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Home My WebLink About20173751.tiffNCMC Board of Trustees Regular Session Minutes Monday, September 25, 2017 12:00 Noon The Board of Trystees.of North Colorado Medical Center met in Regular Session on Monday, September 25, 2DW, in the Richard Stenner Boardroom located at North Colorado Medical Center. Dr. Susan Carter declared a quorum and called the meeting to order at 12:01 p.m. ATTENDANCE REPORT NCMC Board of Trustees: Dr. Susan Carter, Catherine Davis, Mark Lawley, Kevin Mullin, Michael Simone, Jason Yeater, and Sean Conway (Commissioner, non -voting member), with Brian Underwood being excused Banner Health: Margo Karsten (NCMC CEO) -Excused, and Wendy Sparks (NCMC COO) Staff: Ken Schultz (Board Executive) Recording Clerk: Esther Gesick (Weld County Clerk to the Board) PUBLIC COMMENT There was no public comment. Kevin Mullin introduced himself as a seven-year Greeley resident. He is a professional Fundraiser for the Estes Park Medical Center Foundation. APPROVAL OF MINUTES It was MSC (Simone/Yeater) to approve the minutes from the August 28, 2017, Regular Session meeting. CEO REPORT or COO REPORT NCMC COO, Wendy Sparks, gave the following report: Employees —The results of the Voice Survey (employee engagement) have been compiled with 86% participation. Ms. Sparks explained the Engagement dimension reflected 33% of the employees are fully engaged, which placed NCMC in the 66th percentile of similar hospital facilities. They are developing action plans and working with appropriate leadership to improve in this area. In response to Dr. Carter, she committed to providing additional results for the highest overall rating categories at the next meeting. Master Campus Plan — Approval has been granted for two large Capital Expenditures, including $6.3 million to build a new operating room (OR 15) which is expected to be open by April of 2018, as well as $2.3 million for a second surgical XI Robot which will allow for additional procedures. Later in the report there was further discussion in response to Mr. Yeater, at which time Ms. Sparks explained these are large capital projects which have been in the planning process for several years and are not necessarily in response to the new UC Health hospital, rather, the robot is somewhat of a replacement for another unit which is nearing end of life. Dr. Carter further explained the benefits of the new unit which will result in improved efficiencies. Page 1 of 3 September 25, 2017 NCMC Board of Trustees Came 11-/-.1-017 2017-3751 • Press Release - Ms. Sparks distributed a handout, a copy of which is attached to these minutes, regarding a new Provider Network Agreement with Centura Health in an effort to enhance health services and coverage along the Northern Front Range through an increased number of primary care providers and specialists. She stated this was just announced, so she will review further and follow-up next month. • Financials — For the month of August, NCMC was under budget by $1.1 million, and under budget by $2.7 million year to date. She stated the volumes were strong and expenses well controlled; however, the deductions (self -pay, no pay and Medicaid) were higher than budgeted. In response to Commissioner Conway, she stated deductions year-to-date are 67%, compared to a budget of 66.4%, and each percentage point equates to approximately $3 million. She further explained to Mr. Mullin that the estimates are based on the previous 12 months and other anticipated impacts. COMMISSIONER'S REPORT Commissioner Conway reported a Grand Opening Ceremony for the County Road 49 project between U.S. Highway 34 and 1-76 has been scheduled for Saturday, November 18, 2017, at 11:00 a.m., with a location still to be determined. A formal announcement will be forwarded to the Trustees when available. He stated the Highway 34 Coalition will be meeting next week to review the PEL study. He also noted the Commissioners concluded their Early Warning Budget Sessions, highlighting that Weld County is the fastest growing county in the nation, as shown in the BIZ West publication. In response to the growth, the budget reflects additional positions in various departments, as well as an expansion of the jail. In response to Mr. Schultz, he reported the Bright Futures program has been moved under the direction of Upstate Economic Development, with a new 7 -member independent board (2 Commissioners and 7 community members with terms to administer the program). He stated contributions still result in significant property tax deductions and credits, and there will be a strong focus on fundraising to ensure the sustainability of the program. He also reviewed the percentages of students reenrolling and which schools are involved, and stated the Commissioners have budgeted $3 million with hopes of increased donations. VISITATION REPORTS DEPARTMENT OF ONCOLOGY CLINICAL RESEARCH Dr. Susan Carter reviewed her report, dated September, 2017. A written copy of the visitation report is attached as a part of these minutes. PATIENT EXPERIENCE Mark Lawley reviewed his report and related handouts, dated