LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS MEETING THURSDAY, February 8, 2018 Gulf Coast Medical Center Boardroom, Suite 190 13685 Doctors Way Fort Myers, FL 33912 (Held concurrently with the Lee Memorial Health System Board of Directors Meeting)
LEE COUNTY TRAUMA SERVICES DISTRICT BOARD of DIRECTORS OFFICE 239-343-1500 FAX: 239-343-1599 P.O. BOX 2218 FORT MYERS, FLORIDA 33902 LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS MEETING February 8, 2018 - *1:00 p.m. *Held concurrently with Lee Memorial Health System Board Meeting Gulf Coast Medical Center, Medical Office Building 13685 Doctor s Way, Ft. Myers, FL 33912 AGENDA 1. CALL TO ORDER (Sanford Cohen, M.D., Board Chairman) LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS 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 F. Collins DISTRICT FOUR Diane Champion Chris Hansen DISTRICT FIVE Jessica Carter Peer Stephanie L, Meyer, BSN, RN 2. Public Input - Agenda Items: 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 Office prior to meeting. 3. Trauma District Minutes OF 11/30/17 (Approve) (Therese Everly, Board Secretary) 4. Trauma District Financials (Accept) (Mark Atkins, Controller Acute Care) 5. Operations Report (Accept) (Dr. José Diaz, Medical Director, Trauma) 6. Other Items Regional Advisory Committee on Trauma Update (Chris Hansen, Health System Board Member) 7. DATE OF THE NEXT LEE COUNTY TRAUMA SERVICES DISTRICT MEETING, Thursday, May 17, 2018 at 1:00 p.m., held concurrently with Lee Memorial Health System Board Meeting at Gulf Coast Medical Center Boardroom. 8. ADJOURN (Sanford Cohen, M.D., Board Chairman)
LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS 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: 10:15H: 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.
LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS TRAUMA DISTRICT MINUTES OF 11/30/17 (Therese Everly, Board Secretary) (APPROVE)
LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS MEETING MINUTES Thursday, November 30, 2017 Page 1 of 2 LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS MEETING MINUTES Thursday, November 30, 2017 LOCATION: Gulf Coast Medical Center, Medical Office Building, Board of Directors Boardroom, 13685 Doctors Way, Fort Myers, FL 33912 MEMBERS PRESENT: Sanford Cohen, M.D, Board Chairman; Donna Clarke, Board Vice Chairman; David Collins, Board Treasurer; Therese Everly, Board Secretary; Steve Brown, M.D, Board Member; Diane Champion, Board Member; Nancy McGovern, RN, MSM, Board Member; Stephanie Meyer, BSN, RN, Board Member; Chris Hansen, Board Member; Jessica Carter Peer, Board Member MEMBERS ABSENT: -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- 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.leehealth.org/boardofdirectors for public inspection. SUBJECT DISCUSSION ACTION FOLLOW-UP MEETING CALLED TO ORDER The Lee County Trauma Services District Board of Directors Meeting was CALLED TO ORDER at 1:29 p.m. by, Sanford Cohen, M.D., Board Chairman. PUBLIC INPUT AGENDA ITEMS TRAUMA DISTRICT MINUTES TRAUMA DISTRICT FINANCIALS OPERATIONS REPORT LEGISLATIVE UPDATE ON TRAUMA None at this time. Dr. Cohen asked for approval of the Trauma District Minutes of May 4, 2017. Mark Atkins reviewed the Trauma District Financials FYTD as of September 30, 2017. Board Members agreed they would like to remove the Readiness Cost from the Trauma Financials. Discussion followed with CFO Ben Spence. Michael Marcus, RN presented the Trauma Operations Report. Dr. Cohen asked for acceptance of the Operations Report. Discussion