Public Relations and Communications Communications and Public Relations Board Report
EXTERNAL Communications
ADVERTISING:
Radio ads are currently airing to promote the United Medical Center and the launch of the first of two
mobile health clinics that will be providing services to the community. :60 second radio ads are airing
on 93.6 WHUR, Magic 102.3 WMMJ, Praise 104.1 WPRS, and all news 99.1 WNEW. A new “Did You
Know” print ad with important information about the hospital will begin appearing in the Washington
Informer and East of the River community newspapers this week.
A special “Staying Healthy” segment will air twice a month on Magic 102.3 WMMJ featuring a physician
from United Medical Center who will provide health information to the public.
COLLATERAL MATERIALS:
New brochures and other collateral materials are being designed for the Care Center, Radiology,
Cardiology and other departments at the hospital to provide individuals and their family members with
information about the various specialty areas. A general brochure about the hospital is now available
including phone numbers for the various departments.
COMMUNITY OUTREACH:
The hospital has begun a series of community outreach events initially focused on the faith community
to provide residents with information about the hospital and conduct high blood pressure, diabetes and
other tests. To date, UMC has conducted events at Bethlehem Baptist Church on Martin Luther King Jr.
Avenue and Grace Memorial Presbyterian Church on Minnesota Avenue in Ward 8. Some of the
upcoming outreach events with churches planned for Ward 7 and Prince George’s County will include
the mobile health clinic. In addition to the churches, the hospital will also conduct outreach events with
the ANCs and other community organizations in the District and Prince Georges County. Future radio
ads and newspaper ads will promote the events.
MEDIA RELATIONS:
The Washington Informer developed a news story with photos about our outreach to the community
that appeared in last week’s newspaper. East of the River is holding its feature story on the hospital and
will be publishing it in the April issue which will be distributed on the 10th of the month. There were a
number of news stories that appeared in the press following yesterday’s launch of the mobile health
clinic. We are planning follow-up interviews about UMC and the mobile health clinics on WHUR radio,
WMMJ, radio, and the local television stations over the next few weeks.
INTERNAL COMMUNICATIONS:
The hospital’s newsletter, UMC Pride, has been well received by UMC employees. The newsletter
provides noteworthy developments and news about hospital programs and services. UMC Pride also
highlights an employee in each issue. In addition to the newsletter, the Communications and PR
Department also publishes News Pulse, a weekly compilation of news stories that have appeared in USA
Today, the New York Times, CNN and other major media news outlets. News Pulse is distributed to
UMC’s Management Council and the Executive Team to keep them abreast of breaking healthcare news.
The communications team continues to support or manage various events for the hospital’s employees.
Recent events supported include the National Nutrition Month event, Patient Safety Awareness Week,
and the event in February for American Heart Month.
SOCIAL MEDIA:
United Medical Center has launched a Facebook Page for the public to provide comments and feedback
about the hospital and the services that are provided to the community. The site contains information
about the hospital and medical news about topics that are trending. To visit UMC’s Facebook page, go
to www.facebook.com/unitedmedicalcenterdc
The hospital also utilizes Twitter, primarily to keep the news media aware of UMC developments.
UMC’s Twitter handle is Twitter: @UMC_DC
SURVEY:
UMC is currently conducting a survey with residents in Wards 7, 8, and Prince George’s County to
determine what they know about the hospital to help gauge how we should tailor our services to meet
their healthcare needs. The surveys are being conducted at community outreach events at the churches
and at Giant and Safeway grocery stores and shopping malls.
General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 CNO Report Prepared by: Maribel Torres, Chief Nursing Officer BOARD REPORT
PATIENT CARE SERVICES
MARCH, 2015
EMERGENCY DEPARTMENT INITIATIVES / THROUGHPUT

As indicated in the Hospital’s strategic plan, our goal is to decrease the Left Without
Being Seen (LWBS) rate to 2.5%. While we have not yet achieved that goal, the LWBS
rate has been steadily decreasing. New initiates have been put into place to achieve the
strategic goal and have proven to be successful thus far.
Emphasis on Communication


