July 2011
CARE CENTERS WILL IMPROvE COORDINATION & QuALITy OF CARE
S
outhcoast Hospitals Group has recently reorganized the care it provides into five individual care centers with the intention of advancing the overall wellness of patients while improving and refining the care coordination process.
The five care centers —Medicine; Musculoskeletal & Surgery;
allow for better organization of care by properly treating the per-
Cardiovascular & Imaging; Oncology, and Primary Care — each
son from the time they sit in a primary care office or Emergency
contain specifically-defined service lines. They are organized in
Department until the time they are fully improved.
such a way as to improve patient care through teamwork and care
“Our goal is to eventually keep people healthy — caring for
coordination, focusing all efforts on the care of the patient
and treating them before the issue gets too acute,” Bodenmann
throughout their disease or injury. (See sidebar for listing of serv-
said. Carol Conley, RN, Chief Nursing Officer for Southcoast,
ice lines under each care center.) Linda Bodenmann, Chief Operating Officer for Southcoast,
whose nurses work in or with all five care centers, said the centers
said the care centers create a more patient-oriented focus and
work in a number of ways to improve patient care by providing
allow for the coordination of all departments the patient would
nurses with the tools and accessibility of information to properly
require services from while being treated for an ailment or illness.
care for patients that would otherwise have been handled more
Instead of working through individual departments, the focus is
independently. “It helps in cases in which repeat admissions have been
squarely where it should be — on the patient. “It’s more of a patient’s look in than a department’s look out,”
a problem,” Conley said. An example is where care needs to be
Bodenmann said. “With surgery, you have physical therapy, the
coordinated between the hospital and either home care or a
surgeon’s office and the care that occurs after that. Taken from
long-term care facility. “With care centers, our education around
the patient’s point of view, it’s about how these departments all
each case will always be consistent.
work together for the benefit of the patient instead of doing their
“Our hope is that it would cause fewer repeat admissions
own thing. We want to make it easier for the patient to navigate
because through this process, people will be able to remain
through this process.”
healthy at home through a better coordination of care.”
From the employee’s perspective, Bodenmann said care centers
Using total joint replacement as one of many examples of how continued on page 2
The Interview
HealthQuest Recognition Awards
3
Melissa Botelho Kathleen LeBlanc Theresa Sylvia Emilia Sivvianakis
Helio Rosa Director of Design Construction & Project Management
5
Southcoast Care Centers continued from cover care centers can help improve patient care, Carter Hunt, Vice
Eileen Sugrue-McElearney, Vice President of Oncology Services,
President of Surgical Services, said care centers start a relationship
shared an example of how the service line integration helps patients
with a patient beginning with community education programs
in oncology — in the treatment of febrile neutropenia, or low white
through their first visit at the primary care physician’s office, their
blood cell count.
stay at the hospital and their post-surgery rehabilitation to provide
“Patients on certain chemotherapy treatments are at risk for lifethreatening infections and must receive appropriate treatment
greater convenience and continuity of care. “We work collaboratively through many departments to allow for
promptly,” Sugrue-McElearney said. “The care center model facilitates
seamless transitions,” Hunt said. “It’s been very positive for the staff,
the seamless transition of care across departments to expedite appro-
where although everyone knows their own role and has their own
priate treatment. It’s the care center that drives the care, allowing the
focus, each is involved in a coordinated effort. They see their part in
smooth flow between outpatient and inpatient care.”
overall care of the patient is something very positive.” Laurie Mulgrew, Vice President of Cardiovascular & Imaging
Warren Wood II, MD, President of Southcoast Physician Services, said the care centers and service lines are helping physicians find
Services, said with her own care center being online for more than
ways to work and share information to become more efficient in the
a year now, she is already seeing the benefits of the service lines being
care and treatment of patients. “We have programs to address chronic illness including health
integrated within the cardiovascular sector. Mulgrew used an example of a patient being admitted to the hos-
coaches and information to assist in chronic care like diabetes,” Dr.
pital for heart arrhythmia. The care center would treat the arrhyth-
Wood said. “The care focuses on the sicker patients with a higher
mia, but also would look into other symptoms or potential issues that
intensity of care where patients are categorized as chronic sick and
may stem from the original diagnosis, such as the potential for heart
chronic stable. The ones that are chronic stable receiving health
failure.
coach follow-ups while focusing the high-level care on the chronic
“It’s a way to strengthen links between cardiovascular specialists,”
sick. Through the care centers and service lines, this is all done by
Mulgrew said. “If the patient is the center of the wheel, then each of
using a team approach in taking care of patients instead of working
the spokes are cardiovascular specialists and the outside perimeter of
only as individual doctors.” Overall, Dr. Wood said, the concept of care centers addresses a pri-
the wheel is the cardiovascular care center. “It’s a very contemporary approach to managing populations of patients and to always be sure that patients are not treated in silos,” she said. “When someone comes in with chest pain, we won’t just
mary problem with the delivery of health care nationwide — fragmentation of services. “Health care in the United States is very disjointed,” he said. “But
treat the pain but will look to get down to the root cause of the symp-
care centers help to organize care to better meet the needs of the
toms. We have all the cardiac programs, physician specialists and
community.”
