Lee Memorial Health System Planning Board & Full Board
of Directors’ Meetings Thursday, May 14, 2015
1:00 p.m.
BOARD OF DIRECTORS
OFFICE 239-343-1500
FAX: 239-343-1599
13685 DOCTORS WAY #190 FT MYERS, FLORIDA 33912
CAPE CORAL HOSPITAL
GULF COAST MEDICAL CENTER
HEALTHPARK MEDICAL CENTER
LEE MEMORIAL HOSPITAL
GOLISANO CHILDRENS HOSPITAL OF SOUTHWEST FLORIDA
THE REHABILITATION HOSPITAL
LEE PHYSICIAN GROUP
LEE CONVENIENT CARE
BOARD OF DIRECTORS
DISTRICT ONE
Stephen R. Brown, M.D.
Therese Everly, BS, RRT
DISTRICT TWO
Donna Clarke
Nancy M. McGovern, RN, MSM
DISTRICT THREE
Sanford N. Cohen, M.D.
David Collins
DISTRICT FOUR
Diane Champion
Chris Hansen
DISTRICT FIVE
Jessica Carter
Stephanie Meyer, BSN, RN
AGENDA
PLANNING BOARD & FULL BOARD OF DIRECTORS’ MEETINGS May 14, 2015 1:00 p.m.
Gulf Coast Medical Center – Boardroom (Medical Office Building) 13685 Doctors Way, Ft. Myers, FL 33912
051415 PLANNING & FULL BOARD\AGENDA(FINAL).doc Page 1 of 2
1. CALL TO ORDER (Sanford Cohen, M.D., Board Chairman) Lee Memorial Health System Board of Directors, sitting as the Lee Memorial Health System (LMHS) Board of Directors for Gulf Coast Medical Center & Lee Memorial Hospital/HealthPark Medical Center and the Board of Directors of its subsidiary corporations, including but not limited to Cape Memorial Hospital, Inc. doing business as Cape Coral Hospital; Lee Memorial Home Health, Inc.; and HealthPark Care Center, Inc.
2. INVOCATION & PLEDGE OF ALLEGIANCE (Rev. Mason Jackson, MDiv)
3. PUBLIC INPUT –Any Public Input is limited to three minutes and a “Request to Address the Board of Directors” card must be completed and submitted to the Board Staff prior to meeting. Individuals wishing to address the Board on a Non Agenda item must notify the Board Staff of the subject matter at least three (3) days prior to the meeting.
4. PRESIDENT’S REPORT (Jim Nathan, CEO/President)
5. CONSENT AGENDA(Approve) A. Risk Management Report
PLANNING PORTION: DONNA CLARKE, PLANNING LIAISON
6. Planning Board & Full Board of Directors Meeting minutes of 3/19/15(Approve) (Diane Champion, Board Secretary)
7. SYSTEM STRATEGIC INITIATIVES SCORECARD FY2015 (Accept) (Kevin Newingham, Chief Strategy Officer)
8. LEGISLATIVE UPDATE (Sally Jackson, System Director Government & Community Relations and Keith Arnold, Government Relations Professional)
9. CLINICAL INTEGRATION UPDATE (Anne Rose, VP Revenue Cycle/PHO)
10. SOUTH LEE UPDATE (Suzanne Bradach, System Director Special Projects)
11. CAPACITY CHALLENGE UPDATE (Scott Kashman, CAO Cape Coral Hospital)
12. OTHER ITEMS
Date of the next PLANNING BOARD MEETING August 13, 2015, 1:00 p.m. Gulf Coast Medical Center –Boardroom (Medical Office Building) 13685 Doctors Way, Fort Myers, FL 33912
LMHS SYSTEM BUSINESS – SANFORD COHEN, M.D., BOARD CHAIRMAN
BOARD OF DIRECTORS
OFFICE 239-343-1500
FAX: 239-343-1599
13685 DOCTORS WAY #190 FT MYERS, FLORIDA 33912
CAPE CORAL HOSPITAL
GULF COAST MEDICAL CENTER
HEALTHPARK MEDICAL CENTER
LEE MEMORIAL HOSPITAL
GOLISANO CHILDRENS HOSPITAL OF SOUTHWEST FLORIDA
THE REHABILITATION HOSPITAL
LEE PHYSICIAN GROUP
LEE CONVENIENT CARE
BOARD OF DIRECTORS
DISTRICT ONE
Stephen R. Brown, M.D.
Therese Everly, BS, RRT
DISTRICT TWO
Donna Clarke
Nancy M. McGovern, RN, MSM
DISTRICT THREE
Sanford N. Cohen, M.D.
David Collins
DISTRICT FOUR
Diane Champion
Chris Hansen
DISTRICT FIVE
Jessica Carter
Stephanie Meyer, BSN, RN
AGENDA (Page 2 of 2)
PLANNING BOARD & FULL BOARD OF DIRECTORS’ MEETINGS May 14, 2015 1:00 p.m.
051415 PLANNING & FULL BOARD\AGENDA(FINAL).doc Page 2 of 2
13. ACUTE CARE OPERATONS REPORTS – 2nd Quarter, Fiscal Year 2015 (Approve) A. Cape Coral Hospital (Scott Kashman, Chief Administrative Officer) B. Gulf Coast Medical Center (Josh DeTillio, Chief Administrative Officer) C. HealthPark Medical Center (Donna Giannuzzi, Chief Patient Care Officer) D. Lee Memorial Hospital (Lisa Sgarlata, Chief Administrative Officer) E. Golisano Children’s Hospital of SWFL (Kathy Bridge-Liles, Chief Administrative Officer)
14. OLD BUSINESS
15. NEW BUSINESS
16. BOARD MEETING CRITIQUE
17. BOARD OF DIRECTORS REPORTS
18. Date of the next Meeting:
Thursday, May 28, 2015: 1:00pm – Quality/Safety & Full Board of Directors Gulf Coast Medical Center – Boardroom 13685 Doctors Way, Ft. Myers, FL 33912
19. ADJOURN (Sanford Cohen, M.D., Board Chairman)
___________________ L E E M E M O R I A L HEALTH SYSTEM
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PUBLIC INPUT – AGENDA ITEMS:
Any public input
pertaining to items on the Agenda is limited to three
minutes and a “Request to Address the Board of Directors”
card must be completed and submitted to the Board Staff
prior to meeting.
Refer to Board Policy: 10:15F: Public Addressing the Board Non-Agenda Item: Individuals wishing to address the Board on an item NOT on the Agenda, the Board office must be notified of subject matter at least three (3) days prior to the meeting to allow staff time to prepare and to insure the matter is within the jurisdiction of the Board.
___________________
L E E M E M O R I A L HEALTH SYSTEM
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PRESIDENT’S REPORT
Jim Nathan CEO/President
___________________
L E E M E M O R I A L HEALTH SYSTEM
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Risk Management Report to the Board of Directors
FM# 2775 Rev. 07/13
The disclosure of this document and the contents herein does not constitute a waiver of any and all protections afforded PatientSafety Work Product under the Patient Safety Quality Improvement Act of 2005 and implementing regulations.
January 2015 – March 2015
2
Risk Management Program Elements
The Risk Management Program is designed to identify, evaluate and reduce the risk of injury to the patients, personnel, visitors and to reduce the risk of loss to the health system. Risk Managers:
Review adverse incident reports, conduct investigations and analyze events in an effort to reduce risks to patients and the frequency and severity of medical malpractice claims; and
Investigate patient care complaints, provide education, and provide direction in regards to regulatory compliance.
