REPORT TO THE BOARD OF DIRECTORS – April 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.

A team of Joint Commission Surveyors spent 5 days this month conducting a comprehensive survey of NYC Health + Hospital/Jacobi. Interviews were conducted with leadership on infection control processes, medication management, credentialing and privileging, data use, emergency management and leadership. Robert Nolan, ably represented the NYC Health + Hospitals Board at the leadership session, where he was asked about the Board’s role in ensuring quality and a culture of safety.

Jacobi received requirements for improvement, some of which were corrected during the survey, while others will soon be implemented. At the conclusion of the survey, the survey team mentioned several processes that they recommended Jacobi submit to the Joint Commission for inclusion in its Best Practice Library.

Of several areas singled out for praise, were engagement of all staff, including the medical staff, Maternal Modified Early Warning System/Scoring, Post-Partum Hemorrhage In-Situ Drills/Simulation, the Bronx Emergency Preparedness Coalition, Behavioral Health’s Violence Reduction Program and the Re-Admission Reduction Project.

Elmhurst, Harlem, McKinney and Metropolitan remain to be surveyed this year.

On April 5 we announced the appointment of four health care executives who will fill senior leadership positions and help guide our transformation in support of the Vision 2020 goals of financial stability, growth and improving the patient experience.

Richard J. Gannotta has been appointed Senior Vice President for Hospitals, and Maureen E. McClusky has been appointed Senior Vice President of Post-Acute/Long Term Care.

Each will lead newly created leadership structures based on service lines. The new structure replaces the system’s previous organization based on geographic networks centered around hospitals. The change will help strengthen and elevate post-acute/long term care as a strategic area of opportunity to reduce unnecessary hospital admissions and improve health outcomes. Welcome to Richard and Maureen.

Gregory Calliste has been appointed Chief Executive Officer, NYC Health + Hospitals/Woodhull, and Eboné M. Carrington has been appointed Chief Executive Officer, NYC Health + Hospitals/Harlem. These hospital CEO positions have been upgraded from an Executive Director title to reflect the shift away from operations-based management to strategic leadership and responsibilities for growth and patient experience. Welcome and congratulations to Gregory and Ebone.

Last week we celebrated National Volunteer Week, an opportunity to thank the many individuals whose generous contributions of time and talent provide vital support in our effort to provide the best patient experience to all who seek our care.

Our volunteer community – more than 8,500 people strong – infuses our mission with the extra dose of human kindness that is so helpful to the healing process. The benevolent heart can express itself in many ways, and we are grateful that our volunteers eagerly take up a multitude of diverse giving opportunities across our system.

Whether it be tutoring pediatric patients, assisting in occupational therapy, helping communicate with patients in their native languages, or offering uplifting entertainment, each volunteer endeavor is a donation of love, and each is an affirmation of the finest aspects of the human spirit. NYC Health + Hospitals gratefully offers thanks, recognition, and the encouragement to continue to support us in our mission to help each New Yorker lead their healthiest life.

On March 8 the United Hospital Fund held its 23rd annual Hospital Auxilian and Volunteer Achievement Awards celebrating the contributions of volunteers and auxilians who extend our ability to provide the best care possible to patients and their families. We offer our gratitude and congratulations to the honorees.

Joseph Lazarus, NYC Health + Hospitals/ Bellevue
Alicia Goudie, NYC Health + Hospitals/ Carter
Iqra Yaseen, NYC Health + Hospitals/ Coler
Miriam Beyers and Asheka Cuffy, NYC Health + Hospitals/ Coney Island
Jacqueline Narine, NYC Health + Hospitals/ Cumberland
Alejandro Lorca and Maria Rodriguez, NYC Health + Hospitals/ Elmhurst
Kim K. Siak and Dalia Soto, NYC Health + Hospitals/Gouverneur
Rosalyn H. Graves-Wilson and Rev. David Mubiru, NYC Health + Hospitals/Harlem
Valencia Porter, Friends of Harlem Hospital
Adriana Coku, NYC Health + Hospitals/Jacobi
Corey Grignon and Janet Quamina McCollin, NYC Health + Hospitals/Kings County
Dolores Glover and Luis Mercado, NYC Health + Hospitals/Lincoln
Marguerite Dorsey and Lynda Kaufman, NYC Health + Hospitals/Metropolitan
Janet Farr and Esme Sattaur-Low, NYC Health + Hospitals/North Central Bronx
Lorraine Brown-Dwyer and David Michael, NYC Health + Hospitals/Queens
Sarah B. Caliman-Walker, NYC Health + Hospitals/Renaissance
Gustavo Mueses and Joselinne Vallejo, NYC Health + Hospitals/Woodhull

On April 21 Mayor de Blasio and Speaker Mark-Viverito announced expanded benefits for the city’s more than 830,000 IDNYC cardholders through a new partnership with NYC Health + Hospitals and the Department of Health and Mental Hygiene (DOHMH). Cardholders will be able to link their IDNYC number to their health care services during the patient registration process at NYC Health + Hospitals and use their IDNYC card to access DOHMH immunization records. These benefits will streamline patient registration and ease access to medical records. The IDNYC card will also serve as a membership card for ActionHealthNYC participants receiving health care services at designated NYC Health + Hospitals locations.