— Jay Pateakas
services available to the patient within our integrated service lines.”
Care Centers
Medicine
Musculoskeletal & Surgery
Cardiovascular & Imaging
Oncology
Service Lines
Congestive Heart Failure Chronic Obstructive Pulmonary Disorder Diabetes ED Gastro-intestinal Infectious Disease Hospitalists Inpatients Ob/Gyn Pulmonary Psychiatric
Bariatric Ear, Nose & Throat General Surgery Gastro-intestinal Gynecology Neurology Neurosurgery Occupational Health Orthopedics Physical Therapy Plastic Rehabilitation Urology
Cardiac Cardiac Surgery Electrophysiology Imaging Interventional Cardiology Non-invasive Cardiology Respiratory Vascular Surgery/ Endovascular Medicine
Medical Medical (Chemotherapy) (Chemotherapy) Radiation Surgery
Primmary Care
Southcoast Night at the New Bedford Bay Sox Join Southcoast Hospitals on Thursday, July 21, at 6:30 p.m. for “Southcoast Hospitals Night as the Bay Sox.” Southcoast employees who show their hospital ID badges at the gate will be able to buy one ticket and get one ticket free that night. There will also be giveaways, including beach balls, sunscreen and sports towels, for the first 100 people who arrive at Paul Walsh Field that evening. Southcoast Hospitals Group is the official hospital of the New Bedford Bay Sox, a member of the New England Collegiate Baseball League since 1997. The Bay Sox play their home games at Paul Walsh Field in New Bedford. A complete schedule is available at www.nbbaysox.com. Give a Pint get a Pizza and the Bay Sox Throughout the month of July, anyone who donates blood at the Southcoast Blood Bank at St. Luke’s Hospital, or at any of the com-
COASTLINES
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munity blood drives hosted by the Southcoast Blood Bank, will receive a certificate for a free large one-topping Domino’s pizza and two free tickets to a New Bedford Bay Sox home game. The pizza certificate is redeemable at any Domino’s in Fall River, New Bedford, Taunton, Somerset, Swansea and Wareham. The offer is good for any pick-up order or can be combined with a home delivery order but will not be recognized for home delivery orders of a single large one-topping pizza alone. The Bay Sox tickets can be used at any home game during the season and are not redeemable for cash. The Blood Bank is open Monday, Tuesday, Thursday and Friday from 8 a.m. to 4:30 p.m., Wednesdays 8 a.m. to 8 p.m. and Saturdays from 8 to 2:30 p.m. Walk-ins are welcome. For more information or to make an appointment call 508-961-5320. More information is available online at www.southcoast.org/bloodbank/. The schedule for the Southcoast Health Van can be found online at www.southcoast.org/van/ or by calling 508-961-5320.
HealthQuest Recognition Awards
W
hen it comes to maintaining your wellness, it pays to have a good role model to guide you, which is what the HealthQuest Recognition Awards are all about.
The HealthQuest Recognition Awards are given each year to
After gaining a significant amount of
Southcoast employees who are seen as wellness role models to their
weight over the years with no ener-
co-workers. In 2011, those recognized included employees who have
gy to exercise or improve her eat-
encouraged those around them in a wide variety of ways, from initiat-
ing, Theresa Sylvia, Human
ing a triathlon for co-workers to simply focusing on how to eat better
Resources Coordinator at
and exercise and inspiring those around them do the same. Kris Aimone, Wellness Coordinator for Southcoast Hospitals
Charlton, felt it was time to change, but it would take
Group, and coordinator of the awards, said recognition of the employ-
something a little different:
ees stems from people setting a good example for other co-workers
Enter Nintento Wii Fit.
using physical, occupational, intellectual, emotional, occupational, spiritual or social means.
eresa Sylvi h a T
“When it comes to exercise, you just find every excuse you
“These are people who have helped to influence their co-workers,” Aimone said. “They have become the go-to person in their group,
can to not do it, even just walking, and I wasn’t good at eating properly. I
helping others to make healthier choices. Co-workers see this and
have a treadmill in my cellar that I never
think, ‘if they can do it, then so can I.
used,” said the 59-year-old Sylvia, of Westport. “But the Wii Fit is fun.