This report includes Risk Management activities for the quarter and includes a summary of incident and safety reporting rates; impact analysis; report categories; education; claims; general activities; and goals.
3
Patient Safety Evaluation SystemPlease Note: Separate from Florida law program requirements, Risk Managers play an integral role in the health system’s Patient Safety Evaluation System, a voluntary program created by federal law. Employees are encouraged to report patient safety or quality concerns by filing a Patient Safety Report which are utilized by Risk Managers who participate in health system patient safety initiatives.
05101520253035404550
Rate per 100
0 Pa
tient Days
Lee Memorial Health System
LMHS Linear (LMHS)
Reporting Rates
4
This graph shows incident and safety report rate for the system for the last 12 months. The next page shows the reporting rates for each facility
Total number of reports for the third quarter was 3091
Trend Line
6
AnalysisThis graph reflects the percentage of reports that have no impact
on the patient. The graph for the third quarter indicates that 83% (2570) of the reports received involve situations which had no impact on the patient.
Reporting “near misses” is highly encouraged to identify potential areas of improvement. This information allows us to provides data used in our quality improvement activities throughout the system.
Trend line
7
AnalysisThis graph reflects the reporting rate per 1000
patient days and the rate of patient impact for the four facilities during the quarter.
8
CategoriesThis graph shows the rate for the categories of reports from January through March 2015 at all four facilities. Rates per 1000 Patient Days are utilized to be consistent with other system reporting. The top four categories are:Treatment & Testing category includes reports of IV infiltrates, Delays and Omissions, Patient Identification Issues, Failure to Communicate, Documentation issues, etcOther category includes Complaints, Burns, Skin Breakdown, AMAs, Self-Extubation, etcPatient FallsMedication Errors70% of all reported occurrences fall within one of these four categories
During this quarter there were two reports to AHCA
Rate per 1000 Patient Days
0.00 1.00 2.00 3.00 4.00 5.00 6.00 7.00 8.00 9.00
Test & Treatment 7.73 (812)
Other 7.23 (759)
Patient Fall 3.70 (388)
Med Error 2.36 (248)
Med‐Good Catch 2.35 (247)
Lab Labeling 2.32 (244)
Surgical 1.39 (146)
NonPt Fall 0.63 (66)
Equipment 0.58 (61)
Inf/Mat/OB 0.42 (44)
Adverse Drug Rx 0.33 (35)
Transport Issues 0.19 (20)
Assault 0.18 (19)
Sedation for Proc 0.02 (2)
9
Education Activities
• Risk Management Orientation for new hires
• Safety in the Outpatient Setting
• Incident Reporting for 4 West Staff
• Fall Prevention
• Case Management EMTALA education
• Root Cause Analysis Training
• Risk Management Orientation for new hires
• Safety in the Outpatient Setting
• Incident Reporting for 4 West Staff
• Fall Prevention
• Case Management EMTALA education
• Root Cause Analysis Training
10
Liability
The October - December, 2014 quarter ended with 33 pending professional liability claims. The second fiscal quarter 2015 (January - March, 2014) ended with 34 pending claims. The quarter saw 5 claims closed and 6 claims opened. Malpractice prevention, patient safety and quality of care improvement continue to be the primary focus of the Health System’s risk managers.
05101520253035404550
FY13Q1 FY13Q2 FY13Q3 FY13Q4 FY14Q1 FY14Q2 FY14Q3 FY14Q4 FY15Q1 FY15Q2
Num
ber o
f Cases
Number of Cases Linear (Number of Cases)
11
Risk Management ActivitiesContinued participation in system activities including:
• LMHS Policy & Procedure Committee• Individual Hospital Quality & Safety Committees• Daily Safety Check-In Calls• System Quality Safety Management Council• Participated in various Intense Analysis Teams/ Common Cause Analysis
Teams• Medication Safety Committee• Campus Specific Medication Safety Work Groups• Nursing Documentation GAP Analysis• Leadership Accountability• Heart Central Accountability Team• Quality and Conformance• LMHS Ethics Committee• CCH Grievance Committee• MD/Nursing Rounding Project• OB Hospitalist Group Meeting• CCH Retirement Committee• ED Navigation Committee
12
Risk Management Goals
• Continue to track and trend incidents, provide summary data and work closely with various departments and committees engaged in performance improvement and patient safety activities.
• Continue to work with Education and Organizational Development and management staff to assure that all employees are meeting the annual education requirement for risk management and to provide a module for the Competency activities.
• Continue to utilize pre-litigation procedures to resolve meritorious claims in a timely manner.
• Monitor the 3M/Softmed Risk Management System• Continue development of specialized training materials.• Continue to collaborate with others in the Health System with regard to
patient safety initiatives and make recommendations based on trends.• Evaluation and implementation of a Patient Safety Reporting System
with emphasis on compatibility with patient record and standardized PSO reporting (common formatting)
BOARD CHAIRMAN TO PLANNING LIAISON:
PLANNING BOARD OF DIRECTORS
MEETING Thursday, May 14, 2015
1:00pm
PLANNING LIAISON: Donna Clarke, Board Member
LEE MEMORIAL HEALTH SYSTEM
PLANNING BOARD & FULL BOARD OF DIRECTORS MEETING MINUTES Thursday, March 19, 2015
LOCATION: Gulf Coast Medical Center, Medical Office Building, Board of Directors Boardroom, 13685 Doctors Way, Fort Myers, FL 33912 MEMBERS PRESENT: Sanford N. Cohen, M.D., Board Chairman; Chris Hansen, Board Vice Chairman; David Collins, Board Treasurer; Diane Champion, Board Secretary; Donna Clarke, Board Member; Nancy McGovern, RN, MSM, Board Member; Steven Brown, M.D., Board Member; Therese Everly, Board Member; Jessica Carter Peer, Board
Member; Stephanie Meyer, BSN, RN, Board Member
NOTE: Documents referred to in these minutes are on file by reference to this meeting date in the Office of the Board of Directors and on the Board of Directors website at www.leememorial.org/boardofdirectors, for public inspection.
SUBJECT DISCUSSION ACTION FOLLOW-UP
MEETING CALLED TO ORDER
The LEE MEMORIAL HEALTH SYSTEM PLANNING BOARD & FULL BOARD OF DIRECTORS MEETINGS
were CALLED TO ORDER at 1:01 p.m. by Sanford Cohen, M.D., Board Chairman.
INVOCATION AND
PLEDGE OF ALLEGIANCE
Reverend Cynthia Brasher gave the Invocation, followed by the Pledge of Allegiance.
PUBLIC INPUT None at this time.
RECOGNITIONS
Bob Johns spoke about recently gaining federal approval for the FQHC-Look Alike for Lee Community. He introduced Linda Brown Lenz, VP of the Lee Community Health Board and Cedric Hall, Lee Community Health Board Chairperson. Chris Lee presented Lisa Sgarlata and Donna Giannuzzi with the Healthgrades-Top 50 Nations Best Hospital Awards for Lee Memorial Hospital and HealthPark Medical Center. A brief video was shown.
PRESIDENT’S REPORT Jim Nathan presented the President’s report.
LEASE-MEDICAL
OFFICE SPACE FOR PEDIATRIC ALLERGY
Kris Fay asked for approval of the Medical Office Space for Pediatric Allergy lease. A motion was made by David Collins to (1) approve the proposed lease for 1,938 square feet located at 3410 Tamiami Trail, Suite 1, Port Charlotte, FL at $16.00/sq. ft., initial lease term of 1 year with a thirty (30) day notice of termination, and (2) authorize the health system President or Board Chairman to execute the lease. The motion was seconded by Chris Hansen and it carried with no opposition.