Safety huddles have been reintroduced, twice daily, during the beginning of the morning
shift (0700) and the beginning of the night shift (1900). The huddle last approximately
three to five minutes. While our first priority is always the safety of our patients, this
initiative will also assist our strategic mission to improve the overall patient experience
Staff meetings, EMS communication meetings, charge nurse meetings, staff nurse
meetings and Emergency Department technician meetings have been scheduled for the
2015 calendar year. These communication channels are very important to our
department to provide consistent and up-to-date information to our staff and
respective counterparts. Caring for our community does not just begin when the
patient walks or travels thru our doors, it begins on the journey to United Medical
Center, whether it consist of private transportation, the District of Columbia Emergency
Medical Service or the Prince George’s County Emergency Medical Service. We feel that
regular communication with our transport system is necessary to provide our
expectations in safe and proper delivery and treatment prior to arrival to our facility.
Community Outreach

In alliance with the Hospital’s strategic plan, the Nursing Department will participate in
community outreach initiatives which include health fair and community education.
Currently, we are evaluating community needs, with our goal to target prevalent health
issues such as diabetes, hypertension and teenage pregnancy.
Page 1 of 4
ED METRICS
ED Metrics Empower Data
Jan-15
Feb-15
2015 YTD Avg
Visits
4487
3845
4166
Change from Prior Year (Visits)
↓239
↓457
↓348
↓5.06%
↓10.6%
↓7.83%
LWBS
4.6%
3.7%
4.2%
Ambulance Arrivals
Ambulance Patients Admission
Conversion
% of ED patients arrived by
Ambulance
1221
1092
1156.5
283
246
264.5
27.2%
28.4%
27.8%
% of Ambulance Patients Admitted
23.2%
22.5%
22.8%
% Growth
*As of Sept. 2014 data is derived from the ED Meditech System. X-see the data below
ER LWBS (Left Without Being Seen)
Average for Jan and Feb. 2015
Percentage
4.6%
4.2%
3.7%
2.5%
ER LWBS
Average for
Jan & Feb
2015
Page 2 of 4
Jan-15
Feb-15
Goal 2015
2015 YTD
Average
UNIT-SPECIFIC HIGHLIGHTS:
UNIT(S)
HIGHLIGHTS AND INITIATIVES
8-West
Med/Surg &
5-West
Telemetry


Cohort of new graduate nurses are scheduled to be hired this spring.
Education is developing curriculum.
Throughput:
o Implemented “bed ahead” system so that supervisors can autoassign rooms based on information provided from charge nurse
o Bed analysis at the beginning of each shift
o Daily automatic downgrade of telemetry patients based on MECapproved policy
o RN and Tech shift assignments are being standardized on both
units to ensure consistency

Women and
Infant Health


Created a “BRAVO” box for staff, visitors, family members and patients
to leave comments to recognize outstanding staff
Continue to be on-target with goals related to the Baby Friendly
Hospital initiative. The development phase has been completed and
are currently beginning the third (Dissemination) phase
A postpartum hemorrhage task force is being developed to review
current evidence and develop and review our postpartum hemorrhage
guidelines
Perioperative 2015 goals include:
Services
 Decrease turnover time to 15 minutes
 Comprehensive, evidence-based “time-out” created by
multidisciplinary team and approved by HIM Committee
 Increase number of “tracers” to ensure that safety and quality metrics
are met consistently
Professional
 Academic affiliation agreements with Radians College; students to
Development
begin clinical rotations starting Spring, 2015
and
 Similar agreement with UDC currently being negotiated
Education
 Developing comprehensive curriculum and on-boarding process for
new graduate nurses for Spring on-boarding
Critical Care
 The ICU recently received an award for outstanding quality, and
Center
remains the only hospital in the DC metro area, and one of very few
ICUs across the country, that continues to have zero cases of
ventilator-associated pneumonia (VAP) and zero central line acquired
bloodstream infections (CLABSI). We are very proud of this
accomplishment, which ultimately speaks to our ongoing commitment
to quality care and evidence-based practice to ensure the best possible
patient outcomes.
 All rapid responses and ‘code blue’ emergencies resulted in a 100%
patient survival rate for the month of February
Page 3 of 4

A team of clinicians is being developed to move forward with the
implementation of a PICC (Peripheral Inserted Central Cather) team.
This will allow us to provide optimal medication delivery to patients
requiring long term therapy. In addition, having this team in place will
facilitate faster discharges to outside facilities.
OTHER NURSING-RELATED INITIATIVES AND HIGHLIGHTS:
Clinical Practice Council

