BOARD OF DIRECTORS AGENDA PACKET

Transcription

BOARD OF DIRECTORS
AGENDA PACKET
June 10, 2013
The mission of Palomar Health
is to heal, comfort and promote health
in the communities we serve.
BOARD OF DIRECTORS
T.E. Kleiter, Chairman
Stephen P. Yerxa, Vice Chairman
Linda C. Greer, R.N., Secretary
Jerry Kaufman, P.T.M.A., Treasurer
Bruce G. Krider, M.A.
Jeffrey D. Griffith, E.M.T.-P.
Aeron D. Wickes, M.D.
Michael H. Covert, F.A.C.H.E., President and C.E.O.
Regular meetings of the Board of Directors are usually held on the second Monday
of each month at 6:30 p.m., unless indicated otherwise.
For an agenda, locations or further information
call (760) 740-6375, or visit our website at www.pph.org
MISSION STATEMENT
The Mission of Palomar Health is to:
Heal, Comfort, Promote Health in the Communities we Serve
VISION STATEMENT
Palomar Health will be the health system of choice for patients, physicians and employees, recognized nationally for the
highest quality of clinical care and access to comprehensive services
CORE VALUES
Patient’s Well-Being
We passionately give and support heartfelt care that encourages patient comfort and safety
Professionalism
Each of us takes pride in teamwork, self-discipline, our skills and trustworthiness
Highest Quality
We are each accountable for providing the safest, most effective and innovative care
Affiliated Entities
*Palomar Medical Center * Palomar Continuing Care Center * Arch Health Partners*
*Palomar Pomerado Health Foundation * Palomar Pomerado Home Care * Pomerado Hospital*
*Palomar Health Development, Inc.* North San Diego County Health Facilities Financing Authority*
*San Marcos Ambulatory Care Center * Villa Pomerado Palomar Pomerado Health Concern * Palomar Pomerado Health Source*
PALOMAR HEALTH
BOARD OF DIRECTORS
REGULAR MEETING AGENDA
Monday, June 10, 2013
Start Time: 6:30 p.m.
Palomar Health
Downtown Campus
Graybill Auditorium
555 E. Valley Parkway
Escondido, CA 92025
Mission and Vision
“The mission of Palomar Health is to heal, comfort and
promote health in the communities we serve.”
“The vision of Palomar Health is to be the health system of choice for patients,
physicians and employees, recognized nationally for the highest quality
of clinical care and access to comprehensive services.”
Time
I.
II.
CALL TO ORDER
2
OPENING CEREMONY
5
Page
A. Pledge of Allegiance
III.
PUBLIC COMMENTS
5
(5 mins allowed per speaker with cumulative total of 15 mins per group - for
further details and policy see Request for Public Comment notices available
in meeting room.)
IV.
MINUTES *
5
1
A. First Closed Session Meeting - May 13, 2013
B. Second Closed Session Meeting -May 13, 2013
C. Third Closed Session Meeting - May 13, 2013
D. Regular Board Meeting - May 13, 2013
V.
APPROVAL OF AGENDA to accept the Consent Items as listed *
10
A. 1Approval of Revolving, Patient Refund & Payroll Fund Disbursements – April 2013
1. Accounts Payable Invoices
2. Net Payroll
Total
B. 1Ratification of Paid Bills
C. 1Summary of Executed Budgeted Routine Physician Agreements - Finance Committee
D. 1April 2013 and YTD FY2013 Financial Report - Finance Committee
E. 1Arch Health Partners Request for Equity Transfer - Finance Committee
VI.
VII.
PRESENTATIONS
10
A. Bloomberg TV "BRINK" documentary - Palomar Medical Center, Hospital of the Future
Leonel Sanchez, Media Relations Manager
REPORTS
A.
1
Medical Staffs
*1. Palomar Medical Center - Richard C. Engel, M.D.
A. Credentialing and Reappointments
B. Revisions to PMC Pediatric Clinical Privileges
C. Revsions to PMC/POM Emergency Medicine Physician Assistants
Core Privileges
To be forwarded under separate cover later this week
12
5
*2. Pomerado Hospital - Roger Acheatel, M.D.
A. Credentialing and Reappointments
B.
VIII.
IX.
5
Administrative
1 Chairman of the Palomar Health Foundation - John Forst
5
Verbal Report
2 Chairman of the Board - Ted Kleiter
5
Verbal Report
3 President and CEO - Michael Covert, FACHE
5
Verbal Report
10
38
INFORMATION ITEMS
COMMITTEE REPORTS
A. Governance / Audit and Compliance Committee
B. Human Resources Committee
C. Community Relations Committee
D. Strategic / Facilities and Grounds Committee (no meeting in May)
E. Quality Review Committee
F. 1Finance Committee
G. Other Committee Chair Comments on Committee Highlights