September, 2017. A written copy of the visitation report is attached as a part of these minutes. In response to Commissioner Conway, Ms. Sparks explained there are two separate surveys: one is completed for Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) by the U.S. Centers for Medicare and Medicaid Services (CMS), and the other is done by NCMC Banner which interviews a minimum of 300 patients through the InMoment Survey. She noted those results are not reported to CMS; however, they are submitted to HCAHPS. Page 2 of 3 September 25, 2017 NCMC Board of Trustees DISCUSSION: Dr. Carter referenced the Bylaw requirement for Trustee visitations and the occasional need for reports to carry over or be missed due to scheduling conflicts. Mr. Lawley stated the visitation form is helpful, but it is likely that different Trustees may ask different questions based on their background or perspective. He proposed inviting the various departmental leadership personnel to attend the Trustee meetings and make a brief 10-15 minute presentation so the entire group hears the same information and can ask questions. Dr. Carter stated a summary report would still need to be written for submittal to the NCMC Inc. Board to be included in their meeting minutes, and Ms. Sparks and Ms. Karsten generally make note of pertinent feedback if action is needed. It was decided to add this to the next Agenda to allow further discussion concerning potential standardized questions and a PowerPoint presentation template. BANNER OCCUPATIONAL HEALTH SERVICES Catherine Davis' report will be held over until October. VISITATIONS FOR OCTOBER Dr. Susan Carter Michael Simone NCMC, INC. REPORT Mr. Schultz reported the previous rating warnings have been resolved by correcting the Provider Fee. He stated the portfolio has done ver-y well with a robust year, and collectively the investments look to close out the year very well, pending any unexpected changes in the fourth quarter. He confirmed NCMC has an A+(-) rating, which is based on pending competition from UC Health coming to west Greeley. NEW BUSINESS - None OTHER BUSINESS — None. PLANNING SESSION No discussion was held on scheduling a future planning session. ADJOURN There being no further business to come before the Board, it was MSC [Yeater/Davis] to adjourn the meeting at 1:01 p.m. Respectfully submitted, Esther Gesick Page 3 of 3 September 25, 2017 NCMC Board of Trustees '3parks r por� Banner Health® Centura Health,. Contact: Sara Quale, Banner Health, (970) 310-3749 sara. puale@bannerhealth.com Jennifer Wills, Centura Health, (303) 673-8222 jenniferwills@centura.orq Banner Health and Centura Health Enter into Provider Network Agreement Banner Network Colorado joins Colorado Health Neighborhoods, region's largest clinically integrated network Centennial and Greeley, Colo. — Banner Network Colorado (BNC) a fully owned Banner Health entity and Centura Health signed a participation agreement earlier this month to enter into a provider network agreement, enhancing health services and coverage along the Front Range. Effective Jan. 1, 2018, BNC will join Colorado Health Neighborhoods (CHN), Centura Health's clinically integrated network. Banner Health and Centura Health share a common vision, partnering with consumers for integrated care to support their health and well-being, while improving outcomes and quality, and reducing costs. Through the participation agreement, BNC's 60 primary care providers (PCPs), 246 specialists and three Banner Health hospitals in northern Colorado will join CHN, the region's largest physician -led network. CHN is currently comprised of more than 1,400 primary care providers and more than 2,800 specialists who are coordinating care for more than 220,000 lives in value -based agreements. "We're excited to welcome Banner Network Colorado to Colorado Health Neighborhoods," said Peter D. Banko, President and Chief Executive Officer, Centura Health. "Our network of connected, passion -driven caregivers is committed to providing human -centered care and building whole -health communities. This agreement enhances access to health services along the Front Range for our ACO members, and supports our journey in meeting the needs of the thriving communities we serve." "We are fortunate to have found a well -aligned partner in value -based care," said Margo Karsten, Chief Executive Officer for Banner Health in Northern Colorado. "We could not be more pleased to work with Centura Health in this new relationship, and contribute to offering health plan members expanded access to care across the state." MORE Pg. 2, BNC joins CHN Through participation in CHN, BNC will have access to Full Well, Centura Health's collaborative, physician -centric population health resource, that provides tools and competencies to CHN network providers. BNC will also work closely with Centura Health Employer Solutions (CHES). CHES offers direct -to -employer agreements for self -insured employers and has a current membership of more than 30,000 covered lives. ### About Banner Health Banner Health is one of the largest nonprofit health care systems in the country. The