PeaceHealth St. John Medical Center Kirk Raboin, Chief - - PowerPoint PPT Presentation

PeaceHealth St. John Medical Center

Kirk Raboin, Chief Administrative Officer

• St. John Medical Center

July 22, 2014

PeaceHealth’s Core Values:

Social Justice Collaboration Stewardship Respecting Individual Human Dignity and Worth

PeaceHealth was invited to come and serve Cowlitz County in 1943

We serve patients from a VERY large geographic area.

There’s a Lot Going on Here!

PeaceHealth St. John brings an impressive array of health services to you and your family.

People Caring for People...

We’ve been growing the number of services we provide locally ever since.

Behavioral Health Birth Center Cancer Center Cardiovascular Chiropractic Critical Care Unit Dermatology Dialysis Family Medicine Hospitalist Program Imaging Center Internal Medicine Joint Replacement Center Kearney Breast Center PeaceHealth Laboratories Neurology Nutrition and Diabetes Occupational Health Orthopedics Outpatient Therapies Outpatient Pharmacy Pain Management Pediatrics Pulmonology Radiation Oncology Rheumatology Sleep Disorders Center Sports Medicine Surgical Services Trauma Program Women’s Health

We’ve been growing the number of services we provide locally ever since.

Behavioral Health Birth Center Cancer Center Cardiovascular Chiropractic Critical Care Unit Dermatology Dialysis Family Medicine Hospitalist Program Imaging Center Internal Medicine Joint Replacement Center Kearney Breast Center PeaceHealth Laboratories Neurology Nutrition and Diabetes Occupational Health Orthopedics Outpatient Therapies Outpatient Pharmacy Pain Management Pediatrics Pulmonology Radiation Oncology Rheumatology Sleep Disorders Center Sports Medicine Surgical Services Trauma Program Women’s Health

Mother / Baby Unit

(Network of Care) Patients enjoy the most advanced technology available including:

Mother / Baby Unit

(Network of Care) Patients enjoy the most advanced technology available including:

• Telemetry monitor units

usually found in much larger hospitals

Mother / Baby Unit

(Network of Care) Patients enjoy the most advanced technology available including:

• Telemetry monitor units

usually found in much larger hospitals

• Telemedicine access to a

OHSU neonatologist

Mother / Baby Unit

(Network of Care) Patients enjoy the most advanced technology available including:

• Telemetry monitor units

usually found in much larger hospitals

• Telemedicine access to a

OHSU neonatologist

• NICU partnership with

PeaceHealth Southwest Medical Center.

PeaceHealth Medical Group – Family Medicine providers care for you and your family

Photos here

Our Emergency Department provides Level III Trauma Care

Our ICU is one of the most advanced in the Pacific Northwest

Our hospital’s inpatient rooms have all been completely renovated

Photos here

Our Inpatient Behavioral Health Unit is a rare gem – few Washington hospitals

• ffer this imporant service

Photos here

Our Joint Replacement Center gets outstanding marks for outcomes and patient satisfaction

Photos here

Our outstanding surgeons operate with great skill in our advanced technology surgical suites

Photos here

Our Center for Sleep Disorders

• ffers the best diagnostics and treatment
• f more than 100 different sleep disorders

Photos here

Our Imaging Department Offers Excellent Technology

MRI Imaging CT Imaging

Our Cardiac Rehabilitation Center helps heart attack/stroke patients recover their quality of life

Photos here

Outpatient Therapies helps patients learn to function effectively after injury or illness

Photos here

Our beautiful new Kearney Breast Center features the best technology offered by a caring, compassionate team

Our beautiful new Kearney Breast Center features the best technology offered by a caring, compassionate team

Photos here

We invest in your future

Lakefront

We invest in your future

Lakefront Women’s Health Pavilion

We invest in your future

Lakefront Women’s Health Pavilion Cancer Center

Many of the services and specialties provided are exceptionally advanced for a community hospital.

IGRT is the best technology available. PeaceHeath St. John installed in 2011 at a cost of $2.2 million.