Calling it her “couch to 5K” regiment, award winner Melissa
sa Bote elis lh o M
Botelho, RN, a nurse at St.
It’s like a video game and there are so many things you can do with it — yoga, strength, aerobics. You can do something different every day. It’s about finding something fun to do, to keep your attention.”
Luke’s Level II Neonatal
Over two years she lost 40 pounds by exercising and eating right.
Nursery, has lost more
Breakfasts are filled with oatmeal and granola, Healthy Choice meals
than 40 pounds in the last
for lunch and the same food she feeds her family for dinner, just in
six months — and kept it
smaller portions. Co-workers began to notice Sylvia’s weight loss, cit-
off. She’s also gotten three
ing her as an inspiration for their own exercise initiatives. Her goal is
of her night-shift colleagues
to lose an additional 10 pounds — to make it 50 in all — not a bad
to join her, one of whom has
achievement for someone who set out to lose five pounds.
lost more than 30 pounds.
Working in and around Tobey Hospital’s cafeteria, Dietary Aide
“We started with working out
Emilia Sivvianakis always has food at her fingertips. After gaining sig-
one minute every five minutes, start-
nificant weight over the years, Sivvianakis knew something had to
ing slowly like that and working from there,” said Botelho, 29, of New
give. She focused her attention on eating more vegetables and high-fiber foods, and
May we had run a 5K. And this year we were so proud of ourselves,
joined the local Curves and YMCA
improving on our time by six minutes.”
when she realized eating right
The group started cross-training by adding cycling and swimming
wasn’t enough. She and her
and last July completed their first triathlon. In January 2011, they ran
co-workers created their own
a half marathon. Botelho said that despite their daunting 7 p.m. to 7
version of the Biggest Loser
a.m. shift, they begin their training each day at 8 a.m.
competition, taking classes
“We knew when we were starting it that it was going to be a life changer — and it has been,” Botelho said. “People need to pick their niche and run with it and we have.”
c
hleen LeBla t n Ka
Sivvian ilia ak i Em
s
Bedford. “The four of us started running last February 2010 and by
at the gym and encouraging each other to eat better. While she came in second in the contest, Sivvianakis has
For Kathleen LeBlanc, Medical Records Coder at the Southcoast Business Center
managed to keep the weight off, continuing to trim down to a weight loss total of 75 pounds. She continues to
— like many people with
walk up to two miles each day, work out and eat better, earning the
desk jobs — sitting all day
respect of her peers in the process.
has many challenges. Hoping to combine her love for yoga with the need to show others its benefits, LeBlanc took a 200-hour yoga teacher training course and that training has paid dividends at work, leading to her HealthQuest Recognition Award. “We sit all day, straining our shoulders, neck and back and I’m always trying to get co-workers to try and reduce their stress, take
“Every day I try to do something — whether it’s walking, Zumba, swimming — which has caught on with my co-workers. I have three little kids so I always felt like I didn’t have the time or that I would just do it tomorrow but never did,” said Sivvianakis, 47, of Wareham. “My kids have seen a big change in me. I have more energy now, so they help me too.” Aimone said the HealthQuest nominating committee learns a lot about each nominee and the impact they have had on others. “Many of them do not even realize the impact they’ve had,” she said. “They are quiet in many ways, but they find their voice when they
deep breaths and relax,” said LeBlanc, 45, of New Bedford. “In yoga,
are trying to get others to make changes,” said Aimone. “Some start on
the focus is on the present — to take your time in the present and not
their own and end up changing many around them for the better.”
worry about the future or the past, but being present in each
— Jay Pateakas
moment.”
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3
News Briefs Todd Herrmann has joined Southcoast as Director of Strategic Planning. In his new role, Herrmann is responsible for the ongoing strategic and business planning for service growth for the hospitals, physician practices and the Southcoast Visiting Nurse Association. Herrmann most recently held the position of Vice President of Planning & Business Development for the Rehabilitation Hospital of the Cape and Islands in East Sandwich and served previously as Director of Strategic Planning for Children’s Hospital Boston. He also serves as President of the New England Society for Healthcare Strategy and is a member of the Board of Directors for the Sandwich Economic Initiative Corporation. Thomas E. Heenan, RT, has joined Southcoast as the Physician Liaison to the Fall River and Rhode Island regions. In this newly-created role, Heenan will work with service line and executive leaders and physicians to identify new business and referral development opportunities. A registered Respiratory Therapist, Heenan has more than 18 years experience in health care business and referral development, physician relations and network development. He most recently worked as the Director of Business Development for a long-term acute care hospital. Leadership Changes in Finance: Michael Ryan has accepted the position of Executive Director of Southcoast Ventures, Southcoast’s management services organization that provides financial and other operational support for Southcoast Physicians Network, Southcoast Physician Services, Southcoast Primary Care, Southcoast Health Plan, medical office buildings and other ambulatory ventures/services not provided by the hospital. In addition to ensuring that day-to-day financial activities such as billing, payroll and accounting, are performed for these entities, Ryan is accountable for their business planning and overall financial improvement. Earl Delacy replaced Ryan as the Interim Director of Finance for Southcoast. Laurie Mulgrew, Vice President of Clinical Services, Cardiovascular & Imaging, was awarded the Marit Davis Award by the Yankee Alliance. The award is bestowed upon the member of the Yankee Alliance Supply Chain Cooperative member who has exhibited innovative thinking, a passion for implementation, and leadership in the pursuit of health care supply chain excellence. Mulgrew’s efforts in supply chain management have resulted in $3 million in savings in cardiovascular services. This is the first time the Yankee Alliance has presented the award.