1
X.
BOARD MEMBER COMMENTS/AGENDA ITEMS FOR NEXT
MONTH
XI.
ADJOURNMENT
To be forwarded under separate cover later this week
5
BOARD OF DIRECTORS
Closed Session
Pomerado Hospital
15615 Pomerado Rd.
Poway, CA 92064
Monday, May 13, 2013
AGENDA ITEM
DISCUSSION
CONCLUSIONS/ACTION
CALL TO ORDER
ESTABLISHMENT
OF QUORUM
NOTICE OF
MEETING
5:34 P.M.
Present: Directors Kleiter, Krider, Yerxa, Kaufman, Greer, Wickes and
Griffith.
Notice of Meeting was mailed consistent with legal requirements.
Pursuant to California Government Code §54954.5(h) 20
Report Involving Trade Secrets.
PUBLIC
COMMENTS
ADJOURNMENT
TO CLOSED
SESSION
CLOSED SESSION
There were no public comments.
Pursuant to California Government Code §54954.5(h) 20
Report Involving Trade Secrets. Discussion will concern proposed new
facility.
FOLLOW-UP
RESPONSIBLE
PARTY
Chairman Kleiter adjourned the
meeting to closed session.
OPEN SESSION
RESUMES
MOTION: by Chairman Kleiter to
resume open session.
ACTION
RESULTING FROM
CLOSED SESSION
DISCUSSION, IF
ANY
FINAL
ADJOURNMENT
SIGNATURES
MOTION: by Director Kaufman, 2
by Director Greer and carried to
approve the project as described.
nd
All in favor. None opposed.
meeting at 6:04 P.M.
Board Secretary
__________________________________
Linda C. Greer, R.N.
Board Assistant
___________________________________
Debbie Hollick
1
1
BOARD OF DIRECTORS
Closed Session
Pomerado Hospital
15615 Pomerado Rd.
Poway, CA 92064
AGENDA ITEM
CALL TO ORDER
ESTABLISHMENT
OF QUORUM
NOTICE OF
MEETING
PUBLIC
COMMENTS
ADJOURNMENT
TO CLOSED
SESSION
CLOSED SESSION
DISCUSSION
CONCLUSIONS/ACTION
6:05 P.M.
Griffith.
Pursuant to California Government Code Subdivision (a) of Section
54956.9 Conference with Legal Counsel – Existing Litigation
FOLLOW-UP
RESPONSIBLE
PARTY
Quarterly Claims/Risk Management Report
Pursuant to California Government Code Subdivision (a) of Section
54956.9 Conference with Legal Counsel – Existing Litigation
There was no action resulting from
the closed session.
OPEN SESSION
RESUMES
ACTION
RESULTING FROM
CLOSED SESSION
DISCUSSION, IF
ANY
FINAL
ADJOURNMENT
SIGNATURES
Board Secretary
__________________________________
Board Assistant
___________________________________
Debbie Hollick
3
1
BOARD OF DIRECTORS
Closed Session
Pomerado Hospital
15615 Pomerado Rd.
Poway, CA 92064
AGENDA ITEM
DISCUSSION
CONCLUSIONS/ACTION
CALL TO ORDER
ESTABLISHMENT
OF QUORUM
NOTICE OF
MEETING
7:24 P.M.
Griffith.
Pursuant to California Government Code §54954.5(h)
Report Involving Trade Secrets.
PUBLIC
COMMENTS
ADJOURNMENT TO
CLOSED SESSION
Pursuant to California Government Code §54954.5(h)
Report Involving Trade Secrets. Discussion will concern proposed new
service.
FOLLOW-UP
RESPONSIBLE
PARTY
CLOSED SESSION
OPEN SESSION
RESUMES
ACTION
RESULTING FROM
CLOSED SESSION
DISCUSSION, IF
ANY
MOTION: by Director Krider, 2 by
Director Wickes and carried to
approve the proposed Cerner
contract for Information Technology
software and services.
nd
FINAL
ADJOURNMENT
SIGNATURES
Board Secretary
__________________________________
Board Assistant
___________________________________
Debbie Hollick
4
1
BOARD OF DIRECTORS
REGULAR BOARD MEETING
Pomerado Hospital
15615 Pomerado Rd.
Poway, CA 92064
AGENDA ITEM
CALL TO ORDER
OPENING CEREMONY
DISCUSSION
CONCLUSIONS/ACTION
FOLLOW-UP
RESPONSIBLE PARTY
6:33 P.M.
Quorum comprised of Directors Kleiter,
Krider, Yerxa, Wickes, Griffith, Kaufman and
Greer.
The Pledge of Allegiance was recited in
unison.
MISSION AND VISION STATEMENTS
The Palomar Health mission and vision
statements are as follows:
The mission of Palomar Health is to heal,
comfort and promote health in the
communities we serve.
NOTICE OF MEETING
PUBLIC COMMENTS
The vision of Palomar Health is to be the
health system of choice for patients,
physicians and employees, recognized
nationally for the highest quality of
clinical care and access to
comprehensive services.
Notice of Meeting was mailed consistent
with legal requirements
Erik Olson Fernandez and Patty Hirst spoke
about caregivers and nurses.
nd
MOTION: by Director Kaufman, 2
by Director Greer and carried to
approve the Closed Session and
Regular Board Meeting minutes of
April 8, 2013 as submitted.
APPROVAL OF MINUTES
 Closed Session Board Meeting
April 8, 2013
5
1
AGENDA ITEM
DISCUSSION
CONCLUSIONS/ACTION

