REPORT TO THE BOARD OF DIRECTORS – February 2016 | NYC Health + Hospitals

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REPORT TO THE BOARD OF DIRECTORS – February 2016

RAMANATHAN RAJU, MD
HHC PRESIDENT AND CHIEF EXECUTIVE OFFICER
REPORT TO THE BOARD OF DIRECTORS
February 25, 2016

Good afternoon. As is customary, I will highlight just a few items from my report to the board. The full version is available to all here and will be posted on our website.

FLU SEASON DECLARED

Notice was received on February 11th from the NYS Department of Health that flu season has been officially declared in the New York region. It is imperative that all NYC Health + Hospitals personnel get vaccinated. It remains the best way to avoid succumbing to the flu and potentially carrying it to others.

Our VAX or MASK policy is now in effect. ALL employees who have not yet been vaccinated are required to wear surgical masks in their workplaces at all times. The flu can make individuals quite sick, often for several days. Many who are healthy adults may consider this a minor inconvenience – but the flu virus can be fatal to small children, the elderly, pregnant women, and to others with certain chronic conditions.

All NYC Health + Hospitals employees are urged to remember, “it’s not about you.” Don’t place others in jeopardy just to avoid a momentary pin prick. Make the healthy choice, take the healthy action, and get vaccinated immediately. We want to be able to see ALL your faces at work.

COLON CANCER AWARENESS MONTH

March 1 is the kick-off for Colon Cancer awareness month nationally, and here at NYC Health + Hospitals. This observance offers a reminder of how important it is for our own employees to practice good preventive health care. Colon Cancer is one of the most frequently diagnosed cancers and a leading cause of cancer deaths. However, this disease is also highly preventable.

That’s why our physicians performed approximately 22,000 colonoscopies in 2015, and why we helped nearly 6,000 New Yorkers decrease their cancer risk by removing polyps during the procedure.

Throughout March, we will be promoting colon cancer awareness in all of our facilities with posters, newsletter ads and postcards emphasizing that screening and early detection is the right choice for our patients and our staff.

CHIEF NURSING OFFICERS APPOINTED

Three new Chief Nursing Officers have joined our hospitals in the Bronx– Maureen Pode, RN, BSN, MA, at NYC Health + Hospitals/North Central Bronx; Suzanne Pennaccio, MSN, BSN, at NYC Health + Hospitals/Jacobi; and Lillian Diaz, RN, MS, MBA, at NYC Health + Hospitals/Lincoln. These highly trained professionals bring more than 100 combined years of nursing experience to our essential public health care system. We are delighted to welcome them, and look forward to their focus on enhancing overall quality of care, patient safety and improving the health care experience for both patients and their families.

NYC HEALTH + HOSPITALS/SEA VIEW ELI PICK LEADERSHIP AWARD

We have been notified by the American College of Health Care Administrators (ACHCA) that NYC Health + Hospitals/Sea View will be a recipient of the Eli Pick Facility Leadership Award. This is a distinction of significance. Fewer than 9% of facilities nationwide qualify for the award. Congratulations to Angelo Mascia and his Leadership Team.

STATE GRANT FOR PCMH IMPLEMENTATION INTO RESIDENCY PROGRAM

NYC Health + Hospitals /Metropolitan was recently awarded NYS Department of Health grant funding to support care models for improving coordination and quality of care across the health system, and to implement the Patient Centered Medical Home (PCMH) model into residency programs. This funding will allow Metropolitan to strengthen care coordination efforts, and improve health outcomes and patient experience by improving the ability to work seamlessly as a care team as well as make more timely and appropriate referrals to services in the community. Funding will allow expansion of work begun in 2012 with PCMH standards as a foundation to help explore new ways to better connect patients to community-based programs and services. The expanded funding will run through the end of the fiscal year.

TRANSLATION SERVICES VIA HOSPITAL PHONE

In January, Woodhull implemented a Dial 10 Concierge service, allowing non-English speaking patients to use their hospital phone and initiate a conversation in their own language with a patient representative. Although Cyracom and live interpreters are extremely helpful health care team members, 98% of the time, they are used when our physicians or other staff want information from the patient. This “evens the playing field” by offering patients the opportunity to obtain information from us.

BLACK HISTORY MONTH

Our system has one of the nation’s proudest and longstanding tradition of pioneering African American achievement in medicine and nursing.

