REPORT TO THE BOARD OF DIRECTORS – November 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.

Our health care system observed Veterans Day 2016 by marching in America’s Parade, under the NYC Health + Hospitals banner. We demonstrated the deep respect residing in our system for NYC Health + Hospitals’ veterans, reservists, family members, and all who support our military personnel.

Last month we held a great event honoring the nurses who won the 2016 Nursing Excellence Awards. We showcased the work of 6 winners, 160 nominees, and 8,000 nurses throughout our health care system who provide outstanding care for New Yorkers in hospitals, post-acute care centers, neighborhood health centers, nursing homes, and home care across the five boroughs.

Let’s watch a 2 minute slideshow celebrating the awardees.

This month we were proud to learn that only five hospitals in New York City received Leapfrog Group Hospital Safety Ratings of “A” or “B”. All five are within our system. They are:

• NYC Health + Hospitals / North Central Bronx
• NYC Health + Hospitals / Queens
• NYC Health + Hospitals / Woodhull
• NYC Health + Hospitals / Harlem
• NYC Health + Hospitals / Metropolitan

Congratulations to all five hospitals for this well-deserved recognition.

Leapfrog Group is an independent nonprofit focusing on quality of care nationwide. Its Hospital Safety Grade uses 30 measures of publicly available hospital safety data to assign A, B, C, D, and F grades to more than 2,600 U.S. hospitals twice per year. These grades are calculated by top patient safety experts, peer-reviewed, fully transparent, and free to the public. The group’s independent ratings program focuses solely on how effectively hospitals keep their patients safe.

An article in the October issue of the New England Journal of Medicine, authored by Dave A. Chokshi, MD, Chief Population Health Officer of OneCity Health, Ross M. Wilson, MD, Chief Transformation Officer, and Ji E. Chang, MS, PhD, Assistant Professor at NYU College of Global Public Health examines how coverage provisions of the Affordable Care Act are affecting safety-net health systems across the United States. The article also characterizes the responses of these systems to payment reform and charts future directions in scaling up improvements and innovation in delivery systems.

The Morbidity and Mortality Weekly Report, a publication of the Centers for Disease Control & Prevention, published an article in October titled “Preparedness for Zika Virus Disease — New York City, 2016,” written by four NYC Health + Hospitals infectious disease experts. The article lays out a robust emergency preparedness and response program that can help other health care systems limit the effects of the Zika virus and ensure appropriate screening, diagnosis, and care.

On October 26, NYC Health + Hospitals announced the appointment of Rosa M. Colon-Kolacko, PhD, MBA, CDM, as Senior Vice President and Chief People Officer. Dr. Colon-Kolacko’s extensive experience in building inclusive workplaces resulting in a more engaged multicultural workforce will help nurture an environment at NYC Health + Hospitals that supports the health system’s transformation toward financial stability, growth, and improved patient experience.

Most recently, Dr. Colon-Kolacko served as president and founder of Global Learning and Diversity Partners, LLC, a consulting services organization that focuses on building multicultural, inclusive and learning organizations in health systems. For most of the past decade, she served Christiana Care Health System in Delaware, most recently as Senior Vice President of its Learning Institute and Chief Diversity Officer, and earlier as its Vice President of System Learning. Dr. Colon-Kolacko holds a PhD in Organizational Development and Change from Benedictine University and an MBA from Henley Business School, University of Reading, England. She is also a researcher and has held academic positions as professor of professional practice at Bowling Green State University and an adjunct faculty member at Georgetown University and University of Delaware.

MetroPlus has launched a community marketing effort to find and enroll uninsured New Yorkers by tapping nontraditional locations. The health plan has recently been enrolling beneficiaries at the Rikers Island visitors center, at airport employee cafeterias, and at parent association events in city schools. In addition to traditional outreach in hospitals and clinics, MetroPlus plans to expand its presence to wherever New Yorkers need help finding affordable, high-quality health insurance. These innovative efforts are paying off. More than 750 individuals and families have been connected to MetroPlus over the past few months.

The recent installation of a state-of-the-art da Vinci robot at NYC Health + Hospitals/Elmhurst is dramatically expanding gynecologic treatment options for women in Queens. Long a leader in providing high-quality health care to the borough’s women, Elmhurst is using the new technology in the minimally invasive surgical removal of benign and cancerous tumors of the uterus and other parts of the female reproductive system. The robotic technology is also being used in pelvic floor reconstruction.

Elmhurst had previously pioneered an earlier version of the da Vinci robot, which was used only by its urologists for the removal of cancerous prostate, bladder, and kidney growths and the treatment of other urologic disorders. The addition of the more advanced robotic system has allowed for the expansion of treatment options to include gynecology. The hospital anticipates doing 100 gynecologic procedures annually, as well as other urologic procedures.

NYC Health + Hospitals/Bellevue has partnered with NYU to launch the Beatrice W. Welters Breast Cancer Program. Under the leadership of Bellevue’s Chief of Breast Surgery, Kathie-Ann Joseph, MD, MPH the grassroots initiative aims to improve medical outcomes for underserved women by bringing information to them at their salons, places of worship, gyms and more.

