Horizons - Summer 2009 by Catholic Health East

10 Minutes with... Kimberly Lansford

imberly Lansford joined CHE as vice president of compliance and internal audit in January 2009. Kim’s major areas of responsibility include the continued development and implementation of CHE’s compliance and internal audit programs; providing strategic and administrative guidance to senior management and governance in relation to business risks; and monitoring the effectiveness of the control environment. Prior to joining CHE, Kim was vice president and chief compliance officer at Saint Joseph’s Health System in Atlanta, Ga., where she oversaw all aspects of the corporate compliance program. She managed the planning, design and maintenance of system-wide compliance programs, compliance education and policies and procedures. Prior to that, Kim was chief compliance officer at Gwinnett Hospital System in Lawrenceville, Ga. Kim earned a master’s degree in health law, magna cum laude, from Shepard Broad Law Center, Nova Southeastern University in Fort Lauderdale, Fla., and a bachelor of science in nursing from Florida Atlantic University in Boca Raton, Fla. Why did you decide to join the CHE System Office? I felt that a move to the System Office offered me an opportunity to take on new and different challenges and to focus on compliance and internal audit from a system-wide perspective. What is it that attracted you to work for a Catholic health system? The first time I entered Saint Joseph’s Hospital in Atlanta, it felt “different” from non-Catholic hospitals. What attracted me was the obvious fact that colleagues didn’t just “recite” the mission of the organization; they actually “lived” the mission.

RHC/JOA compliance officers, and assessing options to replace a sun-setting web-based compliance education tool. These collaborative efforts among the RHCs, JOAs and the System Office will further enhance the compliance and internal audit programs.

What are your long-term goals for compliance and internal audit at CHE?

Kimberly Lansford Catholic Health East vice president of compliance and internal audit

Can you briefly explain the role and key responsibilities of RHC/JOA compliance officers? The RHC/JOA compliance officers manage the planning, design and maintenance of their compliance programs, which include the following seven basic elements: oversight, standards (code of conduct) and policies & procedures, education and training, auditing and monitoring, enforcement of disciplinary action, response to detected problems and open lines of communication. They work collaboratively with our internal audit team in conducting annual risk assessments and creating work and audit plans that address organizational risk areas.

What are your biggest priorities at the moment within your departments? Our biggest priorities include standardizing and performing the 2010 enterprise-wide risk assessment and creating uniform templates for compliance reporting. In addition to this, we are preparing for new government regulatory requirements, sharing model practices that have been identified through internal audits with

HORIZONS is a publication for the Sponsors, Boards, Regional Leadership, System Office and Colleagues of Catholic Health East.

Horizons Editorial Staff

Published by:

Maria Iaquinto Communications Manager

Scott H. Share Vice President, System Communications

Meg J. Boyd Communication Specialist

3805 West Chester Pike, Suite 100 Newtown Square, PA 19073 Phone 610.355.2000 Fax 610.271.9600 www.che.org Please direct comments and suggestions to info@che.org

Design, Production, Printing & Mailing Fulfillment by JC Marketing Communications • jcmcom.com • Southington, Conn. Catholic Health East is a community of persons committed to being a transforming, healing presence within the communities we serve. Locations: Located in 11 eastern states from Maine to Florida. Workforce: Approx. 54,000 employees.

Long-term goals include developing premier compliance and internal audit programs that increase knowledge sharing and facilitate an enterprise-wide risk management approach to managing risks across CHE.

What can we expect in the future from the compliance and internal audit departments? In the near future, select System Office and RHC/JOA colleagues will be participating in the 2010 enterprise-wide risk assessment process. Additionally, RHC/JOA compliance officers will be working together to create more functional reporting documents, and our internal auditors will be completing their internal audit plans for 2009. Together, we hope to better position the System to respond to the challenges of increased regulatory scrutiny and better address the continuum of risk in the context of an enterprise-wide risk management approach.

What should the typical RHC/JOA and System Office colleague know about compliance? “Do the Right Thing!” Colleagues should know that compliance efforts are designed to establish an organizational culture that promotes prevention, detection and resolution of instances of conduct that do not conform with federal and state law; federal, state and private payor health care program requirements; and organizational policies. They should also know how to report a compliance concern, which includes the use of the confidential hotline in place at their work location. Sponsors Congregation of the Sisters, Servants of the Immaculate Heart of Mary, Scranton, Pa. Franciscan Sisters of Allegany, St. Bonaventure, N.Y. Hope Ministries, Newtown Square, Pa. Sisters of Charity of Seton Hill, Greensburg, Pa. Sisters of Mercy of the Americas: Mid-Atlantic Community, Merion Station, Pa. New York, Pennsylvania, Pacific West Community, Buffalo, N.Y. Northeast Community, Cumberland, R.I. South Central Community, Belmont, N.C. Sisters of Providence, Holyoke, Mass. Sisters of St. Joseph, St. Augustine, Fla.

