Overview 772 beds Private, not for profit No recurring local tax support for indigent care 558 physicians 60+ medical specialties 40 Adult Intensive Care Beds
Service Area
Capabilities Level II Trauma Center Level III Newborn Intensive Care Unit Specialized Intensive Care Units Advanced Endovascular Neuro & Heart Procedures
Community Benefits
Community Benefits Charity & Uncompensated Care $20,440,100 at cost Medical Education Three physician residency programs Family Medicine Internal Medicine General Surgery Nursing Residency Program Pharmacy Residency Program
Patient Access
Main OR Outpatient Surgery Center Red Hills Surgery Center
Patient Location Selection Type of Procedure Case Complexity Support Service Requirements
Efficiencies in Operations Administrative Support Medical Staff Support Avoid Process Duplication
Quality Collaboration: Central Line Infections Interdisciplinary Collaboration Physicians Infection Control Organizational Improvement Nursing
12 10 8 6 4 2 0 2 6 4 2 11 10 7 5 2 CLABSIs by Quarter 2008-2015 6 3 House Wide Surveillance Begins Chloraprep Biopatch CL checklist 5 2 3 1 3 2 6 1 5 Results Swab Caps 2 3 1 1 2 1 1 3 2 1 1 2 2 1 3 4 3 3 1 1 1 Q1 08 Q2 08 Q3 08 Q4 08 Q1 09 Q2 09 Q3 09 Q4 09 Q1 10 Q2 10 Q3 10 Q4 10 Q1 11 Q2 11 Q3 11 Q4 11 Q1 12 Q2 12 Q3 12 Q4 12 Q1 13 Q2 13 Q3 13 Q4 13 Q1 14 Q2 14 Q3 14 Q4 14 Q1 15 Q2 15 1 BSIs Adult-Peds BSIs NICU
Bixler Trauma & Emergency Center Urgent Care Center Emergency Center - Northeast Transition Center
Community Collaboration
Community Partnerships Tallahassee Community College Florida State University Florida A&M University Walgreen s Pharmacy Transition Center NHS Community Center Big Bend AHEC Area Agency on Aging North Florida Medical Centers, Inc Bond Community Center
Transition Center Patients Typical Transition Center Referral Candidates: Patients with 3 or more admissions in the past year Patients with no primary care Patients who are not insured Patients with chronic diseases Patients unable to arrange follow up within 7 days of discharge
Transition Center Model TMH Hospital ER or Inpatient Stay Case manager identifies patient as high risk for readmission Referral is made to the Transition Center Contact made with patient within 48 hours Transition Center Simplified care plan developed Medication review and follow up plan Appointments for appropriate follow up care Telephonic calls to remind patient of appts. Social work team helps patients apply for benefits/services Primary Care On going care and intervention
Transition Center: Impact Reducing visits and costs in first 90 days after discharge Total variable cost avoided $273,759 30 Days After Discharge 90 Days After Discharge Total Inpatient Visits -87% -67% Total Emergency Dept. Visits -73% -53%
TeleHealth Telemedicine A system that utilizes technology to deliver quality healthcare in a setting where the physician (or care provider) and patient are in two different locations Telemonitoring The use of technology to remotely monitor patients
TeleHealth Goals Improve overall health and quality of life for patients Increase patient access to primary and specialty care Increase efficiencies within the regional health system Promote successful transitions in care Reduce readmissions and unnecessary transfers to the emergency department
Telemedicine Telemedicine does not change the way providers care for patients, but changes the delivery method for communication
Telemedicine Equipment
Telemedicine Expansion of Behavioral Health Services to Rural Communities Partnership with Primary Care Providers Rural Emergency Department Baker Act Evaluations Outpatient Follow-up
Telemedicine Services to Rural Hospital Partners Doctors Memorial Hospital in Perry, FL Psychiatry, Dietary, Specialists, Transfers
Telemedicine Specialty Consults Expanding Transitional Care Services Residency Program Training
Telemedicine Reducing unnecessary readmissions and visits to the emergency department by connecting medical directors to LTC/SNFs/rehab facilities Benefits Reduced transfers costs Increased patient safety Increased patient satisfaction Increased provider satisfaction
Telemonitoring Allows providers to remotely monitor key health indicators such as weight, blood pressure, oxygen levels, glucose, and health behaviors. Interventions are provided quickly to prevent health episodes that result in hospitalization or a visit to the ER. Empowers the patient be an active participant in managing their own health.
Telemonitoring 30-90 Day Patient Monitoring Blood Pressure Weight Pulse Ox Medication Adherence Care Plans
Telemonitoring: Impact Remote Monitoring pilot project: 1. 23 high E.D. utilizers where monitored for 30-60 days 2. Nurses were able to monitor and provide timely interventions Results: Visits prior to remote monitoring/interventions Visits after remote monitoring/interventions Impact 105 18 83%
Suggested Improvements Telemedicine Legislation to support reimbursement Human Resources Shortage of physicians and nurses