JCC

Quarter ly

Report

July 2010

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Contents

State of the Hospital 1 Census Licensing & Certification Survey Board of Supervisors Quarterly Report New Additions to the Medical Executive Team Budget and Finance Staffing Report

Transition Planning 3

Performance Improvement Initiatives 4

Organizational Effectiveness Project Restricted Smoking Hours Accommodating Cultural Food Preferences Promoting Choice and Resident Centered Care

Events and Milestones 6 Ribbon Cutting Laguna Honda Opening Gala Nursing Retreat Byxbee House Opens

Awards and Honors 8 Gene O’Connell Award Employees of the Month

Appendices Board of Supervisors Report on Admissions Quarterly Discharge Report Grapevine Newsletters News Clip From Advance for Nurses Magazine

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State of the Hospital

Census Averages for Second Quarter, 2010

SNF Occupied Beds Held SNF Census M7A L4A Daily Census Total Paid Beds758.25 6.1 764.35 2.21 1.54 762 768.1

Licensing and Certification Survey

The final licensing and certification survey in the old Laguna Honda found substantially high qual-ity of care, quality of life and resident safety. Twelve surveyors from the California Department of Public Health spent one week at the hospital from May 11 to May 19 reviewing hospital practices for consistency with standards mandated by the federal Centers for Medicare and Medicaid Ser-vices. Surveyors found no substandard care. The hospital’s plan of correction for items specified in the standard statement of deficiencies was submitted and accepted in June. The survey marks the fourth year in a row the hospital license has been renewed without requiring a re-survey. Ongo-ing performance improvement initiatives and staff education and training have helped to create a culture of competence in which the organization is survey-ready at all times.

Board of Supervisors Quarterly Report

Average percentage of admissions from San Francisco General Hospital for the 2nd quarter of 2010 was 55%. Full report to Board of Supervisors appended.

New Additions to the Medical Executive Committee

The medical staff held elections in June and the following medical staff will be members of the Medical Executive Committee:

Dr. Michael McShane - Vice Chief of Staff Dr. Victoria Behrman - Member at LargeBrenda Austin, Ph.D. - Member at Large

Budget and Finance

Budget ReportTo date, the hospital’s FY 10-11 budget includes an increase of $17 million over last year; $12 mil-lion for debt service and $5 million for an increase in fringe benefits. The budget reflects revenue for increased acute patient days and increased utilization of primary care clinics, an estimated en-hancement of $2 million. It also reflects an additional 9 FTEs to support revenue initiatives and 6.81 FTEs for new hospital operations including support for new and expanded information technology systems. The budget has no provision for structural fixes on pharmacy and food supplies; hence, as

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in years prior, funding will be through the supplemental budget process.

Transition BudgetThe $10 million budget is 33% spent. All transition positions have been filled. A surge in spending is expected from now until move day due to heavy training schedules and move preparation.

Financial ReportAs of Feb 2010, the hospital shows an overall $4.5 million shortfall for which supplemental budget-ing has been approved. Patient revenues collection target is projected to be met. The shortfall is primarily attributable to unfunded retirement one-time pay-outs and pharmacy and food costs. The audited annual financial reports are scheduled for completion by October 29th. An audit entrance conference was held July 1st. The preliminary audit is scheduled for the third week of September and the field work audit starts the week of October 4.

Staffing Report

Laguna Honda has 1,130 regular employees moving forward the hospital’s mission and 102 positions that are budgeted and authorized for hiring resulting in a vacancy rate of 9%.

The hospital is actively recruiting for 46 Home Health Aide positions to support the new Laguna Honda delivery of care.

Laguna Honda recruited 21 Licensed Vocational Nurses last quarter and we are proud to report that 11 of those 21 were Laguna Honda staff promoted from Nursing Assistants/Patient Care Assistants to LVNs.

And lastly, we are pleased to report that 10 staff members tested and passed the Spanish Bilingual Exam last week to further advance Laguna Honda’s diversity and language competency to support residents. This is in addition to the 120 which are already certified in various languages.

Newsletters

The Laguna Honda Grapevine issues for April-July 2010 are appended.

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Transit ion Planning

Transition Timeline

The timeline continues to follow a milestone approach: the resident move will be triggered not by dates, but by the completion of key safety milestones:

Certification by the Office of Statewide Hospital Planning and Development (OSHPD) that each 1. building meets California’s requirements for hospital construction, Installation of furniture and equipment, 2. Staff training, 3. Licensing by the California Department of Public Health.4.