Southcoast Employees Trained for Emergency Preparedness
S
ome 40 Southcoast Hospitals employees underwent a week of intensive emergency management training in March to help improve the organization’s preparedness in times of a mass-casualty emergency.
The training, known as the Healthcare Leadership and Administrative Decision Making Course, was provided and fully funded by the U.S. Department of Homeland Security at the Federal Emergency Management Agency’s Center for Domestic Preparedness (CDP) at Fort McClellan in Alabama. The training took place at Noble Army Hospital in Anniston, Ala., which was converted in 1998 into a training site for health and medical education in terrorism, manmade and natural disasters. The National Training Facility (NTF) is the only hospital facility in the U.S. dedicated to training hospital and health care professionals in disaster preparedness and response. This was the second time a group of Southcoast staff attended the training, which is fully paid for by the U.S. Department of Homeland Security. Attendees received advanced hands-on training by the country’s top-leaders in disaster preparedness. The four-day training included two days of lectures and tabletop drills plus two days of functional exercises taking place in a simulated hospital environment. Scenarios were incorporated in the drills such as infant abduction, mass causalities, hazardous chemical spill requiring decontamination of victims, bomb threat and small pox pandemic response. The 40 Southcoast participants represent various departments across the three hospital sites. Also participating in the training were a number of outside agencies including Sturdy Memorial Hospital in Attleboro, the Onset Fire Department, Nantucket Cottage Hospital in Nantucket and first responders from Fall River and Wareham. Southcoast employees who took part in the training include: Teresa E. Allen-Richard, RN Fatima Andrade, RN Michele L. Azevedo Diana N. Barton, RN Lynn Bordwick Richard L. Branco Rolinda M. Brooks Kevin C. Buckley, RN John C. Cabral Robert Crepeau Dawn M. Davidian, RN Carolyn DeSpirito Lisa Dumont, RN
Donna L. Finni, RN Julie S. Gagnon, RN Jeanette Goyette Tricia Grime Deborah Harlow Janet Thompson Hathaway Gina T. Hill Edward J. Joseph Susan A. Mangini, RN Jeffrey McCallister Sharlene A. McGovern, RN Susan A. Miller, RN Heather M. Morgan
Lori L. Mullins Nancy S. Oakes, RN Janet W. Peirce Alicia M. Pimentel, RN Harvey R. Price Helio Rosa Theresa C. Sexton, RN Theresa Marie Souza, NP Katherine Tsonis Susan I. Valdez, RN Bruce L. Vierra, RN James B. Witkowski, MD
Radiology Program Graduates 17 Seventeen students completed their diagnostic imaging clinical rotations at Southcoast in April with a graduation ceremony attended by family, friends and staff. Yan Ping Chen and Brandy Clapprood received Arthur C. Hannefin scholarships. Hannefin began his career in Radiology in the early 1960s at Truesdale Hospital and retired from Charlton in 1992. After his death, his family established a scholarship fund at Southcoast for students enrolled in radiologic science programs.
Pictured are: Clinical Educators: Pablo Corral, Team Leader, Paula Billard, Diagnostic Medical Sonography, Elizabeth Daigle, Radiologic Technology, Meghan Murphy, Diagnostic Medical Sonography, Adam Pisapia, Nuclear Medicine, and Marilyn Wiggin, Radiologic Technology. Graduates: Caroline D. Burnham, Jeffrey Camara, Kimberly A. Casey, Yan Ping Chen, Brandy A. Clapprood, Stephanie M. Costa, Katherine J. Dumont, Cheryl Economos, Colby Gamboa, Ashley Jandron, Alison L. Mayer, Tathiani Hellen Ruzzo, Susan Sokoloski and Caitlin Sullivan.