CONSENT AGENDA Dr. Cohen asked for approval of the Consent Agenda consisting of the following:
A. Workshop Minutes of 3/5/15 B. Lease Approval- Park Windsor Warehouse space C. Extension of 2011 Bank of America Term Loan
Therese pulled item B for further discussion.
A motion was made by Donna Clarke to approve the Consent Agenda consisting of: A. Workshop Minutes of 3/5/15 C. Extension of 2011 Bank of America Term Loan The motion was seconded by Jessica Carter Peer and it carried with no opposition. A motion was made by Therese Everly to approve item B of the
LEE MEMORIAL HEALTH SYSTEM PLANNING BOARD & FULL BOARD OF DIRECTORS MEETING MINUTES
Thursday, March 19, 2015 Page 2 of 3
SUBJECT DISCUSSION ACTION FOLLOW-UP
Consent Agenda. The motion was seconded by Jessica Carter Peer and carried with no opposition.
CHAIRMAN TO PLANNING LIAISON
The gavel was turned over to PLANNING Liaison, Donna Clarke, to CONVENE the Planning portion of the meeting at 2:03 p.m.
CONSENT AGENDA Donna Clarke asked for approval of the Consent Agenda which consisted of: A. Planning Board & Full Board of Directors meeting minutes of 1/15/15 B. System Strategic Initiatives Scorecard FY 2015 C. Revision to Strategic Plan
A motion was made by Dr. Cohen to approve the Consent Agenda consisting of: A. Planning Board & Full Board of Directors meeting minutes of 1/15/15 B. System Strategic Initiatives Scorecard FY 2015 C. Revision to Strategic Plan The motion was seconded by David Collins and it carried with no opposition.
CAPACITY
CHALLENGES AND RECOMMENDATIONS
Josh DeTillio and Dave Kistel presented Capacity Challenges and Recommendations for approval. Discussion ensued.
A motion was made by Chris Hansen to approve $7,289,781.00 for the design, construction, furniture, equipment, and information technology to implement and operationalize patient care beds at Lee Memorial Hospital and observation beds at Gulf Coast Medical Center and HealthPark Medical Center as presented. Then motion was seconded by Dr. Cohen and it carried with no opposition.
ARCHITECT AND CONSTRUCTION
MANAGER SELECTION
Dave Kistel presented and requested approval for the Architect and Construction Manager Selection.
A motion was made by Dr. Cohen to approve to proceed with selection of an Architectural Led Design team, Construction Manager at Risk, and Building Commissioning Authority per Board Policy, for the 275 bed expansion of Gulf Coast Medical Center. The motion was seconded by Nancy McGovern and it carried with no opposition.
.
MEDICAL STAFF DEVELOPMENT
Kevin Newingham presented the Medical Staff Development plan.
OTHER ITEMS
None at this time.
NEXT PLANNING
MEETING The next Lee Memorial Health System Planning Board Meeting is:
Thursday, May 14, 2015, 1:00 p.m. Gulf Coast Medical Center, Medical Office, Boardroom
13685 Doctors Way, Fort Myers, FL 33912
The Lee Memorial Health System Planning portion of the Meeting was ADJOURNED at 3:36 p.m. by PLANNING LIAISON, Donna Clarke. The
gavel was turned back to Sanford Cohen, M.D., Board Chairman, At 3:36 p.m. to RECONVENE
the LMHS Full Board portion of the meeting.
MEDICAL STAFF
RECOMMENDATIONS Dr. Cohen requested a motion to approve the following Medical Staff Recommendations of March 18, 2015:
A. Lee Memorial Hospital B. Cape Coral Hospital C. Gulf Coast Medical Center D. HealthPark Medical Center
E. Golisano Children’s Hospital of SWFL
A motion was made by Nancy McGovern to approve the Medical Staff Recommendations of March 18, 2015:
A. Lee Memorial Hospital B. Cape Coral Hospital C. Gulf Coast Medical Center D. HealthPark Medical Center E. Golisano Children’s Hospital of SW FL
The motion was seconded by Steve Brown and it carried with no
LEE MEMORIAL HEALTH SYSTEM PLANNING BOARD & FULL BOARD OF DIRECTORS MEETING MINUTES
Thursday, March 19, 2015 Page 3 of 3
SUBJECT DISCUSSION ACTION FOLLOW-UP
opposition.
OLD BUSINESS None at this time.
NEW BUSINESS None at this time.
BOARD MEETING CRITIQUE
All were in agreement that it was a good meeting with great information and dialogue.
BOARD OF
DIRECTORS REPORTS
Jessica Carter Peer announced the opening of the new Rehabilitation and Wellness Center. Nancy McGovern stated she will speak at the Long Service Awards ceremony this weekend in Dr. Cohen’s absence. Dr. Cohen stated they have closed the loop with the Medical Staff on the issue of the recent Surgeon General visit. Donna Clarke stated the System Scorecard will now be presented at every other Planning meeting. Therese Everly reminded everyone of the upcoming Home Health Open House. Steve Brown stated he attended the recent Sanibel Cares sponsor party where sponsors being honored pledged a total of $2 million to Golisano Children’s Hospital.
NEXT REGULAR
MEETING The next LEE MEMORIAL HEALTH SYSTEM QUALITY/SAFETY BOARD
& FULL BOARD MEETING will be held on April 9, 2015, 1:00 p.m. in the Gulf Coast Medical Center, Medical Office Building, Boardroom
13685 Doctors Way, Fort Myers, FL 33912
ADJOURNMENT The LEE MEMORIAL HEALTH SYSTEM PLANNING BOARD
& FULL BOARD OF DIRECTORS MEETINGS ADJOURNED at 4:01 p.m.
by Sanford Cohen, M.D., Board Chairman.
Minutes were recorded by Katie Fournier, Board Assistant/Board of Directors Office
________________________________________ Diane Champion Date approved
Board Secretary
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UPDATE REPORT TO THE BOARD (No Action Required)
DATE: May 14, 2015 NAME OF SERVICE LINE/ENTITY UPDATE: LMHS FY2015 Strategic Scorecard Update PERSON RESPONSIBLE & TITLE: Kevin Newingham, Chief Strategy Officer KEY ACCOMPLISHMENTS na GOALS (MET) na
GOALS (UNMET)
FINANCIAL STATUS (including cash flow statement, projected cash flow, balance sheet and income statement) na PROBLEMS/ISSUES na ANTICIPATED NEEDS na SUMMARY/COMMENTS LMHS FY2015 Strategic Scorecard is updated with the most recent performance. This UPDATE supports the following Strategic Initiative(s): All
BOD/Forms/Board UPDATE Report to the Board Form – Updated 052113cs
Keep form to one page, EMAIL to: [email protected] by Noon eight (8) days PRIOR to presenting.