On a building-by-building basis, milestone completion is taking place first in the South Residence, then in the Pavilion, and finally in the North Residence.

The South Residence is now under city ownership. Installation of furniture and equipment is com-plete with the exception of phones and Information Systems equipment. Staff training is underway in a learning lab on the third floor. Fifty-three percent of staff have completed orientation and life safety training.

In the Pavilion, only the production kitchen remains to be approved by OSHPD. Installation of furni-ture and equipment is nearly complete. The hospital received OSHPD approval on July 19 for staff-ing of the Pavilion wththe exception of the production kitchen and servery. Staff training will com-mence in the Pavilion in the near future.

The North Residence is midway in the OSHPD process. Installation of furniture began on July 7, and is projected to be complete on August 28.

Completion of all pre-licensing milestones is expected by September. The resident move will take place within 30 days of licensing. The hospital Quality Management Dept. has submitted a detailed transition report to the California Department of Public Health for its review and comment.

Four move drills have been held so far to test proposed routes, communications, sequencing of de-partures and arrivals, and assignment of move day duties. A fifth drill is planned for July 28.

Resident transition information is provided regularly in community meetings on the units and in house-wide workshops held in the library where a mock-up of a new resident room has been set up. Resident materials include photo books of the new living environment, Power Point presentations, a computerized virtual tour of the new buildings, and a regularly updated guide to frequently asked questions.

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Performance Improvement Initiatives

Quarterly Discharge Report

The 2nd Quarter calendar year discharge report is appended.

Organizational Effectiveness Project

Lumetra Health Care Solutions completed its fifth on-site visit in July. The national leader in nursing home reform was retained by the Controller’s Office to assist with the development of resident centered care at Laguna Honda. The week-long visit focused on developing the Laguna Honda Dream Teams, interdisciplinary staff-ing cohorts, each of which will be responsible for one of 13 neigh-borhoods in the new Laguna Honda. Each neighborhood, consisting of 60 residents living in four 15-person households, will be the site of one of the hospital’s specialized nursing programs, Memory Care, Positive Care, Integrated Wellness, Hospice, Enhanced Support, and the Chinese and Spanish Language focus programs.

The Dream Team concept is meant to build staff engagement and foster ground-up decision making so resident needs and preferences take precedence over top-down institutional priorities. The transi-tion from institutionalized care to individualized care facilitated by the Dream Teams puts Laguna Honda in the mainstream of nursing home best practices nationally.

Dream Teams cut horizontally across organizational silos, and in-clude staff members from every discipline working together on an equal footing. Each team is made up of nurses, nursing assistants, clinical nurse specialists, home health aides, a physician, psycholo-gist or psychiatrist, social worker, dietitian or nutritionist, consult-ing pharmacists, quality management staff, housekeepers, building maintenance staff, a medical records clerk, food service workers, an activity therapist, and a member of the executive staff serving as a liaison to facilitate service delivery innovations developed by the team on the ground.

The Lumetra project will continue through the calendar year.

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A Laguna Honda Dream Team from one of the Memory Care neighborhoods

poses at this month’s orientation facili-tated by the Lumetra group.

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Restricted Smoking Hours

Shorter hours beginning in May at the Laguna Honda smoking area, Har-mony Park, have helped curb cigarette use. The park is now closed from 11 pm to 6 am daily. During a pilot period, off hours were monitored for safety by a sheriff’s cadet. There were three reports of noncompliance, all successfully addressed by counseling interventions. The hospital provides nighttime smoking alternatives such as gum, snacks, and nicotine replace-ment when needed. The new hours at Harmony Park are part of the La-guna Honda strategic goal to maximize a healing environment.

Accommodating Cultural Food Preferences

Many of our Asian focus unit residents have requested that their menus include more Chinese food. As part of our effort to meet the cultural needs of the Asian Focus Units (C4/G4) & improve satisfaction at meals, we have begun to include assorted steamed dim sum with the lunch meal tray of-ferings. Assorted steamed dim sum will now be sent with the lunch meal trays weekly.

Promoting Choice and Resident Centered Care

Continuously looking for ways to increase resident-centered care, the Nutrition and Nursing departments are accomodating preferences in meal times and offerings by instituting a leisurely breakfast for multiple units. The leisurely breakfast consists of a continental breakfast kept on the unit which contains breads, cereals, hard boiled eggs, and a variety of fresh fruit (whatever is in seasonally available).

