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October 29, 2012 Volume 1, Issue 33


Strategic Plan, QUEST Goals Focus of Town Hall Meeting

At the Oct. 24 Town Hall Meeting, President and CEO Kate Walsh laid out the progress BMC has made on its strategic plan and QUEST goals over the past year, and introduced the new QUEST goals for fiscal year 2013.

Walsh opened by reminding staff that BMC is well positioned to succeed in the era of health care reform, thanks to its network of 15 community health centers, HealthNet plan and critical mix of patients.

Kate Walsh
President Walsh hosted the Town Hall Meeting

“BMC is ideally positioned to lead the way in health care reform in the state and the nation because our hospital, health center and health plan make us a fully integrated delivery system,” said Walsh. “We have a system of care that others are trying to build.”

She then reviewed progress made to date on key strategic plan initiatives, noting positive work on the patient experience, ongoing work to create patient-centered medical homes for primary care patients, an information technology transformation that includes moving to one electronic health record system (see story below), and earning supplemental government funding for providing exceptional, high quality care.

Thanks to the hard work of staff in the past year, Walsh noted that BMC had earned an A grade on Leapfrog’s Hospital Safety Score, improved the patient experience, performed better financially than expected by breaking even, and seen significant growth in outpatient volume. Substantial inpatient volume decline continues and BMC will need to continue to operate as efficiently as possible, she said.

“As coverage expands for patients, we have to do what we can to be efficient and be part of the solution with heath care costs,” noted Walsh. “That’s our job.”

QUEST logo

Looking forward, BMC projects that primarily due to inflation, expenses will grow sufficiently to outpace revenue, leading to a $70-80 million dollar gap by 2015 that BMC must close to break even.

“We dealt with this before and we will deal with it again,” Walsh said. “We are a team that has closed one of the biggest financial gaps in the country. We see the challenges ahead and are taking steps to address them through our QUEST goals.”

Walsh then updated the audience on how BMC performed on its QUEST goals in 2012 and announced the 2013 goals:

  1. QU: Quality
    • 2012 Goal: Improve performance on the University Health Systems Consortium (UHC) mortality index to current UHC median of .97.

      The mortality index is a standard measure of BMC’s mortality performance adjusted for the illness level of our patient population. BMC shares quality data with the UHC and uses UHC benchmarks for evaluating performance and setting quality goals.

      2012: BMC is on track to meet this goal and is waiting for complete data for the year to confirm it. The data will be available in November.

      2013 goal: Achieve a mortality index that moves BMC into the top third of hospitals around the country.

    • 2012 Goal: Schedule 80 percent of new primary care patients to be seen within 14 days; improve the number of new patients seen in all other specialties combined within 14 days by an average of 10 percent.

      2012: BMC did not meet this goal.
      “We missed on this but we did increase the number of new primary care patients by 18 percent and the number of new patients seen in specialty areas by 14 percent,” noted Walsh.

    • 2013 goal: Schedule 70 percent of new primary care patients and 45 percent of new specialty patients to be seen within in 14 days.

    • 2013 goal: Achieve 90 percent staff influenza vaccination. BMC plans to require universal staff flu vaccination for the 2012-13 flu season. All staff who wear a BMC ID badge must get a flu shot by Nov. 30. Information about the universal staff flu vaccination is available on the BMC intranet.

  2. E: Efficiency
    • 2012 Goal: Hold spending to the budgeted amount of $810 million for the expense categories of wages, employee benefits, physician services, drugs, supplies and utilities.

      2012: BMC achieved this goal.
      “We achieved this goal due to the hard work of staff,” said Walsh. “This is an organization that is prudent in how it uses resources, and a significant part of our financial turnaround is due to our rigorous expense management.”

      2013 goal: Achieve an expense budget of $12,192 per patient discharge.
      Walsh noted that the budget number includes inpatient discharges and monetary credit for outpatients.

