Contingency Capital Request: South Tower - Virtual Med-Rooms

Transcription

1 Contingency Capital Request: South Tower - Virtual Med-Rooms Current unit configuration necessitates medications storage in multiple locations Resulting in inefficiencies, delays, and interruptions to the med-admin process Unsecured medications are frequently noted during EOC rounds posing safety and regulatory risks across all South Tower Units.

2 Contingency Capital Request: South Tower - Virtual Med-Rooms The ED utilizes a series of secure Acudose units to create a virtual med-room in near the West RN station Proposal: Create virtual med-rooms down each hallway of the South Tower Capital substitution request to fund the $525,000 cost Six week delivery and installation timeline.

3 Contingency Capital Request: South Tower Needs Assessment

4 Contingency Capital Request: Summary Expense Proposal

5 UPMC Hamot Board of Directors Meeting Minutes Date: March 28, 2013 Time: 12:00pm Recorded by: Carrie Ennis, Secretary Attendees Present: G. Baldwin Esq., J. Beach CPA, Bishop D. Brock, B. Burnside, M. Bula, L. Davis, R. DeMichiei, R. Ferraro MD, R. Griffith, R. Hamilton, T. Heppenstall, D. Holder, C. Masters PhD, D. McDonald, M. Raimy, B. Stamm MD, T. Tupitza Esq., J. Walton, G. Welch Attendees Absent: Also Present: M. Joy, S. Kern Esq., L. Myers, R. Nygaard, N. Scott A. Bula, S. Danch, J. Donnelly, C. Ennis, S. Erhartic, J. Fiorenzo, D. Gibbons, C. Larson MD, R. Long MD, G. Maras, L. Rupp Minutes: The Meeting was called to order by Vice Chair Des McDonald at 12:15p.m. I. Board Education Mr. McDonald introduced Carrie Ennis, to report on UPMC Hamot s Community Health Needs Assessment and Implementation Plan. Ms. Ennis described UPMC Hamot s historical investments in the community and the requirements of the Affordable Care Act of 2010 for non-profit hospitals to conduct a Community Health Needs Assessment at least once every three years in order to ensure community programs are addressing the needs of the community. UPMC Hamot worked with the Erie County Department of Health and other local hospitals and community organizations to develop a CHNA and also convened its own Community Advisory Council to develop Hamot s Implementation Plan. The Community Advisory Council consists of the UPMC Hamot Board Planning Committee and four additional community members. Ms. Ennis presented the highlights of the implementation plan developed by UPMC Hamot management and recommended by the Board Planning Committee. The plan consists of improving community resources and education for End of Life Care, Maternal, Prenatal, and Infant Care and Preventive Screenings. Board members proposed adding Erie Together and Gannon s Erie-GAINS programs as community partners for implementation. Discussion also ensued regarding the necessary investment in human capital in order to implement the plan. (See full presentation for details). Motion was made, seconded and passed to accept the Implementation Plan. II. UPMC Corporate Update Ms. Davis shared that UPMC East has now been open for one year, has been operating at approximately 65% capacity and has brought new business to the UPMC System. A new Integrated Clinical Labs Building will open soon in Oakland to consolidate lab services for the Oakland hospitals. The SEIU has been held at bay. The Page 1

