Our welcome message

Tomorrow you will see a new advertisement from Community, welcoming some physicians from Upstate University Hospital to Community's medical staff. It does not mean the Upstate doctors have left their University responsibilities, only that they are now serving patients at Community too.

The idea for the message came from a Community-affiliated doctor who said that, although physicians are well aware of the presence of Upstate doctors on Community's medical staff, some patients may not be. It is impressive how many Upstate doctors now work under contracts with the Community General Hospital.

The most recent physicians to join Community's medical staff are specialists in intensive care medicine, called intensivists. They joined the staff and started working in Community's ICU this month. They followed a number of hospitalists from Upstate, who began work at Community in July.

Since 2008 Community has been served by University Emergency Physicians, the same group of emergency care specialists who practice in University Hospital downtown. Several years before that, Community welcomed to its staff specialists in rehabilitative medicine from Upstate. These professionals provide care and medical direction at the only two acute rehabilitation services in Syracuse -- at Community General and at University Hospitals.

Each of these arrangements has been made on a case-by-case basis as the need and opportunity for specialty care has arisen. The Upstate additions enhance and broaden Community's services. They do not supplant or replace them. Nor do these additions mean that the proposed merger with Upstate is a "done deal." The merger is a complex process that is still being studied.

Could there be additional instances where Community’s subspecialty depth is enhanced by physicians from Upstate? The answer is "yes," but Community does not intend to add physicians merely for the sake of doing so. These service relationships are intended to be supportive of Community's doctors in their private practices, and not as interfering with or displacing their practices.

We welcome the presence at Community of Upstate physicians, who have demonstrated an ability to cooperate and broaden coverage in patient care situations while the broader merger issues are under discussion.

Our "final exam"

Everyone knows what it is like to prepare for a final exam. The last minute cram sessions. The study lists. Classmates challenging one another with questions and answers in late night study groups. But it's a rare person who can make up in a few cram sessions for studies otherwise neglected during a semester's classes.

This week was a kind of final exam for Community General Hospital. The examiners were on-site surveyors from the Joint Commission, the body that accredits hospitals. Yes, we have been cramming for this examination for some time, but it is not a test you can study for short-term. You have to be following the polices and processes every day in order to meet accreditation standards.

We did not know the date of our examination. But we knew that Community was due for a survey in 2010.

Last Tuesday morning the surveyors arrived on campus unannounced for the four-day examination. Throughout the week they met with patients and caregivers, they reviewed our policies and processes, observed a surgical procedure, reviewed performance data, and they met with board members, physicians, nurses and support staff.

The Joint Commission has four categories of scoring:

1. There is an immediate threat to life.

2. Specific situations prompt a preliminary accreditation denial or make an accreditation conditional.

3. There is a direct impact on safety or quality

4. There is an indirect impact on safety or quality.

First, I am glad to say that Community did well. Although we won't have the final results for ten days, it appears we will receive a full three-year renewal of our accreditation.

Second, we learned a lot.

It is not strange to say that our learning continued, even during this "final exam." The surveyors score the hospital on what they find, grouping the findings into the four categories summarized above.

But the point of the survey is not only to check off "wrong answers." It is also a collaborative process, and that means surveyors suggest ways to achieve better results. They told us what other hospitals are doing, and they gave us examples.

In some cases, the surveyors asked us for copies of policies, forms, or data displays that they thought were effective and could benefit others. I was happy to hear that Community demonstrated good team work and showed evidence of good patient care. But we are far from perfect.

The surveyors cited Community for seven direct findings and for 12 indirect findings. We have six to eight weeks to address these issues, depending on whether it is a direct or indirect finding.

Here are the surveyors' findings in areas that have direct impacts on safety or quality:

▪ Managing safety: Documentation of weekly checks of emergency eye wash stations was missing in two areas. There were several instances where call-alarm pull-cords were wrapped around grab bars. And a red bag (infectious waste) was improperly left in a patient care corridor in one area.

▪ Managing hazardous materials: In two cases, employees were not able to respond immediately to questions about what to do in the event of a formaldehyde spill. (Formaldehyde is toxic chemical compound.) Also, rooftop exhaust fans were not identified with bioharzard labels.

▪ Utility risk management: Electrical junction boxes were not properly covered in several locations, and proper room ventilation was not checked in a procedure room earlier this year when such checks were done on all operating rooms.

▪ Medical equipment: The daily check of a backpack containing emergency supplies was not documented, and checking an emergency cart in another area was not documented on three different days.