  3. S: Satisfaction
    • 2012 Goal: Increase the commitment score on BMC’s Employee Engagement survey by 5 percent.

      The commitment score reflects the degree to which employees feel committed to BMC and their willingness to recommend BMC as a good place to work and to receive care.

      2012: BMC administered the Employee Engagement survey earlier this month, achieving a 73 percent response rate, a large jump from 60 percent the year before. The results of the survey will be available in November and BMC will then know if it achieved this goal.

      2013 goal: Increase the commitment score on the 2013 survey 5 percent above the results on the 2012 survey.

    • 2012 Goal: Increase the percentage of patients who rate BMC a 9 or 10 on the “Overall Rating of Hospital” to 70 percent for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, as measured by Press Ganey.

      2012: BMC came close to meeting this goal (69 percent), but did not achieve 70 percent.
      “We moved from 62 to 69 percent which is a big improvement for an organization,” noted Walsh.

      2013 goal: Achieve the 70 percent HCAHPS standard.

      2013 goal: Achieve a 75 percent rating score on composite outpatient surveys.

  4. T: Total Revenue
    • 2012 Goal: Achieve patient service revenue of $854 million

      2012: BMC met this goal. Walsh noted that BMC achieved this despite a significant decrease in inpatient volume.

      2013 goal: Achieve a revenue budget of $886 million.

      2013 goal: Achieve 25,108 inpatient discharges.

      2013 goal: Achieve 698,715 outpatient clinic visits.

Walsh summed up the 2013 goals by saying: “What they really mean is we have to take good care of our patients, we have to be good stewards of the resources we are given, we have to ensure this is great place to work and support one other to make sure our patients are satisfied and happy with the care we give them, and we have to make sure that we continue to grow as an organization.”

“If we do this, as we have in the past, we will continue to succeed,” she concluded.

Visit the BMC intranet to learn more about the QUEST goals.

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ITS Focused on Improving Services, Implementing Epic

As part of BMC’s strategic plan work to be the “lowest cost, highest performance health care provider,” the hospital is transforming its information technology services (ITS). Work on this includes the implementation of BMC’s new electronic health record (EHR) system, Epic, and internal improvements to the ITS department.

BMC was an early leader in the adoption of electronic medical records (EMR) and implemented many specialized systems that were the best options at the time. Today, the hospital has multiple EMRs and face challenges in keeping up with multiple system upgrades and the ever-increasing need for information flow between systems. Looking toward the future, it was clear that BMC would be better served by a single EHR system.

Epic
Epic is BMC's new electronic health record system

Last month after a rigorous review process that included the input of 150 staff members and BMC’s Board of Trustees, BMC selected Epic as its new EHR system. Epic will replace existing systems in ambulatory, inpatient, emergency and labor and delivery, and will provide a single, up-to-date medical record for every BMC patient.

Epic is a national EMR leader and has been installed at major academic medical centers like Johns Hopkins Hospital, Stanford University and the University of Pennsylvania. It is an effective tool for supporting continuing improvement in quality, safety and efficiency and is considered by most to be the gold standard in the industry.

“A robust EMR is critical to reaching our strategic plan goals to provide the right care for every patient, be the lowest cost/highest performance provider, and lead in integrated care,” says Stanley Hochberg, MD, Senior Vice President, Quality, Safety and Technology. “Our analysis shows that investing in Epic will yield a wide range of quality and operational improvements that will benefit our patients and staff.”

Those improvements include an increase in preventive screenings, improved performance on quality metrics and increased efficiency among staff.

As health care delivery changes, BMC will be increasingly responsible for coordinating care in all settings for a population of patients. An excellent EHR system is critical to that effort.

The implementation of Epic is a two-year process that will ultimately impact everyone at BMC. The system is projected to go live between April and June 2014, with the hope to extend the system to BMC’s community health center partners in 2015. A team in ITS has been dedicated to the project and recruitment of additional staff has begun.

The ITS department is not just focused on Epic. This summer the department began an assessment of its internal operations, with the goal to improve and standardize support to its customers.