6 System is bracing for the new normal where we are challenged to do more with less as a result of lower payments and increasing observation status patients. Mr. DeMichiei provided a summary of the suit filed by Pittsburgh s Mayor challenging UPMC s tax-exempt status. He explained that UPMC is simply a corporate holding company and does pay tax on corporate headquarters and other corporate properties. The UPMC Hospital s own 97% of the System s tax exempt properties. Mr. Heppenstall shared that Highmark s agreement to purchase WPAHS does not yet have approval from the Pennsylvania Insurance Department. The bondholders have until April 26, 2013 to decide whether to agree to sell the bonds at a discount. Highmark has asked the PA Insurance Department to make a ruling by April 30 th. UPMC will continue to follow developments closely and recognizes that competition is good. III. Consent Agenda Mr. Tupitza recommended the statement in the RHS minutes elected three new members be changed to elected three new officers. Ms. Ennis agreed to make that change. Ms. Ennis clarified that the Affiliate Board Appointments are: Steve Danch to the ACL/CPI Board and Brad Dinger to the Emergycare Board and Executive Committee. Motion was made, seconded and passed to approve the minutes of the January 24, 2013 UPMC Hamot Board of Directors Meeting as presented, the minutes of the February 18, 2013 HHF Board of Trustees meeting as presented, the minutes of the February 27, 2013 RHS Board meeting with the change noted above, updated wording for the UPMC Hamot Core Values and Quality Policy, and the Affiliate Board Appointments per the clarification above. IV. Committee Reports A. Executive Committee The minutes of the February 26, 2013 Executive Committee Meetings were as mailed; there was no further discussion. B. Finance The minutes of the March 7, 2013 meeting were as mailed; Mr. Raimy commented that the Committee is working on finalizing the $25million capital budget to include IT, continuation of the air handler project and other items. The ED expansion and lobby project were tabled for further investigation and review. The committee also approved purchase of accudose units from contingency. C. Governance Committee The minutes of the March 7, 2013 meeting were as mailed; there was no further discussion. D. Hamot Health Foundation Report Ms. Bula shared that the HHF Board approved distribution of funds to move the pediatric unit from the main hospital to the UPMC Hamot Womens Hospital. Reminders that the Doctors Day appeal has been mailed and the quarterly Leadership Breakfast will be held on April 4, E. Hamot Heart Institute The minutes were as presented. Mr. Raimy noted that the Board did approve Medicor to seek privileges at Millcreek Community Hospital. Mr. Maras commented the critical importance of recruiting for CV Surgery, working with UPMC to develop candidates. Mr. Maras shared that Medicor has signed a cardiologist who will start in June and that Dr. Bishop will be joining the group. Dr. Ferraro and Fitzgibbon continue to receive Page 2

7 kudos for their TAVR cases proctors have come from around the world. The team has performed the procedure for approximately 30 patients. Mr. Maras expects an announcement shortly that Bradford Regional Medical Center will join the Highmark network. F. Institutional Review Board The minutes of the January 8 and February 5, 2013 meetings were as mailed; Ms. Masters noted that the UPMC Hamot IRB voted to accept Central IRB approval which will improve efficiency while maintaining local monitoring of studies. G. Partnership Affiliation No meetings H. Planning Committee The minutes of the March 21, 2013 meeting were available in the folders. Mr. McDonald noted that the Committee discussed the regional strategy in detail and will hold a special regional strategy session. The Committee also discussed declines in Hamot s Patient Safety and Quality scores since the big bang EHR implementation. I. Quality Improvement Committee The minutes of the March 27, 2013 meeting were included in the board folder. Dr. Stamm shared that the new Clinical Decision Unit on 3Main is to be commended and that Ms. Shears presented an infection control plan due to the upcoming discontinuation of MedMined. J. Inclusion and Diversity The minutes of the March 8, 2013 meeting were in the board folder. Bishop Brock, Chair, indicated he was very encouraged by the renaissance of the committee and that the committee has adopted an action plan. V. Credentials and Peer Review Actions A. Dr. Long reviewed the actions of the medial staff executive committee at their meeting on February 19, All recommendations of the qualifications and credentials committee from their meeting of February 12, 2013 were approved (reports attached). Motion was made, seconded and passed to approve the reports as presented. B. Dr. Long reviewed the new physician contracts as per attached. C. Dr. Long reviewed the resignations per attached. D. Dr. Long invited Board members to attend the April 10 th special Medical Staff Townhall meeting where Dr. Marshall Webster, Leslie Davis, and UPMC Legal will provide an update on the Highmark situation. VI. Medical Staff Report Dr. Larson noted that the Doctors Day reception will be held on April 18 th and that the medical staff leadership training fund will be used to host a dinner session with the Healthcare Advisory Board at the Bayfront Sheraton on May 8 th. VII. President s Report A. Mr. Fiorenzo shared that we are busy recruiting for key specialties and have had success with critical care and urology. A detailed cost containment plan is being developed by David Gibbons. One component is a new leader for UPMC Hamot HR Brian Durniok. This is part of the System-wide restructuring of HR. Page 3