Last month Bellevue also kicked off a new community lecture – public seminar series on breast cancer that is free and open to the public and will feature Bellevue experts discussing topics of interest to the community.

As a National Accreditation Program for Breast Centers, the NYC Health + Hospitals/Jacobi Breast Service earned a 3-year, $75,000/year award from Governor Cuomo’s Breast Cancer Awareness and Screening initiative outlined in the 2016 State of the State address.

At Jacobi, these funds will be used to bring on additional patient navigator support and increase screening by 10%. Jacobi is one of just three NYC Health + Hospitals facilities to earn this award (Bellevue and NYC Health + Hospitals/Lincoln also received grant awards).

Jacobi’s Congenital Craniofacial Care Center was granted accreditation by the American Cleft Palate/Craniofacial Association. It is the only craniofacial program in the Bronx to earn this recognition, and one of just nine such teams in New York State. Congratulations to Eugene Sidoti, MD and his team.

Behavioral Health Services at Jacobi observed National Depression Awareness Day by providing depression education and screening for 43 participants. Nine Jacobi physicians completed a three-month leadership training program sponsored by Physician Affiliate Group of New York (PAGNY), which developed the program in collaboration with consultants at Lee Hecht Harris. The training included a practical project involving NYC Health + Hospitals Predictive Index (PI) measures.

In October NYC Health + Hospitals/Lincoln’s Kids Ride Club held its first outing that included students from P.S. 18 (the John Peter Zenger School in the Bronx). The Club provided helmets and bicycles to the kids who rode round trip for nine miles from Lincoln to Randall’s Island with stops at areas of interest along the way. Lincoln attending physicians James Zisfein MD, eight students, several parents and siblings of some of the students accompanied the group on the ride.

Also in October, Lincoln held its second Asthma Reading Clinic on the heels of its successful kick-off in August 2016. The Clinic provides information and education on asthma in a fun and interactive setting. At the most recent event, there were 29 participants, including 22 children, five teenagers and two infants. Among the 10 “Celebrity Readers” was the President of Hostos College David Gomez, Ed.D MetroPlus, Healthfirst and TD Bank provided supplies for the event which included pumpkins, snacks, and pencils. The next event is scheduled for January 2017.

Representatives from NYC Health + Hospitals / Metropolitan and NYC Health + Hospitals/Elmhurst participated in an LGBTQ Resource Fair at the Jackson Heights Jewish Center, hosted by the Mayor’s Community Affairs Unit. Representatives from various city agencies spoke about the services provided for lesbian, gay, bisexual, transgender, and queer New Yorkers. NYC Health + Hospitals representatives were there to share information about our LGBTQ affirming services and our status as a Leader in LGBTQ Healthcare Equality.

Metropolitan’s Central Sterile Department was recognized by 3M for providing the highest standard of care in sterile processing by practicing “Every Load Monitoring.” The process uses biological indicators to ensure the proper sterilization of equipment for every single patient. Central Sterile helps to ensure patient safety by reducing the risk of hospital-acquired infections.

Let me begin by saying that successor, I know that I am turning over the reins to a very steady pair of hands in Stanley Brezenoff. Stan is eminently qualified to take on this task. I believe I speak for all of us, when I say how appreciative we are that he has agreed to come on board.

I hope you’ll indulge me for a few moments, by letting me speak one last time as your CEO to express what’s in my heart about our iconic organization—which has been at the core of my life for over a decade.

And I should say at the outset, that I am very grateful to Mayor De Blasio, First Deputy Mayor Shorris, Deputy Mayor Palacio, and members of our Board of Directors for giving me the opportunity to serve as your President and CEO.

I feel a deep sense of humility and gratitude.

Twenty years ago, I left my practice as a trauma surgeon to become a health care executive. I hoped doing so would offer me a chance to work on a broader scale. A chance to work for better health for more people than I could ever touch in my own practice. Well, there’s nothing broader in the public health universe than NYC Health + Hospitals. And it’s been my dream job to serve at the helm, as we worked together to defeat health disparities and to further health equity in our city.

So, I hope you won’t mind my taking a few minutes to offer my aspirations for our system.

As we all know, these are times of great upheaval across the health care landscape nationally, and here in New York City. Which makes it even more important that we demonstrate value. Value to the city. Value to our patients. And value in everything we do. This means we must do two things at once:

We must continue to fulfill our mission of providing health care to all who need it. And we must prove that we will transform to be financially responsible and viable in the future.

I believe we’ve made significant progress.

We have dispensed with the outdated network system, and have reorganized along system-wide service lines that will place us on a more competitive footing.

We have searched the nation, and within our own system, to find the next generation of talented leaders.

We have successfully completed phase 1 implementation of EPIC. We have launched Enterprise Resource Planning to modernize key back-office functions. And we are making progress in unifying ancillary systems like radiology, and laboratory. We have a long IT journey in front of us, but we’ve made real headway, which makes me very proud.