Dr. Anne Ruggieri, MD, with Arthur C. Hannefin scholarship recipients Lauren Camara and Stefanie Kepinski, and John Lentini, MD. COASTLINES
4
Vicki Mignault, ED Tech, (left) and Diane Read, RN, demonstrate Bedside Medication Verification.
ACIS update:
Computerized Provider Order Entry Implemented at Charlton ED
T
he much anticipated transition to Computerized Provider Order Entry took place at the Charlton Emergency Department on May 3, virtually without a hitch.
“The entire transition went very smoothly,” said Joseph Tondreau,
use the system and pharmacists,
MD, Emergency Physician at Charlton. “There is a little fine-tuning to
trained resource nurses and staff
do, but the switch-over has been painless and did not impact patient
from MIS were on-hand during the
care.”
transition to help us through.”
Diane Read, RN, an Emergency Department Nurse for almost 25
That help, she said, continues to be just a
years, has been excited by CPOE and the entire ACIS project since she
phone call away.
first learned about it.
“Pharmacists and MIS staff are always available to answer any questions
“I was excited from the very beginning because I could see beyond all the training and the
that might come up,” she said. Physicians as well as nurses have come to embrace the system.
learning curve to how it would
“The transition was very smooth,” Dr. Tondreau said. “Much of that
improve patient safety,” Read
was due to how actively MIS engaged physicians during the develop-
said. “Things can happen pret-
ment process. They worked very hard to make the
ty fast in the ED, there are a
system user friendly.”
great deal of verbal orders
The transition to electronic medical records has had little
and a great deal of medica-
impact on patient/physician contact, Dr. Tondreau said.
tions that look alike or
“There has always been concern that the physician
sound alike. When you
would be stuck behind a computer and not as actively
are moving quickly, that
engaged with the patient, but that is not the case,” he said.
creates a greater potential
“I find myself spending just as much time at the bedside as
for error.”
I have in the past.”
Read is particularly
The great advantage he sees, like Read, is one of patient
pleased with Bedside
safety and efficiency.
Medication Verification.
“Staff do not have to figure out physicians’ handwriting, so
“You scan the barcode on
the guesswork is taken out of medication and other orders,” Dr.
the patient’s bracelet and then the
Tondreau said. “The system also monitors medication interactions
barcode on the medication — and you immediately know if you are about to give the patient the right medication at the
and dosing. Joseph Tondreau, MD, updates a patient record.
dosage ordered for them,” she said. “You know whether or not you are doing the right thing and patients are fascinated by how it works. They appreciate the safety aspect of it.” The support and training staff received was key to the smooth transition, Read said.
A physician can choose to override the dosing alerts, but they are very valuable to have as a double check.” Read said she can already see how “going electronic” is improving patient care, but understands why staff might be skeptical. “We kept hearing about how great it was going to be, but you don’t really know that for sure until you see it and get to work with it,” she said. “Taking advantage of the training is so important. Using the system is not
“The support we had at the beginning and continue to have is
hard and the support is fantastic.”
incredible,” she said. “There were classes beforehand teaching us how to
Employee Appeal update
W
hether you donate to help improve our workplace or you want to give back to the community in which you live, our annual Employee Appeal helps support all that we do here at Southcoast.
We would love to hear why you donate. Send an email telling us why you think it is important to donate. And if you have yet to donate to this year’s appeal, it’s not too late! Contact Amy Winn at winna@southcoast.org or at Ext. 65-5358 to tell us why you donate or for information as to how you can help support Southcoast! Why they donate:
“I decided to contribute to the Southcoast Employee Appeal program because I feel that Southcoast is very generous to their employees. To contribute shows my appreciation of being a Southcoast employee.” Darcie Silvia Health Information Management, South Coast Business Center
“Being a little generous can go a long way.” Edward Durand, Maintenance & Facilities, Charlton
“As a Southcoast employee I am grateful for the many years I am employed here. I take pride in my work and am proud to work for a caring and devoted facility within my community. Because of this I am proud to participate in the Employee Appeal Campaign.” Pamela Sousa Health Information Management, South Coast Business Center
"A while back when I needed help, Southcoast Hospitals were there for me. It is important for me to give back by supporting the Employee Appeal so that someone else who is in need will get the care they need and deserve." Nancy Souza Environmental Services, St. Luke’s
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5
System-
Wise
Keith A. Hovan President, Southcoast Health System President & CEO, Southcoast Hospitals Group
It’s not often that Patrick and I dedicate our columns to the same
“We want to express our sincere gratitude and apprecia-
topic, but the patient experience and creating a healing environment
tion to the wonderful staff that provided support and
is that important.
exemplary care to our mom while being at your hospital this week. The care was above our expectations that are
In this increasingly competitive health care environment, patients
high to begin with, given that we have three nurses in the
have many choices as to where they get their care.