System Strategic Initiatives
FY 2015 ScorecardAs of May 6, 2015
Strategic Initiative
Key Performance
Indicator
Meets
2015
Exceeds
2015
Desired
Direction
Current
Status Tracking
Reporting
Period
Service, Safety,
Quality
Patient Experience (Systemwide rollup of
"Overall Rate…" top box)
74.7% 77.2%higher is
better67.4% Below Goal
2Q
FY 2015
Serious Safety Event
Rate(per 10,000 adjusted patient
days)
0.06 0.05lower is
better0.04
Exceeds
Goal
Mar 2015
12 mos avg
Clinical
Integration30-day Readmissions(LMHS data)
12.25% 11.75%lower is
better13.22% Below Goal FYTD Feb
Length of Stay
Improvement4.35 4.30
lower is
better4.56 Below Goal FYTD Mar
Aligned Multi-
specialty Group
Year over year
freestanding net
outpatient revenue
growth (2014 vs 2015)
5.0% 7.5%higher is
better12.3%
Exceeds
GoalFYTD Mar
Increase the LPG
Primary Care Patient
Base (new patients)
5,000 7,000higher is
better4,340
In progress
(on track)
June 2014
- Dec 2014
Caring PeopleEmployee
Engagement73.4 73.7
higher is
betterTBD
Annual Study
starts July 2015
Financial Viability Operating Margin % 3.2% >3.6%higher is
better8.4%
Exceeds
GoalFYTD Mar
Labor as a % of net
operating revenue46.4% <46.0%
lower is
better43.9%
Exceeds
GoalFYTD Mar
Page 1 of 3
FY 2015 System Scorecard - Trending History
64%
66%
68%
70%
72%
74%
76%
78%
Q4 FY14 Q1 FY15 Q2 FY15 Q3 FY15 Q4 FY15
Patient Experience (higher is better)
Meets Goal
Historical data not available
0.00
0.02
0.04
0.06
0.08
0.10
0.12
Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15
Serious Safety Event Rate (lower is better)
12-mos rolling average
4.0
4.2
4.4
4.6
4.8
Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15
Length of Stay (lower is better)
Monthly FYTD 15 10%
11%
12%
13%
14%
15%
Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15
30-day Readmissions (lower is better)
Monthly FYTD 15
0%
2%
4%
6%
8%
10%
12%
Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15
Operating Margin (higher is better)
Monthly FYTD 15
0
2,000
4,000
6,000
8,000
Q4 FY14 Q1 FY15 Q2 FY15 Q3 FY15
New Primary Care Patients (higher is better)
Quarterly Cumulative
Quarterly
-10%
0%
10%
20%
30%
Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15
Increase in Freestanding OP Net Rev. (higher is better)
Monthly FYTD 15
35%
40%
45%
50%
Mar-14 Apr-14 May-14 Jun-14 Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15
Labor as a % of Revenue (lower is better)
Monthly FYTD 15
Page 2 of 3
System Strategic InitiativesFY 2015 Scorecard
DefinitionsStrategic
Initiative
Key Performance
Indicator
Exceeds
2015
Initiative Indicator/Measure Period Definition
Service, Safety
& Quality
Patient Experience 4Q
FY 2015
Systemwide rollup of "Overall Rate..." top box score (9 & 10)
across all survey types throughout the system.
Serious Safety Event Rate (per 10,000 adjusted patient days)
FY 2015
Average
Number of Serious Safety Events, per 10,000 adjusted patient
days. Data is based on a 12-month rolling average. Adjusted
patient days includes impact of outpatient stays.
Clinical
Integration
Length of Stay Improvement FY 2015
Average
Average Length of Stay for inpatient adults, excluding the
Rehab hospital. It is calculated by taking the number of
discharges for the fiscal year divided by the number of patient
days associated with those discharges.
30-day Readmissions(LMHS data)
3Q
FYTD 2015
LMHS internal all cause 30-day readmissions from acute care
to acute care within the health system (all payers). Total
acute care readmissions within 30 days divided by total acute
care discharges.
Aligned
Multispecialty
Group
Year over year freestanding net
outpatient revenue growth (2014 vs 2015)
FY 2015
Average
Annual percentage increase in net revenues generated in
freestanding outpatient centers. Compare growth between
FY 2014 and FY 2015.
Increase the LPG Primary Care
Patient Base (new patients)
July 2014
thru
June 2015
Grow primary care base of patients measured by unique
patients seen within last two years.
Caring People Employee Engagement Index FY 2015
Annual
Study
There are three questions included in the index:
*I am comfortable discussing issues or problems with leaders
in my department
*I have input in making decisions that affect my job.
*Work processes are designed in a way that allows me to do
my work effectively.
Calculate the mean score for each question, and then
calculate the average of the three scores. Goal is based on
Annual Study.
Financial
Viability
Operating Margin FY 2015
Average
Operating Margin percent is calculated by dividing the
system's gain from operations by total operating revenues.
This is reported in the monthly consolidated financial
statements on page A-8 and A-9 along with comparatives.
Labor as a % of net operating
revenueFY 2015
Average
Amount spent on salaries compared to net operating revenue.
Page 3 of 3
System Strategic Initiatives
FY 2015 System Scorecard Update
©Copyright Lee Memorial Health System • All rights reserved
Kevin Newingham
May 14, 2015
Service, Safety, & Quality
Strategic Initiative
Key Performance Indicator
Meets 2015
Exceeds 2015
Desired Direction
Current Status Tracking
Reporting Period
Service, Safety, Quality
Patient Experience (Systemwide rollup of "Overall Rate…" top box)
74.7% 77.2%higher is better
67.4%Below Goal
2QFY 2015
Serious Safety Event Rate(per 10,000 adjusted patient days)
0.06 0.05lower is better
0.04Exceeds Goal
Mar 201512 mos avg
Clinical Integration
Strategic Initiative
Key Performance Indicator
Meets 2015
Exceeds 2015
Desired Direction
Current Status Tracking
Reporting Period
Clinical Integration
30‐day Readmissions(LMHS data)
12.25% 11.75%lower is better
13.22%Below Goal
FYTD Feb
Length of Stay Improvement
4.35 4.30lower is better
4.56Below Goal
FYTD Mar
Aligned Multispecialty Group
Strategic Initiative
Key Performance Indicator
Meets 2015
Exceeds 2015
Desired Direction
Current Status Tracking
Reporting Period
Aligned Multi‐specialty Group
Year over year freestanding net outpatient revenue growth (2014 vs 2015)
5.0% 7.5%higher is better
12.3%Exceeds Goal
FYTD Mar
Increase the LPG Primary Care Patient Base (new patients)
5,000 7,000higher is better
4,340In progress (on track)
June 2014 ‐ Dec 2014
Caring People
Strategic Initiative
Key Performance Indicator
Meets 2015
Exceeds 2015
Desired Direction
Current Status Tracking
Reporting Period
Caring PeopleEmployee Engagement
73.4 73.7higher is better
TBDAnnual Study starts July 2015
Financial Viability
Strategic Initiative
Key Performance Indicator
Meets 2015
Exceeds 2015
Desired Direction
Current Status Tracking
Reporting Period
Financial Viability Operating Margin % 3.2% >3.6%higher is better
8.4%Exceeds Goal
FYTD Mar
Labor as a % of net operating revenue
46.4% <46.0%lower is better
43.9%Exceeds Goal
FYTD Mar
___________________
L E E M E M O R I A L HEALTH SYSTEM
BBBOOOAAARRRDDD OOOFFF DDDIIIRRREEECCCTTTOOORRRSSS
LEGISLATIVE UPDATE
Verbal Report
(Sally Jackson, System Director Government & Community Relations and Keith Arnold, Government
Relations Professional)
Clinical Integration UpdateAnne Rose
VP Revenue Cycle/PHO
Joby Kolsun D.O.Medical Director
May 14, 2015
LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM
Background
• During 2013, Lee Memorial Health System (LMHS) requested the Lee Physician Hospital Organization (LPHO) create a Clinical Integration Program (CI Program) in order to prepare for the shift from volume‐based payments to value‐based payments.