Expanding on ways New Yorkers can access City services, IDNYC has partnered with NYC Health + Hospitals to allow IDNYC cards to serve as a registration card to help improve the patient experience by reducing registration wait times, streamlining the registration process and providing patients with a convenient way to register at patient care locations within the health system. Once a patient’s IDNYC card number has been linked in the system, the patient can use the IDNYC card during registration at any NYC Health + Hospitals patient care location. The initial NYC Health + Hospitals rollout has started at NYC Health + Hospitals/Coney Island, with plans to expand citywide throughout 2016 and 2017.

On April 10, Dr. Ram Raju, President and CEO of NYC Health + Hospitals received the “Booker T. Washington Award” from the National Minority Quality Forum (NMQF) for efforts to advance diversity in health care, reduce health disparities, and provide health equity to all patients. The National Minority Quality Forum is a Washington, DC-based not-for-profit, non-partisan, independent research and education organization founded in 1998. The organization is dedicated to improving the quality of health care available for and provided to all populations. Dr. Raju accepted the award on April 11 at NMQF’s “Leadership Summit on Health Disparities and Congressional Black Caucus Spring Health Braintrust” in Washington, D.C.

In presenting Dr. Raju with the award, Tomás León, President and CEO of the American Hospital Association-affiliated Institute for Diversity in Health Management, cited Vision 2020 as a roadmap to enhancing equitable care that builds on NYC Health + Hospitals’ exceptionally diverse workforce, looks to improving patient experience and outcomes, and helps to build healthier communities.

Also this month, DR. Raju, placed #24 on Modern Healthcare’s 2016 “50 Most Influential Physician Executives and Leaders.” This is his fourth consecutive year ranking among the top half of this annual list. Modern Healthcare’s list honors physicians working in the health care industry who are deemed by their peers and an expert panel to be the most influential in terms of demonstrating leadership and impact. These physician leaders are innovators, excel in community services, and demonstrate reputable executive authority. These awards and recognitions reflect the work of every employee of NYC Health + Hospitals, whose dedication to our patients—and efforts to empower them to live their healthiest lives possible, are what distinguishes the public hospital system and makes it essential to New York City.

Throughout April, New York City celebrates the contributions of the millions of immigrants who have shaped our great city. Way back on April 17, 1907, more immigrants arrived at Ellis Island than on any other date in history.

NYC Health + Hospitals has proudly joined the city’s observances with our first-ever system-wide celebration of Immigrant Heritage. We are hosting a series of special events to salute our staff’s diversity, share ethnic dishes from our homelands, and strengthen our understanding of religious beliefs among our colleagues and staff.

We have also launched a resource website diversity.nychhc.org available to all of our staff. Under the direction of our new Office of Diversity and Inclusion, the new site offers valuable information about the cultures, norms, and customs of the patients and communities we serve. It also features population demographics for each of our patient care locations, key documents in our top 13 languages, and the latest online courses to help our staff strengthen their cultural responsiveness.

Our health system is unique because we serve patients from more than 170 foreign countries – and much of our staff —hail from similar backgrounds. If a patient tells us they are from any corner of the globe, we can likely find someone in our system who comes from that same corner of the world. Even when we don’t share the same place of origin, the experienced and compassionate health care workers in our system have gained so much knowledge and expertise in caring for our city’s immigrant population that we can always find someone who can communicate with that patient, and who understands their culture.

I invite you to join in the celebrations by taking pride in our roots and making a commitment to learn more about the cultures and customs of others in our workforce and community. Together, we can work to provide culturally responsive care for our patients regardless of their background or culture.

Earlier this month, through The Fund for NYC Health + Hospitals’ longstanding partnership with the American Cancer Society (ACS), Tom’s of Maine and New England made a sizable donation of natural personal care products to NYC Health + Hospitals sites that treat women who are either survivors of breast cancer or who are getting screenings for breast cancer.

The arrangement was facilitated by Duane Chandler, Assistant Director of The Fund, who worked with ACS’ Kristina Thompson and Tom’s of Maine General Manager Nancy Pak. At the time of the donation, Pak said, “At Tom’s of Maine, we’ve always believed that our goals should include more than just making a profit. We are proud to be a positive and sustainable force for good in the communities where we operate.”

NYC Health + Hospitals/Bellevue, Coney Island, Queens, Kings County, and Lincoln were chosen because of their commitment to cancer care, demonstrated by their designation as certified Cancer Care programs. These facilities will be able to distribute the items to more than 3,100 patients.

