REPORT TO THE BOARD OF DIRECTORS – March 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.

NYC Health + Hospitals/Kings County- Behavioral Health has successfully reduced their Third Next Available Appointment (TNAA) from 29 days to 5 days in the month of February.

A series of Lean Interventions to target access metrics was launched In January of 2016; including a Soarian training with Revenue Management, scrubbing all provider Soarian templates, creating a centralized intake calendar, and launching a double booking pilot for intake appointments.

These interventions and ongoing maintenance have resulted in an 86% reduction in wait time for a new appointment in the Kings County- Adult Outpatient Department.

NYC Health + Hospitals/ Sea View has been awarded the American Medical Directors Association (AMDA) Quality Improvement and Health Outcome Award.

Sea View’s winning submission is entitled: “Reduction of Antipsychotic Medication in Long Term Care Dementia Population Utilizing Novel Non Pharmacological Approaches”.

Recipients receive this prestigious award for improving the quality of life for persons living in nursing homes.

On Monday, March 21 NYC Health + Hospitals’ President and CEO Dr. Ram Raju testified at a preliminary FY 2017 budget hearing held by the New York City Council’s Committee on Health.

Testimony focused on Vision 2020 transformation, the financial challenges our system faces, and ways we are working with the City and State to bridge our budget deficit as we work to secure financial viability.

The Joint Commission survey process began with TJC Corporate Orientation, which was held February 22, 2016. The Orientation is an opportunity for facility staff to meet the TJC survey team leader and for us to orient TJC staff to NYC Health + Hospitals, as well as emphasize those systemic functions and practices that enable us to comply with the intent of the Joint Commission standards.

This year, six (6) facilities – McKinney, Elmhurst, Gouverneur, Jacobi, Harlem and Metropolitan, will be surveyed. All surveys are unannounced and could occur anytime between March and December 2016.

Gouverneur’s Skilled Nursing Facility was visited by Joint Commission on Monday, March 14th-Wednesday, March 16th. Joint Commission Surveyor, Betsy Bradford, spent three days conducting a comprehensive survey utilizing tracer methodologies, speaking with staff and reviewing records. Gouverneur’s survey concluded with complements from the surveyor and some requirements for improvement. Gouverneur will use these recommendations to improve the services provided to its patients and residents. Several of the recommendations have already been implemented and the others are expected to be in-place soon. Areas singled out for their high-quality include the caring staff and their relationship with residents, cleanliness of facility, organization of the HR and Credentialing functions, fire alarm system and Emergency Management Plans and staff safety program, and flu vaccination program.

United for Safety is the national theme for Patient Safety Awareness Month 2016.

Events during the month across our system emphasize that safety is everyone’s responsibility. Hand-offs, escalations and teamwork are essential to maintaining the great safety culture we have built, and to helping us meet and exceed our patient’s expectations in the future. Congratulations to the 23 Patient Safety Champions selected from around our system earlier this month. They carry the torch of our safety agenda, and help us remain vigilant in our fundamental commitment to providing safe care.

March is also National Social Work Month, a time to salute the great work that our social workers do to improve the quality of our patients’ lives, and of the health care they receive. Our social workers push the mark, by reaching beyond the medical silo to address circumstances and environments that impact our patients’ health and well-being. The counseling, guidance and referrals they offer patients every day form the basis of our holistic approach to care… care that doesn’t end just because a patient is discharged. Linking our direct medical treatment to non-medical social services helps ensure that patients stay connected—and continue receiving responsive attention to their health needs long after a hospital stay or neighborhood health center visit is over. Please remember to let a social worker colleague know how much this system values the work that they do each and every day.

NYC Health + Hospitals/ Coney Island provided free dental screenings during February’s Children’s Dental Health Month to over 280 NYC Public School students as part of a collaboration initiative with UFT and District 21 schools to improve community health.

NYC Health + Hospitals/ Elmhurst has been awarded a March of Dimes/ New York State Chapter Community Grant Award supported with $22,500 from the Anthem Foundation. This award continues support of the Queens Healthy Babies are Worth the Wait Community Program which aims to decrease preterm births by providing resources to increase knowledge about factors that cause preterm birth, change the attitudes and behaviors of providers and health care consumers in order to impact community-specific risk factors, and implement strategies to prevent preterm births.

NYC Health + Hospitals/ Harlem’s HIV Services department received the Ryan White Ending the Epidemic Grant in the amount of $357,892.00 from the New York City (NYC) Department of Health and Mental Hygiene (DOHMH), as Grantee of the New York Eligible Metropolitan Area (NY EMA).