“We have taken a best practice approach to IT service management and are using it to review each of our services to determine how we can better manage them to increase efficiency, customer service and overall staff satisfaction,” says Steve Groff, Director, ITS Infrastructure. “This is an ongoing process, with our end goal being to provide a consistent, effective response when handling customer issues so our users know what to expect.”

As part of this process, IT has created an online survey to gauge employees’ experiences with the department. To take the survey, click here. The results will help IT determine future improvements it can make to its services and the tools it provides to staff.

“We are committed to improving service and support for our customers,” says Hochberg. “We appreciate staff taking the time to tell us what they think and helping us improve.”

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Patient Navigation Benefits Timely Cancer Diagnosis, Care for Vulnerable Patient Populations

A new study led by Tracy Battaglia, MD, MPH, Women's Health Group, demonstrates the importance of patient navigation in helping vulnerable populations get the care that they need in a timely manner.

The study, published in the journal Cancer Epidemiology, Biomarkers & Prevention, shows that patient navigation services help decrease the time to diagnosis for female patients who have received an abnormal result from a breast or cervical cancer screening.

Tracy Battaglia 
Tracy Battaglia, MD, MPH

The women in the study who received navigation services were diagnosed in significantly less time and were more likely to complete their care compared to those who did not receive services. The decrease in time was shown among all women who received abnormal cervical screening results and among the subset of women with abnormal breast cancer screening results who took longer than 60 days to complete their care.

Data shows that low-income racial/ethnic minority patients often do not access timely, quality cancer treatment and services, and support from patient navigators is one approach to addressing that disparity.

“The goal of patient navigation is to facilitate timely care for these vulnerable patients by addressing barriers to care,” says Battaglia. Patient navigation services include identifying patients at risk for delays in treatment and facilitating appointment scheduling by identifying and addressing barriers that may interfere with this care, such as: child care and transportation services; coordinating care among numerous providers; organizing interpreter services; and providing guidance and support so patients can advocate for themselves.

“This study confirms the long presumed benefit of navigation for vulnerable populations and supports recent standard recommendations for all cancer centers to provide patient navigation services to their patients, especially those whose patients are at risk for delays in care,” says Battaglia.

BMC implemented a patient navigator program more than a decade ago and offers patient navigators to every new patient seen in the Cancer Care Center. Learn more about BMC Cancer Care Patient Navigators.

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What Do You Do, Rick Lucas?

Name: Rick Lucas
Title: Staff Sonographer
Department: Radiology/Ultrasound
Years at BMC: 40

Rick Lucas
Rick Lucas

What brought you to BMC?
I had friends working at the former Boston City Hospital, and I applied for a job there after X-ray school in1971. As an X-ray technician I spent two years in radiology training and experienced different elements of the field. Ultrasound was still in its infancy, but I really enjoyed the one-on-one time you have with the patient, and that’s where I’ve stayed for 40 years!

What do you do here?
For the last 16 years I’ve worked the weekend shift. I see patients from the Emergency Department (ED) and priority patients who are coming from nearby community health centers. We don’t have scheduled appointments on the weekend, so every day is different. However, on a typical weekday, we are busy all day, juggling ED patient and inpatient needs plus outpatients, too. During any downtime, we clean the ultrasound areas and stock the rooms with supplies.

How does your job contribute to the patient experience?
In ultrasound we are with patients throughout their entire experience, from bringing them in and out of the exam room to speaking with them about their symptoms and letting that guide us. We have built a rapport with radiologists and ER physicians, which has made treating patients smooth and efficient.

After 40 years of service you’re retiring next week. Congratulations! What has been your best memory of BMC?
I have many great memories of BMC, but the people I work with are the best. I like seeing the “cycle of a sonographer,” meaning you have worked hard throughout your career and it is nice to have wonderful, committed people to pass on the torch. I will miss working at BMC, but I know that the ultrasound department is in good hands!

What do you plan to do in retirement?
I’m an avid hunter and fisher so I plan to spend a lot more time outdoors, and I have a new granddaughter who I’m looking forward to spending more time with. Education is also very important to me, so my wife and I would like to volunteer as school aids to help children learn how to read at an earlier age. I might even find time to learn how to use my cell phone!