• The Lee Employee Health Plan (LEHP) agreed to be the initial payer in the CI Program.
LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM Background (continued)• Clinical Integration Program means the adoption of
active and ongoing clinical initiatives that are designed to improve quality, increase efficiency, and control costs.
• The Clinical Integration Program will initially be available to Lee Health Plan members and will support improving the coordination of care.
• The LEHP will share savings with the LPHO that are a result of the CI Program initiatives.
• Over 600 physicians enrolled in the initial cycle of CI Program (2014).
• Today, over 800 physicians are in the CI Program.
LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM
CI Program VisionTo develop advanced care management capabilities across the PHO network that will:• Improve the coordination and quality of care provided to
the community, thereby lowering costs and improving the health status of the community.
• Position the provider community for continued success and stability as health care transitions to value‐based payment models.
LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM Operating Committee, 2015Elected by PhysiciansH. Lee Adkins, Fort Myers Family MedicineJon Burdzy, D.O., Physicians Primary CareRamiah Krishnan, M.D., Ramiah Krishnan, M.D.David MacKoul, M.D., MacKoul PediatricsStephen Zellner, M.D., Internal Medicine Associates Julio Conrado, M.D., (CHAIR), Specialists in HealthcareDaniel Dosoretz, M.D., 21st Century OncologyValerie Dyke, M.D., The Colorectal InstituteThomas Kowalsky, M.D., Associates in General & Vascular SurgerySanford N. Cohen, M.D., Invited Member, LMHS Board
Appointed by Health SystemLarry Antonucci, M.D., COOAvra Bowers, M.D., (VICE‐CHAIR), System Medical Director Primary Care ServicesNelayda Fonte, D.O., Trauma SurgeonBen Spence, CFOMarilyn Kole, M.D., System Medical Director Specialty Care ServicesScott Nygaard, M.D., CMO Physician Services
LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM
2014 LEHP Results• In collaboration with the Lee Health Plan, we closed
over 7,000 care gaps that were identified in the reports related to diabetes, asthma, and cancer screenings.
• As a result of closing care gaps, we met 100% of the quality measures established by the Lee Health Plan.
• Through our shared savings arrangement with the Lee Health Plan we received $381,815 to distribute to our participating physicians.
LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM
2015 Initiatives• Distributed 1st quarter Closing Care Gaps report package
in April/May
• Implementing Process Improvement Programs that have been adopted by the Operating Committee
• Expanding our payer base through additional shared savings contracts; commercial payer expansion scheduled for July 1, 2015; Medicare expansion targeted for January 1, 2016.
LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM
2015 Initiatives• Quality Programs
Care Gaps
• Process Improvement ProgramsEnhanced Primary Care, Care Transitions, Generic Drugs, Complex Care, Specialty Care – Cancer, Perinatal Care
• Utilization ManagementHospital Services, Service Lines, Panel Cost Management
LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM
2015 InitiativesPerformance Improvement Program
Closing Care Gaps• Improve the quality of care provided to patients• Prevent complications of disease• Screen for preventative diseases
LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM
2015 InitiativesPerformance Improvement Program
Care Transitions Goal • Improve communication and coordination of patient
care handoffs• To reduce unnecessary ED Visits, Admissions and
Readmissions
LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM
2015 InitiativesPerformance Improvement Program
Enhanced Primary Care Model Goal • Promote an enhanced Primary Care Provider model
proven to deliver quality and cost effective primary care.
• Improve patient engagement in their care
LEE PHYSICIAN HOSPITAL ORGANIZATION CLINICAL INTEGRATION PROGRAM
Next Steps• Continue Implementation of PI Programs• Continue Work with CI Program Physicians to Review
and Validate Reports• Continue Outreach and Education• Continue Payer Expansion Work
___________________
L E E M E M O R I A L HEALTH SYSTEM
BBBOOOAAARRRDDD OOOFFF DDDIIIRRREEECCCTTTOOORRRSSS
SOUTH LEE
UPDATE VERBAL REPORT
(Suzanne Bradach, System Director Special Projects)
System-Wide Bed
Capacity
Scott Kashman CAO CCH
May 14, 2015
©Copyright Lee Memorial Health System • All rights
reserved
Key Bed Capacity Measures
What will we achieve
• Number of ER Holds/Boarders Goal = Zero
• Available and staffed acute care beds
• Left without being seen and Left without treatment <1%
• EMS off loads <30 min at least 90% of the time
• Idea must impact metrics• Doable in immediate, medium or long term • Prioritized projects must be designed for standardized
enterprise deployment
Ideas worth doing
Key Bed Capacity Measures
1. ED Scheduling to physician offices
2. ED to IP Reverse Report
3. Housekeeping and Transport staffing to ensure enhanced turnover times
4. IP Discharge Planning and IP Discharge Execution
5. Dispensing DME
6. Operations Resource Center (more information pending)
• Other:– Staffing, additional Bed Options and Surge Plans
ADJOURNMENT __________________
L E E M E M O R I A L HEALTH SYSTEM BBBOOOAAARRRDDD OOOFFF DDDIIIRRREEECCCTTTOOORRRSSS
DATE OF THE NEXT REGULARLY SCHEDULED
MEETING
PLANNING FULL BOARD MEETING
August 13, 2015
Gulf Coast Medical Center- Boardroom Medical Office Building
13685 Doctors Way Ft. Myers, FL 33912
LIAISON TO CHAIRMAN:
Lee Memorial Health System
FULL BOARD OF DIRECTORS MEETING Thursday, May 14, 2015
BOARD CHAIRMAN: Sanford Cohen, M.D.
Admissions – YTD March FY15
Admissions: Up from budget 11.1% / Up 11.0% from PY
7,500
8,000
8,500
9,000
9,500
Admissions
8,170
9,079
8,180
Budget
Actual
Prior Year
Budget Actual Prior Yr Var Bud Var PYAdult 7,373 8,274 7,378 12.2% 12.1%Obstetrics 797 805 802 1.0% 0.4%
Patient Days – YTD March FY15
Patient Days: Up 15.9% from budget / Up 14.2% from PY
30,000
35,000
40,000
Patient Days
33,727
39,104
34,254
Budget
Actual
Prior Year
ALOS: Up 4.3% from budget / Up 2.9% from PY
4.00 4.10 4.20 4.30 4.40
ALOS
4.13
4.31
4.19
Budget
Actual
Prior Year
Statistics – YTD March FY15
32,000
32,500
33,000
33,500
34,000
34,500
35,000
ED Visits
34,128
34,777
33,169
3,300
3,400
3,500
3,600
3,700
3,800
3,900
4,000
Surgeries
3,933
3,5443,597
0
50
100
150
200
250
300
Cath Lab Cases
147
288
141
658
660
662
664
666
668
670
672
Deliveries
664
671
667
Budget Actual Prior Year
Revenue – YTD March FY15
Net Revenue: $104,749,497– Up 1.3% from budget Up 6.2% from PY
Net Rev. per Adj. Admit: $7,236 – $216 less than budget$47 less than PY
Medicare55.4%
Medicaid12.5%
HMO/PPO20.4%
Self Pay / Charity
6.6%
Other5.1%
Budget
Medicare57.2%
Medicaid11.8%
HMO/PPO19.6%
Self Pay / Charity
6.1%
Other5.4%
Actual
Payer Mix
Salary Expense – YTD March FY15
Staffing:
Salaries and Benefits: $43,272,167
• $831,251 less than budget
FTEs: 1,327
• 24 less than budget
FTEs per AOB: 3.87
• 0.42 less than budget
3.80 3.90 4.00 4.10 4.20 4.30
FTE'S Per AOB
4.29
3.87 4.07
Budget
Actual
Prior Year
Supply Expense – YTD March FY15
Supply Expense per Adj Admit: $1,314
• Down 3.7% from budget
• Up 0.6% from PY
1250
1300
1350
1400
Supply Expense/Adj Admit
1,364
1,314 1,306
Budget
Actual
Prior Year
Profitability – YTD March FY15
EBITDA: $36.1 million, $4.6 million more than budget
EBITDA %: 33.5% vs. Budget of 30.2%
Gain From Operations : $29.97 million, $4.44 million more than budget
Operating Margin: 27.8% vs. Budget of 24.5%
22,000
24,000
26,000
28,000
30,000
Gain from Operations
25,529
29,967
26,904
Budget
Actual
Prior Year
Service
HCAHPS:2Q FY15 Overall Rating was 64% Down 3 point (67% vs 64%) from the previous quarter ED CAHPS- T &R (Adult) CCH 45.5% GOAL 64.7% ED T&R (Peds) CCH 45.6% GOAL 69.1%
ED Team Completed “ADVANCE” to enhance culture and process improvement efforts
Key Challenges & Opportunities
Challenges1. ED volumes remain higher than previous years despite “season end” with > 190 visits/daily.