8 Additional back office staffing changes are planned. Mr. Fiorenzo participates on a weekly Highmark Community Blue Task Force the main message is that the patients come first. He shared that the region is moving fast: Charles Cole is requesting formal affiliation, WCA is also discussing the potential of advancing to full affiliation, and LERHSNY dismissed its CEO at its March Board meeting due to his failure to make decisions and improvements in a timely manner. Mr. Danch acts as an advisor to the LERHSNY Board and has offered for UPMC Hamot to help with the transition. Mr. McDonald reminded the group that business from 3 of the counties (Erie, Chautauqua, and Crawford) make up 80% of UPMC Hamot s business and that it is important the Hamot remain in control of negotiations. Ms. Davis shared that UPMC is evaluating its downlink strategy system-wide. Mr. DeMichiei reminded the group that this round of cost containment will focus on back office areas and will not affect direct patient care. B. COO Report Mr. Gibbons provided an update on the continued success of the CDU and noted that ED volume is still high. Mr. Danch shared that a review of Milliman Utilization data indicates that Erie County ED utilization is higher than the estimate of 120,000 visits. This likely indicates that Erie County residents are using the ED in place of Primary Care. Mr. Gibbons highlighted upcoming hospital surveys: trauma, Joint Commission, DOH, and stroke. The group discussed the capacity at the Women s Hospital. Capacity and utilization is consistent with original projections. C. Patient Safety & Quality and Nursing Report Mr. Donnelly reported that nursing has reduced overtime utilization by 50% and achieved savings of $50,000 per pay period. He also provided more details about the success of the CDU and gave credit to the nurse leaders as well as the physicians who have been involved. Hamot has achieved only 64% of its PSQ goals. Challenges include staff adjustment to changes in documentation as well as process since the big bang. Focus areas for improvement will be the SCIP measures and hand hygiene. Mr. Donnelly also provided an overview of the Focus Standards Assesment (FSA) recently completed in preparation for the Joint Commission survey. Focus areas for improvement will be the SCIP measures and hand hygiene. Plans of correction have been submitted for areas that fell short of standard. A proposal for a contingency capital expenditure to improve patient care and regulatory compliance was reviewed. (See full report for details). Mr. Donnelly asked for a resolution to approved $525,000 to purchase Acudose units to improve medication safety and security. Motion was made, seconded, and passed. Ms. Holder reminded the group that the continued success of the CDU will depend on access to outpatient services to accommodate discharged patients in a reasonable time period. VIII. Regional Health Services Ms. Rupp shared that the RHS recruitment strategy has shifted to a cautious approach recognizing that investments in providers need to be thoroughly evaluated for community benefit and productivity. Infectious disease and critical care are two crucial specialties. Ms. Rupp is working with the primary care network to expand access with existing providers (extended hours). RHS is also considering office consolidations and reviewing staffing models. RHS financial performance is $16million worse than last year (see full report for details). IX. Financial Report Mr. Danch reported on February FYTD highlights; volume is flat, length of stay is down, surgical volumes have improved but are below budget. Payments and case mix continue to deteriorate as charity care continues to Page 4

9 increase. Case mix index was 1.82 last year compared to 1.72 this year with each point translating into $1million per month. Charity care was $4million per month last year. For January and February, charity care is over budget by $5million. A cost containment plan has been submitted to corporate. The plan includes $7.1 million in FTE reductions (both vacant positions and existing) and $4.4million in operating expenses (see full report for details). Discussion ensued regarding PR for the FTE reductions and assurance that most will be back office and some clinical leadership. Mr. DeMichiei stated that UPMC is in better position than most hospitals and trimming the back office functions will be easier than if we had to reach into clinical areas. X. Resolutions A. Community Health Needs Assessment Implementation Plan Motion made, seconded and passed. B. Charles Hamot Strong Trust annual certification. Motion made, seconded and passed. XI. Executive Session The Board met in executive session without management present. Two main issues were discussed. A. Board discussed management s attention to the region vs. Erie County. Suggestion was that management not lose focus on the importance of Hamot s growth and share within Erie County. B. Board requested an update on the UPMC Hamot marketing plan. XII. Meeting Evaluation/Adjournment A. Meeting Evaluation Board members were asked to complete the meeting evaluation. B. Announcements/Adjournment There being no further business the meeting was adjourned at 3:00 pm. Respectfully submitted Des McDonald, Vice Chair Page 5