Do you know a staff member who should be profiled? Send your suggestions to communications@bmc.org.

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In Their Words

Patients share their BMC experience

Letter writing 

Dear Dr. Tannoury,

I wanted to tell you that after two-and-a-half years in rehab, my dad moved back home to his house with my mom. They are learning to adjust to the changes since he left three years ago but I think they are doing remarkably well. Dad is able to walk about 50 feet with his walker, more if I hold a lottery scratch ticket out in front of him; can put on his socks with his adaptive device; use his computer; get in and out of the car on his own; and go out to lunch and to the casino!

The first day dad went into the house after being away for so long, he wheeled himself over to the sink, stood up and washed his hands. It's a memory that I will always cherish.

We have you to thank for this miracle and his fortitude to taking it one step further - no pun intended!

He still goes to outpatient physical therapy two days a week and is doing his exercises at home.

I just wanted you to know how amazing this whole journey has been for all of us. We were guided to you that first day at BMC and we are so lucky we found you and you found us!

Thank you for giving my father his life back!

Holliston, Mass.

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News of Note

New leadership at Child Witness to Violence Project
Maxine Weinreb, EdD, has been named Director for the Child Witness to Violence Project. Jenifer Goldman Fraser, PhD, MPH, has been named Associate Director of Research and Development. Weinreb has been with the program since 1995, first serving as Director of Training and later as Assistant Director. Goldman Fraser is a developmental psychologist specializing in the emotional well-being of young children. She has worked at RTI International, a research and development firm, leading projects focusing on vulnerable children.

Located in the Department of Pediatrics, the Child Witness to Violence Program provides trauma-focused counseling services for children age 8 and under, and their families who are affected by community and domestic violence.

Heffernan named Chief Compliance Officer
Kathleen Heffernan, RN, JD, joins BMC Nov. 12 as Chief Compliance Officer. Heffernan previously worked at South Shore Hospital as Chief Compliance Officer, Chief Risk Officer and Vice President of Regulatory Affairs.

New Department of Surgery website
The Department of Surgery has launched a new website. The site includes new faculty profiles and updated content about the department’s clinical services, residency program, research initiatives and educational resources. In addition, the site will include up-to-date news postings, announcements and event listings.

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Awards and Accolades

Susan Langmore
Susan Langmore, PhD, CCC-SLP, BRS-S

Susan Langmore, PhD, CCC-SLP, BRS-S, Otolaryngology, has been named a recipient of the Honors of the Association Award by the American Speech-Language-Hearing Association. The association’s highest honor, it recognizes members for their distinguished contributions to the discipline of communications sciences and disorders.

The Department of Obstetrics and Gynecology has been named a Center of Excellence in Minimally Invasive Gynecology by the American Association of Gynecologic Laparoscopists (AAGL). The AAGL is the largest minimally invasive gynecologic professional organization in the world. The designation is awarded to facilities that have met AAGL’s requirements for delivering high-quality perioperative patient care and are dedicated to offering women minimally invasive surgery whenever possible.

Keith Lewis, MD, Chief and Chair, Anesthesiology, has been named a 2012 Distinguished Achievement Award recipient by the University of Rhode Island (URI) Office of the President. The award honors those who personify URI’s excellence in achievement, leadership and service. Lewis is an alumnus of the university.

Jim Feldman
Jim Feldman, MD, MPH, FACEP

Jim Feldman, MD, MPH, FACEP, Emergency Medicine, has been named recipient of the prestigious Region IV Mark E. Weinstein MD Award for his outstanding dedication and commitment to the metropolitan Boston Emergency Medical Services region.

Ali Guermazi, MD, PhD, Chief, Section of Musculoskeletal, Radiology, has been awarded a 2012 Honored Educator Award by the Radiological Society of North America (RSNA). The award is given to individuals who deliver high-quality educational content in their field of study.

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