We have rebranded, to make New Yorkers more aware of who we are, what we do, and why we are essential. We are letting them know of the transformational changes occurring under our roof…and we are articulating our values more loudly and clearly than ever before.

We are making New Yorkers aware that we will meet the future head-on with our labor partners and community supporters to build a more unified, more cohesive, pubic health care system…a system that is more focused than ever on better patient outcomes and more ambulatory-based care.

But at the end of the day what makes us different from other health care delivery systems is our compassion, our resiliency, and our toughness in the service of our patients.

We hold our mission as self-evident.

And we will always fight for it.

Which is why my aspiration for all of you, and for the public system we have dedicated our professional lives to, is this:

I hope you will continue to do everything possible to eliminate health disparities that exist all too often within the communities and populations we serve.

And I hope you will continue to fight for a more diverse health care workforce nationally.

At NYC Health + Hospitals we have successfully built a pipeline of physicians, nurses, and clinicians from diverse backgrounds — of Latino, Asian, African American and Caucasian descent because we believe this is the most effective way to make a difference on health disparities…… disparities in all the diseases and conditions that afflict the communities we serve, disproportionately and unfairly. Health care delivery systems across the country should emulate the work on diversity that we have accomplished here at NYC Health + Hospitals.

I also hope that you will continue the great work we’ve begun to reach beyond the four walls of our hospitals and beyond our traditional medical silo, to allow us to act across the city as social change agents. Because, we understand the direct connection between social conditions like unstable housing, lack of nutrition and legal problems, and how they can undermine the care we provide.

I couldn’t be more proud of the stand we have taken to deeply involve our system in solutions to social conditions that for too long were considered outside the ambit of health care organizations like ours.

Finally, let’s acknowledge that these are tumultuous and challenging times for the system we are working so hard to safeguard.

In public service, achievements and successes often go unnoticed. But failures sell newspapers.

This may be unfair, but it is nothing new. My hope for you is this: Don’t let that dynamic have a chilling effect on your creativity. Don’t let the possibility of failure dampen your sense of innovation. Don’t let worry about a negative media story impede your willingness to take risks on behalf of our patients. Because, history teaches us time and time again that the future belongs to people who are not afraid to take risks, and indeed, to people who are not afraid to fail.

Which is why in a system whose failures are magnified and accomplishments under-played, the new CEO needs a partner and not just a supervising authority. I hope each of you, as members of our Board of Directors, will work closely with our new CEO, offering him the same flexibility, the same support, the same wise counsel that you generously offered me.

At the end of the day, don’t ever forget that our success is measured by our patients: their outcomes, their needs, their access, their ability to lead the healthiest lives possible. One million patients last year alone:

• 4.2 million outpatient visits
• Over 18,000 babies born in our Labor and Delivery suites
• 1.2 million ER visits
• Some of busiest trauma centers and EDs in the nation.
• Approximately 45% of all inpatient behavioral health care delivered in New York last year

The numbers are staggering. They reflect how many New Yorkers rely on us for care each and every day. Which is why, no matter what the external challenges, no matter what the financial difficulties we face, no matter who sits in the White House or in the Halls of Congress, for us, it will always be patient care that matters most.

I deeply believe that what sets our healthcare system apart from our competition is this: It is in our DNA to treat each individual who comes through our doors as a person with their own history, their own needs, and their own hopes. We are not simply a healthcare system that treats diseases. We are much more than that. We don’t just treat diabetes, we treat Mrs. Gonzales. We don’t just treat heart disease, we treat Mr. Jones. Because, we know we are in the business of health care, not the health care business.

For myself, this has been the greatest of journeys. I’ve been more privileged than I can say, to have all of you at my side. Thank you for welcoming me into your facilities, and into your hearts. There are so many folks I need to thank…some of them are leaders and many more of them are what I call silent heroes. You know who you are and I know who you are. Thank you from the bottom of my heart for all the kindness and tolerance you have shown me. My goal was always to help make your jobs a little easier, a little more tolerable, a little better than the day before. Only time will tell how far I succeeded in that aspiration, but I leave with a sense of fulfillment that I tried to contribute a little to this wonderful organization, and a sense of optimism that the greatest days for NYC Health + Hospitals lay ahead.

Although I will no longer be serving as your CEO in the days going forward, once a member of the public hospitals team, always a member. I will remain your biggest fan, a proud New Yorker, and the person rooting for you loudly from the sidelines.

When emotions run high and words fail you….you borrow from others.

So let me end with a quote from my lifelong hero, and our greatest President, Abraham Lincoln:

“My friends, no one who isn’t in my situation, can appreciate my feeling of sadness at this parting. To this place, and the kindness of these people, I owe everything. I now leave, not knowing when or whether I may return, but I am not crying that it is over, I am smiling that it happened.”

I wish you all best of luck. You will always be in my heart and in my prayers.