2009 Governance-Management Conference Focuses on Person-Centered Health Care

1&6-9

CHE’s 2008 Community Benefit Annual Report Now Available 4 CHE Partners with Philips to Advance Telehealth Initiatives

Breakfast of Connections

Diagnostic Software for Doctors

Saint Michael’s Medical Center Deploys Decon Team, Tests Innovative Kit

3 Across the System

ACT Initiative Update

4 10 Minutes with … Kim Lansford

Summer 2009

10 & 11 12

HORIZONS CATHOLIC

HEALTH

EAST

2009 Governance-Management Conference

Focuses on Person-Centered Health Care M

System (Athens, Ga.); Pittsburgh Mercy Health System; Mercy Hospital (Portland, Maine); Lourdes Health System (Camden, N.J.); and St. Mary Medical Center (Langhorne, Pa.)—allowed us to share their personal journeys through and interactions with our health care ministry. Each had an engaging and compelling story to tell. Snippets of their stories and experiences were played throughout the conference; their willingness to be open and honest and share their emotions and feelings with our conference attendees brought an added sense of reality, purpose and connection to the gathering.

ission Possible: Building the Bridge to Person-Centered Health Care was Catholic Health East’s first attempt to bring together all of our key leadership constituencies—Sponsors, board members, senior management and clinicians—into a single forum to discuss, review and initiate strategic matters of great importance to the future of our health system (photo 1). More than 300 leaders attended the two-and-a-half day event in Florida. By assembling all of these individuals in one place, at one time, the goal was to create organizational alignment between managers, board members, clinicians and Sponsors on the necessity for the change to person-centered care throughout CHE. The conference was designed to review and dialogue about the challenges and opportunities that face us on four different levels: the health care industry level, the CHE level, the RHC/JOA level and the individual leadership level. Conference attendees had the opportunity to participate in general and breakout sessions on key topics, then meet with their individual RHC/JOA teams to discuss how these topics impacted at the local level. Two innovations were introduced at this conference. Attendees were continuously reminded about the realities of person-

Connections were a continuing theme for this year’s conference, even during session breaks. On page 9, in the article Breakfast of Connections, you will read about a reconnection made between two people who were once a world away, brought together again with a simple introduction.

The theme of this year’s GovernanceManagement Conference was Mission Possible: Building the Bridge to Person-Centered Health Care.

centered health care via a series of patient/resident “vignettes” that had been created prior to the conference. Six individuals—representing Mercy Medical (Daphne, Ala.); St. Mary’s Health Care

Another innovation involved the use of technology during the course of the conference; each attendee was given a hand-held device (much like the audience in the show “Who Wants to Be a Millionaire”) that enabled him/her to react immediately to questions posed by the conference moderator, Sr. Kathleen Popko, S.P., executive vice president, strategy and mission development (photo 2 on page 6). Results of the questions were tabulated immediately and displayed on large screens

continued on pages 6 through 9

A PUBLICATION FOR THE SPONSORS, BOARDS, REGIONAL LEADERSHIP, SYSTEM OFFICE AND COLLEAGUES OF CATHOLIC HEALTH EAST

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Diagnostic Software for Doctors

n March 2009, the Journal of the American Medical Association noted that diagnostic errors are the next frontier for patient safety, and new efforts are being made to mitigate diagnostic errors to promote safer health care. According to a recent supplement to the American Journal of Medicine, a phenomenon known as diagnosis error occurs in most areas of medicine at the rate of 10 to 15 percent. As part of our ongoing effort to improve quality and patient safety, Catholic Health East has joined forces with an outside company, Isabel Healthcare, to improve diagnostic decision-making throughout our health care system. The Isabel pilot is a 2009 Enterprise Risk Management (ERM) initiative implemented by the CHE claims services and clinical loss prevention department. Using state-of-the-art software, Isabel Healthcare, Inc. technology enables physicians to enter a patient’s vital signs and symptoms and instantly receive a checklist of likely diagnoses and more information from medical journals and textbooks, hospital protocols, algorithms and online web resources. CHE-affiliated physicians will be able to access Isabel, which leverages a vast clinical database of more than 11,000 diagnoses, bio-terrorism conditions and 4,500 drugs, from anywhere they have Internet access. The system helps clinicians at the point-of-care to more quickly arrive at and confirm the correct diagnosis and determine the appropriate treatment plan. “The first step in managing diseases is accurate and early diagnosis,” said Tom Garthwaite, M.D., executive vice president and chief medical officer, CHE. “The Isabel system does not replace the diagnostic work done by a doctor. Instead, it becomes a crucial tool for physicians when they are not certain about a patient’s condition. Subscribing to Isabel underscores CHE’s commitment to quality and patient safety.” Isabel Healthcare was founded in 2000 by pediatrician Dr. Joseph Britto and Jason

Before ...

... and after Isabel brings up a diagnosis and offers a description or further information from medical literature.

Hyundai Hope On Wheels™ donated $35,000 to St. Joseph’s Children’s Hospital to support Childhood Cancer Research. Pictured is Shamya (age 4), one of a dozen St. Joseph’s Children’s Hospital patients who added their handprint to the “Hope on Wheels” vehicle on Wednesday, June 17, 2009, commemorating the brave battles of pediatric cancer patients. Hyundai and its dealers presented pediatric oncologist Tung Wynn, M.D., with a check for $35,000. Dr. Wynn was selected as one of 30 Hyundai scholars nationwide, and the donation will support his research in developing a non-invasive therapeutic protocol for medulloblastoma in children—the most common brain cancer.