2. Continuing challenges to get experienced staff to balance nurse intern hires to meet actual need and increasing complexity of patient population.
Opportunities1. Relocation of stroke patients to 4 North and develop a Neuroscience presence/service line
focus..
2. Relocation of cardiac decision unit to 3 North and incorporation of CHF, other cardiac services for a total of 39 beds.
3. Recruit staff for expanded bed utilization in preparation for 2015-2016 seasonal plan for 291 staffed beds.
4. Healthy Garden (Wellness Education Park) continues to influence our optimal healing environment (OHE) with produce being served in CCH Cafeteria and continued student participation with Caloosa Elementary and Middle Schools, part of the School District of Lee County.
PeopleRecognition:
Quarterly Recognition Winners Bobbi Jesse- Outstanding Ancillary
Lynnette Morrow- Outstanding Support/Corporate
Dr. Saunders- Outstanding Physician
Solange Coulanges- Outstanding Patient Care Services
Arlene Tompkins- Outstanding Volunteer
Sterling The Florida Governor’s Sterling Award is a method to assess an organization’s model for high performance.
CCH submitted an application for the Governor’s Sterling Award in November, 2014 and completed the full review in February 2015. Final Report and decisions expected May 2015.
Sterling matches the Malcolm Baldrige-based assessment. Our management system is assessed against research-based best practices in seven categories:
Leadership Strategic Planning Customer Focus Measurement, Analysis, Knowledge Management Workforce Focus Operations Focus Results
DNVThere were two findings:
Fall Risk in ICU patients History and Physical Update before Surgery
People
Connectivity! Over 1,000+ staff have participated this year. Started Connectivity/OHE Rounds (Optimal Healing Environment) with Healing
Environment and HR Business Partners to focus on practical applications of supporting our operational priorities and key performance indicators.
Staff working on 2nd edition of Connectivity Video: Around the Cape in 90 seconds focused on showcasing “Because We Care” examples and operational stories specific to safety, flow and experience.
Health & Wellness Speaker Series: Dr. Joel Fuhrman – May 19, 2015. Joel Fuhrman, M.D. is a family
physician, five-time New York Times best-selling author and nutritional researcher who specializes in preventing and reversing disease through nutritional and natural methods. Dr. Fuhrman is an internationally recognized expert on nutrition and natural healing, and has appeared on The Dr. Oz Show, The Today Show, Good Morning America, and Live with Kelly.
Stroke “Ability” Fair held on April 30, 2015, with over 200 community members and staff attending. Focus was on education of signs and symptoms of stroke but more importantly on what services are available in our community for stroke survivors and their families.
Admissions - YTD March 31, 2015
Admissions: Up 6.6% from budget/Up 7.0% from PY
10,50011,00011,50012,00012,500
Admissions
11,351
12,095
11,301
Budget
Actual
Prior Year
Budget Actual Prior Yr Var Bud Var PYAdult 10,402 11,173 10,399 7.4% 7.4%Obstetrics 949 922 902 -2.8% 2.2%
Patient Days - YTD March 31, 2015
Patient Days: Up 15.4% to Budget/Up 15.4% from PY
45,000
50,000
55,000
60,000
Patient Days
49,177
56,758
49,166
Budget
Actual
Prior Year
ALOS: Up 8.3% from budget/Up 7.9 from PY
4.00
4.50
5.00
ALOS
4.33
4.69
4.35
Budget
Actual
Prior Year
Short Stays - YTD March 31, 2015
Short Stays: Down 24.5% to Budget/Down 11.0% from PY
02,0004,0006,0008,000
Short Stays
6,1964,679 5,260
Budget
Actual
Prior Year
Statistics - YTD March 31, 2015
31,00031,50032,00032,50033,00033,50034,00034,50035,00035,500
ED Visits
33,090
35,120
32,702
4,950
5,000
5,050
5,100
5,150
5,200
5,250
5,300
Surgeries
5,227
5,276
5,090
0
5
10
15
20
25
30
35
Kidney Transplants
32 30
20
830835840845850855860865870875
Deliveries
846
871
862
Budget Actual Prior Year
Revenue - YTD March 31, 2015
Net Revenue: $162,780,000 – Up 7.1% from Budget/Up 9.3% from PYNet Rev. per Adj. Admit: $9,594 - $229 more than budget
$367 more than PY
Medicare60.0%Medicaid
11.3 %
HMO/PPO17.9%
Self Pay / Charity5.6 %
Other5.2%
Budget
Medicare61.3%
Medicaid10.9%
HMO/PPO18.2%
Self Pay / Charity4.4 %
Other5.2 %
ActualPayer Mix
Salary Expense -YTD March 31, 2015
Staffing: Salaries and Benefits: $713,953 over budget
FTEs: 1,801 – 16 over budget
FTEs per AOB – 4.21 vs. Budget 4.66
4.00 4.10 4.20 4.30 4.40 4.50 4.60
FTE'S Per AOB
4.66
4.21
4.51 Budget
Actual
Prior Year
Supply Expense - YTD March 31, 2015
Supply Expense per Adj Admit: $2,264 Actual vs. $2,196 BudgetUp 3.1% from BudgetUp 11.4% from PY
1,900
2,000
2,100
2,200
2,300
Supply Expense/Adj Admit
2,1962,264
2,031
Budget
Actual
Prior Year
Profitability - YTD March 31, 2015
EBDITA: $54.3 million, $7.0 million more than budget
EBDITA %: 33.4% vs. Budget of 31.2%
Gain From Operations : $36.7 million, $7.2 million more than budget/$4.9 million more than PY
Operating Margin %: 22.5% vs. Budget of 19.4%
-
10,000
20,000
30,000
40,000
Gain from Operations
29,446 36,687
31,741
Budget
Actual
Prior Year
Key Challenges and Opportunities
Challenges1. Seasonal volumes have been extremely high. ED volumes are up 17%
YOY
Opportunities1. Physician’s Regional closed their Neuro-interventional program in April
20152. Looking at opportunities for incremental bed capacity and additional staff
for Season 2016
Celebrations1. Recently certified as a DNV Comprehensive Stroke Center2. Door-to-Needle times for Stroke patients are world class, 20-30 minutes
Admissions - YTD March 31, 2015
Admissions: Up 7.5% from Budget/Up 7.4% from PY
11,500
12,000
12,500
13,000
Admissions
11,989
12,893
12,009
Budget
Actual
Prior Year
Budget Actual Prior Yr Var Bud Var PYAdult 7,439 7,994 7,370 7.5% 8.5%Obstetrics 1,853 2,184 1,956 17.9% 11.7%Pediatrics 2,333 2,313 2,317 -0.9% -0.2%NICU 364 402 366 10.4% 9.8%
Patient Days - YTD March 31, 2015
Patient Days: Up 8.2% from Budget/Up 7.1% from PY
52,00054,00056,00058,00060,000
Patient Days
54,295
58,731
54,824
Budget
Actual
Prior Year
ALOS: Up 0.6% from Budget/Down 0.2% from PY