March 31, 2016 was the end of DSRIP Year One and was a reporting deadline to the New York State Department of Health (NYS DOH) for our clinical projects which were underway across the entire OneCity Health network.

As we noted last month, we surpassed our quarterly target for Project 11. We recently shared a new Project Participation Opportunity to identify additional community partners to be a part of this project. Over the next 12 months, we have committed to administering 55,000 Patient Activation Measure surveys while also implementing new procedures to link uninsured New Yorkers and low- and non-utilizers of Medicaid to primary care and social services.

Additionally, we’ll begin trainings as needed with both NYC Health + Hospitals and community-based partner staff to engage clients and patients in a culturally responsive way so that they actively participate in managing their health conditions.

For the integration of palliative care into the Patient Centered Medical Home (PCMH), we surpassed our commitment to provide simple advance care planning and did so within NYC Health + Hospitals primary care sites. Moving forward, we’ll begin to implement additional interventions throughout our partner network to ensure patients’ symptoms and advanced illnesses are appropriately managed in the primary care setting.

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

OneCity Health has initiated pilots for multiple other DSRIP clinical projects:

ED Care Triage planning at four NYC Health + Hospitals facilities, which begins the effort to connect patients with primary care from the Emergency Department.

Care Transitions planning at two NYC Health + Hospitals facilities, for which our goal is to provide a supportive transition to the community for patients who were admitted to the hospital and reduce readmissions.

Health Home At-Risk planning at five NYC Health + Hospitals sites, in which the objective is to extend care management services equivalent to the New York State Health Home program.
We concluded our recent slate of Project Advisory Committee (PAC) meetings, which were held with our community partners in each of our four borough-based hubs. PAC Meetings are important opportunities for us to engage with our partners and provide updates on project implementation.

This month NYC Health + Hospitals reached a critical milestone with the first phase of our adoption of the best, top-of-the-line Electronic Medical Record available today, EPIC. The new EMR is absolutely integral to all of our transformation goals; excellence in patient experience, expanded access, and growth. It’s how we will provide better care to all of our patients, in every care setting, across our system. It’s how we will meet the future.

As you all know, on April 2, we went live at Queens, Elmhurst, and for Home Care. And I want to highlight something unprecedented about our achievement, in that we not only went live with our EMR, EPIC, we did it simultaneously with Cerner-Lab and Cerner-Soarian interfaces. This was, and will continue to be, a monumental undertaking. One that is built on the expertise, and dedication of thousands of our colleagues.

However, we know it’s not time yet to declare “mission accomplished”. Based on the experience of other large systems, we understand that we will continue to tweak the system, and we will resolve workflow issues as they arise. But the first phase went as planned – on time and on budget. And that is cause for all of us to be very proud.

With the new EMR, the possibilities for better serving our patients are enormous. But instead of me talking about all the benefits, take a few minutes now to read for yourself the feedback we have received from the new users in our system.

Please join me in thanking Go Live leads Queens CEO Dona Green and Elmhurst CEO Wayne Zimmerman, as well as Sal Guido, our Chief Information Officer, and Edward W. Marx, Chief Information Officer -EPIC, for the strength of their leadership and hard work.

Everyone involved in the EMR implementation deserves our deepest appreciation. So many people worked so hard, so intelligently, with so much commitment to our cause, that if I read all their names we would all be here until next month’s Board Meeting.

Nevertheless I’d like to highlight the contributions of four colleagues who were truly instrumental in getting us to where we are today, and whose work on EMR personifies that of hundreds of others across our system.

Others will no doubt be recognized as the implementation process continues. But today, these four are Go-Live Most Valuable Players (MVPs) and our Team of the Month.

Pamela Saechow

is Senior Assistant Vice President for Enterprise IT Services, and our EPIC implementation Project Manager. The success of this monumental task depends on all of us—but a lion’s share of the responsibility falls on her shoulders. With over a decade working in EPIC development, she is making a tremendous difference for us every day.

Ginu John

is our Interim Director for Epic Implementation Training. In a very short time frame the vitality and resourcefulness of Ginu’s leadership enabled us to develop a comprehensive program that met the training and support needs at each facility. Under very stressful conditions, he embodies the kind of accountability that we need to succeed.

Agnes Ho-Periola

joined us in 1990 as a staff nurse in psychiatry, and has served our patients with distinction ever since. As Elmhurst’s Nurse Champion during EMR GO implementation, Agnes helped create our EMR for Behavioral Health. As a SuperUser during GoLive, she contributed to the solution for many build and workflow issues. We are very lucky to have the benefit of her experience, and her compassion.

Jennifer Coard

is Breakthrough Deployment Officer at NYC Health + Hospitals/Queens. Her expertise was critical to our development of rapid problem solving capabilities needed to overcome integration challenges across our operations. The external support of Jennifer and the rest of the Breakthrough team were essential in maintaining the patient and staff trust that, at the end of the day, is what made this first phase of EMR implementation a success.