NEW HOPE MINISTRIES MEMBERS

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“Subscribing to Isabel underscores CHE’s commitment to quality and patient safety.” Tom Garthwaite, M.D., executive vice president and chief medical officer, CHE

Maude. It is named after Mr. Maude’s young daughter, who almost died in 1999 after a physician did not recognize a potentially fatal illness. “Isabel searches through medical texts and provides the clinician with a checklist of likely diagnoses to consider,” said Dr. Britto. “It actually reminds clinicians of other diagnoses that might not have been remembered or recognized.” At CHE, Isabel was piloted by physicians at Mercy Fitzgerald Hospital (Darby, Pa.) and Mercy Philadelphia Hospital (Philadelphia, Pa.) both of which are part of Mercy Health System of Southeastern Pennsylvania. Training and educational sessions were initiated in late March for approximately 55 emergency physicians, hospitalists, residents and other attending 2

physicians. Jeffry Komins, M.D., chief medical officer for Mercy SEPA, said, “this is an exciting new approach to the diagnosis of challenging and complex medical conditions. It has generated much interest among our medical staff and residents. The pilot will help us to determine the efficacy and pragmatism of this process.” As of June 5, 2009, nearly 300 “log-ins” were recorded, with over 1,600 total Isabel components used; the most frequently used component (a total of 733) was “suggest diagnosis.” For more information on CHE’s Isabel pilot, contact Stacey Ann Stephens, CHE manager, litigation at 610.492.3860 or sstephens@che.org.

NEW CHE

BOARD MEMBERS Michael J. Rooney has joined the CHE board of directors for a three-year term. Rooney previously served as the chair of the board of directors of St. Joseph of the Pines, Southern Pines, N.C.

Sr. Margaret Taylor, R.S.M., has joined the CHE board of directors for a three-year term. Sr. Margaret is a former member of Hope Ministries, and is a member of the Sisters of Mercy of the Americas, Mid-Atlantic Community. She is also the first director of Sponsorship for the Mid-Atlantic Community.

Three individuals were recently appointed as members of Hope Ministries, a public juridic person which sponsors Global Health Ministry, Newtown Square, Pa.; St. Mary Medical Center, Langhorne, Pa.; Nazareth Hospital, Philadelphia, Pa.; St. Francis Hospital, Wilmington, Del.; St. Francis Medical Center, Trenton, N.J.; St. Agnes Continuing Care Center, Philadelphia, Pa.; and Saint Michael’s Medical Center, Newark, N.J. M. Eileen Schmitt, M.D., is a former vice president, medical affairs (1997-99) and CEO (1999-2001) of St. Francis Hospital in Wilmington, Del. She has been a member of the medical staffs at St. Francis Hospital and Christiana Care Health System since 1983, and served as president of St. Francis Hospital’s medical staff from 1994-96. Dr. Schmitt is a member of the Delaware Medical Society and the American Academy of Family Physicians.

Harry R. Hill, Jr., has been a member of the St. Francis Medical Center (Trenton, N.J.) board of trustees since 1985 and served as chairman from 1988-90. He also served as a board member of the St. Francis Medical Center Foundation from 1993-2001. Mr. Hill is a member of the New Jersey State and American Bar Associations and the American Academy of Hospital Attorneys.

Barbara A. Draper, R.N., has been with the St. Francis Medical Center (Trenton, N.J.) family since 1984. Most recently, she served as executive director, mission services (2000-02) and vice president, mission and ministry services (2002-06). Draper also served as editor of Lifelines, SFMC’s nursing publication, (19982006). In 2007 she received the St. Francis Medical Center Foundation Spirit of St. Francis Award. Draper is a member of the St. Francis School of Nursing Alumnae Association, the Organization of Nurse Executives, New Jersey and the National Association of Catholic Chaplains (2002-06).

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Saint Michael’s Medical Center Deploys Decon Team, Tests Innovative Kit

Judy Persichilli, executive vice president, acute care, was one of four CHE leaders who teamed up to present “Preserving a Catholic Health Care Presence in an Urban Environment” at the Catholic Health Association’s 2009 Assembly, held June 7-9 in New Orleans. Persichilli, (along with Bob Stanek, president and chief executive officer, CHE; Sr. Kathleen Popko, S.P., executive vice president, strategy and ministry development, CHE; and Alexander J. Hatala, president and CEO, CHE-NJ) shared insight into the process that led to the successful integration of Saint Michael’s Medical Center into the Catholic Health East family.

ire. Flood. Chemical spills. Disasters can happen at any time, any place. And for the health care industry, plans of action for such instances are only as good as when it’s practiced in real time. Knowing that preparation makes for a better recovery, health workers at Saint Michael’s Medical Center in Newark, N.J., recently tested the hospital’s Decon Kit, which is designed to preserve the privacy and dignity of people who must be stripped and decontaminated in an emergency.

Experts at Saint Michael’s developed the twopart kit—known as the Saint Michael’s PreDecon Kit and Post-Decon Kit—as part of the hospital’s ongoing efforts to improve its ability to respond to a disaster such as a biohazard accident.

A team of 30 prestigious Japanese physicians and nurses with special interest in infectious diseases took a tour of Holy Cross Hospital on June 11. The tour focused on Holy Cross’s successful infection control program and its policies and procedures used to minimize the risk of spreading infections. The group visited the emergency department, outpatient radiation therapy and infusion therapy, heart/cath labs and cardiovascular intensive care unit, among other areas of the hospital.

Saint Michael’s personnel used the kits at a successful full-scale disaster exercise in which the hospital activated its Emergency Operations Plan in response to a simulated terrorist attack in the city.

Dr. Regina Benjamin Nominated to be U.S. Surgeon General

(President Barack Obama with Surgeon General nominee Dr. Regina Benjamin in the Rose Garden of the White House, July 13, 2009. Official White House Photo by Lawrence Jackson) On May 30, Catholic Health volunteers collected nearly nine tons of electronic recyclable material as part of the system’s Go Green Initiative. The electronic recycling day allowed associates and physician across the system to drop off their unwanted computers, monitors, TVs and everything electronic. The volunteers also collected 500 pounds of food for the Food Bank of Western New York—one of Catholic Health’s designated charities for 2009.