An evidence-based best practice, the clinical practice council committee is anticipated
to bridge the communication and ethics gap within our department. This forum will
provide for multi-disciplinary decision making amongst the department. By
implementing this committee, staff will have a say in rebuilding and restructuring the
department. Voices will be heard, changes will be implemented with the assistance of
new and seasoned staff and professionalism with be built and/or mended.
SUBMITTED BY:
Maribel A. Torres, MSM, RN-BC
Executive Vice President, Patient Care Services
and Chief Nursing Officer
Page 4 of 4
General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 Ambulatory & Ancillary Services Report Prepared by: Charletta Washington VP, Ambulatory & Ancillary Services Division Ambulatory and Ancillary Services
March 2015
Goal 5: Contribute to overall health within the communities that UMC serves
Mobile Health
As part of achieving Goal 5 of the Board of Director’s approved strategic initiative, “to contribute to the
overall health within the communities that UMC serves” the Hospital will commence offering outpatient
care directly to the community via a mobile health clinic. Mobile Health Clinics (MHCs) have become
a key source of health care for underserved populations, because they provide care in a way that makes
healthcare more accessible. The majority of MHCs have grown out of a specific community need
defined by the health care disparities of that community.
In 2013, the District of Columbia’s community needs assessment revealed that there were six health care
disparities: Cardiovascular Disease, Diabetes, Hypertension, Infant Mortality, HIV/AIDS, and
Oncology. The Mobile Health Center will allow UMC to positively impact the morbidity and mortality
rates by providing increased and direct community access to primary care and specialty physicians,
increase health education, health maintenance, public awareness, and linkage to other health care and
social services.
The implementation of UMC’s Mobile Health Unit will:






Reduce non-emergent Emergency Department visits by approximately 22%
Allow for additional resource programming through a reallocation of a $1.1 million of avoidable
Emergency Department Cost
Eliminate the need for transportation
Provide direct access to health screenings, wellness/sick visits and linkage coordination
Remove a key barrier to health care access by offering a low cost option to emergency room
utilization
Represent a trustworthy source of health care because it becomes part of the community.
2
Goal 2: Achieve financial Stability
Goal 4: Achieve Superior quality and patient safety outcomes
Laboratory
Chlamydia and gonorrhea are the most commonly reported sexually transmitted infections in the United
States. Each year there are over 3 million new cases annually, and worldwide the World Health
Organization estimates the annual incidence of chlamydia to be 105.7 million and 106.1 million for
gonorrhea. These staggering statistics have a direct impact on laboratory testing at United Medical
Center resulting in an approximate $800,000 annual spend to an outside vendor to obtain the results of
these frequently ordered tests.
Looking to the Board approved strategic plan to achieve financial stability and achieve superior quality
and patient safety outcomes, the hospital completed capital equipment purchased of the GenProbe
Panther. The GenProbe Panther (pictured below) provides the latest technology to control workflow,
driven by random-access, and continuous loading of molecular samples, reagents and consumables.
This innovative design enables the lab to improve productivity and accelerate results, ultimately helping
enhance patient care, while reducing lab costs.
The GenProbe Panther
Pictured with from Left to right: Trevail Stokes, John Izuegbu, and Florentino Solanzo
Division of Ambulatory and Ancillary Services
Primary Care
Center
October
November
December
January
February
PCC
531
493
538
608
473
ORTHOPEDICS
200
195
204
190
189
GI
60
31
12
28
33
UROLOGY
26
55
34
26
42
OB/GYN
329
281
293
279
267
CARDIOLOGY
29
37
12
29
37
CARE CENTER
106
107
124
139
121
PRIMARY CARE
TOTAL
1281
1199
1217
1299
1162
March
April
May
June
July
August
September
4
General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 Chief Executive Reports Presented by: Barbara Roberson-‐Thomas, Interim CFO David Small, Interim CEO General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 CFO Report Prepared by: Barbara Roberson-‐Thomas Interim Chief Financial Officer General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 CEO Report Presented by: David Small Interim CEO NOT-FOR-PROFIT HOSPITAL CORPORATION
Executive Management Report
To
Not-For-Profit Hospital Corporation Board
March 26, 2015 Meeting
Submitted by
David R. Small, FACHE
Chief Executive Officer
1|Page
OPERATIONS SUMMARY THROUGH FEBRUARY, 2015
The month of February was a very soft month for UMC in terms of hospital admissions and Emergency
Room visits, with admissions coming in at almost 15% below expectations and the ER visits being 14%
off budget. One of the reasons for the lower admission numbers is clearly the hard winter weather
with several storms experienced in the month. Another key driver is that we had budgeted positive
inpatient impact from the first community-based ambulatory center that was planned to be in
operation in November, which of course did not occur. While we are still working on the
development of such a site for this fiscal year, we hope to achieve some of that intended
“downstream” benefit from the commencement of the mobile health clinic van at the end of this
month.
On a Year-to-Date basis, our admissions are about 5% below budget and the ER visits about 4%. Both
of these trends will continued to be closely monitored with any necessary adjustments to operational
costs made to compensate should we continue to see slower growth than planned.
Case Mix Index (CMI), the measure for severity of patient illness for our inpatients, for the month of
February was above budget which goes to a slightly higher than budgeted Length of Stay for the
month, but again the CMO, Dr. Allen and the Medical Staff is focused on achieving appropriate
performance in this area against national benchmarks by diagnostic related groups (DRGs).
In the ambulatory arena, our goal of creating more access to appropriate and timely levels of
outpatient care continues to be met as overall clinic visit totals were 26% ahead of plan for the month
and over 30% for the fiscal year. Again this is all additional volume for patients served on the UMC
campus and will be rapidly augmented with the commencement of mobile services.
On the expense side, we continue to see our Salary, Wages, and Benefits expenses come in below
budget, with the month of February at approximately $400K below expected putting us $2M below
budget for the fiscal year thus far. Medical supply expense was below budget for the month;
Purchased services expenses were over budget for the month but largely one-time in nature such as
the expense payment associated with the large Rural Floor Settlement (Medicare group case) which
yielded additional revenues to the hospital as a result and was previously reported to the Board and
Finance Committee, or Meaningful Use associated costs that resulted in reported Incentive payments
to UMC. Overtime ran over budget as we are in the recruitment mode, particularly for the SNF, but
still need to ensure required nursing staffing schedules are maintained on the units.
For the fiscal year through the first five months, our Net Patient Service Revenue is ahead of budget
by $800K, the Total Operating Revenue is ahead of budget by $1.7M, Total Operating Expenses are
below budget by almost $400K, and Net Income from Operations (Margin from Operations) stands at
$2.674M (against a planned result of $620K).
2|Page
OTHER INFORMATIONAL MATTERS OF NOTE
SERVICE EXPANSION UPDATE:
The first of our planned two Mobile Health Clinic Vans is scheduled to arrive this month and the
schedule for neighborhood visits throughout Wards 7 & 8 and Prince Georges County is rapidly filling