followed. Mary Andrews presented a verbal Legislative Update on Trauma. A motion was made by Therese Everly to approve the Trauma District Minutes of May 4, 2017. The motion was seconded by Chris Hansen and carried with no opposition. A motion was made by David Collins to approve the Trauma District Financials FYTD as of September 30, 2017. The motion was seconded by Jessica Carter Peer and carried with no opposition. A motion was made by David Collins to accept the Operations Report. The motion was seconded by Nancy McGovern and carried with no opposition. OTHER ITEMS None at this time. NEXT REGULAR SCHEDULED MEETING The date of the next meeting of the Lee County Trauma Services District Board of Directors is on Thursday, February 8, 2018, at *1:00 p.m., in the Gulf Coast Medical Center, Medical Office Building, Board of Directors Boardroom. *(Meeting concurrent with the Lee Health Meeting) Lee Memorial Health System Board of Directors
LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS MEETING MINUTES Thursday, November 30, 2017 Page 2 of 2 SUBJECT DISCUSSION ACTION FOLLOW-UP ADJOURNMENT The Lee County Trauma Services District Board of Directors meeting was ADJOURNED at 2:07 p.m. by Sanford Cohen, M.D., Board Chairman. Minutes were recorded by Jennifer Zager, Assistant to the Board of Directors Therese Everly Date Board Secretary Lee Memorial Health System Board of Directors
LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS TRAUMA DISTRICT FINANCIALS (Mark Atkins, Controller Acute Care) (ACCEPT)
Trauma District Financials FISCAL YEAR TO DATE as of December 31, 2017 Dr. Jose Diaz and Mark Atkins January 24, 2018 #3400.159 Rev. 10/16
TRAUMA DISTRICT VOLUMES-For the quarter ended Dec 31 FY 17 FY 18 Inpatient Discharges 693 620 Inpatient Days 3,388 3,088 Average Length of Stay 4.89 4.98 Trauma Surgeon Visits 2,507 2,760 Case Mix Index 2.13 1.93
TRAUMA DISTRICT Key Indicators-For the quarter ended Dec 31 FY 17 FY 18 Revenue per Discharge $19,329 $19,524 Cost per Discharge $19,330 $18,430 Operating Margin(excludes Corp OH) 1.5% 5.6% Trauma Surg Visits per IP Disch 3.6 4.5
Trauma District-Payor Mix 40% 35% 30% 32% 34% 35% 31% 25% 20% 15% 10% 5% 7% 4% 11% 3% 9% 5% 6% 10% 2% 11% 0% FY'17 DEC YTD FY'18 DEC YTD Medicare Medicaid Auto/Liab Workers Comp Commercial State/Emp/Champ Charity/Self Pay
Trauma District-Special Payments Special Trauma Funding 12/31/2017 03/31/2018 6/30/2018 9/30/2018 SEP 18 FYTD Extra Court Fines 0 0 Red Light Running 0 0 Enhanced Speed Zones 0 0 Improper passing a school bus 0 0 Racing on highways & reckless driving 0 0 Camera Bill 0 0 Total 0 0
Trauma District- Statement of Operations FYTD December 31, 2017 FYTD 17 FYTD 18 Change Hospital Net Revenue 13,113,271 11,619,303 (1,493,968) Physician Net Revenue 476,337 480,823 4,486 Other Operating Revenue 5,795 4,920 (875) Total Revenues 13,595,403 12,105,046 (1,490,357) Hospital Expenses 11,442,124 9,567,865 (1,874,259) Physician Expenses 1,953,633 1,858,925 (94,708) Total Expenses 13,395,756 11,426,790 (1,968,966) - Net Gain/(Loss) 199,646 678,256 478,610 -
Lee County Trauma Service District Value Based Care Clinical performance Outcomes Survival to discharge >94% ALOS decrease by 1 day (FY 16-17) O/E ratio < 1 AVG ISS 11 Financial performance Operating margin Decrease in costs (FY 16-17)
Thank You
LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS OPERATIONS REPORT (Dr. José Diaz, Medical Director, Trauma (ACCEPT)
Lee County Trauma Services District Board of Directors Meeting Trauma Report February 8, 2018