At a nationally telecast press briefing on July 13, President Obama announced his nomination of Regina Benjamin, M.D., M.B.A., as the next U.S. Surgeon General. Dr. Benjamin, a member of Hope Ministries and former CHE board member, is founder and CEO of the Bayou La Batre Rural Health Clinic in Alabama. Congratulations to Dr. Benjamin for this outstanding achievement!

The disaster drill included the deployment of the hospital’s Decon Team, a group of multidisciplinary clinicians and staff who are specially trained to decontaminate individuals affected by a disaster such as a chemical spill or terrorist incident. After the attacks on September 11, 2001, the hospital created makeshift showers to decontaminate people exposed to fallout. “We realized we needed a more sophisticated solution,” said Mary Danish, the hospital’s director of emergency preparedness. “Before the creation of the kit, there was no good way to safeguard the privacy of people who need to get undressed outdoors. In an emergency situation, some people might refuse to remove their clothing, potentially harming themselves or others. The kit ensures that their dignity—and their safety—are preserved.” Danish pointed out that the kit also minimizes the hospital’s liability, citing an incident in Seattle, Wash., in which two female police officers brought a successful lawsuit after their privacy was compromised in a decontamination event. The kit includes such items as disposable

A member of the Saint Michael's Medical Center Decon Team, outfitted in a Tychem ® SL Hazmat Suit and a Level B full-face respirator with supplied air (required for first responders), participates in a disaster exercise at the hospital. The suit allows exposure to an agent for a maximum of eight hours before needing to be exchanged. Also note that every seam is sealed with duct tape as an extra precaution; and it is applied in a very specific way to allow for team members to be able to remove all of the tape in one motion, in the event of a medical emergency with the suited individual.

shoes, wipes, towels and a type of poncho beneath which a person’s clothing and jewelry can be removed. In addition, the kit includes bags to separate contaminated clothing and collect valuables. All bags are given a unique marking so that the contents’ owner can be identified. Danish said that the kit’s effectiveness has led to its adoption by other hospitals in the region, such as nearby University Hospital, and by the Nutley (N.J.) Hazardous Materials Unit, which used the kit extensively when they mobilized personnel to assist in Hurricane Katrina disaster relief efforts. The Decon Kit is just one of the tools employed by the Decon Team, which—like the kit—is a model of its type. “We involved every department in the formation of the team,” said Danish. “We wanted to ensure that we could get buy-in from multiple clinical and administrative areas/staff and schedule the team appropriately so that members will be ready to respond at any time of the day or night.” Prospective Decon Team members must undergo comprehensive training and preparation required by OSHA, including a medical screening, quantitative fit testing for full-face respirators, and participation in a Hazmat Operations Course taught by members of the New Jersey State Police Hazardous Materials Response Unit. Team members must also attend quarterly training events to maintain 3

their competency levels. In an actual disaster incident, the Decon Setup Team would be quickly deployed to an area outside the hospital where they would erect decontamination tents, establish the decontamination corridor, and instruct arriving patients on the use of the Pre-Decon Kit. Simultaneously, additional team members would receive a medical evaluation before donning personal protective equipment and full-face respirators appropriate to the event. They would then be responsible for cleaning and decontaminating patients and for controlling the flow of affected people from the “warm zone” (the contaminated area) to the “cold zone” (the uncontaminated areas of the hospital facility, where patients would receive additional emergency treatment). “In our recent disaster exercise, the team assembled the tents within about ten minutes of the first call of a Code Orange-External, the emergency code for a Hazardous Materials Incident and activation of the Decon Team,” said Danish. “They acted quickly, responded appropriately, and treated dozens of volunteer patients in various states of distress. I’m very proud of my colleagues on the Decon Team at Saint Michael’s Medical Center. They’re among the best in the industry at what they do.” For more information, please contact Mary Danish at 973.877.5507 or mdanish@smmcnj.org.

ACT Initiative Update

ince its inception in early 2009, the ACT (Advancing Clinical Transformation) Initiative has made significant strides toward its key objective: to identify, analyze and implement clinical transformation opportunities that result in superb clinical outcomes and enhance quality and patient safety across the system, which result in excellent operating and financial performance.

As a recap, the short-term goal was to identify $100 million or more in savings—beyond what was already included in the 2009 budget—within the first one hundred days of 2009. At least $25 million of these actions are to be implemented in 2009. The long-term goal of ACT is to implement breakthrough processes that reduce/eliminate the incidence of hospital-acquired conditions, reduce length of stay, reduce readmissions within 30 days, decrease expenses associated with denial management, further reorganize the System Office to better support clinical transformation and enhance operational improvements related to supply chain value realization, labor management and revenue management. At a May meeting, the ACT steering committee reviewed the action plans developed to achieve the savings with RHC CEOs and System Office leaders. As a result of table discussions the RHCs committed to approximately $104 million in savings. These savings were driven by improvement in hospitalacquired conditions, reduction in Medicare length of stay (LOS), reduction in payment denials and additional opportunities associated with supplies and labor management. The identified savings will be validated by the CHE finance department and included in the 2010 budget. All RHC CEOs signed a “commitment declaration” that recognizes the work accomplished in the first 100 days and the effort required to achieve the goals for 2010. Since this meeting, hospital-acquired condition task forces have been convened, the definitions for hospital-acquired conditions have been confirmed and the action plans have been initiated. A system-wide target was set as zero for three areas (falls, ventilator associated pneumonia and central line infections). CHE also implemented the MIDAS+ software, which enables us to collect baseline data regarding