NYC Health + Hospitals’ activities celebrating Black History Month for 2016 included a ceremony sponsored by the Joint Labor-Management Committee at NYC Health + Hospitals/Queens featuring a keynote address by Dennis Walcott, former Deputy Mayor of New York City and Chancellor of the Department of Education, on historical and current insights about the journey of African Americans in the health care system.

The event featured enthusiastic staff engagement activities, including creation and performance of inspirational essays, poems and video selfies to answer the question, “What Black History Means to Me?” And, taking photos or selfies in-front of a banner with the quotations “I have a dream”, “Black History is American History”, Yes We Can”, “Say it Loud! “, and “Live Your Healthiest Life”.

And at NYC Health + Hospitals/Lincoln, a reception was held on January 21, 2016, to recognize Michael Kelly Williams, an artist whose work will be on display at Lincoln’s Exhibition Hall until March 4, 2016, in celebration of African American Heritage.

JOINT LABOR MANAGEMENT PATIENT SAFETY FORUM

On January 28, 2016, the Corporate Office of Patient Safety and Employee Safety and the Committee of Interns and Residents (CIR)/SEIU Healthcare held a day long Joint Labor-Management Patient Safety Forum at Jacobi Conference Center entitled: motivational interviewing to Enhance Patient Experience and Safety.

Dr. Jonathan Fader, a nationally recognized expert in Motivational Interviewing was the keynote presenter. Dr. Fader offered clinical teams and frontline staff a presentation on the theory of motivational interviewing — techniques to engage patients so they can sustain participation in managing their health to achieve physical, mental and social well-being. The teams were taught how to be patient-centered and use language to improve care, and enhance patient experience. The patient safety event was attended by 200 interdisciplinary team members (physicians, medical residents, nurses, dietitians, social workers, patient safety officers, etc.) and leaders from across NYC Health + Hospitals and our union partners from CIR/SEIU.

ZIKA UPDATE

Our Ebola and Special Pathogens “Tiger” Team has launched a Zika Information and Resource page on the NYC Health + Hospitals “Insider” Intranet website. This page includes links to travel advisories posted by the New York City Department of Health.

The page also links to current information on the virus from the Center for Disease Control, concerning symptoms, diagnosis, treatment and precautions for pregnant women, and women trying to get pregnant.

A Zika-related pregnancy travel warning flyer is being distributed throughout facilities in our system.

MUSIC & MEMORY PROGRAM FEATURED AT GRAMMY EVENT

Earlier this month The Fund for NYC Health + Hospitals’ Music & Memory program was featured at a high-profile pre-Grammy event in Los Angeles, attended by several hundred prominent musicians, music executives and celebrities.

The Fund’s Executive Director Joe Schick introduced attendees to Music & Memory, which provides customized music playlists to residents and patients with Alzheimer’s, dementia, or traumatic brain injury. The program currently serves about 800 residents and patients at eight NYC Health + Hospitals facilities. The therapy powerfully establishes periods of personal connection through music that is both familiar and remembered in the brain, even among those with deep cognitive impairment. While the periods of connection may be brief, they regularly and dramatically improve quality of life for patients, families, and caregivers.

Awareness of Music & Memory is growing. Toyota Motor Corporation was an official sponsor of the Los Angeles event, and will soon launch a co-branded national call-to-action for used iPods to benefit the program.

The Fund partnered recently with the Bronx Documentary Center to create a brief, but very moving film about Music & Memory. All guests at the Los Angeles event received USB drives with a pre-uploaded copy of this movie, which was shot at NYC Health + Hospitals/Coler.

Let’s take a few minutes now to watch:

Bryan-Michael Cox’s annual pre-Grammy event brings together artists and executives and honors those making significant contributions to American music and culture. Mr. Schick served as one of the award presenters to DJ Khaled and Kawan “KP” Prather, Grammy winners and honorees. Mr. Cox, who has received seven Grammys for his work with artists such as Janet Jackson, Usher, and Mariah Carey, delivered the keynote address at The Fund’s Music & Memory conference in October 2015, and was instrumental in making our program the official call-to-action for this year’s pre-Grammy event, which he and others promoted actively through social media.

AMPUTATION SUPPORT GROUP AT HARLEM

The Rehabilitation Center at NYC Health + Hospitals/Harlem has launched an Amputee Support Group. This peer-led group is anticipated to be an important addition to the center’s commitment to the total rehabilitation of patients who have suffered from limb loss.