up for the month of April. A public ribbon cutting event is planned for the 25th of this month to
formally announce the launching of this new service for our local residents. The second such van will
be ordered within the next month with an expected delivery of the middle of the summer for
operation commencement.
New physicians in the areas of cardio-vascular, orthopedics, and general surgery (specialty in liver and
abdomen) have contractual agreements for review and execution, with expected start dates over the
coming weeks and months.
We have continued to experience some challenges with the identification of a suitable site for our
Ward 8 Community Ambulatory Healthcare Center, and the Department of General Services (DGS) has
not indicated any action on their part that might suggest immediate success. Our staff has located
one or two potential locations and has forwarded that information to DGS; we are awaiting further
response. As a reminder we must be operational to comply with the time frame associated with the
CON exemption granted to us for this purpose by the Council in January, by the end of this calendar
year. We continue to look for shared sense of urgency and of course are pursuing any and all other
creative solutions that will result in increased community-based access to primary and urgent care
within our primary service areas. We also continue to seek opportunities within Ward 7 as well as
Prince George’s County.
SKILLED NURSING FACILITY:
While we have received confirmation from the Department of Health that they have evaluated UMC
as being in compliance with local regulations and Conditions of Participation under CMS program
requirements, we remain focused on delivering on continued improvement of services and
performance for the SNF. New admissions have begun to commence and as part of our targeted
growth strategy in the area of more complex, short -term skilled nursing care delivery for our units,
we have begun conversations with other local hospital and community providers, as well as our own
Medical Staff on the identification and referral for admission of new patients for our SNF. Our
established target for this fiscal year is to see approximately 25% of our daily SNF census maintained
for these types of patients.
LABOR RELATIONS:
I am pleased to report that the Council earlier this month, gave final approval to the two new
Collective Bargaining Agreements (IUOE and UFSPO) that your Board had approved. We are very
happy to have finally concluded all of the steps and planned compensation and other contract
provisions for our staff can now move forward and be immediately implemented.
3|Page
An Arbitrator has been selected for our CBA impasse with SEIU; the management along with OLRCB is
busy preparing the hospital’s formal statement of position and supporting documentation in
preparation for this next step in the process. We hope to hear of a date for the arbitration hearing(s)
in the very near future.
Negotiations with DCNA continue with discussion now moving to economic issues. Again, all are
working to bring this negotiation to a successful conclusion as rapidly as possible so that staff
compensation levels can be adjusted and other significant changes contained within the Board’s
adopted Strategic Plan can be implemented.
CAPITAL FUNDING FOR FY2015:
We are still waiting for a bit over $5M of approved capital funds to be “reprogrammed” by the budget
staff downtown; these were dollars originally thought to be expended through access to the Districtwide master lease program but it has been determined that the best course is for the hospital to not
utilize that program. Once the dollars are reprogrammed to “PayGo” dollars which carry greater
flexibility in use criteria, purchases against those dollars will be initiated. In the meantime purchase
orders are rapidly being issued to utilize the other capital dollars for this year’s capital investment
program (patient care area repairs and upgrades, new equipment, program expansions, deferred
maintenance, improvements to our ORs, and information technology). As stated within Ms. Lee’s
report, a significant number of facility upgrade projects are commencing with the goal of all being
completed by the end of this current fiscal year.
NURSE QUOTA BILL:
On March 3rd, Chairman Mendelson introduced a “nurse quota bill” now titled the Safe Working
Conditions for Healthcare workers Amendment Act of 2015. This a bill largely pushed by the Nursing
Unions that calls for mandated nurse/patient staffing ratios, or nurse quotas. The legislation was
introduced last year as the Patient Protection Act (and did not receive a committee hearing) is very
similar to numerous other pieces of legislation introduced across the country (and with the exception
of the very first one in California in 2001 none being passed). This year’s sponsors are Mendelson,
Orange, Bonds, Silverman, and Allen. Councilmembers who were sponsors last year but are not this
year are Alexander, Evans, McDuffie, and Mayor Bowser. The hospitals have successfully argued that
there is no empirical research data that supports the premise that mandated staffing ratios lead to
better patient care perhaps that is why this newly introduced bill has a different title.
We at UMC have long employed staff scheduling methodology that is typical throughout the industry
and is predicated on the fact that staffing should be adjusted in accordance with individual patient
needs (which of course change throughout a patients course of illness or hospital stay) rather than
mandated simply based upon a ratio of nurses to numbers of patients in beds. Our staffing patterns
are based upon schedules that are in line with best practices and were confirmed during Huron’s two
years of assistance and consultation on labor and productivity. We have estimated that quotas called
for within such legislation would require an approximate $4+M of fixed staffing costs on an annual
basis, with no correlation to evidence that proves greater quality and outcomes for those additional
dollars. Such additional expense would not be covered by continuing reductions in governmental