4.50
4.55
4.60
ALOS
4.53
4.56 4.57
Budget
Actual
Prior Year
Short Stays - YTD March 31, 2015
Short Stays: Down 4.6% to Budget/Up 9.7% from PY
3,000
3,500
4,000
4,500
Short Stays
4,2014,009
3,656
Budget
Actual
Prior Year
Statistics - YTD March 31, 2015
30,000
31,000
32,000
33,000
34,000
35,000
36,000
37,000
ED Visits
33,672
36,340
32,702
5,200
5,300
5,400
5,500
5,600
5,700
5,800
Surgeries
5,466
5,782
5,415
380
400
420
440
460
480
500
Open Hearts
420
499
438
1,4501,5001,5501,6001,6501,7001,7501,8001,850
Deliveries
1,602
1,811
1,691
Budget Actual Prior Year
Revenue - YTD March 31, 2015
Net Revenue: $189,048,000 – Up 7.0% from Budget/Up 10.6% from PYNet Rev. per Adj. Admit: $9,911 - $94 less than Budget
$95 more than PY
Medicare45.6%
Medicaid24.4%
HMO/PPO20.7%
Self Pay / Charity
4.6%
Other4.7%
Budget
Medicare47.4%
Medicaid24.1%
HMO/PPO19.9%
Self Pay / Charity
3.9%
Other4.7%
ActualPayer Mix
Salary Expense -YTD March 31, 2015
Staffing: Salaries and Benefits: $506,000 over Budget
FTEs: 1,970 – 21 more than Budget
FTEs per AOB – 4.24 vs. Budget 4.52
4.00 4.10 4.20 4.30 4.40 4.50 4.60
FTE'S Per AOB
4.52
4.24
4.43
Budget
Actual
Prior Year
Supply Expense - YTD March 31, 2015
Supply Expense per Adj Admit: $2,017 Actual vs. $2,112 BudgetDown 4.5% from BudgetUp 2.2% over PY
1,9001,9502,0002,0502,1002,150
Supply Expense/Adj Admit
2,112
2,0171,973
Budget
Actual
Prior Year
Profitability - YTD March 31, 2015
EBDITA: $70.909 million, $10,828,000 more than Budget
EBDITA %: 37.5% vs. Budget of 34.0%
Gain From Operations : $63.977 million, $11,018,000 more than Budget/$11,401,000 million more than PY
Operating Margin %: 33.8% vs. Budget of 30.0%
-
20,000
40,000
60,000
80,000
Gain from Operations
52,960 63,977
52,576
Budget
Actual
Prior Year
People – Nurse’s Week 2015
The Nurses Week 2015 theme this year is the story of the Redwood Theory
• The tallest trees on earth, the redwoods grow to heights of 350 feet. Yet, their shallow root system extends more than 100 feet from the base. The roots from one redwood intertwine with the roots of others, and each redwood is connected to another—thus increasing the bond and stability of the forest of trees. The metaphor of the redwoods shows how clinicians, too, are connected to one another to be the strongest team possible. Each member of our team brings strengths, as well as opportunities for growth. Our nurses offer the nurturing strength of interlocking roots linking together and strengthening the teams of a caring organization.
• Each year, the system recognizes over 3561 nurses in the system with a special lunch and celebration.
People Continued
• On April 9th Lee Memorial Health System announced the creation of The Shipley Center for Cardiothoracic Surgery Innovation, Education & Research to advance the care and treatment of heart and vascular disease. The center, when built in 2017, will expand upon the health system’s current cardiac care expertise by establishing an innovation hub focused on patient care optimization, research, and learning opportunities for surgical teams worldwide.
• For the 2nd straight year in a row, the HPMC and LMH have ranked in the Top 1% in the nation which equates to one of the 50 Best Hospitals in the nation.
• On May 19th, HPMC will celebrate the end of season and Hospital Week with a “Picnic in the Park” in the Atrium Courtyard for employees and volunteers.
Construction
• March 2015: Major Diagnostic Equipment arrived for Cath Lab and EP Labs• April 2015: Completion of CEP generator fuel tanks and bulk oxygen tank farm• July 2015: Cath/EP/COU open for Business • August 2015: Begin Phase 1 of the Surgery Renovation Project
• Construction Fun Facts:o Over 240 miles of electrical wire and low voltage cabling has been installed
on the project to date. This represents only the Cath Lab Renovation and OR build out phases of the project. That is enough wire to stretch from Fort Myers to the Bahamas
o In our continued focus on infection control, we have used over 30,000 sticky mats through the end of February 2015 that prevent dust and debris from being tracked out of the construction areas by the contractors. That is enough sticky mats to cover 3 ½ football fields.
o 1,951 tons of steel will be hidden in the concrete to help reinforce the Golisano Children’s Hospital structure. This equates to 1,204 Toyota Camry’s!
Construction Continued
• Thank you for approving the expansion of 16 Observation beds at HealthParkMedical center. The beds will be constructed, staffed and ready for season by converting meeting rooms 1A/1B to eight Cardiac Observation bends and Endoscopy (once relocated) will become an eight bed cardiac intervention unit.
• The final phases of the Courtyard Improvements have been completed. New plantings have been placed in all of the Landscape Beds and are integrated with the dry stream bed using black lava rock. The sound system has been reactivated which will allow for unlimited choices of sound to be introduced into the area when the piano is not in use. The beautiful copper patina birds have all found new homes within the plantings.
• Watch for the “facelift” of the courtyard with new furnishings, lighting and whimsical “sails.”
Key Challenges and Opportunities
Challenges:• The renovation and move of the Cath Labs from
the third floor to the second floor is on schedule for a July opening
• Phase two of the cafeteria renovation is beginning
• Parking for visitors• Air handler changes due to upgrades• Managing significant unexpected inpatient
volumes• Volume increases have necessitated the
postponement of major renovations of the Surgical Progressive Care Unit
• Crowding impact on Patient Experience results
Key Challenges and Opportunities
Opportunities:• The addition of 16 observation beds• “State of the Art” Cath and EP Labs• Endoscopy Lab renovation will
provide needed space relief• Continued Philanthropic interest in
the Shipley Center
Patient Experience
HPMC- Rolling Average is
• The three month rolling percentage is 72.7% which is meeting the goal of 70.9% and just shy of the Exceeds goal of 73.5%.
