FORKS COMMUNITY HOSPITAL
BOARD OF COMMISSIONERS
October 22nd, 2013
Present: Commissioners Daisy Anderson, Gerry Lane, Don Lawley, Bill McMillan (CEO), Jim Chaney (CFO/COO), Dr. Harmon (Chief of Staff), Heidi Anderson (CNO)
The meeting was called to order at 5:00pm by Daisy Anderson.
Community Communications: John Weston, Char Weston & Sherri Merriman expressed their concerns with a patient care issue. Bill & Heidi will address.
Community Advisory Board: None
Medical Staff: Medical Staff Committee minutes from October 9th, 2013 were reviewed.
ACTION: It was moved, seconded and passed to approve the Medical Staff meeting minutes.
Medical Staff Privileges: Reviewed request for privileges as presented for Phillip Muir, CDP, Rex Averill, MD & Theodore Matheny, MD.
ACTION: It was moved, seconded and passed to approve appointment privileges for Phillip Muir, CDP.
ACTION: It was moved, seconded and passed to approve appointment privileges for Rex Averill, MD.
ACTION: It was moved, seconded and passed to approve re- appointment privileges for Theodore Matheny, MD.
Performance/Quality Improvement: Verbal Meeting Minutes from October 21st, 2013 were reviewed.
Minutes: Board of Commissioner’s Meeting Minutes September 24th, 2013 were reviewed.
ACTION: It was moved, seconded and passed to approve the Board of Commissioners Meeting Minutes for September 24th, 2013.
· Managers Forum Meeting Minutes from October 1st, 2013 were reviewed.
· Mid-Level Meeting Minutes from October 1st, 2013 were reviewed.
· Safety Committee Meeting Minutes September 17th, 2013 were reviewed.
ACTION: It was moved, seconded and passed to approve the September 2013 General A/P vouchers numbered 077821 through 078218 in the amount of $973,978.05 and the General P/R vouchers numbered 540317 through 540439 in the amount of $95,653.21
ACTION: It was moved, seconded and passed to approve the Write Offs for October 2013 in the amount of $134,118.64.
Bill McMillan submitted report topics to include:
DNV Survey: As mentioned in the weekly update we had our initial, unannounced survey from DNV this past week. As part of our current strategic plan we have set as a strategy a quest for continual improvement in our quality; organizational performance, clinical outcomes and patient satisfaction across all programs and divisions. The continual improvement process will be measured and documented through the Performance Improvement Committee (PIC) and verified through an external third-party evaluation. We selected Det Norske Veritas, (DNV) as our third party evaluator because of their adherence to the ISO 9001 / National Integrated Accreditation for Healthcare Organizations (NIAHO) quality management system. Our survey team found 19 “non-conformities” or findings which will be confirmed in a report we will receive in 2 weeks. Upon acceptance of our corrective action plan by DNV we will achieve initial accreditation this year, and build towards ISO 9001 standards compliance in 2016. Because of the subtle and not so subtle outcomes of accreditation, or more specifically the way we will manage our operations so as to maintain compliance, we will hardwire the continuous quality improvement efforts, not only in our clinical areas, but more importantly in the business operations of the organization.
CDBG Update: We have received 4 proposals from architectural firms and will select an architect no later than October 25. The project is on schedule, and we anticipate opening the new entrance no later than October of 2014.
Forks Hospital Foundation (FHF): Our foundation, a separate 501 (c) (3) has just over $70,000 in unrestricted funds in its account, with no restricted funds. Like other hospital foundations FHF was formed to benefit hospital operations by providing a mechanism for donors to make tax favored gifts to FCH. FHF has been dormant for the past several years. There is no organized effort to promote giving. Our Hospital Advisory Committee member Ellen Matheny has volunteered to chair a newly-revitalized FHF and will be recruiting members and with our assistance will draft and implement a planned giving campaign. We hope to begin making giving presentations to estate attorneys and financial advisors in the first quarter of 2014. FHF is also the vehicle for receiving private foundation grants from foundations that require a benefiting organization to be a non-profit; accordingly both the KR Murdock Charitable Trust and First Federal have or will be giving to FCHF to support our digital mammography acquisition. Ms. Matheny has also agreed to help write an additional $140,000 in grants to complete the funding of this technology.
MedMan / Clinics Update: The MedMan consulting report outline was sent out via email. I will review their findings in a presentation with this written summarization; Both MedMan and FCH are influenced by Studer Group processes. Accordingly we have organized our work plan around the 5 Pillar approaches of People, Service, Quality, Finance and Growth.