SONG OF LOVE AT ELMHURST

On January 21, U.S. Representative Joseph Crowley performed a song in the Elmhurst pediatric clinic for patients and families. The event was held to highlight the Congressman’s recording of a personalized song for Victor, an Elmhurst pediatric patient who has cerebral palsy. The song donation was made possible by the Songs of Love Foundation, a non-profit organization dedicated to providing personalized uplifting songs, free of charge, for children currently facing tough medical, physical or emotional challenges.

MODERN HEALTHCARE MAGAZINE TOP 25 MINORITIES IN HEALTH CARE

NYC Health + Hospitals President Dr. Ram Raju has been named to Modern Healthcare’s “Top 25 Minority Executives in Healthcare” for 2016. Dr. Raju has committed his career to dismantling health disparities suffered by underserved and minority communities here in New York City and across the country. 2016 marks the third consecutive year Dr. Raju has received this biennial recognition.

ONECITY HEALTH

OneCity Health continues site-level planning and implementation for DSRIP clinical projects across the entire OneCity Health network:

As part of our integrated care management strategy, two project participation opportunities have been launched:

  • A Project Participation Opportunity (PPO) has been distributed to help us identify community partners who may help create a seamless transition into the community by focusing on reducing modifiable risk factors for readmissions, which may be social, functional, clinical or systems-based.
  • In order to expand care management services to New Yorkers who need more intensive services but do not qualify for the NYS DOH Health Home program, we also distributed a Project Participation Opportunity to the four (4) lead Health Home agencies in our OneCity Health Network.

Implementation of Project 11 and integration of palliative care into the Patient Centered Medical Home (PCMH) remain on a positive track at sites including a subset of NYC Health + Hospitals and community provider organizations.

Our asthma home-based self-management implementation work continues at both select NYC H+H and community partner sites.

As required by the NYS DOH, OneCity Health is surveying all partner organizations regarding two subjects:

  • A baseline workforce assessment, which is being conducted by consultant BDO in collaboration with four (4) NYC Performing Provider Systems. We have engaged our labor partners in this effort to identify current workforce by NYS DOH-defined job titles, which is a first step in developing an engagement and training strategy to prepare our workforce for a more community-facing delivery system.
  • The state also requires OneCity Health to assess the financial strength of its network and to develop a sustainability strategy. Later in February, we’ll survey our DSRIP partner network in order to understand our current state.

To ensure responsiveness to New Yorkers who seek medical and social services through
NYC Health + Hospitals and partner organizations, OneCity Health has launched four new Consumer Advisory Workgroups, one for each borough-based hub. These workgroups seek to ensure that the perspective of the patients is incorporated into our DSRIP program work. Membership is comprised entirely of community residents who utilize the services of OneCity Health partner organizations, and also includes NYC Health + Hospitals Community Advisory Board members.

As part of the OneCity Health primary care strategy, an important foundational requirement is to achieve PCMH Level III status under NCQA 2014 standards as well as to achieve certain core competencies within the primary care setting, including ability to function operationally as a high-performing care team. For our non-NYC Health + Hospitals community partners, we have developed a contracting framework to achieve those goals and remain on-track to execute contracts in February. For NYC Health + Hospitals, we are proud that our sites are currently at PCMH Level III status and their primary care planning will continue under leadership of the Division of Medical and Professional Affairs with DSRIP funding as appropriate.

OneCity Health is working closely with community based organizations (CBOs) to distribute startup and ongoing funding for Project 11, which requires us to engage our uninsured patients, administer the PAM® survey as required by NYS DOH to assess their ability to self-manage their health, and to link them to insurance and primary care. They will be the first partners for funding distribution, which is expected to occur in March.

FEDERAL LEGISLATIVE UPDATE

President’s 2017 Budget‎ Proposes Medicare Funding Reductions/DSH Cut:

Earlier this month, President Obama released his Fiscal Year 2017 budget request ‎to Congress. The Administration proposed nearly $420 billion in reductions to Medicare payments to providers over 10 years. The budget request would also reduce an additional $27.6 billion over 10 years for Medicaid and the Children’s Health Insurance Program‎. Additionally, the budget would extend Medicaid Disproportionate Share Hospital (DSH) reductions another year to FFY 2026. If approved, the cost to NYC Health + Hospitals of this particular change could be as high as $462 million. We are working to educate members of New York City’s Congressional delegation on the effect of the cuts and will be meeting with members and staff in Washington D.C. early next month.