▪ Construction safety: The hospital's policy did not require temporary sign placement when an emergency egress route is temporarily changed during construction.

▪ Emergency exits: The sliding doors at main entrances had manufacturer-installed locking devices that compromised the breakaway feature in an emergency. Also, surveyors noted several instances where equipment in hallways partially obstructed corridors.

▪ Informed consent: There were two instances where the informed consent process was incomplete. In one case documentation did not include a patent's likelihood of achieving his or her goals. In another, the risks, benefits, and side-effects of alternatives were not documented.

In a few cases we were able to make changes on-the spot, such as the roof vent labels, junction box covers, and breakaway door switches. Other changes will take time, and we have Joint Commission deadlines.

There is work to do as a result of these survey results, and next week we start with a meeting of the Board of Directors. The survey shows how well we are doing things, but the real goal is to get better, and our "final exam" will help us do that.

Community this summer

Community's Division of External Affairs took advantage of the cherry picker (aka hydraladder) that was on campus last week for seasonal maintenance on lighting fixtures and other high elevation work.

This panoramic view of Community General Hospital is a composite of several images taken on August 6 by Dan Cameron, Community's graphic designer.

Patient satisfaction at the 75th percentile

This week we celebrated impressive improvements in Community General Hospital's patient satisfaction scores . . . across the board.

There were free sundaes in the cafeteria on Wednesday, and Chris Stryker, Chief Nursing Officer, and her Directors Nancy Thompson, Lyn Pittinger, and Cathy North brought ice cream to night staff in various departments.

The graph shows Community's overall patient satisfaction rating, as posted in the hospital this week.

The Press Ganey survey scores (second quarter, 2010) show patients overall rating of the hospital at 86.4%, a statistically significant improvement over previous scores. That score puts Community at the 75th percentile for hospitals of our size nationally and for hospitals in our Central New York comparison area.

The overall rating reflects improving patient satisfaction in all areas, including these statistically significant gains:

▪ Satisfaction with nursing care and communication -- 89.9%, up over two percentage points
▪ Satisfaction with doctors care and communication -- 88.7%, up over two points
▪ Satisfaction with the handling of personal issues -- 87.0%, up over two points
▪ Satisfaction with hospital accommodations -- 81.4%, up over four points

We've seen the improvements coming as we track the changes from week-to-week and quarter-to-quarter.

Improved patient satisfaction has also been evident in the HCAHPS* scores the federal government posts on its Hospital Compare website. I talked about the HCAHPS improvements in employee meetings last May.

It's great to know that patients see improved value from our caring and in our hospital environment. Congratulations to Community's employees, to our management team, and to our medical staff.

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* HCAHPS stands for "Hospital Consumer Assessment of Healthcare Providers and Systems." HCAHPS track and report the opinion of Medicare patients at hospitals across the nation.

A remarkable man

In about two hours, there will be a funeral in Williamsville, NY for an 88-year old Italian immigrant who came to America during the Great Depression, who was a decorated World War II fighter pilot, and who became a noted test pilot.

Nello Infanti was the father of Steven Infanti, who is Chairman of the Board at Community General Hospital. I never met Mr. Infanti, but I feel I know him from stories Steve has told over the years. He was a remarkable man.

▪ During World War II, Nello Infanti flew 63 combat missions in a P-38 over Africa, Europe, and Russia.

He received the Distinguished Flying Cross and the Air Medal with Seven Oak Leaf Clusters.

▪ He earned an Aeronautical Engineering Degree from Rennsselaer Polytecnic Institute, plus many hours of post graduate studies at the University of Buffalo and Edwards Air Force Base.

▪ He worked for 40 years at the Cornell Aeronautical Laboratory and became its Chief Test Pilot in 1963. Mr. Infanti flew over 100 types of aircraft, many highly classified.

▪ He trained over over 800 test pilots, more than 40 of whom became astronauts. He flew with Neil Armstrong and Buz Aldrin. He also flew all the X-15 pilots, shuttle, B-1, B-2 and F-17 pilots.

▪ Mr. Infanti was a Fellow in the Society of Experimental Test Pilots.

There is a report about this remarkable man in the Buffalo News, along with his obituary.

I extend my condolences to Steve Infanti, to his mother Louise, and to the entire family.

How are we doin'?

My 'round-the-clock meetings with employees were well attended last Wednesday and Thursday.

Understandably, many were not able to attend so I am posting a summary of my slide presentation here.