family. The emergency room staff was transitioning to a
Increasingly, insurers are asking patients for feedback on their satis-
new computer system/process but that didn't get in the
faction with not only the care they receive, but the entire experience
way of the staff attending to my mom's needs and provid-
around receiving that care.
ing appropriate updates to the family as more information
Governing bodies care, too. The Patient Protection & Affordable
became available. We were impressed with the initiative
Care Act passed last year — commonly known as national health care
and teamwork of the emergency room staff that included a
reform — makes specific reference to collecting data and basing pay-
great team of nurses, some of which were not assigned to
ment on the patient experience, patient engagement, outcomes and
our mom but helped out when it was necessary, and doc-
quality of care in both hospitals and physicians offices. PPACA names
tors Tondreau, Awad and Ruggieri who were very profes-
a series of measures that recognize the positive patient experience.
sional and effective in coordinating care and keeping us
We need to better understand a patient’s perceptions about what
informed of the test results and recommended care.
a positive experience in our care is.
… we were astounded by the exemplary care, compas-
To do so, we are moving — on the inpatient side— from internal
sion and support in the ICU including nurses Kristin,
measures to more rigorous measures instituted by Press Ganey.
Christine and Robin, and PA Rebecca. Our mom dedicated
Press Ganey is an independent organization that is recognized as
her life to raising a large family and it was important to
a leader in health care performance improvement. They work with 50
all of us that the ICU support our wishes to be by her side.
percent of all U.S. hospitals to improve clinical and business outcomes.
THANK YOU for allowing all of us to share this precious,
Press Ganey helps us compare our performance to hospitals similar
limited time with our mom despite us adding more work
to ours in cities similar to ours. They provide detailed analysis of our
for you to work around the group of family members that
patient satisfaction data that will show us where to focus our improve-
were in her room. While it was very emotional for all of
ment efforts.
us to lose our mom, we are comforted to know that she
Patients get their impressions of us at every touch — from the
was in good hands and that the staff gave us 110%”.
moment they walk through our doors (and sometimes before) until after they leave our care.
The new “computer system” the writer refers to is the Computerized
And impressions do last. An employee once told me about when
Provider Order Entry system that was rolled out in the Charlton ED the
a friend commented on the “bad care” their neighbor received at one
very week the patient came in for care. Even with the stresses of learn-
of our hospital’s EDs. When the employee asked for details about the
ing that new system the ED staff provided exemplary care while the
incident, she learned that it had happened 20 years earlier! Her friend
ICU staff clearly went above and beyond in accommodating a large
was still basing his opinion of the hospital on an incident that had
family in the patient’s last hours of life. Though the family is surely
happened two decades ago.
grieving the lost of their loved one, they are thoroughly satisfied with
But, it is also true that patients and their families have long memories of the outstanding care they receive. Here is an example from a letter I recently received from the family of a patient who passed
the care they all received during their most difficult hour. This is the impression we want to leave with our patients every time.
away in our ICU:
Financial
Update
For the Seven Months Ended April 30, 2011
Operating Results For the month of April, Southcoast generated income from opera-
William E. Grigg CPA, FHFMA Chief Financial Officer Southcoast Health System
Through April, operating revenues were ahead of budget by $17.7 million, or 4.3 percent, due primarily to unprecedented inpatient volumes, which exceeded budget by 10 percent in April and exceed the
tions of $2.1 million. The combination of very high inpatient volume
year-to-date budget and the prior year period by 11.2 percent and 13.7
and close-to-budget outpatient revenue again produced a very positive
percent, respectively. Outpatient diagnostic procedures improved in
financial result. Looking back to the disappointing results in January
April as outpatient laboratory tests were ahead of budget by 2.5 per-
and February, both months saw high inpatient census along with
cent and outpatient radiology procedures missed budget by less than
weak outpatient volume. For the seven months ended in April,
1 percent. Outpatient treatments in both medical and radiation oncol-
Southcoast earned $8.9 million, or 1.8 percent margin, from opera-
ogy continued their positive-to-budget trends in April and now exceed
tions, which exceeds budget by $5.1 million and was $2.9 million
budget by 14 percent and 33 percent, respectively, year-to-date.
ahead of the first seven months of Fiscal Year 2010. In addition to the
Emergency Department visits maintained a 2.5 percent better than
positive results for hospital services, financial results for the employed
budget pace for the year-to-date.
physician groups exceeded budget due to growth in revenues.
continued on page 7 COASTLINES
6
Quality&
Patrick Gannon Vice President of Performance Improvement Chief Quality Officer, Southcoast Health System
When we talk about the quality of the care we provide our patients, we historically have focused on the clinical side of care. Are our out-
Safety
help patients communicate what their pain goals are and record them on their white boards for all to see and understand.
comes what they should be? Are we preventing errors? Are we employing best practices?