Regular Board Meeting
April 8, 2013
APPROVAL OF AGENDA
FOLLOW-UP
RESPONSIBLE PARTY
nd
Director Kaufman and carried to
approve the Consent Items as
submitted.
(to accept the Consent Items as listed)
A. Approval of Revolving, Patient
Refund & Payroll Fund Disbursements– March
2013
Accounts Payable Invoices
$ 34,273,150.00
Net Payroll
$ 21,184,082.00
Total
$ 55,457,232.00
B. Ratification of Paid Bills
C. Budgeted Routine Physician Agreements
Board Summary Report
D. March 2013 & YTD FY2014 Financial Report
E. CEP – Final Hospitalist Agreement - Finance
Committee
F. Resolution No. 05.13.13(02)-01 – Morgan
Stanley – Authorized Persons &
Enabling Resolutions for Municipalities and
Certain Other Unincorporated Entities
G. Banking and Treasury Services RFP
H. Annual Financial Audit Policy - 21808 –
Governance / Audit & Compliance Committee
I. Board Self-Evaluation Policy - 21782 Governance / Audit & Compliance Committee
J. Confidentiality Statement Policy - 21799 –
K. Establishing Board Meeting Dates Policy –
21793 - Governance / Audit & Compliance
Committee
L. Gifts & Donations Policy - 21776 –
M. Board Community Relations Committee
Description Governance / Audit &
Compliance Committee
N. Board Governance / Audit & Compliance
Committee Description Governance / Audit &
O. Board Finance Committee Description
P. Board Human Resources Committee
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2
AGENDA ITEM
Description Governance / Audit & Compliance
Committee
Q. Board Quality Review Committee Description
R. Board Strategic & Facilities Planning
Committee Description Governance / Audit &
S. Board Handbook Table of Contents
T. Palomar Medical Center Medical Staff Bylaws
June 2011 Governance / Audit & Compliance
Committee
U. Pomerado Medical Staff Bylaws June 2011
PRESENTATIONS
REPORTS
Medical Staff
Palomar Medical Center
 Credentialing and Reappointments
DISCUSSION
CONCLUSIONS/ACTION
FOLLOW-UP
RESPONSIBLE PARTY
There were no presentations.
Richard Engel, M.D., Chief of Staff, Palomar
Medical Center, presented requests for
approval of Credentialing and
Reappointment Recommendations.
nd
Director Yerxa and carried to
approve the Palomar Medical
Center Medical Staff Executive
Committee Credentialing and
Reappointments recommendations
for the Palomar Medical Center
Staff as presented.
Pomerado Medical Center