Community's occupancy has been quite high recently, and I very much appreciate all that employees and physicians are doing to provide patient care and services during these hot summer days.

As you'll see from the meeting material, occupancy is not the only thing that is "up" -- there are improvements in quality, patient satisfaction, renovations, etc.

Our discussions with SUNY Upstate

In late May, I announced that Community was interested in discussing a potential affiliation with SUNY Upstate University Hospital. Yesterday, I reported on the progress we have made in discussions with Upstate.

Here is the text of a memo I sent to members of the Community General family:

On Thursday, June 24, the Community General Hospital board of directors voted to approve a letter of intent that identifies CGH’s desire to negotiate a merger with Upstate University Hospital. I am very pleased to report that the ongoing discussions with University Hospital’s leadership have been productive. The potential benefits of a merger are encouraging for each facility, and more importantly, for the Central New York community.

This afternoon the SUNY Board of Trustees approved a resolution to support SUNY Upstate Medical University’s acquisition of Community General Hospital. As such, Community General Hospital would partner with Upstate University Hospital and expand Upstate Medical University’s clinical presence in the Syracuse area. The approval of the resolution today demonstrates SUNY’s commitment to improving the health care resources in the Syracuse area. CGH’s strategic plan to become part of a larger health system took a significant step forward because of the action by the SUNY trustees.

CGH and Upstate have drafted a vision and set of principles for the proposed relationship. Key among these is respect for the voluntary medical staff at CGH. These principles were reviewed at the semi-annual meeting of the CGH medical staff on June 12, 2010.

Planning committees related to finance, communications, and operations are currently being established with representatives from Upstate and CGH, while medical staff representatives are expected to begin discussions soon regarding clinical service improvements. In addition, Upstate has retained PricewaterhouseCoopers to develop a business plan for the proposed merged entity.

There are many parts to any new relationship, and our potential affiliation with Upstate is no different. A tremendous amount of progress has been made in a short period of time, and representatives from both institutions are working efficiently, but carefully, to establish the most comprehensive health care system for the community at large.

I will continue to keep the CGH family updated as additional details become available in the coming weeks and months. I thank you for your continued hard work and dedication to CGH and the patients we serve.

This year it was Bill's Tourney

Last week -- the 26th anniversary of the Community General Foundation Pro-Am Golf Tournament -- was held in memory of Bill Towsley.

Until his death on March 10, Bill was the Business Manager of IBEW Local Union #43. He was also a member of the Foundation Board and a long-time friend of Community General Hospital.

More than 200 people attended the Pro-Am on June 18 at the Shenandoah Golf Club at the Turning Stone Resort under picture-perfect skies.

Bill's son Ken played in the IBEW #43 foursome, and all his children attended the award ceremonies at the end of play. They are Ken (with Jen), Billie (with Sarah), Tracy (with Tate), and Jennifer (with Jeremy). It was a wonderful and emotional end to a great day.

That's Don Morgan in the photo, at right. He is the Business Manger of IBEW Local Union #43, and with him are NECA Manager Marilyn Oppedisano and Pat Costello, Assistant Business Manager/ President of the Local.

This year's Pro-Am was supported by more than 90 local and national companies. It is Central New York's only charitable pro-am style tournament. Special thanks go to the Central New York PGA and its executive Alan Seamans for all the help and support in putting together this annual event.

Since its inception the Community General Foundation Pro-Am has raised over $2.2 million in support of Community General Hospital. Greg Cohen, senior vice president of EBS-RMSCO, Inc., and co-chair of the 2010 Golf Committee, announced that this year's Pro-Am was the most successful yet, raising some $170,000. He said this was the result of "tremendous generosity" from the sponsors. My thanks to Greg and to Jim Aiello, who also co-chaired the Golf Committee.

In the closing ceremonies, Greg officially announced the Pro-Am's new name: The Towsley Pro-Am to Benefit the Community General Foundation. Under Bill's leadership, Local #43 donated more than $80,000 to Pro-Am over the past nine years.

Bill passed away on March 10 after a courageous battle with cancer. He discussed the illness with me a number of times. Bill made no secret of the battle he was in, and he was as tough, as straightforward, and as honest in facing cancer as he was in his life as a labor leader.

I told Bill I admired his stoicism about the illness, and I allowed that "it must be tough for you sometimes, Bill."

"Sure it is," he said. "Sometimes you wake up in the middle of the night. You can't help but think about things. But what are you going to do? You've got to face this thing and get on with your life."