Medicare LOS and 30-day readmission rates in order to finalize 2009-10 targets. “While there is certainly a ways to go to meet our objectives, I think we can all take pride in how leaders have risen to meet the challenge of achieving true clinical transformation throughout our health care system,” said Mark O’Neil, CHE’s executive vice president and chief operating officer. “We have achieved tangible results that put us on the path to meeting our clinical and financial objectives, and I am confident that the teamwork and sharing of best practices that has occurred to date will continue to grow and support our long-term efforts.” The steering committee continues to meet biweekly to monitor results and the workplans developed for each initiative and to identify additional savings. Progress at the RHC and system levels will be formally reviewed by August 1 and adjusted if needed. 4

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...from the Governance-Management Conference

Breakfast of Connections

“There are no such things as strangers, only friends we haven’t met yet.” — Anonymous

CHE’s 2008 Community Benefit Annual Report Now Available

On May 11, 2009, RHC leaders across CHE signed this document outlining their commitment to the ACT initiative and to ensuring quality, enhancing patient safety and implementing clinical transformation opportunities within their facilities.

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In 2008, Catholic Health East facilities combined provided over $301 million in community benefit programs and services. This number—which includes charity care, unpaid costs of Medicaid programs and free and subsidized community health and education services—represents an eight percent increase over the prior year. These are impressive and meaningful results, and should be shared proudly throughout our health system. But numbers are often difficult to connect to … so we decided to illustrate the great work being accomplished in community benefit throughout CHE by inviting each RHC and JOA to submit the story of an individual or a family who directly benefitted from these programs and services in 2008. CHE’s 2008 Community Benefit Annual Report is a compendium of stories from each of our 21 RHCs/JOAs, as well as from Global Health Ministry and Allegany Franciscan Ministries. Each person or family has a story to tell … about how their lives were enriched thanks to community benefit programs and services available throughout our health ministry. In addition, this year’s report includes a sampling of some of the key events and accomplishments that occurred at facilities across the system … as well as an overview of key operational statistics. The report is available on CHE’s website at www.che.org/publications. Also, each individual story is available on the CHE portal so that they can be easily copied and used with many different audiences. Additional print copies of the entire 2008 CHE Community Benefit Annual Report are also available upon request. If you’d like additional copies, or if you need any assistance in accessing these materials in the portal, please contact Meg Boyd (mboyd@che.org or Maria Iaquinto (miaquinto@che.org) in the CHE communications department.

ometimes people come into our paths for a purpose, be it a reconnection to our past … or a new beginning. An informal introduction between two women led to a connection of long ago. At the recent CHE Governance-Management Conference in Florida, two strangers found themselves next to one another at breakfast.

“When I attend a conference, I like to circulate and to introduce myself to individuals who are by themselves at the time,” said Linda Bigelow, Ph.D., R.N., vice president and CNO, St. Mary's Health Care System, Inc., Athens, Ga. “I saw Sr. Guadalupe (Loly) Lumantas, at the breakfast counter. I simply said ‘Hello, I am Linda Bigelow, from Athens, Georgia and Pittsburgh, Pennsylvania’. She introduced herself and mentioned that she was from the Philippines.” “I immediately thought about Dr. Paul Beltran, who was also present at the conference, and mentioned to Sr. Loly, that Dr. Beltran is chair of our medical executive committee and that he is also from the Philippines. Dr. Paul Beltran and I are on several hospital committees and I have participated in his and his wife Marilyn’s fundraising events for the Philippines.” The conversation evolved from there. The two women later met during a break and decided to watch as the other attendees gathered in the corridor. After a few minutes, ‘voila’ … Dr. Beltran came through, and the introduction was made. Dr. Beltran and Sr. Loly quickly began talking about the Philippines, including a recent mission trip he and his wife had taken to deliver donated supplies from St. Mary’s O.R. The more they talked, the more animated Sr. Loly became. “We shared where we were both from in the Philippines. He mentioned that his wife was from the Philippines too,” said Sr. Loly. Soon, she asked for his wife’s name. When

(l-r) Linda Bigelow, Ph.D., R.N., vice president and CNO, St. Mary’s Health Care System, Athens, Ga.; Sister Guadalupe (Loly) Lumantas, R.S.M., member of the leadership team of the Sisters of Mercy of the Americas – New York, Pennsylvania, Pacific West Community; and Paul Beltran, M.D., medical staff president, St. Mary’s Health Care System, Athens, Ga.

he told her—Marilyn Digamon—her eyes lit up.

(NyPPaW) with administrative offices in Buffalo.”

‘I was her teacher!’ she said. “I was teaching mathematics in fourth year high school in Stella Maris College, Oroquieta City, Misamis Occidental in Mindanao, Philippines. Marilyn was one of the students in my class. She was a bright student and a good person. I was still Miss Guadalupe Lumantas when I met Marilyn.”

Sr. Loly was elected to the leadership team of NyPPaW and attended the GovernanceManagement Conference as a Sponsor of Catholic Health East.

