Yesterday's 'round-the-clock meetings

Yesterday I held a series of employee meetings, starting at 7:00 a.m. and ending at 11:30 p.m. This was an opportunity to talk about current hospital issues and to hear what’s on the minds of employees. I thank all who were able to get away from their work stations for at least a few minutes to participate.

For those who could not attend, I offer this recap of the discussion.

I talked about the difficulties of 2008, the increasing numbers of uninsured and charity care patients, plus the changes this year in the OB medical staff. Obstetrician recruitment is a priority for us.

Last January, the sixth floor skilled nursing facility was closed as a result of the decisions of the Berger Commission. To comply with the Commission, Community formed a planning company for the campus we share with the Van Duyn Home and Hospital. Our planning company is called the Community Health Information and Planning Services, or CHIPS.

In September 2006, the state promised a $12.8 million grant to help Community and Van Duyn comply with the Commission. The grant contract has yet to be completed in Albany, although we are hopeful that final signatures will be forthcoming before year end. Completion of the grant contract will set the stage for the $7.6 million renovation of our sixth floor, starting in 2009. We will create a new, 40-bed acute care unit on that floor, with mostly private rooms. The Certificate of Need (CON) application for the sixth floor renovation was filed with the Department of Health this fall.

2008 was a year characterized by protracted labor negations. The collective bargaining agreement expired on April 30, but its renewal was not concluded until June 26, when the tentative agreement was reached. The contract was subsequently ratified by employees on July 2.

The summer was filled with the Legionella issue, as Community worked with County and State officials to address the risk factors immediately. This was successful, and our hospital continued to operate fully and safely throughout the summer weeks.

As a result of the above, 2008 has been a financially challenging year for Community. Nonetheless, we've made progress in many areas.

With the new daVinci S Surgical System, Community began robot-assisted surgeries in urology and gynecology during August. The start-up of robot surgery here was described as “astounding” by Po Lam, MD, Medical Director of Robotics, in a recent address to the Medical Staff. “It is pretty astounding," he said, "to establish a completely new robotic program without the glitches and the pitfalls typical of a start-up.” We have had a significant number of robot-assisted surgeries already, characterized by minimal blood loss, short stays, and good outcomes.

This year Community added a new pharmacy robot (photo, at left) in the completely renovated Pharmacy. After the Pharmacy open house, I asked what happened to the old pharmacy robot, and the answer surprised me. The manufacturer asked to keep some of the original parts for a museum display in its home office. A decade ago, Community’s robot was the first at a community hospital, and that old machine, it turns out, is of historical interest.

This summer Computerized Physician Order Entry (CPOE), a project in the planning for some time, went “live” on the first patient care unit, Four North (orthopedics). About ten percent of the nations’ hospitals have CPOE, which increases patient safety.

Community introduced digital mammography this year, replacing the old film equipment. Also, Medical Imaging converted to PACS (Picture Archival Communications System) for better storage and comparison of diagnostic images and for instant image availability to physicians over the Internet.

We introduced a new quality report card for our Board of Directors and made strides in improving patient satisfaction (especially in the Emergency Department). A national hospital rating company reaffirmed our preeminence in overall orthopedics, as well as spine and neck surgery, hip and joint replacement surgery. In addition, for the first time, we received the highest rating in maternity services from a national hospital rating firm. I encourage you to research Community General Hospital’s ratings by conducting your own Google search, and enter key words Hospital Ratings.

Also discussed were updates to the hospital’s strategic plan, including both strategic objectives and operational priorities. A key concept in strategic projects is the importance of services that are reimbursed as relatively higher levels in helping to subsidize those community services with lesser reimbursement.

There was a lot of discussion about the difficult economic environment generally. The closure of Syracuse China (in yesterday’s news) was on the minds of many employees. I raised the question of the difficult New York State budget and the impact on hospitals. I spoke about a recent editorial board meeting at the Post-Standard where I, along with other hospital CEOs, discussed the state’s proposed taxation of hospitals and its proposed Medicaid cutbacks. That news story prompted a response last Sunday by State Health Commissioner Richard Daines, MD, and further discussion just yesterday by the Hospital Executive Council.

It’s been a challenging year, 2008. And we face many challenges for 2009. Our attention is focused on the importance of disciplined daily operations, as well as our overall strategy.