People: Recommendations included establishing a Clinical Coordinator position for the Clinical (back of house) operations, thus relieving Rae Wilson of multiple clinical management issues to concentrate on finance, training, and customer service. Not necessary to be a new position as one of the other recommendations was to reduce the number of RN’s working in the clinic to 1 FTE and we can re-purpose one of the former RN positions to be the clinical coordinator. We have deferred action on these two moves till Q1 2014. The other recommendation was to form the providers into a “Provider Advisory Council” with a specific charter intended to give the providers a greater influence on clinic operations.
Service: The Service recommendation was to implement a standard, structured patient satisfaction survey to measure satisfaction. We will contract with NRC-Picker for a clinic based “Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS, pronounced H-Caps). This will give us quantitative data to assess and improve the patient experience, and data to share with our community.
Quality: Recommendations here included removal of all the paper signs in the clinic and make the areas look professional. Move the hosting of Centricity to internal services and eliminate the third party hosting arrangement that has been so challenging for the past two years, and in doing so integrate lab and x-ray data into the EMR. We intend to re-train all staff on the newest version of Centricity. Med Man has also recommended two dedicated biller-coders for the clinic, a recommendation we elected to defer.
Finance: Recommendations included implementing a low census staffing plan to flex worked hours in relation to the volume of appointments, identify and more effectively report on key performance indicators and benchmark against other successful MedMan clinics, and document and implement clinic specific revenue cycle improvement efforts; registration demographics, coding accuracy, ICD – 10 implementation.
Growth: The MedMan findings regarding growth were that given the number of people in the community that have had negative associations with past clinic operations we should consider some re-branding of the clinic in 2014. We generally agree with this finding, but view it as needing to be done in conjunction with other organizational marketing efforts (see following report segment)
Community Health – Marketing & Logo: As mentioned at our last Board of Commissioners meeting in September we have an opportunity to re-focus our Community Health department to support our much needed marketing efforts. Accordingly we have redone the job description and will recruit to the position’s specifications. Following along with that effort I want to share a small learning that came about at our recent Swedish Health Network meeting. At one point during this meeting the presenters had the logos of the five participating entities; Swedish Hospital, Providence Health & Services , Olympic Medical Center, Jefferson Healthcare and Fork Community Hospital. These logos are presented in a separate attachment. Forks has two different logos; Forks Community Hospital and Clallam County Public Hospital District No.1. Neither compare to the other logos for brand recognition. Once we have achieved DNV accreditation we are permitted to use the DNV symbol in our literature as recognition of the accreditation, and so accordingly it’s time to re-design our logo to be more contemporary, and supportive of brand-enhancement. We will work with a local graphics designer to establish some logo alternatives, and to establish graphics standards so that our “look and feel” across literature, hospital displays, website and other branded media is consistent.
Physician Recruitment: We now have a number of potential candidates in the pipeline. This report will not indicate names to preserve the recruitment process. While we are struggling to recruit a Family Practice with OB physician (FP/OB) we have identified several potential OB/GYN candidates. Our provider demand tool indicates a need for an 80% FTE OB/GYN for this area through 2018. We have 1 day / month OB/GY N service which is inadequate to meet any need and as there are so few GYN services / procedures done in our facility we have suggested exploring an OB/GYN position. While the compensation for an OB/GYN is about $100,000/year more than an FP/OB, the mean production in terms of gross charges is around $245,000 higher. We would be in a position to provide quality GYN services to our market. Our providers do have a concern that a full time OB/GYN, especially a female, would absorb all of the OB care, leaving our one FP/OB with very little OB. There is one FP/OB candidate that we are highly interested in as the physician is bi-lingual English / Spanish. We anticipate adding one provider before the end of the year.
Affordable Care Act / In-Person Assisters: We have four staff that have received the training to assist folks with the process of applying for either the expanded Medicaid program, or to purchase insurance through the state Exchange. It’s our goal to offer this service to every uninsured or under insured patient that we encounter. The Washington website www.wahealthplanfinder.org has not encountered the myriad glitches of the federally supported website, however the rate of local enrollment is slow; we have done less than 10 for October to-date.
Finance: Jim Chaney presented the September 2013 finance report, which was reviewed and
· The current hospital beds were purchased in 1992. The hospital will purchase three beds, bedside cabinets and recliners a year until all beds have been replaced.
ACTION: It was moved, seconded and passed to approve the purchase of three hospital beds, bedside cabinets and recliners a year, not to exceed $30,000.00
Additional Agenda Items:
Board Calendar: Special Board of Commissioners meeting is scheduled for October 28th, 2013 at 5:00pm.
Executive Session: Physician Charting -Time In: 6:20pm Time Out: 6:30pm
With no further business, the meeting was adjourned at 6:30 pm.
The next Board of Commissioners meeting is scheduled for November 26th, 2013 at 5:00pm.
Minutes recorded by Laci Johnson, Executive Specialist.
Gerry Lane, Secretary