“It’s a very small world,” Dr. Beltran said. “God has a way of connecting people.” Small world indeed. “I entered the Religious Sisters of Mercy Congregation and continued teaching during the formation years of my religious life which took place in the province of Lanao del Norte, Mindanao. The R.S.M. Philippines later merged with the R.S.M.s in Buffalo, Rochester, Erie and Pittsburgh, to form the New York, Pennsylvania, Pacific West Community

After being introduced to Sr. Loly, Dr. Beltran called his wife, who is now Dr. Marilyn Beltran. “We shared the happy memories of her being one of my fourth year students. We promised to keep in touch with each other through e-mails, telephone calls and hopefully a visit someday. I live in Buffalo and her family is in Atlanta,” said Sr. Loly. “One thing remarkable among us Filipinos is the love to be connected with each other especially when we are in a foreign country. We treasure our friendship and care for each other in whatever way we can be of help,” she added.

...continued from page 7

...from the Governance-Management Conference

7 (from left) Kirk Wilson, CEO, Saint Joseph’s

Health System; Jacquelyn Kinder, CHE board chair; Sr. Jane Gerety, Saint Joseph’s board of directors; and Donald Brooks.

Special Awards Honored Exemplary Individuals and Programs Three system-wide awards were presented at the Governance-Management conference. The Excellence in Governance Award honors one RHC/JOA board member who distinguishes himself/herself as a visionary leader, collaborator and strategic thinker. This year’s awardee was Donald B. Brooks, a board member of Saint Joseph’s Health System in Atlanta, Ga. During his tenure, Brooks was instrumental in Saint Joseph’s becoming part of the Eastern Mercy Health System, one of the three health systems that came together in 1998 to form Catholic Health East. At present, he serves on the Saint Joseph’s Health System board, the executive and strategic planning committees, and is the chair of the finance committee. Brooks is also the vice chair of the CHE board of directors investment committee. He has used his business expertise to help Saint Joseph’s grow to meet the needs of its community by assisting in the acquisition of land and acting as a development consultant on several medical office building projects (photo 7). The Richard A. Stebbins Award recognizes one CHE colleague who represents the Core Values of the health system and who has particularly demonstrated the capacity to build community and foster harmonious and supportive relationships between and among organizations and people. This year’s awardee was Nora Baratto, LCSW-R, C.C.M., A.C.M., manager, case management at St. Peter’s Health Care Services in Albany, N.Y. Baratto truly exemplifies the Core Value of Justice by advocating for those in the

8 (from left) Sr. Mary Caritas Geary, Hope Ministries

member; Jacquelyn Kinder, CHE board chair; Nora Baratto; and Steve Boyle, CEO, St. Peter’s.

community whose social conditions make them vulnerable and often the most marginalized of our society. A dedicated social worker and administrator, she utilized her skills and experience to develop a community-based management program that provides comprehensive in-home assessment and care planning, referral and ongoing management of high risk older adults. Baratto has advocated for the removal of regulatory, community and inter-agency system barriers that fragment care and result in special needs populations being inappropriately admitted to high levels of care (photo 8). The Daniel F. Russell Innovative Service to Those Who Are Poor Award recognizes a program within CHE that clearly demonstrates innovative and creative service to those who are poor and shares such learnings across the ministry and with other values-compatible organizations. This year’s winner was the Madre y Niño Program, a program based in Chulucanas, Peru that is supported by Global Health Ministry (GHM). Sr. Mary Jo McGinley, GHM executive director, accepted the award on behalf of the program. (photo 9). This program, focused on reducing the high maternal mortality rate, sends primary care teams to Chulucanas twice a year to provide medical care, education and supplies. They provide a stipend for a nurse to conduct trainer education sessions for community volunteers and midwives each month in three target areas. With the assistance of two grants acquired from the Sisters of Mercy, this program’s goal is to reduce maternal mortality by 50 percent in five years. Since 2004, maternal deaths have declined from 18 per year to seven in 2007 … over a 50 percent reduction. 8

9 (from left) Jacquelyn Kinder, CHE board chair; Sr. Mary Persico, CHE Sponsors Council coordinator; Andrea Divers-Murph, administrative assistant, GHM; Sr. Mary Jo McGinley, executive director, GHM; Ginny Marchetti, manager, program enhancement, GHM; Sr. Kathleen Keenan, GHM board chair; and Dan Russell, president emeritus, CHE.

When the last presentation was given and the last survey turned in, the two key conference “architects”—Anita Jensen, CHE’s vice president, leadership development (left), and Sr. Kathleen Popko, CHE’s executive vice president, strategy and ministry development— were FINALLY able to rest!

Meeting Planning: A Key Ingredient for a Successful Conference Led by Anita Jensen, vice president of leadership development, CHE, the 2009 Governance-Management Conference was a full year in the making. Anita led the conference planning efforts and, working with the support of many leaders and clinicians system-wide, developed and implemented what many have said was the best conference ever hosted by CHE. Also supporting our internal planning efforts were the firms Site Search & Select (led by Michael Hudson) and Solstice Event Group (led by Stephanie Krzywanski). The results speak for themselves. Post-conference survey results rated “conference coordination” as a 4.9 on a five-point scale; 91 percent of respondents gave it an “excellent” rating. If you are planning a meeting for your organization and would like more information about either firm, please contact Mike (www.sitesearchselect.com or 718.398.9566) or Stephanie (Stephanie@solstice-events.com or 215.485.7314).

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CHE Partners with Philips

to Advance Telehealth Initiatives

tatistics show that individuals with one or more chronic conditions—such as heart failure, COPD, diabetes and hypertension—account for “the overwhelming majority” of medical expenses in the United States. In fact, these chronic conditions are responsible for 78 percent of the nearly $2 trillion spent on health care in the U.S. each year.