CITY LEGISLATIVE UPDATE

On February 23 2016, Roslyn Weinstein, Senior Assistant Vice President for Facilities Development and Special Projects, testified at a joint oversight hearing of the New York City Council Committee on Health and Committee on Resiliency and Recovery on the recovery of the City’s hospitals after Superstorm Sandy. Ms. Weinstein updated the members on what initiatives we have taken so far to protect our facilities from damaging storms as well as the timeline for all of the mitigation work that will occur. The Council asked questions regarding the budget, timeline and processes we have in place to ensure the work is done on time and on budget.

PROGRAM OF THE MONTH:

NYC HEALTH AND HOSPITALS/ HOSPITAL POLICE

As you know, each month we recognize a program that is making a positive difference in the care we offer our patients. Today we shine a spotlight on great work being done by our Hospital Police.

First impressions count.

And our officers are usually the first person patients meet when entering a hospital or health center. They set the tone for every interaction patients have with us after passing through our doors.

However, until last year, incoming officers did not receive training that was specific to the healthcare environment. They entered our system unprepared for daily life in a big city hospital or health center.

  • They lacked experience dealing with very sick or injured people
  • people suffering with mental illness, and grief-stricken and distraught families.

Our officers must handle those situations not as the exception, but as the rule. Each and every day they are called on to balance firmness and authority, with compassion and kindness.

So last year, we changed our approach.

We established a new Hospital Police Academy, with a curriculum designed to teach officers how to be effective within the public hospital system. Now they are trained firsthand about the complexity and sensitivity of life inside a hospital. And this training is better-aligned with our goal of bringing excellence to patient experience.
Because, from day one officers are instilled in guiding principles that prioritize serving patients first.

They learn to treat all patients with dignity, even those who are agitated, or violent, or under arrest. They learn to act as patient advocates, as well as patient protectors.

I’m glad to say the Academy is off to a great start. 50 new recruits graduated from our first class in January. They are thriving in their new positions at facilities throughout our system.

A second academy class is planned for later this year, and we hope to expand the program so that other professionals will join the training team.

Our officers deserve this quality training, because they do a difficult—and often unrecognized—job. They maintain the safe and welcoming environment that patients and staff need.

So please join me in offering a round of applause for work well done by our Hospital Police leadership:

Joseph Sweeney, Senior Director of Hospital Police from NYC Health + Hospitals/Bellevue
Thomas Egan, Hospital Police, Director of Training from NYC Health + Hospitals/Bellevue
Juan Toranzo, Hospital Police Deputy Director of Training from NYC Health + Hospitals/Kings County

As well as the following officers:

Kristina McCollum and Shakima Muskelly from NYC Health + Hospitals/Kings County
Fitzroy Smith and Alex Clarke from NYC Health + Hospitals/Woodhull
Marcos Castro from NYC Health + Hospitals/Harlem

PERSON OF THE MONTH THE REVEREND PAUL STEINKE

Although we are in the business of health care, we all know that treating illness, promoting wellness, and offering comfort to our patients involves more than medicine. Faith also plays a key role in what we do—and in what our patients experience every day.

We have a deep appreciation, and comfort level, with faith as an important element of health care. Today, we turn to a leader of our system who has toiled for many years, to bring the comfort of faith and spirituality to our patients.

I’m pleased to recognize Reverend Paul Steinke, Associate Director of Chaplaincy at NYC Health + Hospitals/Bellevue, as February’s NYC Health + Hospitals Person of the Month.

Reverend Paul was ordained as a Lutheran minister in 1961. He has served with the Chaplaincy program —which is celebrating an incredible 200 years of existence—since 2005. He is also supervisor of our Clinical Pastoral Education program which has trained chaplains to work throughout our system for the past 75 years.

It’s impossible to adequately summarize a life devoted so richly to the service of others. However, in coming to know and admire Reverend Paul, I’ve been struck by his commitment to addressing social concerns—especially those surrounding the treatment of the mentally ill.

His strength and humility are reflected in the guidance he offers his chaplaincy students:

  • He teaches them to really listen to patients in order to hear the “music behind their words”, and understand what they need most…
  • He teaches them to avoid platitudes, and instead to offer a strong comforting presence at a patient’s bedside.
  • He teaches them to be pastors who “Go into the dark, with a light.”

Excellence in patient experience means using every tool at our disposal to make our patients feel better at some of the most difficult moments in their lives. And for many patients, no tool is as powerful as faith, for offering compassion, kindness, and strength…for treating our patients as we would want our own mothers, our own sons, our own daughters to be treated.

Paul’s work has embodied this ethos. He is retiring next month, and he will be deeply missed. But his legacy will endure.

Please join me in thanking Reverend Paul and his wife Ann Williams.

WE ALWAYS PUT PATIENTS FIRST