Radiation Oncology program also includes Intensity Modulated Radiation Therapy, Dynamin Multi-Leaf Collimator, 3-D Conformal External Beam Therapy, Brachytherapy, Digital Portal Imaging, Cone Beam CT

We’ve added a 2nd cardiac catheterization lab, allowing us to perform interventional cardiology

Photos here

We are working to Keep You Safe

The numbers clearly show that PeaceHealth St. John patients have excellent overall outcomes when compared to patients at similar sized medical centers.

Facility/County Comparisons

Whatcom

(PH Bellingham Hospital)

Lane

(PH Oregon Hospital)

Clark

(PH Vancouver Hospital)

Cowlitz

(PH Longview Hospital) Health Outcomes

Robert Wood Johnson Foundation

5

• f 39

17

• f 36

10

• f 39

34

• f 39

Health Factors

Robert Wood Johnson Foundation

8

• f 39

7

• f 36

15

• f 39

32

• f 39

Acute IP Days Avg/Month

(FY14 YTD thru Feb)

4,954 10,348 7,920 2,638 ED Visits Avg/Month

(FY14 YTD thru Feb)

4,729 6,813 6,111 4,264 (51,000 this year) Level of Care Level II trauma, stroke, cardiovascular , IP BH Level II trauma, stroke, trauma, cancer, cardiovascular, IP & OP BH Level II trauma, stroke, trauma, cancer, cardiovascular, IP BH Level III trauma, stroke, cancer, cardiovascular, IP & OP BH Payer Mix Commercial Medicare Medicaid Self Pay 29.6% 51.1% 14.8% 4.5% 28.7% 47.7% 17.2% 6.4% 32.2% 43.8% 17.8% 6.2% 23.4% 48.7% 20.8% 5.7%

Community Challenges related to Healthy Population Rates

Health Indicator Cowlitz County Whatcom County State Average Coronary Heart Disease 8th highest in the state Lower than state average 1:100,000 Asthma >13% <7% 9.6% Diabetes 7% 5% 6% Access to Primary Health Care Services 76% 80% 78% Unemployment Rates 12.1% 8.3% 8.2% College Education 13.3% 27.2 27.7%

SJMC ICU

APACHE Outcomes Comparison Report

Clinical Performance-Resource Utilization Index

BEST WORST

APACHE Outcomes Comparison Report

Clinical Performance-Resource Utilization Index

BEST WORST

Geriatric Fracture Program

Orthopedic/Renal Unit PeaceHealth St. John Medical Center

PeaceHealth’s Orthopedic/Renal Unit has instituted a successful geriatric fracture program (GFP) for patients 65+ with a fractured hips.

Geriatric Fracture Program

Orthopedic/Renal Unit PeaceHealth St. John Medical Center

PeaceHealth’s Orthopedic/Renal Unit has instituted a successful geriatric fracture program (GFP) for patients 65+ with a fractured hips. The Joint Replacement Center is proud of its low rate of surgical complications: National Average – 0.9% PeaceHealth St. John – 0.0%

• St. John – SSI SIR
• St. John – Central Line SIR
• St. John – Urinary Cath
• St. John – CDiff

CAUTI taskforce

• Medical Staff Education & MEC presentations
• Appropriate Cath Initiative (DOH could not observe one case in three day survey…)
• St. John Reduction in Infection Rates

SIR rate = 1.2 lowest in PH

Accolades From WHSA: Congratulations! You have achieved a 40% reduction from baseline and are in the Top Quartile:

• ICU-CAUTI
• ICU-CLABSI
• EED – (39 Week Early Delivery Initiative)
• Pressure Ulcers – (Inpatient Care in Bed)
• Surgical Site Infection Rate (SSI) -specifically: Hip replacement, Knee replacement, and abdominal

hysterectomy

• VAP (Ventilator acquired Pneumonia)
• VTE (Blood clots after surgery in extremities)

This is truly an achievement to be celebrated!

PeaceHealth St. John A Jewel for Our Community.

PeaceHealth St. John is a jewel for our community. However…. There are strong headwinds challenging us.