Based on CHE’s own internal data, in 2007 our hospitals collectively had more than 14,000 Medicare patients discharged with a primary diagnosis in one of the four chronic conditions listed above. Approximately 18 percent of these patients end up being readmitted within 30 days of their discharge. This translates into about 2,500 readmissions in one year throughout CHE. The good news is that we believe there is a way to significantly reduce this readmission rate, improve quality and enhance patient satisfaction: through the use of telemonitoring. Through our recent partnership with Philips’ telehealth experts, we estimate that more than seven out of every 10 of our current “readmissions” can be prevented in the future through the use of telehealth technologies. Experience has demonstrated that daily monitoring of patient vital signs (weight, blood pressure, etc.) and health status/symptoms can identify early signs of deterioration, allowing for clinical intervention before patients are critically decompensated. Such early intervention through post-discharge home telemonitoring of patients at most risk for readmission within 30 days of discharge can prevent unnecessary hospitalizations. In addition to reducing readmission rates, the key goals of CHE’s telehealth program are to:

Telehealth patients can monitor their vital signs from the convenience of their home after discharge. That information is then transferred immediately and securely to their physicians who can detect any potential concerns.

• help our facilities deliver the right care at the right time in the right setting

training and deployment services that Philips offers, as well as ongoing training and educational services.

• enable patient self-care

Among the RHCs who have initiated telehealth programs are: Mercy Health System of Southeastern Pennsylvania (St. Mary Home Care, Langhorne, Pa.); Sisters of Providence Health System (Mercy Home Care, Springfield, Mass.) and St. Mary’s Health Care System (St. Mary’s Home Health Care, Athens, Ga.).

• improve medication and plan-ofcare adherence • reduce unnecessary visits to the emergency department • improve home care visit efficiency CHE and Philips have been working together for several months to implement telehealth programs at several CHE member organizations. As of July 2009, three RHCs have implemented rental agreements with Philips. Two more plan to initiate telehealth programs by the end of 2009. In addition to preferred pricing, CHE facilities benefit from delivery, set-up, 5

The Fall 2009 issue of Horizons will highlight some of CHE’s more established telehealth programs, and we will share some of the best practices gathered from these telehealth “pioneers.” In the meantime, if you have any questions about how your RHC/JOA can initiate a telehealth program for your patients, please contact Scott Ash, CHE vice president, business development, at 610.355.2040 or sash@che.org.

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...from the Governance-Management Conference

Mission Possible: Building the Bridge to Person-Centered Health Care

...continued from page 1

organization that is re-imaged, reinterpreted and sustained anew in our day.

continue our journey of faith as, together, we help implement this change as we assemble the planks of the bridge to person-centered health care.”

Attendees used a hand-held audience response system to provide feedback throughout the conference.

for all attendees to read. Results were also broken out by attendee affiliation (e.g., board member, Sponsor, manager or clinician). These results allowed audience members to be contributors to the dialogue throughout the conference, and helped to raise interesting and often provocative questions for further discussion by the group. Jacquelyn Kinder, Ed.D., chairperson of the CHE board of directors, and Sr. Mary Persico, I.H.M., CHE Sponsors Council coordinator, welcomed attendees to the conference, emphasizing the importance of the organizational commitment to personcentered care. “In order to make meaningful strides towards achieving the goal of personcentered care, we need to have everyone throughout our health ministry take deliberate, coordinated action,” Kinder said. “Everyone in this room must be an agent for change.” “We stand at the brink of a truly transformational moment in the history of our Catholic health ministry,” said Sr. Mary Persico. “We have talked many times in the past about the importance of change; over the next three days, we

Bob Stanek, CHE president and chief executive officer, emphasized the importance of using the group’s time together to help answer questions that would help guide our person-centered care strategy moving forward; he quoted Dave Pollard, a noted business management expert as saying “… the group’s answer is almost invariably much better than any individual expert’s answer, even better than the best answer of the expert in the group.” Stanek described the conference as “… a watershed event which will be the genesis of CHE’s transformation to a truly personcentered health care delivery model.” The agenda included presentations from several nationally renowned speakers. Sr. Carol Keehan, D.C., president and chief executive officer of the Catholic Health Association of the United States, shared her “insider” view of the current health care reform process (photo 3). Bill Strickland, president and CEO of Manchester Bidwell Corporation and a MacArthur “genius” awardee for leadership and ingenuity in the arts, shared the successes he has experienced in partnering with local industries to improve educational and job training opportunities in urban areas (photo 4). Elliott Fisher, M.D., M.P.H., director of the Center for Health Policy Research at Dartmouth Medical School and one of the authors of the Dartmouth Atlas, shared his thoughts on the industrywide quest to achieve accountability for health quality and costs (photo 5). And John DeGioia, Ph.D., president of Georgetown University and the world’s first lay president of a Jesuit university, spoke passionately about his own spirituality and challenged us to identify the animating vision of our 6

CHA President Sr. Carol Keehan greets Hope Ministries member Regina Benjamin, M.D., (left) and Bob Stanek (right).