The New York City Police Department and Its 83rd Police Precinct expressed gratitude for the excellent care provided to 2 police officers by NYC Health + Hospitals/Kings County Level 1 Trauma Center. The two officers were brought to the hospital with gunshot wounds suffered on February 20th. One officer was released the same day, while his fellow officer was discharged on February 23rd. A press conference was held with Mayor de Blasio and President Raju on the morning of the shooting to keep the public apprised of the officers’ condition. An honor contingent of NYPD officers paid tribute to him at the time of their release. Executive Director Baptiste, Medical Director Dr. Jamaleddine and the medical team extended their recovery wishes to both officers.

On February 4, 2016, two injured NYPD officers were brought to NYC Health + Hospitals/Lincoln after being shot and wounded at Melrose Houses. Interim Chair of Surgery, Valerie Katz, MD, and her team were personally thanked by both Mayor Bill de Blasio and NYPD Deputy Commissioner Benjamin Turner at a press conference held at 10:30 pm that same evening. Officers held around the clock vigils for Officer Diaria Cruz and on February 10, 2016, she was released home. Officer Cruz left Lincoln with applause from various ranked NYPD officers, family members and Lincoln leadership.

NYC Health + Hospitals/Queens’ focus on providing excellence in patient experience has extended to the hospital’s Food and Nutrition Department. Queens has implemented a hot breakfast service which includes buttermilk pancakes, French toast and even cholesterol-free omelets. To compliment the hot breakfast, patients receive seasonal fresh fruit daily and on most days, a fresh low-fat yogurt is on their tray. Representatives from Food and Nutrition do rounding with the patients every day. Feedback has been very favorable.

NYC Health + Hospitals/Queens celebrated its First Annual Step-Up Queens Winter Program on Thursday, January 21. This program was developed by the Joint Labor-Management’s Wellness Committee to encourage employees to participate in initiatives to improve their own overall health. Thirty-eight eager participants across different departments and various shifts accepted the challenge of the Step-Up Queens Winter Program, which ran from November 30 through December 31. Many of the participants were members of the Emergency Department staff who, wearing pedometers provided by MetroPlus, kept track of their steps and were astounded to learn that along with participants from other departments, their steps totaled more than four million in only one month!

NYC Health + Hospitals/ Woodhull has been awarded a $64,000 grant from the Greater New York City Susan G. Komen Affiliate to support breast cancer screening and diagnostic services for the women of North Brooklyn. The grant funds a Patient Navigator who ensures that women referred to breast cancer screening and diagnostics are seen in a timely manner, and that all women who have abnormal findings are seen by the oncologist with biopsies completed in less than 30 days. The grant also funds a Continuing Medical Education Program enabling providers who attend the Tumor Board to receive 1.0 hours of CME.

NYC Health + Hospitals’ Breakthrough initiative is pursuing a three service line focus:

Emergency Services: Urgent ED patients are receiving more timely services at Queens, Kings County, Jacobi and Metropolitan. Examples of improvements are: Jacobi: baseline (time patient entry to discharge in ED: LOS) of 345 minutes to 158 minutes; Queens: Walkout rate reduced from average of 5.7%/month to 3.4%/month (40% reduction).

Ambulatory Care: Teams have been established in Kings County and Morrisania Neighborhood Family Health Center. Work has started to reduce the clinic patient cycle time and focus on daily improvements.

Behavioral Health: Work at Kings County and Jacobi, focuses on improving patient access to BH’s outpatient services by increasing the timely availability of appointments (TNAA). Initial result at Kings County: TNAA was reduced from a baseline of 28 days to an average of 6 days for the 5 weeks since improvements were implemented.

March 31st marks the end of the first year of New York State’s Delivery System Reform Incentive Program (DSRIP), as well as a reporting deadline to the New York State Department of Health (NYS DOH) for clinical projects which are currently underway across the entire OneCity Health network.

We are pleased to announce that we have surpassed our quarterly target for Project 11. To date, we have successfully administered over 12,000 Patient Activation Measure® (PAM) surveys, passing the target of 11,000.

In addition, we remain on track to meet our commitments regarding the integration of palliative care into the Patient Centered Medical Home (PCMH).

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

As required by the NYS DOH, OneCity Health completed surveying all partner organizations regarding two subjects in March: The consultant BDO, in collaboration with four (4) NYC Performing Provider Systems, completed a workforce survey. This was an initial step in developing an engagement and training strategy to prepare our workforce for a more community-facing delivery system. We continue to engage our labor partners in this effort. OneCity Health also assessed the financial strength of its network in order to deliver a sustainability strategy to the NYS DOH at the end of March.