Credentialing and Reappointments
Roger Acheatel, M.D., Chief of Staff for
Pomerado Hospital, presented requests for
approval of Credentialing and
Reappointments Recommendations.
nd
Director Yerxa and carried to
approve the Pomerado Hospital
Medical Staff‘s Executive
Committee Credentialing and
Reappointments recommendations
for the Pomerado Medical Staff as
presented.
Administrative
7
3
AGENDA ITEM
Palomar Health Foundation
DISCUSSION
CONCLUSIONS/ACTION
FOLLOW-UP
RESPONSIBLE PARTY
John Forst, Palomar Health Foundation,
Board Chair
Chairman Forst reported that in April 2013,
the Foundation received $268,113 in cash,
new pledges and pledge payments. Yearto-date $2,972,804 in cash, new pledges
and pledge payments have been received.
The Medical Staff Campaign has received
$3,838,978 million toward the $5 million
goal in cash and pledges as of April 30,
2013, including gifts made in response to
the physician alumni reunion event which
took place last month.
The Chapel Campaign has received
$283,854 in cash. A firm has been
contracted to begin the design process for
the chapel project. A visioning session has
been planned for Tuesday, May 21, at
which point the Chapel Committee will
present their vision for the chapel to the
Architects.
The Employee Campaign has received
$2,827,113 million in cash and pledges as
of April 30, 2013. During the month of April,
$61,700 in new employee gifts were
received during rounds conducted by
Employee Campaign members lead by
Sonia Lopez.
In the past twelve weeks since the
Corporate Partners in Health Annual Giving
and Sponsorship program launched, 16
corporations and organizations have
pledged their support at various
sponsorship levels, generating $164,104 in
sponsorships.
Letters and follow-up phone calls have been
made to 1,305 households since the
program launched in April. The program
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4
AGENDA ITEM
DISCUSSION
CONCLUSIONS/ACTION
FOLLOW-UP
RESPONSIBLE PARTY
has generated $23,925 in new gifts and
pledges nearing the $25,000 matching gift
made by Kevin Harkenrider, Foundation
Board member. The program will continue
through the spring and summer months with
letters and phone calls planned for a total of
10,000 households.
The next issue of the Foundation newsletter
will be sent to nearly 20,000 households
later this week. The newsletter features
articles on the Physician Alumni Reunion,
and a cover article on Penny and Harold
Dokmo for their generous gift in support of
the chapel project at the new hospital. Mr.
Dokmo is a member of the Foundation
board and a Rancho Bernardo business
owner.
A series of oral history sessions filmed by
Dr. Ralph Ocampo have been hosted at the
Palomar Health Foundation. The series
features panels of retired and former
Palomar Health-affiliated physicians who
share their historical account of Palomar
Health’s past. The next Oral History Project
session is scheduled this Wednesday, May
15, and will feature Palomar Health Board
Chairman, Ted Kleiter, as the featured
speaker.
Chairman of the Board
Ted Kleiter
Chairman Kleiter reported that he and Chief
Financial Officer Robert Hemker attended
the recent HealthPro annual meeting
(HealthPro being the proprietary arm of
BETA). He also went on to congratulate Mr.
Hemker for being elected chair of the
HealthPro Board.
President and CEO
Michael Covert
Mr. Covert reported that talks are continuing
with Loma Linda re: partnering to establish
9
5
AGENDA ITEM
DISCUSSION
CONCLUSIONS/ACTION
FOLLOW-UP
RESPONSIBLE PARTY
a common insurance product. He also
noted that there are great opportunities for
Palomar Health to build a presence in
Riverside county.
Mr. Covert stated that, due to issues such
as lower reimbursement rates, Medicare
sequestration, patient satisfaction scores
and lower census levels, the organization
has been compelled to look for ways to
right-size itself and deal with these
challenges. Therefore, several staffing
positions will be reduced and 84 employees
(or approximately 2% of the workforce) will
be laid off. The organization is looking to
make reductions in all expenses, not just
labor. Mr. Covert also noted that coming to
an agreement with the union that is
amenable to all parties will be vital to the
growth of the organization and its
employees.
Mr. Covert reported that the Board Strategic
& Facilities Planning committee has
approved the 2013 - 2017 Strategic Plan as
presented; the plan will be shared with all
physicians and staff as it has implications
for the organization and its growth as a
whole.
Mr. Covert stated that changes need to be
made to the way that we price our services.
Unfortunately much of Palomar Health’s
pricing has been built over the years
utilizing CMS/Medicare chargemaster. He
included that he would like to have
discussion, perhaps at the Board Finance
level, on how to best address this and to
challenge ourselves to come up with a new
way to create a realistic charging
methodology for services rendered.
Chairman Kleiter noted that that he
appreciates the work that will be done to
10
6
AGENDA ITEM
DISCUSSION
CONCLUSIONS/ACTION
FOLLOW-UP
RESPONSIBLE PARTY
help clarify the chargemaster issues, noting
that the system needs major improvements
as it currently varies from one hospital to
anther and from one state to another.
On behalf of the Board of Directors, Mr.
Covert presented Dr. Paul Neustein with an
award for his service in 2012 as Chief of
Staff-elect at Pomerado Hospital.
COMMITTEE CHAIR COMMENTS