reimbursements. The DC Hospital Association, in its representation of all of the district hospitals, has
been lobbying and educating the Council members and continues to do so. We will keep the Board
apprised of any developments regarding this Bill.
4|Page
LETTER OF INTENT AND PROPOSED PARTNERSHIP:
Finally, due diligence work continues as called for under the Letter of Intent related to the proposed
sale of the hospital’s operations and lease from the District of the current facilities. Information
continues to be exchanged and analyzed/reviewed, while the development of the definitive
documents (operations sale transaction and facilities lease) by the “sellers” (represented by NFPHC
Counsel and Baker Donaldson, OAG, OCFO, and Mayor) continue toward completion. It is anticipated
that those documents will be approved and subsequently shared within the next several weeks with
the “buyers” for next steps of the anticipated review, discussion, and negotiation process. Further
information will be shared within the Board’s deliberative process of the scheduled closed session.
5|Page
General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 Governance Committee Report Virgil McDonald, Chair • Meeting Minutes – Mar. 10th • February 26th Evaluation Summary Not-For-Profit Hospital Corporation
Governance Committee Meeting Minutes
March 10, 2015
Present:
Virgil McDonald (Chair), Steve Lyons, Maria Gomez, Bishop Hudson, David Small, Kai Blissett (General Counsel), Yolanda Raine
(Administrative Assistant)
Excused:
Others:
Agenda Item
Call to Order
Determination of a
Quorum
Approval of the
Agenda
Approval of
Minutes
Consent Agenda
Discussions
Discussion
Quorum was determined by the Committee Chair
Action Item
Agenda was approved by committee with necessary changes.
Minutes from the January 13, 2015 Governance meeting were approved.
N/A
Highlights include:
Board Member Self-Assessment Status
Virgil McDonald led discussion on 2015 Board Member Self-Assessment to be completed
online by Board members.
Yolanda Raine to contact Board
members individually to
provide a reminder to complete
the Board assessment.
Board Meeting Education Sessions for 2015
David Small led discussion on schedule of Board Education Sessions for March –
December 2015.
1
Update on MOTA Nominations to the UMC Board
Kai Blissett provided a status update to committee members on
nominations/appointments to the NFPHC Board.
Standing Committee Monitoring Procedures of CEO 2015 Goals
Virgil McDonald led discussion on Standing Committee Charges.
Work Plans
Maria Gomez and Steve Lyons provided an update on the development of Patient Safety
and Quality and Finance committee work plans in comparison to the CEO 2015 goals.
AHA Annual Meeting
Other Business
David Small to send AHA
Annual Meeting materials and
invitation to the full Board for
consideration.
February 2015 Board Meeting Evaluation Summary
Virgil McDonald led brief discussion on the February 2015 Board Meeting Evaluation
Summary.
Email Access
Virgil McDonald led discussion on issues with accessing UMC email.
Yolanda Raine to contact
UMC’s IT department for
troubleshooting information.
2015 Board Retreat
Virgil McDonald led brief discussion on the planning of a Board Retreat later in 2015.
Next meeting date – April 14, 2015 at 8:00am
Adjourned at 9:10am
2
Board of Directors Evaluation Summary
February 2015
Areas of Evaluation
Average Response Rank
Proper notice was given to Board Members & community
The Board packet was received in a timely manner
The majority of Board Members were present
The meeting agenda is appropriate.
The Board packet provided the appropriate information to support
solid discussions and decisions
Executive reports were concise, yet informative
Directors’ discussions were on target and focused
Directors were prepared and involved
All recommendations and decisions made by the Board are
documented and monitored to ensure implementation
Appropriate Board and staff assignments were made
Board Members’ conduct was business-like, cordial, results-oriented
and respectful of diversity
Meeting ran on time
I am satisfied with this meeting
4.6
4.2
3.6
4.8
4.6
4.4
4.8
4.6
4.4
4.6
5
4.6
4.6
In the evaluation form, the board members were invited to provide feedback on three specific
questions. Some of the comments received are summarized below.
What aspects of this meeting were particularly good?
 Did not run too long
 It was very professional with appropriate questions and discussions
What aspects of this meeting were particularly bad?
 Late start and poor attendance in person
 Difficult with so many people on the phone. Understand the weather issues.
Do you have any suggestions or comments about this meeting?
Thank you everyone for providing such valuable feedback. We can assure you that we will take your feedback in
consideration in planning our next board meeting to increase overall productivity.
General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 Finance Committee Report Steve Lyons, Chair • Minutes – Mar. 10th • Meeting Materials Not-For-Profit Hospital Corporation
Finance Committee Meeting Minutes
March 17, 2015
Present:
Excused:
Public:
Steve Lyons (Chair), Virgil McDonald, Dr. Konrad Dawson, Bishop Hudson, David Small, Barbara Roberson, Diji Omisore, Andrew
Nowake, Yolanda Raine(Administrative Assistant)
Darrin Shaffer, Agency Fiscal Officer (District of Columbia Department of Health Care Finance)
Agenda Item
Call to Order
Discussion
The meeting was called to order at 2:41pm
Determination of a
Quorum
Quorum was Determined by Steve Lyons (Chair)
Approval of the
Agenda
Approved
Approval of
Minutes
Minutes from February 24, 2015 meeting approved with necessary corrections.
Consent Agenda
Review of Prior
Meeting Action
Items
N/A
None
Action Item
Financial
Statement Review
FINANCIAL REPORT
Barbara Roberson, Interim CEO, presented Summary of Operating Results for the onemonth period ending February 28, 2015. (Attachments presented to Committee
members and filed in the Office of the Secretary of the Corporation)
Discussion Highlights (Please refer to financial statements provided in Finance materials):