On the day he died, a reporter called to ask my recollections of Bill. I told her stories about how I met him and how Bill and the IBEW supported a number of charities. At one point I described Bill as applying "gentle pressure" as he fought to make sure that firms using union labor were included in the competitive bidding process for construction jobs.

"You're the first person I've heard use the word 'gentle' in the same sentence as Bill Towsley," said the reporter.

I knew Bill as someone unapologetic about his union interests, one who was practical and forthright in pursuing his goals, one who was interested in the community, and one who stood by his friends.

At Bill's calling hours, I ran into a prominent elected official coming out of the Edward J. Ryan Funeral Home as I joined the hundreds-long waiting line going in. "We lost a good man," I said.

"He was a good one alright," said the official, "but he didn't hesitate to yell at me."

"Oh, he could yell at me too," I said. "But he was smart, he was a straight shooter, and he had a big heart."

I couldn't be prouder that the Pro-Am is now named for Bill and that in its first year the Towsley Tourney topped previous records for the Community General Foundation. I'd like to acknowledge and thank the sponsors of the 2010 Pro-Am, including:

Presenting Sponsor
IBEW Local 43/ NECA

Course Sponsor
Pepsi

Cart Sponsors
Syracuse Orthopedic Specialists
Welch Allyn

Pro Sponsor
Crouse Radiology Associates

Lunch Sponsors
Alliance Bank
Bond, Schoeneck & King PLLC
Buffalo Hospital Supply
Burns Bros Contractors
Carrier Corporation
Empower FCU
Fust Charles Chambers
Honeywell, Inc.
Key Bank
M.S. Kennedy Corporation
Mackenzie Hughes, LLP
Practice Resource
Rural Metro
Upstate Emergency Medicine

Remembering Bev Lippert

Kristin Schofield, Community's Director of Volunteer Services, sent the following remembrance of Bev Lippert, who died unexpectedly yesterday:

Our volunteers and staff are deeply saddened by the loss of our volunteer Beverly Lippert. Bev was killed in a car accident yesterday morning, June 21.

Beverly was a long time employee and retiree of CGH. She loved to tell stories of how she was the employee who ordered all of the first supplies for the Nursery when we first opened. She made all the decisions what to purchase and where to put it. If you walk to the cafeteria and see the photo from the 60’s of a nurse tending to a newborn baby you will see Bev at her finest, doing what she loved, clad in her nursing whites and her cap. She was a very dedicated nurse who cared for several current staff members when they had babies (as well as some staff members who were the babies themselves).

After retirement, Bev continued at CGH as a volunteer, Auxilian and was a current Auxiliary board member. Many of you may recognize Bev as Mimi’s handler. Mimi was her toy poodle that, for years, she brought to the nursing floors to visit patients. Bev also gave many hours as a volunteer at the Diagnostic Desk on Thursday mornings. As of June 17, the last day she volunteered with us, she had given over 4,800 hours to volunteer service.

Calling hours will be tomorrow at Buranich Funeral Home in Camillus from 4 – 7pm and the funeral will be held Thursday at 10 am in the Fairmount Community Church.
Bev did not have any immediate family members but made a lot of friends CGH in the 47 years she was associated with us and considered us her family. She will be missed and remembered fondly. Please keep her in your thoughts.

Thank you, Kristin, for remembering Bev and her part in the CGH family. Bev was a true caring professional.


You can read the obituary in today's Post-Standard.

A broader look at affiliation

On May 19, I sent the following announcement to Community General family:

Yesterday, the CGH board of directors decided it was in the best interests of the community to examine more than one option for hospital affiliation. Accordingly, the board did not proceed to the next step of the merger planning process with Crouse Hospital. CGH remains interested in continuing strategic planning with Crouse, but not on an exclusive basis. Therefore, the board exercised its right to dissolve the Memorandum of Understanding (MOU), which required exclusive joint planning.

Upstate University Hospital has recently provided CGH with an alternative strategic proposal, which is well-developed and comprehensive. The CGH board believes it is in the best interests of the community to examine all options when considering the community’s long-term needs for health care quality, service and access to care.

As details of this become clearer, I will, of course, provide additional information to the CGH family about these important issues.

We have much to be proud of - our medical staff, our employees, our facilities and the support of the community-at-large. We have demonstrated excellence in many areas. We continue to plan the best way to improve upon these assets as we prepare for the many changes to come in health care delivery, technology and finance.

I thank you for your continued hard work and dedication to CGH.