Governance / Audit and Compliance

Human Resources

Quality Review
Director Greer commented on the State
Legislatives Bills report that was presented
at the last Governance Audit and
Compliance committee meeting. She noted
that, if approved, AB 900 will have a
significant impact to the organization. AB
900 involves cuts that will reduce the MediCal reimbursement to Palomar Health’s
DP/SNFs by 30% and 37%. The state will
also seek to recuperate the higher
reimbursements dating back to June 1,
2011, resulting in an effective rate reduction
of 50%.
Director Krider reported that the Human
Resources committee did not convene in
April, opting to utilize that time for orienting
Director Aeron Wickes to their departmental
structure, processes and programs.
Director Greer wished to express to
everyone that the Board has the ear of the
employees and the community regarding
the quality of care provided to our patients.
She shared that she regularly hears many
good things from patients and their families,
but allowed that we all need to continuously
strive to improve. She stated that she is fully
aware of what goes on in the front lines of
patient care, noting that the organization is
currently focusing efforts on the patient flow
process, from admission to post-discharge.
She reiterated that the Board is proud of the
work and effort put forth by all Palomar
staff.
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7
AGENDA ITEM
DISCUSSION

Strategic & Facilities Planning

Finance

Community Relations

Additional Comments
The April 2013 Board Strategic & Facilities
Planning Committee meeting summary was
accepted as written.
The April 2013 Board Finance Committee
meeting summary was accepted as written.
Marketing / Public Relations Specialist
Bobette Brown provided a Community
Relations Committee Health Care
Communicators update, noting that
Palomar Health has once again been
lauded with many honors by this longstanding organization. Such honors include
the prestigious Best in Show Award for
Media Relations for the opening of the new
Palomar Health Medical Center. This
auspicious recognition was compounded by
the fact that the winner must receive a
perfect score!
Director Krider asked everyone to keep the
current issues facing the organization in
perspective, and to know that the Board and
administration are fully invested in ensuring
that the compensation offered to Palomar
Health employees is in line with the market
survey rates for facilities in the area. He
also requested that the issues not be taken
out of context.
ADJOURNMENT
SIGNATURES
CONCLUSIONS/ACTION
FOLLOW-UP
RESPONSIBLE PARTY
Director Greer questioned whether the
upcoming Board Budget Workshop meeting
packet would be published in advance of
the meeting, to which an affirmative
response was given.
7:17 P.M.

Board Secretary
__________________________________

Board Assistant
___________________________________
Debbie Hollick
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MEM OR AND UM
TO:
Debbie Hollick, Executive Assistant to the Board
FROM: Tammy Chung, Assistant to the Board Community Relations Committee
DATE:
May 22, 2013
RE:
Board Community Relations Committee – May 8, 2013 Meeting Summary
INFORMATION ITEMS:
Leonel Sanchez reported on Palomar Health in the news including media monitoring and analytics 2012/2013.
Samples of FREE media:
• U-T San Diego – Headline: “Palomar moves patients to new hospital” – UT San Diego 8/19/2012 (A-1)
• Bloomberg Television
• ENR.com – Engineering News-Record
• NCT, 8/20/2012 Headline: Open for Business Photo: Palomar Health nurse caring for the Rev. Harry
Kuehl, one of first patients at PMC
• Health Care Design Magazine
• HealthLeaders Magazine
• ModernHealthcare.com
Leonel mentioned that Palomar Health appeared in the news 1,706 times since 1/15/12 with a total ad value of
$1.4 million in free media, including print circulation of 26.7 million and total unique online visitors of 640 million.
This information was derived from a PR media-monitoring tool called Vocus, which tracks media and prepares
reports. Vocus is also able to gauge tone of story. The majority of Palomar Health’s coverage was neutral to