For the quarter ending January 31, 2015, the hospital is ahead of budget and is
performing better than in the same period in the prior year.
o Net Income – $1.1M
o Net Operating Income - $1.7M
o Operating Expenses - $9.1M
o Net Patient Revenue - $9.5M
o DSH Revenue - $244 thousand

Operating Expenses
o SWBCL accounted for 60.6% of the total operating expenses for the
month. The total SWBCL expenses totaled to $5.5 million, which were
$402.1 thousand or 6.8% lower than budget.
 Paid FTEs for the year were 859 (3 FTEs above budget).
 Hospital FTEs – 763 (7 FTEs above budget).
 SNF FTEs 96 (4 FTEs below budget).
o Overtime accounted for 36.57 FTSs or $253 thousand of total salary
expense; this was 17.5% higher than expectations. Overtime as a percent
of total salary expense was 6.5% compared to a budgeted 4.4%.

Professional Fees
The total Professional Fees expense was $596.7 thousand, which was 15.6%
below budget.

Purchased Services
The Purchase Services expense of $1.1M was 62.9% above budget.

Other Expenses
The total expense in this line item was $867.1 thousand for the month which was
81.1% higher than budget.

Cash Flow
On February 28, 2015, NFPHC held $12.7 million of cash, a decrease of $1.6
million over prior month.
o Day’s cash on hand (including reserve) was 43.1 days (decrease of 5.3
days from the previous month).
o $584 thousand in Cash was provided by Operations in February 2015.
o $977.2 thousand has been used capital additions thus far.

Collections
Total cash collections for the month were 20.8% below budget.

Accounts Receivable
Net patient accounts receivable totaled $14.5 million as of February 28, 2015 and
was up by $3.4 million from the prior month.

Aged Trade Payable
As of February 28, 2015, trade accounts payable (APs) totaled $4.6 million, which
was $1.0 million higher than the AP balance for the prior month.

Liquidity
As of February 28, 2015, net working capital was $11.7 million an increase in net
working capital of approximately $1.0 million compared to the prior month.
Volume – Inpatient
Total admissions for the reporting period were 516 which were 90 admissions lower
than the budgeted admissions of 606.
 Hospital admissions – Hospital admission was below budget by 13.4% for the