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E v e n t s a n d M i l e s t o n e s

Ribbon Cutting

Many thanks from the Laguna Honda executive staff to the Health Com-mission for helping to celebrate the ribbon cutting for the new Laguna Honda on June 26, 2010.

Over 500 celebrants turned out to inaugurate the country’s newest center for skilled nursing and rehabilitation. Mayor Gavin Newsom, Congresswoman Jackie Speier and Laguna Honda Residents’ Council President Elizabeth Cutler presided. The U.S. Green Building Council awarded silver certification to Laguna Honda on June 18th, making it the first LEED – certified hospital in California.

Over 50 Laguna Honda residents attended the ceremony, thanks to the hospital’s expert activity therapy staff, which coordinated resident attendance. Health Commission President Jim Illig made remarks, as did Director of Health Mitch Katz, Executive Administrator Mivic Hirose, Supervisor Sean Elsbernd, State Senators Leland Yee and Mark Leno, Laguna Honda Foundation President Louise Renne, Newsom, Speier and Cutler. Once the ribbon was cut, the doors opened for a self-guid-ed tour of the new buildings. Nearly 100 Laguna Honda staff members volunteered to assist on opening day.

Laguna Honda Opening Gala

The opening of the new Laguna Honda provided a welcome oppor-tunity to honor the charitable work of two long-time benefactors of the hospital, Betty Sutro and the late H. Boyd Seymour. At the gala celebration in her honor on June 24, Mrs. Sutro told the San Francisco Chronicle, “I’ve always loved Laguna Honda because it has always taken care of its residents.”

Gavin Newsom, Elizabeth Cutler, Jackie Speier

Residents at the Ceremony

Cutting the Ribbon

At the Gala (left to right): Commis-sioners David Sanchez, Margine

Sako, President Jim Illig, Sonia Melara and Ed Chow.

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Byxbee Home

Union members at the celebration

DPH Nursing Leadership Retreat

The featured speaker at the 4th Annual Nurse Leaders Retreat on June 4th was Ed O’Neil, Ph.D., Co-Director of the Center for the Health Professions at UCSF. Dr. O’Neil spoke on “strategic nursing success in a changing health care landscape.” His talk identified those parts of the recent health care reform on which nursing leaders should focus and pointed to key elements for success. He also discussed skill building for change manage-ment, leadership development, and team building.

The mission of the DPH Nursing Leadership Council, sponsor of the re-treat, is to promote the mission and vision of the Department of Public Health by providing leadership, communication, education, and promo-tion of nursing throughout the department, and to integrate nursing care across the populations served.

Byxbee Home Opens

The newest housing option for developmentally disabled (DD) adults in San Francisco is the Byxbee Home, which celebrated its grand opening on June 4. A collaboration involving Laguna Honda, the Golden Gate Regional Center, the city Department of Aging and Adult Services and the housing office of the Department of Public Health, Byxbee will house four former Laguna Honda residents in an 1800 square foot, four bedroom home with a fully accessible backyard.

The home is operated by former Laguna Honda staff members. Byxbee is the latest new housing for the DD population to open as part of Laguna Honda’s partnership with other agencies to expand community integra-tion opportunities for adults with developmental disabilities. Last year, the same former staff members opened another DD home, Capay Circle, and a third home is scheduled to open in December.

SEIU Local 1021 Celebrates at Laguna Honda

SEIU Local 1021, the union that represents over 75% of Laguna Honda staff , was on site May 28 to celebrate the passage of a tentative agree-ment restoring pay for Patient Care Assistants affected by the skill mix change from Nursing Assistants earlier this year. The tentative agree-ment passed with 92% of the vote.

There were over 700 attendees at the celebration including many Laguna Honda residents. Thank you SEIU for your continued support.

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April Bi Huang, RN

Medical Clinic

May Jacky Spencer-Davies,

Nurse Manager Positive Care

JuneLucy Guzman

Secretary Social Services

July Team Award

Materials Management Department

(pictured l to r: Sharon Cheng, Russell Nakai,

Marshall Morales, and Stanley Lee)

Employees of the Month

Clinical Nurse Specialist Anne Hughes was this year’s recipient of the Gene O’Connell award, given by the Department of Public Health Nurs-ing Leadership Council at the Nurse Week celebration in May. Anne was recognized for her many clinical and academic accomplishments, includ-ing research into health care disparities, efforts to advance end-of-life and bioethics issues in the health care community, and endless compassion for people in need.

Anne Hughes

Gene O’Connell Award

Awards and Honors