system owns and operates 28 acute - care hospitals, plus health centers and medical clinics, an insurance division, a research division, academic and employed physician groups, urgent care, home care and hospice services, outpatient surgery centers, pharmacies and a nursing registry. Banner Health is in six states: Arizona, California, Colorado, Nebraska, Nevada and Wyoming. For more information, visit www.BannerHealth.com. About Centura Health Centura Health connects individuals, families and neighborhoods across Colorado and western Kansas with more than 6,000 physicians and 21,000 of the best hearts and minds in health care. Through our 17 hospitals, two senior living communities, health neighborhoods, physician practices and clinics, home care and hospice services, and Flight For Life® Colorado, we are making the region's best health care accessible and affordable in every community we serve. We believe you can inspire the people you care about to live healthier lives by encouraging them to do the little things that can make a big difference. We're Centura Health, and we're here for your health. For information on Centura Health or any of the facilities in our network, please visit www.centura.orq. Centura Health does not discriminate against any person on the basis of race, color, national origin, disability, age, sex, religion, creed, ancestry, sexual orientation, and marital status in admission, treatment, or participation in its programs, services and activities, or in employment. For further information about this policy contact Centura Health's Office of the General Counsel at 1-303-673-8166 (TTY: 711). Copyright © Centura Health, 2017. ATENCION: Si habla espan`ol, tiene a su disposicion servicios gratuitos de asistencia linguistica. Llame al 1-303-673-8166 (TTY: 711). CHIT : Neu ban ndi Tieng Viet, co cac djch vu ho try ngon nga' mien phi dbnh cho ban. Gai so 1-303-673-8166 (TTY: 711). eat-evu NCMC Board of Trustees Report, September 2017 Visit conducted by Trustee Susan Carter, MD Department - Department of Oncology Clinical Research, NCMC Interview with Theresa Henley, RN Department History - No recent changes in department; physically moved to office previously occupied by Pain Clinic then Infectious Disease, on the ground floor of Oncology center adjacent to the elevators. Services provided - Clinical Trials enrollment and monitoring, Cancer Committee, Tumor Board. Clinical Trial patients are seen from recruitment, through treatment, and for the remainder of their lifespan. Staff (4 RN's) - Mandy Garza(Supervisor), Theresa Henley at NCMC Joan LaTourneau, Pam Lemme at McKee Mandy reports to Julianne Fritz- Director of Oncology Services Revenue/Budget- n/a Affiliations - Colorado Research Program, located in Denver. Advantages include all regulations in place, allows participation in National Trials Ex Partnering currently with U of Wyoming, an RN and a Pharmacist who are distributing a questionnaire on caregivers Numbers - Clinical Trials- 45 patients 2017 year to date. Tumor Board (patients diagnosed here or here for treatment), they have screened 50 patients to date in Sept. August- 73. 8-900/year Successes - Providing National and Regional Clinical Trials keeps patients local, helps families, too. Care of patients with close monitoring, not always standard of care, sometimes pick up on another condition, etc. Sometimes cost savings if experimental drug is provided. Keep current on changing medication, "cutting edge". Challenges/obstacles- Because of new drugs with high specificity, and genetic profiling, more difficult these days to offer Trials due to exclusions. Departmental Needs/Requests- As the program grows, they will need to provide more support and will eventually need more staffing. (S. Carter opinion- maybe clerical support?) Visit conducted by: Mark lawley Amada Gonzales Department Patient Experience Service(s) Provided Patient services mission is to survey patients shortly after their discharge. This survey focuses on a patient's entire care experience. The survey provides opportunity for improvement, encourages patients to recommend using Banner Health and the information is provided to CMS for reimbursement purposes. The care model is driven around earning trust and loyalty of patients through patient education based on ensuring the patient understands at discharge how to manage their care at home. The concept provides for improved outcomes and decreases admissions. All physicians and nurses are trained on how to interact and have a two way conversation about patient care. A significant amount of effort has been directed toward training and working with all staff on how to interact with customers. The primary focus is patient satisfaction and getting patients to recommend. Banner had 4 million visits to their location last year, 2.8 million were confident in Banner Health Services and care, the other 1.2 million thought there was room for improvement. The focus for Banner has been aligning and developing staff and teams through training and practice and working on process improvement efforts on what patients are conveying and what