month.
Med/Surg admissions – Admissions to the Medical/Surgical unit were 9.5% lower
than the budget. Medical/Surgical admissions account for 72.3% of the total
hospital admissions.
Psychiatry admissions – Admissions to this unit were higher than budget by 3.7%
for the reporting period.
Nursery/OBGYN admissions – Admissions to Nursery/OBGYN were below budget
by 45.8% for the period.
SNF admissions – Admissions on SNF were below budget by 100.0% for the
reporting period due to DOH imposed restrictions.
Case Mix Index – The Hospital Case Mix Index was at 1.2070 for the month. The
Medicare Case Mix Index was at 1.6800 for the month.
Volume – Outpatient
 Outpatient Visits – Outpatient visits were below budget by 4.8% primarily driven
by clinic and ED activity
 ED Volumes – ED visits trailed the budget by 14.3%
 Radiology Visits – Radiology visits were 4.5% above budget.
 Clinic Visits – Clinic visits were up 25.1% compared to budget.
 Same Day Surgery – The actual number of visits in this category was 30.0% below
budget.
 Observation admissions – There were 150 observation admissions, trailed
budget by 8.9%
 ER visits – For the current month, ER visits were 14.3% below budget.
o 449 admissions from ED, represents 87.0% of total admissions and 11.8%
of total ED visits.
o 3.3% of ED visits has zero charges applied.
Other Business
Any expected financial issues/pressures
Brief discussion was held by the Committee on any expected financial issues/pressures.
Revenue Cycle Report
Andrew Nowake presented update on the Revenue Cycle Committee. (Attachments
presented to Committee members and filed in the Office of the Secretary of the
Corporation)
Update on Potential DSH Funding Recoupment
Darren Shaffer, Agency Fiscal Officer (District of Columbia Department of Health Care
Finance) provided an update on potential DSH funding recoupment.
Monitoring the CEO’s Objectives
Virgil McDonald provided an overview of ensuring the committee monitors the CEO’s
Objectives for the 2015 fiscal year.
Announcements
Next Finance Committee conference call is Tuesday, April 21, 2015 at 2:30pm
Adjourned at 3:53pm.
General Board Meeting Date: March 26, 2015 Location: Conference Rooms 2/3 Patient Safety & Quality Committee Report Maria Gomez, Chair • Minutes – Mar. 10th • Meeting Materials Not-For-Profit Hospital Corporation
Patient Safety & Quality Committee Meeting Minutes
March 10, 2015
Present:
Excused:
Others:
Maria Gomez, Dr. Julianne Malveaux, Pamela Lee, David Small, Dr. Raymond Tu, Maribel Torres, Stanley Pierre, Yolanda Raine
Girume Ashenafi, Dr. Cyril Allen
N/A
Agenda Item
Call to Order
Determination of a
Quorum
Approval of the
Agenda
Approval of
Minutes
Consent Agenda
Discussion
Discussion
Quorum determined by Committee Chair
Action Item
Approved
N/A
N/A
Highlights include: (Discussion materials have been filed in the Office of the Secretary of
the Corporation)
Old Business
UMNC Skilled Nursing Facility Follow-Up Survey
Maribel Torres provided an update on the UMNC Skilled Nursing Facility Follow-Up
Survey. UMNC is back to full standing with new leadership.
Centers for Medicare & Medicaid Services – 11th Scope of Work
Pam Lee provided an update on the next steps to complete the Memorandum of
Agreement with Delmarva.
Maria Gomez to provide signed
MOU agreement to Pam Lee.
1
The following New Business topics were discussed:
New Business
Draft Governing Board Patient Safety & Quality Committee Charter
Pam Lee led discussion and provided highlights from the Draft Governing Board Patient
Safety & Quality Committee Charter.
Draft Governing Board Patient Safety & Quality Committee Priorities
Safety & Quality Committee Priorities. Incorporating initiatives related to employee
recruitment and retention as a priority was discussed.
Pam Lee to provide updated
Governing Board Patient Safety
& Quality Committee Priorities.
Pam Lee to work with Jackie
Johnson (VP of Human
Resources) to provide an
update at the next Patient
Safety and Quality meeting in
April.
Governing Board Patient Safety & Quality Committee Work Plan
Safety & Quality Committee Work Plan, current status, and upcoming deadlines.
2014 Year End PI Summary Dashboard
Pam Lee provided an overview of the metrics for the 2014 Year End PI Summary
Dashboard which shows progress in several areas over the last year.
Committee to perform an
effective review (via conference
call) to approve the following:
- GPPSQ Charter
- 2015 PI Priorities
- 2015 GBPSQ Work Plan
2015 Reportable PI Process & Outcomes Measures
Pam Lee led discussion on the 2015 Reportable PI Process and Outcome Measures and
indicators that will be monitored, measured, and improved upon.
2015 Performance Improvement Tactics
Pam Lee provided an overview of the 2015 Performance Improvement tactics that are
being implemented to ensure improved performance. The tactics will be incorporated
2
into a comprehensive action plan.
Medical Staff Leadership, Quality, and Patient Safety
Dr. Raymond Tu provided an update on Medical Staff Leadership, Quality, and Patient
Safety with the following highlights:
- Core Measures: Each department to focus on 1 core measure each week to
ensure patients are receiving quality care.
- Incorporation of an education center in the Physician’s Lounge to provide
resources for medical staff to stay abreast with recent news and developments
in healthcare.
Other Business
Announcements
Next meeting will be held on April 14, 2015 at 11:30am
Adjourned: 12:32pm
3

General Board Meeting - United Medical Center

Transcription

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