Call Light Response: Led by Susan Mangini, RN, Associate Chief
But quality is about much more than that. It also includes the inter-
Nursing Officer at Charlton, the team is beginning their work by set-
actions patients and their families have from the moment of first con-
ting expectations with patients and accountabilities with care teams.
tact with Southcoast — whether it be through our Emergency
The team is also investigating a holistic approach to actions, behaviors
Departments, a referral from a physician’s office or any other way —
and technology use so that expectations for staff coincide with work
to well beyond the time they are released from our care. It includes the
of the Noise Reduction and Response to Pain teams. For call light
environment, the feeling of being cared for as a person and much
response in particular, this team is looking at a standardized commu-
more. All of these things make up the patient experience — a topic,
nication model to keep patients informed, and may pilot a “no pass
which is drawing increasing attention in the health care world.
zone” — meaning that any staff member seeing an illuminated call
In March we assembled five patient experience teams to look at
light will go into the room to acknowledge the patient and see what
specific issues that have an impact on the healing environment. Three
the patient needs and help to address that need personally or via the
of those teams are looking at inpatient elements and two are looking
appropriate staff member.
at elements of care in the ED. Carol Conley, RN, Chief Nursing Officer, and I are assigned the
The Emergency Department Teams are:
responsibility of being “barrier busters.” When any of the teams encounter an issue that hinders their progress, Carol or I will step in
Pain Management: Headed by Lisa Bechard, RN, Director of the
to help resolve it. We will also be sure the teams continue to move
Charlton ED, the team is trialing an ED pain protocol in Charlton
forward.
ExpressCare. They are also teaching staff non-medical approaches to pain management and using town hall meetings and huddles to main-
Inpatient Healing Environment Teams are:
tain awareness of the topic with staff.
Noise Reduction: Led by Irene Casey, RN, Associate Chief Nursing
Staff Cared About Me: Michele Ford, Patient Advocate for the St.
Officer at St. Luke’s, and Michael Bachstein, Vice President of Facilities
Luke’s ED, is leading a team that is working on identifying processes
Development & Engineering, the team is beginning its investigation
and desired outcomes around creating a more caring environment in
by measuring the noise level (in decibels) on one unit at each site to
the EDs. One of their interventions is to conduct shift-change rounds
establish a baseline for improvement. They are also considering “quiet
at the patient’s bedside to introduce the oncoming staff member and
time” for patients — specified hours during which patients are left
explain what is expected to happen next in the patient’s care.
alone (such as no surveying, vital sign taking, visitors or room clean-
Beyond these specific initiatives, creating a healing environment
ing) to help them get the rest they need. The team is also testing sever-
involves all of us. In fact, we should all think of ourselves as “patient
al ideas to reduce noise at night to make it easier for patients to sleep.
healers” and contributors to the healing environment. Patient/family experience extends beyond the bedside — it includes
Response to Pain: Sue Ventura, RN, Associate Chief Nursing Officer at
contact with Communications, Patient Accounts, Centralized
Tobey, is leading the way with this team that is working on improving
Scheduling, Health Information Management, Physician Offices, the
our scores on the CMS Patient Experience Survey — known as HCAH-
Southcoast VNA, our Website and many other areas. It starts by look-
PS — question, “Did staff do everything to help with pain?” The team
ing at everything we do from the patient’s perspective.
conducted focused surveys on five inpatient units throughout the three hospital sites and is working on developing a practice that will
Editor’s Note: Expect to see a feature article on creating a healing environment in the next issue of Coastlines.
Financial update continued from page 6
Through April, operating expenses were over budget by $13.5 mil-
ing staff. Southcoast’s ability to meet its financial goals for FY 2011 will
lion, or 3.3 percent. Personnel costs were $9.9 million, or 3.9 percent,
also depend on meeting Medicare’s “meaningful use” requirements for
over budget through April. Almost half of the variance was due to the
the ACIS project in the next couple of months, which will result in
growth in outpatient physician visits within Southcoast’s employed
additional Medicare payments of a few million dollars.