positive.
The top outlets by news article listing since January 2012:
1. UT San Diego/NC Times: 221
2. San Diego Daily Transcript: 111
3. Pomerado News: 108
4. California Patch: 49
5. KGTV: 40
6. Ramona Sentinel: 35
7. Individual.com (aggregator): 31
8. KFMB: 29
9. KUSI: 24
10. KSWB: 24
The media seems to be most interested in technology, expansion of services and newness.
Palomar Health was featured in articles across the nation including The Boston Globe, Health Care Design
Magazine, HealthLeaders Magazine and ModernHealthcare.com.
Leonel shared a clip from the Bloomberg TV’s print time program BRINK that featured PMC on May 6, 2013.
Bloomberg Television reaches 310 million households
Cameron Curry, Executive Director of The Classical Academy, provided an overview of the Classical Academy
organization, founded in 1999 by a group of dedicated parents and community members. There are elementary
schools in Escondido and Oceanside with a Learning Center in Vista. The Classical Academies collaborated with
rd
ViaSat, Genentech, Northrop Grumman and California State University San Marcos to provide the 3 Annual
Super STEM Saturday on March 16, 2013. This interactive event focused on science, technology, engineering
and math. They are making plans for their 2014 STEM Saturday event and invited Palomar Health to be a
partner. The 2014 event will be March 15, 2014.
39
Janet Klitzner provided an overview of the Health Care Communicators of San Diego County. The HCC was
established in 1977 and serves as a valuable networking resource for the region’s health care marketing and
communications professionals. They host programming/networking meetings on a monthly basis with their
largest evening being the HCC Finest Awards, which started in 1993. This year’s event received 121 entries from
14 different health-care organizations. Palomar Health submitted 14 entries. The entries were judged by Orange
County health care marketing professionals in four categories: goal, planning, creativity and results. Palomar
Health has earned over 20 awards from 2004 – 2012 including “Best in Show for the Prop BB Campaign in 2004.
Bobette Brown has served on the Board for the past two years as the Finest Chair and now serves as President.
Palomar Health earned the following awards:
Ad Campaign -- GOLD – Opening of the New PMC
Media Relations -- Gold – Opening of the New PMC
Logo Creation/Brand Identity -- Gold – Palomar Health Logo
Single-Day Event -- Gold – The New PMC Community Celebration
Invitation--Gold – The New PMC Community Celebration Invitation
Internal/External Magazine -- Silver – The HealthSource Magazine
Special Publication -- Silver – The New PMC Community Celebration Program
Brochure -- Silver – Excitement is Building Brochure Series
Off the Wall -- Silver – Employee Passport (No Gold Award)
BEST IN SHOW -- Opening of the New PMC -- Media Relations
(Must receive a PERFECT score)
Elly Garner provided a Government Affairs update:
AB 900 – Reverse Cuts to Distinct-Part Skilled-Nursing Facilities
Passed Assembly Health unanimously
Was heard in the Assembly Appropriations Committee on 5/8/2013
Elly also provided an overview of the Scope of Practice Bills:
• SB 491 – Nurse Practitioners
– Changes the Nurse Practice Act; would remove requirement that medical acts performed by a
nurse practitioner need standardized procedure or consultation with a physician or surgeon
• SB 492 – Optometrists
– Allows optometrists to perform certain health-related services, including preventing, diagnosing,
and treating any disease, condition, or disorder of the visual system, the human eye, and
adjacent and related structures, prescribing appropriate drugs, and administering immunizations
• SB 493 – Pharmacists
– Authorizes a pharmacist to administer drugs and biological products that have been ordered by a
prescriber; would expand other functions pharmacists are authorized to perform
ACTION ITEMS:
40
MEM OR AND UM
Debbie Hollick, Executive Assistant to the Board
TO:
FROM: Sherry McClendon, Assistant to the Board Quality Committee
DATE:
May 21, 2013
RE:
Board Quality Review Committee – May 20, 2013 Meeting Summary
INFORMATION ITEMS:

Nursing Division Update: Lorie Shoemaker, Chief Nursing Officer provided an overview
of the Nursing Division key accomplishments to include: Stabilization of key processes at
PMC, Nursing/Medical Director Dyads, Community Care Transition Program and Patient
Flow. Lorie also shared the focus for the immediate future to include: shift huddles,
incident debrief, service excellence bundle, falls bundle and accountability metrics and
audits.
Joe Parker, Care Transitions Nurse Leader also presented on the Alert Management
Taskforce Performance Improvement Project which reduced overall alerts by 71.6%.

Skilled Nursing Facility Update: Steve Gold, Chief Officer Post Acute Services and staff
provided an overview to include Infection Control Norovirus outbreaks, California
Department of Public Health (CDPH) survey outcomes to include 8 minor deficiencies at
Villa Pomerado and 4 minor deficiencies at PCCC. Deficiencies are under the National
average of 9.4 and California average of 12.4.
Laura Weber, Nurse Practitioner presented on the Re-Admission Performance
Improvement Project. Findings found 70% of readmitted patients at PCCC returned to the
hospital within 10 days, discharge diagnoses for re-admission did not show trends, and readmits most frequent on Thursday at PCCC and Friday at Villa POM.

Hospitality Performance Improvement Update: David Tam, M.D., Chief Administrative
Office, POM provided an update on Hospitality Services for Palomar Hospital. Aramark’s
contract will end on June 30, 2013 and Palomar Hospital will be creating a new Hospitality
Division.

Quality / Patient Safety Plan: Opal Reinbold, Chief Quality Officer provided an update on
the Quality / Patient Safety Plan to include the kick-off of working with Truven to improve
reporting capabilities, Dr. Neustein has stepped in as MD Champion for Infection Control,
Executive Health Resource (EHR) will be starting on July 1, 2013 to assist with the
appropriate level of care, and the Patient Flow pilot was kicked off on May 1, 2013.
ACTION ITEMS:

No Action Items
40

BOARD OF DIRECTORS AGENDA PACKET

Transcription

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