New York State awarded NYC Health + Hospitals up to $300.5 million for five capital projects through the state’s Capital Restructuring Financing Program (CRFP), a funding initiative that is aligned with the DSRIP program. The allocation to NYC Health + Hospitals represents the largest total award by the state under the $1.4 billion CRFP program. OneCity Health is awaiting further instruction on how to qualify and meet CRFP requirements for potential funding.

The OneCity Health Executive Committee convened in March and approved the following: Ten new candidates for various governance committees. Four new care models, covering the Health Home At-Risk, Care Transitions, ED Care Triage for At-Risk Populations, and Integration of Primary Care and Behavioral Health Services projects. The addition of Schedule C – which further defines the roles of the OneCity Health Central Services Organization – to the Master Services Agreement, which establishes the general roles and responsibilities of partners, NYC Health + Hospitals and the CSO.

I can’t think of a better example of our transformation to providing true health care than our work to further health equity for LGBTQ patients. As healers, we know that the doctor-patient relationship is the essence of medicine. Patients must feel safe with us, and comfortable confiding in us, in order for us to offer the most effective care.

Which is why I am so proud of our LGBTQ Health Equity Campaign. Initiatives like our—

• “To Treat Me You Have To Know Who I am” video
• our extensive and mandatory staff training on LGBTQ issues
• and our broad community outreach
• signal our determination to create a welcoming environment for our LGBTQ patients. Today we are particularly happy to report that 21 of our acute care hospitals and community health centers have received “Leader in LGBT HealthCare Equality” designation from the Human Rights Campaign Foundation (HRCF), the nation’s largest LGBTQ civil rights organization. To celebrate this great news, we are launching a system-wide marketing effort called “We are an ally”. The campaign will make more LGBTQ New Yorkers aware that at NYC Health + Hospitals, they can depend on receiving health care that addresses their specific needs. And that we strive always to create an environment that combines competence with compassion, and approaches issues of non-discrimination with a cordial heart.

I couldn’t be more proud of our progress in this area, and of the smart and talented team that is leading our efforts. Please join me in applauding the LGBTQ Health Equity Campaign as our program of the month, and in thanking members of the team who join us today:

• Mark Winiarski
• Sarah Bender
• Evelyn Borges
• Anthony DiVittis
• Vivian Nolan
• Glenn Zuraw

TEAM OF THE MONTH HARLEM FIRE FIRST RESPONDERS

As you know, each month we choose employees or volunteers who exemplify NYC Health + Hospitals’ spirit of commitment, compassion and love for our patients.

We have so many great caregivers, and supporters of caregivers, that sometimes it’s difficult to choose a person of the month. But today the choice is easy. We are delighted to honor a group of five employees who acted heroically when a dangerous fire broke out recently at NYC Health + Hospitals/ Harlem.

At 11 am on March 4th flames engulfed a patient bathroom on a 10th floor Behavioral Health unit. Nurse Kwame Ankoma grabbed a fire extinguisher and did his best to douse the flames. And as smoke billowed out into the hallways, his colleagues on the unit acted quickly and calmly to move acute behavioral health patients out of harm’s way.

The professionalism these five employees demonstrated was mirrored throughout the rest of the day by many others at Harlem, Lincoln and Central Office.

While the fire left much of the 10th floor reeking of smoke and soaked with water from sprinklers, our colleagues evacuated 50 patients, some of them in wheelchairs, first horizontally, and then vertically down ten stories.

They organized the transport and relocation of 21 patients in need of accommodations.

Lincoln’s staff stepped up to make new rooms ready for displaced patients.

By 6 p.m., emergency credentials and facility privileges were issued to Harlem psychiatrists and nursing staff, patient medical records were transferred, and a temporary unit at Lincoln was furnished and equipped for patient care to continue uninterrupted.

By 1 p.m. the next day, repair efforts had cleaned up the unit at Harlem, allowing displaced patients to return.

We all know how fast and deadly a hospital fire can be, as evidenced in the past by a terrible fire in Brooklyn that claimed several lives. So it makes me extremely grateful for the example set by our Team of the Month honorees.

Because it was Mrs. Bolus’s idea to present the honorees with a token of our appreciation, if she wouldn’t mind reading their names:

• Kwame Ankoma, RN
• William Coit, Behavioral Health Associate
• Vladimir Laguerre RN
• Delroy Campbell, Unit Clerk
• Daniele Luker, Patient Care Associate

Join me in offering them our deepest thanks. And let’s also give a round of applause for our leadership at Harlem and Lincoln hospitals and for the Central Office support provided by our Operations, Facilities and Emergency Management specialists. Each of you have our deepest appreciation and gratitude.