is important. dumber of staff: ►4 staff members and three divisions. Revenues/Budgets if relevant successes starting to see employees working toward the new Banner Mindset. ,00k- For opportunities to improve any situation. Ask questions so I understand what is expected of me and I contribute our success. )wn- Take personal responsibility for how I contribute to any situation and take individual action to ensure a desired lutcome. solve- I bring solutions ideas and suggestions to my department. ict- I take action to achieve results and improve our success. Challenges/Obstacles Scores don't always reflect what a face to face conversation can provide. Departmental Needs/Requests None Manager's suggestions for improvement None What would the department manage/director like NCMC, Inc. to know, if anything? Nothing noted. ids\a Danner Health' PATIENT EXPERIENCE Inpatient Key Driver Plan • To continuously earn the trust and loyalty of our patients by taking action on what our patients tell us is most important • To build education and customer obsessed behaviors into our inpatient discharge process ♦ To provide tools and sustainable training resources for our inpatient physicians and nurses In 2016, 41% of Banner Health patients surveyed, representative of 88,047 patients, told us they didn't always understand how to care for themselves when they left the hospital. Ensuring that patients understand how to manage their care leads to improved outcomes and decreased readmissions. Our patients have told us that communication of medications, follow up, and special instructions are needed to feel confident in managing their health. When we educate on these steps and confirm our patient's understanding through the demonstration of teach -back, we earn their trust and loyalty. Purpose Explain our goal of ensuring the patient understands how to take care of themselves when they go home. We want to make sure they are safe and confident to leave the hospital. Set the stage for a two-way conversation. Medications Follow Up Special Instructions (i.e. wound care, diet, activity, equipment) Connect Physician Interaction Detailed review Teach -back on new medications Physician Interaction Share signs and symptoms for when to return Physician interaction General overview of important instructions assistinliffelit _ • Nurse Interaction General overview including next dose Nurse interaction Appointments including specialty (i e heart doctor) and why it is important Nurse Interaction Detailed review Teach -back any new instructions What questions do you have for me? This model was developed as the result of reading and categorizing patient comments when determining Patient Experi- ence (PX) key drivers, as listed in the 2017 Conversation Starters Packet, Banner Physician and Nursing departments contributed to the creation of the Understanding Self Care Model. Hospital VBP Program: FY 2017 Domain Weights & Measures Domain Weights Patient and r'ealVer Centered Experience of C are/Cal e Coot din:Ztlo)11 Sfr" Safety 21J0o 25% Outcomes Clinical Care 5«.() Procesc Efficiency and Cost Reduction 1SO 0 Patient and Caregiver Centered Experience of Care/Care Coordination Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey Clinical Care (.)i1e Process MORT-30-AMI MORT-30-HF MORT-30-PN AMI-7a BIM -2 Pc -op Efficiency and Cost Reduction MS PB-1 Safer\ CLABSI CAVTI SSI: Colon Surgery and Abdominal Hysterectomy :URSA* C-difficile* A.HRQ PSI -90 An asterisk (') indicates a newly adopted measure for S Hospital VBP Program 7, Banner Health` IP Questionnaire (survey invitation is not included in screen shot) 004, Banner Health Strongly Disagree 0 1 My in:eract:ens with nurse were excellent. My interactions with aoctors were excellent Hospital staff (e g. rurse;, doctors, cleaning staff, food service) were responsive to my needs My room was as clean as i thought it should be The environment of the hospital helped me heal I received the be possible care. I understooa how to rare for myself when I got home I would recommend the hospital to my family and friends. Strong',' Agree 4 3 6 a 9 10 V;:, I5 there anything e'se :•ou would like to share about your experience? apd end' Banner Health' ED Questionnaire (survey invitation is not included in screen shot) Banner Health Strongly Disagree 0 My Interaction with the check -in staff was excellent My interactions with nurses were excellent. My 'nteractic)ns with providers (e.g., doctor, physician assistant, nurse practitioner) were excellent Staff (e_g_ check -in, nurses, technicians) acicnowted ged me while I was waiting. was kept informed about the next steps in my care. The Emergency department was as clean as I thought it should be The staff who collected payment treated me with courtesy and respect It was easy to receive rare at the Emergency Deparvnent I understood what to do when I Left the Emergency department The lea & n for my visit was addressed. fi would recommend the Emergency department to my family and friends_ '• Back 3 Strong , Agree 8 9 10 t\l'A Hint ; Is there anything else you would like to share about your experience? aed 710/Banner Health A r Hello