Trauma Registry Entries 300 250 200 150 # Registry Patients 100 50 0 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
Trauma Alerts 140 120 100 80 60 # Trauma Alerts 40 20 0 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
Trauma Volume 1994-2016 Trauma Alerts Injury Admissions 3000 2500 2000 1750 1697 1953 2071 2068 2153 2430 2580 2599 2188 2079 2085 2053 1883 2157 2388 2569 2491 1500 1000 500 0 461 1185 1301 480 490 1296 457 2000 1999 1998 1997 1996 1995 1994 1157 1331 1339 548 597 773 762 893 1071 1178 1218 1324 1206 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 1013 1015 931 1002 1025 982 1022 1196 1254 2017 2016 2015 2014 2013 1253
Mechanism of Injury Trauma Alerts (CY 2017) % Pts 60 50 40 30 20 10 Alerts 0 MVC Fall GSW Stab Other Blunt Other Pen Burns Ped vs Auto Bicycle Assault
County of Injury (% YTD) County of Injury %YTD Injured Patient %YTD Trauma Alert Lee 73% 57% Collier 14% 21% Charlotte 7% 12% Hendry 3% 4% Glades / Highlands 0% 2% Other 3% 4%
Trauma Service Admissions 150 130 110 90 70 50 # Trauma Svc. Admits 30 10-10 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17
Trauma Alert ISS Range Analysis
Trauma TeamSTEPPS Training News Team Strategies & Tools to Enhance Performance and Patient Safety Evidence-based framework to optimize team performance across the health care delivery system. Four teachable-learnable skills: Communication Leadership Situation Monitoring Mutual Support
Lee County Mass Hemorrhage Control Education Implementation GOAL: Distribute hemorrhage control kits to ALL local law enforcement agencies using local funding sources Each kit contains: 5x9 Surgipad Dressing 6 inch ace wrap Combat Tourniquet (CAT) 4 inch bandage conform Tegaderm dressing Gloves (PPE) We chose to NOT put hemostatic dressings in civilian kits - requires application of direct pressure as they do not stop bleeding without firm direct pressure, and we have had some experience with misadventures using these products. This significantly lowered the price of each kit. We funded 721 kits in total and all of Lee County local law enforcement agencies received the number of kits they required. Additionally, Firehouse Subs (Local Franchise) donated the kits needed for Cape Coral Police Department, which helped in fulfilling every department s request. Program status update: - Working on funding to place hemorrhage control kits in large public venues and public access areas next to AED locations (Stadiums / Libraries/ High School sports venues). - RAC members to help in surrounding Counties (Collier/ Charlotte / Hendry / Glades) within trauma catchment area. - LH Disaster Committee discussing facility-wide / system-wide implementation of hemorrhage control training at March 6 meeting. - We have been fortunate with local funding for Lee County, however will need to find new sources to roll out to surrounding areas - Check with RAC. - Injury Prevention reports kits are being utilized at MVC/MCC scenes with major extremity injuries so far
Trauma Team Questions?
LEE COUNTY TRAUMA SERVICES DISTRICT BOARD OF DIRECTORS OTHER ITEMS Regional Advisory Committee Update (Chris Hansen, Board Member)
ADJOURNMENT LEE COUNTY TRAUMA SERVICES DISTRICT DATE OF THE NEXT REGULARLY SCHEDULED LEE COUNTY TRAUMA SERVICES DISTRICT MEETING: Thursday, May 17, 2018 1:00pm* Gulf Coast Medical Center 13685 Doctors Way Fort Myers, FL 33912 *(Held concurrent with the Lee Memorial Health System Board of Directors Meeting)
TRAUMA DISTRICT MEETING TO CHAIRMAN: RECONVENE Lee Memorial Health System FULL BOARD OF DIRECTORS MEETING Thursday, February 8, 2018 BOARD CHAIRMAN: Sanford Cohen, M.D.