Dr. Elliott Fisher (right) takes a question from the audience as Dr. Tom Garthwaite, CHE’s chief medical officer, looks on.

to “flip.” Sr. Kathleen Popko led a session that detailed the steps involved in “building the bridge” to personcentered health care, as well as the Each conference attendee leadership implications that this change participated in one of nine concurrent will require at all levels of our health breakout sessions, presented principally system. Sr. Kathleen addressed the by subject matter experts from within audience as CHE’s “bridge construction CHE. Topics included the use of crew,” and described the work that we innovative technology in health care; will all be involved in as we build the patient-centered comprehensive care planks (IT-enabled information, patientmanagement; aligning provider, centered comprehensive care, aligned physician and payer incentives; incentives, reimbursement reform, reimbursement reform; innovations in payer participation, collaboration across the care of special needs populations; the continuum of care and remote and the changing role of independent care) for the bridge to person-centered practitioners. Later in the conference, all care. attendees gathered by their respective RHC/JOA to share their conference “These are the key planks on the experiences with their local colleagues, bridge to our goal of person-centered and to initiate a plan of action for how care,” said Sr. Kathleen. “We have their RHC/JOA would begin to build its crossed the bridge … at least in theory. bridge to person-centered health care Now we must begin the hard work of (photo 6). spanning this chasm at each one of our organizations. I know this crew is ready We know that in spite of all of the for the challenge.” discussions and analysis and talk about person-centered health care, this is an concludes on pages 8 & 9 evolutionary process; there is no switch

Eileen Skinner (left), president and CEO, Mercy Health System of Maine, leads the discussion among her assembled team of Sponsors, board members, managers and clinicians.

Dr. Mark Publicker, medical director, Mercy Recovery Center, Mercy Health System of Maine (right), and Ray Welch, president and CEO, Mercy Health System of Southeastern Pennsylvania (center)—lined up to share their thoughts with Bill Strickland.

Throughout the conference, attendees were inspired by the words and music of Elliott Wimbush (left) and Rob Glover.

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...from the Governance-Management Conference

Mission Possible: Building the Bridge to Person-Centered Health Care

...continued from page 1

organization that is re-imaged, reinterpreted and sustained anew in our day.

continue our journey of faith as, together, we help implement this change as we assemble the planks of the bridge to person-centered health care.”

Attendees used a hand-held audience response system to provide feedback throughout the conference.

CHA President Sr. Carol Keehan greets Hope Ministries member Regina Benjamin, M.D., (left) and Bob Stanek (right).

Dr. Elliott Fisher (right) takes a question from the audience as Dr. Tom Garthwaite, CHE’s chief medical officer, looks on.

Eileen Skinner (left), president and CEO, Mercy Health System of Maine, leads the discussion among her assembled team of Sponsors, board members, managers and clinicians.

Throughout the conference, attendees were inspired by the words and music of Elliott Wimbush (left) and Rob Glover.

...continued from page 7

...from the Governance-Management Conference

7 (from left) Kirk Wilson, CEO, Saint Joseph’s

Health System; Jacquelyn Kinder, CHE board chair; Sr. Jane Gerety, Saint Joseph’s board of directors; and Donald Brooks.

8 (from left) Sr. Mary Caritas Geary, Hope Ministries

member; Jacquelyn Kinder, CHE board chair; Nora Baratto; and Steve Boyle, CEO, St. Peter’s.

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CHE Partners with Philips

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• help our facilities deliver the right care at the right time in the right setting

training and deployment services that Philips offers, as well as ongoing training and educational services.

• enable patient self-care

ACT Initiative Update

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...from the Governance-Management Conference

Breakfast of Connections

“There are no such things as strangers, only friends we haven’t met yet.” — Anonymous

CHE’s 2008 Community Benefit Annual Report Now Available

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he told her—Marilyn Digamon—her eyes lit up.

(NyPPaW) with administrative offices in Buffalo.”

Sr. Loly was elected to the leadership team of NyPPaW and attended the GovernanceManagement Conference as a Sponsor of Catholic Health East.

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Saint Michael’s Medical Center Deploys Decon Team, Tests Innovative Kit

Dr. Regina Benjamin Nominated to be U.S. Surgeon General

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Diagnostic Software for Doctors

Before ...

... and after Isabel brings up a diagnosis and offers a description or further information from medical literature.

NEW HOPE MINISTRIES MEMBERS

{

}

“Subscribing to Isabel underscores CHE’s commitment to quality and patient safety.” Tom Garthwaite, M.D., executive vice president and chief medical officer, CHE

NEW CHE

10 Minutes with... Kimberly Lansford

What are your long-term goals for compliance and internal audit at CHE?

Kimberly Lansford Catholic Health East vice president of compliance and internal audit

HORIZONS is a publication for the Sponsors, Boards, Regional Leadership, System Office and Colleagues of Catholic Health East.

Horizons Editorial Staff

Published by:

Maria Iaquinto Communications Manager

Scott H. Share Vice President, System Communications

Meg J. Boyd Communication Specialist

3805 West Chester Pike, Suite 100 Newtown Square, PA 19073 Phone 610.355.2000 Fax 610.271.9600 www.che.org Please direct comments and suggestions to info@che.org

2009 Governance-Management Conference Focuses on Person-Centered Health Care

1&6-9

CHE’s 2008 Community Benefit Annual Report Now Available 4 CHE Partners with Philips to Advance Telehealth Initiatives

Breakfast of Connections

Diagnostic Software for Doctors

Saint Michael’s Medical Center Deploys Decon Team, Tests Innovative Kit

3 Across the System

ACT Initiative Update

4 10 Minutes with … Kim Lansford

Summer 2009

10 & 11 12

HORIZONS CATHOLIC

HEALTH

EAST

2009 Governance-Management Conference

Focuses on Person-Centered Health Care M

The theme of this year’s GovernanceManagement Conference was Mission Possible: Building the Bridge to Person-Centered Health Care.

continued on pages 6 through 9

A PUBLICATION FOR THE SPONSORS, BOARDS, REGIONAL LEADERSHIP, SYSTEM OFFICE AND COLLEAGUES OF CATHOLIC HEALTH EAST