physician groups. The remainder represented premium pay such as overtime, agency staff and ETO costs used to meet the inpatient hospital volume. Additionally, supply expenses were over budget by $1.9 million, or 3.5 percent, but when flexed for volume, supply expenses per adjusted-occupied-bed were under budget by 2 percent year-todate. The year-to-date positive results place Southcoast in a good position to begin the summer months, which typically have closer to break-even financial results due to dips in volume and the higher cost of replacing vacation-
Average Daily Census Hospital Discharges Average Length-of-Stay Surgery Cases Emergency Room Visits Home Care Episodes of Care (Medicare only)
Month of April Actual 594 3,781 4.71 3,032 14,699 493
Budget 523 3,331 4.71 3,087 14,230 554
Year-to-Date Difference 71 450 0 (55) 469 (61)
Actual 590 26,186 4.78 21,100 102,229 3,557
Budget 534 23,773 4.76 21,490 99,745 3,908
Difference 56 2,413 0.02 (390) 2,484 (351)
COASTLINES
7
the
Interview Helio Rosa
Director of Design, Construction & Project Management As part of creating a healing environment for patients, South coast focuses not only on the quality of the care it provides everyday, but on the quality of the facilities where it delivers that care. Here, Helio Rosa, Director of Design, Construction & Project Management, talks about why great facilities are so important and what it’s like to build those facilities in his own community.
What do you do?
Southcoast has come out with a set of design standards that bring
Most of my efforts center around the programming and planning of
similar colors and styles to all three hospitals. Why is that important?
projects and spaces for Southcoast. This can include leading the archi-
In the past, when a consultant was brought in to work on a project,
tectural design and the Massachusetts Department of Public Health
they came in with their own ideas. The result was a contrast of styles,
review process. My department consists of three project specialists and
colors and materials that didn’t provide a consistent look to the organi-
an interior designer. Together we facilitate and manage any project that
zation. Now, we are implementing one unified vision that serves to
involves design, construction, space planning and moves.
strengthen the Southcoast brand. We provide enough flexibility in the design standards to allow each space to retain its own identity.
Why is it necessary to have such services in house?
Additionally, as with any other standardization, we realize cost savings
Historically, these services were either managed by the Facilities
with implementation.
Department or outsourced. Having a dedicated in-house team helps us design and manage projects much more efficiently. We get more accomplished this way and do it in a much more cost-effective way.
What are some of the projects you are working on now? The new Southcoast Centers for Cancer Care, in Fairhaven, and the medical office building, in Wareham, are the largest and most visible.
What did you do previously?
We currently have the new Southcoast VNA space under construction
I worked for a Boston architectural and construction management firm
at the South Coast Business Center and are designing the Truesdale
for many years and, during that time, we designed and built many
Cardiology and St. Luke’s separation of power projects. The Human
major Southcoast projects, including the Surgical Building and lobby
Resources office at Charlton is getting some upgrades and we are work-
at Charlton, the main lobby, Surgicenter and Memorial Building expan-
ing on a number of “green” initiatives at our facilities.
sions at St. Luke’s and the surgical and ICU expansion at Tobey.
Also, in our effort to support Southcoast’s Journey to Zero, we have a project to incorporate handwashing stations at all our inpatient units.
What made you want to work for Southcoast?
For us, these are just a few examples. There are many more exciting
I’m a local resident and actually worked at St. Luke’s in the Engineering
projects coming that we are getting started on so stay tuned!
Department before the merger, while I was in school. I really enjoyed that experience and my subsequent working relationship with
Why do we need to be making all these improvements in a time when
Southcoast. When this opportunity presented itself, I took it — and
we are trying to find efficiencies and save money?
I am glad I did. Southcoast is a treasured community institution and
Our goal is to provide quality care every day and that includes provid-
I wanted to be a part of it.
ing a healing environment that enhances our people’s experience while they are with us. If they enter a building or department that looks old, tired and damaged, it reflects upon what they think of us as an institution and how they feel about the care they receive. In the same way that we have to keep up with changing and emerging technologies, our
COASTLINES is a monthly publication produced by the Marketing & Public Relations Department of Southcoast Health System. Copyright ©2010 by Southcoast Health System. All rights reserved. Patricia Giramma
Editor Graphic Designer
facilities and programs must also keep up. We are also implementing changes that will bring long-term savings. The materials we are using, for example, are longer lasting and require less maintenance than the materials we are replacing thus providing long term cost savings.
Heather Tomaz, Jane Tucker
Contributors
Patrick Gannon, William E. Grigg, CPA, FHFMA, Keith A. Hovan, Jay Pateakas
What makes you proud to work here?
Photographers
John Robson, Christine Azevedo Katherine Tsonis, Jane Tucker
the experience our patients, visitors and staff have while they are with
Address inquiries to: Editor, Coastlines Marketing & Public Relations, Southcoast Health System 101 Page Street, New Bedford, MA 02740 girammap@southcoast.org
COASTLINES
8
While we don’t provide direct patient care, we support that care and us and I believe our work makes a difference. I have the best job, with the best team, working in a fantastic organization where, in my own way, I get to serve my community.