ACA Hospital Payment Cuts

2013-2023

Projected Cumulative Increase in Newly Insured Population2

I. The ACA is Changing Everything

Affordable Care Act (ACA)

signed March 23rd, 2010

Affordable Care Act (ACA)

signed March 23rd, 2010

Has expanded availability of Medicare/Medicaid health insurance to millions of Americans. In most cases, Medicare/Medicaid does not fully reimburse providers for the cost of care. Cowlitz County has a higher-than-average Medicare/Medicaid population (PeaceHealth Longview 4.5 : 1 Ratio of Medicaid to Commercial) Each 1% increase in Medicaid is approximately $500K loss to PH St. John Medical Center unless offset with Commercial Business

Longview Change in Patient Mix

Patients Are Holding Off on Care

95%

Percentage of primary care physicians reporting that patients rationing or forgoing medications, treatments due to financial concerns “We have a very weak economy and it’s just a different environment for the elective parts of

• healthcare. This could go beyond the
• recession. Being a less aggressive consumer
• f healthcare is here to stay.”

Paul Ginsburg, Economist, Center for Studying Health System Change

Households Postponing or Cancelling Medical Care

2006 2009

…Or an Enduring Trend? Is it Cyclical… “In 2009, despite the economic downturn, the number of prescription drugs dispensed rebounded to prerecession rates

• f growth.”

Health Affairs 2011

Other Regulatory Headwinds that May be Impacts on Revenue Two-Midnight rule Pay for Performance Value Based Purchasing ICD-10 (Coding)

PeaceHealth St. John is a jewel for our community. We need your Support to continue to shine for you and your families.

All of the services, equipment, and people you have seen here have been developed and deliver this care --- Locally To provide for you, your family, your employee’s families, and our community members in their time of need. If patients stop using these services, it becomes increasingly difficult to sustain them locally.

Very simply, we must use it or we may lose it.

How Can We Support Each Other?

When considering a health plan, ask if the plan allows access to All Available LOCAL Healthcare Services. PeaceHealth Commitment:

• 1. Local Care (Recruitment, Core and Specialty services)
• 2. Highest Quality care
• 3. Lowest Cost Care
• 4. Patient Satisfaction
• 5. Network of Care- Concierge Program

How Can We Support Each Other?

The Community Has been a Huge Contributor to St. John

An Example is the support of our PeaceHealth St. John Foundation which has advanced both Technology and Programs.

THANK YOU!!!

PeaceHealth St. John Medical Center Foundation Ten Year Impact: 2004 -2014

$12.2 Million Raised $12.2 Million Distributed BRICKS & MORTAR Women’s Health Pavilion

• Lower Columbia

Regional Cancer Center

• Kearney Breast Center
• Kidney Dialysis Center

Renovation

• Hospital Renovation
• Emergency Department
• Birth Center
• ICU
• Medical/Surgical floors
• Cardiac Catheterization

Lab EQUIPMENT

• Ultrasound units
• Hospital-grade

furniture

• ECG machines
• Wheelchair scales
• Automatic blood

pressure machines

• Bariatric chairs
• Neoblue blankets
• Sleep monitors
• Stretchers
• Much more!

PROGRAMS

• Dialysis
• A Child’s Place
• Dove Pantry
• Birth Center
• Critical Care
• Patient Floors
• Emergency

Department

• Mammography
• Cardiac Care
• Cancer Center
• Behavioral Health
• Much more!

Longview

What we are working on today

Recapturing Healthcare In Longview :

• Improving physician Referrals and Care – Keep Care that can be Provided

Here Local…

• Ensuring we are staying Patient Centric to our Network of Care getting the

patient to the Right care at the Right time to the Right place.

• Recruitment of Primary Care – 7 New Providers starting mid to late Summer
• Enhancing Patient Satisfaction – Owning Patient Satisfaction at all Levels and

all Times.

• Retaining and Maintaining TRUST by our patients receiving care LOCALLY
• Talk about the Great Care Delivered Here LOCALLY – More Vocal about

“Telling our Story”

• Development of more alignment and partnerships with Local providers of

care.

Current Collaborative Partnerships and Future Opportunities

PeaceHealth Foundation / Governing Board

Community Child Wellness Initiative

We have been proud to serve you for the past 71 years.

We would be Proud to serve you for 71 more.

61

Questions?

62

Addendum slides

CHNA Update

Jeane Conrad, Director Patient Support & Community Services Chere Weiss, Project Coordinator Community Ministries

Leadership Meeting June 11, 2014