Admissions - YTD March 31, 2015
Admissions: Up 8.7% from Budget/Up 11.7% from PY
6,5007,0007,5008,0008,500
Admissions
7,616
8,281
7,413
Budget
Actual
Prior Year
Budget Actual Prior Yr Var Bud Var PYAdult 7,616 8,281 7,413 8.7% 11.7%
Patient Days - YTD March 31, 2015
Patient Days: Up 15.6% from Budget/Up 15.7% from PY
30,000
35,000
40,000
45,000
Patient Days
35,858
41,461
35,839
Budget
Actual
Prior Year
ALOS: Up 6.3% from Budget/Up 3.6% from PY
4.50
5.00
5.50
ALOS
4.71
5.01 4.83
Budget
Actual
Prior Year
Short Stays - YTD March 31, 2015
Short Stays: Down 2.6% to Budget/Down 3.9% from PY
2,7002,7502,8002,8502,9002,950
Short Stays
2,868
2,794
2,907Budget
Actual
Prior Year
Statistics - YTD March 31, 2015
26,20026,40026,60026,80027,00027,20027,40027,60027,80028,000
ED Visits
26,796
27,980
26,844
5,100
5,150
5,200
5,250
5,300
5,350
5,400
5,450
Surgeries
5,353
5,443
5,246
Budget Actual Prior Year
Revenue - YTD March 31, 2015
Net Revenue: $134,444,442 – Up 5.9% from Budget/Up 17.7% from PYNet Rev. per Adj. Admit: $11,201 - $18 less than Budget
$809 more than PY
Medicare46.7%
Medicaid13.3%
HMO/PPO16.3%
Self Pay / Charity
9.5%
Commercial10.1%
Other4.1%
Budget
Medicare48.8%
Medicaid12.5%
HMO/PPO15.4%
Self Pay / Charity
8.4%
Commercial10.1%
Other4.1%
ActualPayer Mix
Salary Expense - YTD March 31, 2015
Total FTEs: 1,408 – 44 more than Budget
OT and Contract FTEs: Up 56.4% from Budget/Up 44.9% from PY
0
50
100
Premium Labor - OT + Contract
3860
41
Budget
Actual
Prior Year
FTEs per AOB: 4.25 vs. Budget 4.68
4.00
4.50
5.00
FTEs per AOB
4.68
4.25 4.51
Budget
Actual
Prior Year
Supply Expense - YTD March 31, 2015
Supply Expense per Adj Admit: $2,677 Actual vs. $2,589 BudgetUp 3.4% from BudgetUP 4.6% from PY
2,500
2,550
2,600
2,650
2,700
Supply Expense/Adj Admit
2,589
2,677
2,559
Budget
Actual
Prior Year
Profitability - YTD March 31, 2015
EBDITA: $48.7 million, $7.1 million more than Budget
EBDITA %: 35.0% vs. Budget of 32.0%
Gain From Operations : $43.9 million, $8.6 million more than Budget/$13.7 million more than PY
Operating Margin %: 31.5% vs. Budget of 27.1%
-
20,000
40,000
60,000
Gain from Operations
35,317 43,867
30,174
Budget
Actual
Prior Year
Celebrations
Employee of the Quarter Dan Carlson , Supply Chain Management
Lab Week (April 12, 2015)
Nurses’ Week (May 7, 2015)
Operational Highlights
Quality Readmissions: VSM for COPD (System-wide)
Hospital Acquired Conditions (CAUTI)
Sepsis Improvement Team
Physician/Nurse Rounding Spread: 4W
Transfusion Safety – MTP and Blood product management (Trauma)
Admissions – 2nd Quarter 2015
Admissions: Up 0.8% from Budget / Up 1.3% from PY
2,7402,7602,7802,8002,820
Admissions
2,791
2,814
2,777
Budget
Actual
Prior Year
Budget Actual Prior Yr Var Bud Var PYPediatrics 2,333 2,313 2,317 -0.9% -0.2%NICU 364 402 366 10.4% 9.8%SCN 94 99 94 5.3% 5.3%
Patient Days – 2nd Quarter 2015
Patient Days: Up 2.5% from Budget / Up 2.3% from PY
16,000
16,500
17,000
Patient Days
16,232
16,644
16,268
Budget
Actual
Prior Year
ALOS: Up 1.7% from Budget / Up 1.0% from PY
5.75 5.80 5.85 5.90 5.95
ALOS
5.82
5.91 5.86
Budget
Actual
Prior Year
Short Stay Days 2nd Quarter 2015
Short Stay Days: Up 93.2% from Budget/Up 98.1% from PY
0200400600800
Short Stay Days
325
628
317
Budget
Actual
Prior Year
Statistics – 2nd Quarter 2015
Actual Prior Year
1,400
1,450
1,500
1,550
1,600
1,650
1,700
ED Admits
1,699
1,505
46.0%
47.0%
48.0%
49.0%
50.0%
Pediatric ED Visits as % ofTotal ED Visits
49.7%
47.3%
1,7001,7501,8001,8501,9001,9502,0002,0502,100
Peds Surgeries
2,073
1,845
Ed Visits +2,090 and ED Admits +194 from Prior Year
10,000
10,500
11,000
11,500
12,000
12,500
13,000
13,500
Ed Visits
13,299
11,209
Salary Expense- 2nd Quarter 2015
Staffing*:
Salaries and Benefits: $314.6 thousand under fixed budget
FTEs: 340 vs. fixed budget of 355
FTEs per AOB: 3.48 vs. fixed budget 3.79
3.20
3.40
3.60
3.80
FTE'S Per AOB
3.79
3.48 3.54
Budget
Actual
Prior Year
*This does not include ancillary departments
Supply Expense – 2nd Quarter 2015
Supply Expense per Adj Admit*: $351 Actual vs. $363 Fixed BudgetDown 3.5% from BudgetDown 0.6% to PY
Anesthetics, Raw Food and Medical Gases are the top three expenses with a favorable variance to budget
340
350
360
370
Supply Expense/Adj Admit
363
351 353
Budget
Actual
Prior Year
*This does not include ancillary departments
Quality
Pediatric Asthma Core Measures
CAC 1 100% Reliever ordered and administered
CAC 2 100% Systemic corticosteroid ordered and administered
CAC 3 82% Written Home Management Plan of Care at discharge
Service - continued
GCHSWF Overall Stoplight Report (return dates from Feb 1, 2015 to April 30, 2015)
Child HCAHPS Overall (TOP Box “Rate this Hospital)Apr 2015 Mar 2015 Feb 201583.3% 75.0% 80%
Opportunities Opportunity to improve score related to “Communication with
Nurses”
Key Opportunities
FHA-HEN contract completed to participate through Florida Association of Children’s Hospitals 30 Day Readmission rates
ADE - John Armitstead is representing Golisano in the Pediatric HEN
Central Line Associated Blood Stream Infections in 3 units: PICU, NICU and Hematology/Oncology
Began design phase for the new Golisano Pediatric Urgent Care Facility and sub specialty offices in Naples
PDCA completed to begin comprehensive physical and cultural transition to the new hospital – in progress
Golisano now participating in CIT (Care Innovation & Transformation) Program (AONE). Focus- strengthen the nurse/physician relationship to improve patient experience and outcomes.
Planning pediatric genetic telehealth consults with MCH (in progress)
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BOARD MEETING CRITIQUE
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BOARD OF
DIRECTORS’ REPORTS
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DATE OF THE NEXT REGULARLY SCHEDULED
MEETING:
TRAUMA District & FULL BOARD OF DIRECTORS
MEETINGS Thursday, May 28, 2015
1:00pm
Gulf Coast Medical Center Boardroom 13685 Doctors Way, Ft. Myers, FL 33912