Posted 9 months ago
By Kevin Horn
Box Butte General Hospital department managers and administration staff are in the midst of budget planning for the coming 2013-14 fiscal year, according to a report given to the BBGH Trustees Monday evening by Controller Lori Mazanec and administration team members.
Participating in the report were Ms. Mazanec, Special Services Director Mary Mockerman, COO/CIO Jim Parks, Clinic Administrator Scott Alwin and CNO Jane McConkey. Each presented strategic goals for the various departments under their leadership. Ms. Mazanec said each department had to use a SMART Goals template, which uses five steps, including: specificity, if they are measurable, attainable, relevant, and a timeframe for goal accomplishment.
Ms. Mockerman focused on the Special Services Division, touching on five goals identified in her department for the coming year: Establish a plan to respond to, assist and support patients and their families who are in need of behavioral health and/or substance abuse treatment services; Incorporate the HOPE Plan check-list model to be used for all patients with discharge diagnosis of Congestive Heart Failure or joint replacement to assure patients are prepared to manage their care at home; Reduce risk of healthcare acquired infections via monitoring of hand hygiene and isolation precautions; Optimize patient outcomes and reduce preventable re-admissions through best clinical and infection prevention practices; Implement an improved process for the accident investigation process within workers compensation.
Ms. McConkey presented the Nursing Division goals: Coordinate and implement nursing orientation programs to impact current and new BBGH nursing staff as well as visiting nursing students; Re-evaluate and revise systems and processes for Medication Reconciliation on the Patient Care Unit as needed and ongoing for more efficiency and safety; Implement hand-offs for transitions of care for patients transferred from the ED/ICU, Surgery and Obstetrics to the Patient Care Unit; Continue to meet the Network #12 Facility Adequacy lab goal of 100% and increase the Facility Phosphorous lab goal to 75% in target for the Dialysis Unit; Decrease knowledge deficit of nursing staff related to infusion therapy devices, medication indications and side effects, and chemotherapy; Implement a revised exercise program for Pulmonary Rehab; Improve patient/staff satisfaction by implementing a food management software program in the Dietary Dept.; Decrease knowledge deficit of nursing and rehab staff regarding wound identification and care; and Improve transitions of care for Specialty Clinic patients being scheduled for surgery at BBGH.
Mr. Parks presented the Support Services Division goals, including: Having consistency in BBGH values and standards from contracted services and technologists in the Medical Imaging Department; Implement Glycohemoglobin testing in-house, using Joint Commission implementation guidelines so providers can get results quicker and lower fees for patients; Implement a plan to complete in the regional Ulrasound market; Reduce the average number of days to correct a not-charted medication errors to four days; Implement a linen inventory process to be completed twice annually; Migrate to the Centriq platform; and CMS attestation for Meaningful Use for the hospital, then begin looking at clinic opportunities.
Mr. Alwin said the Rehab and Clinic Division goals of: Providing community education of The Rehab & Wellness Center renovation project by holding one annual community event including fundraising efforts for the Box Butte Health Foundation; Effectively carries out Swing Bed activity services in accordance with state laws, increasing participation to 75%; Improve BBGH staff utilization of the dysphagia (swallowing disorders) program for inpatients; Create a new Mission/Vision Statement to use in branding and establishment of unity and direction of all the clinics; Cross-train two registration staff and two clinical nurses between Alliance and Hemingford to offer assistance when needed and reduce loss of continuity and patient care; Establish financial indicators for the clinics.
Ms. Mazanec presented the Finance Division goals of: improved BBGH clinical documentation for patient safety and accurate and complete medical records; Implement standardized insurance verification methods and pre-admit processes; Reach 100% attainment of CPAT Certification; Develop a record retention policy specific to HR/Payroll records; Provide feedback and education to nursing staff regarding appropriate charging and documentation; and Develop an improved method of researching, ordering, documenting and placing in-service all capital and minor equipment purchases.
Other agenda items included the following items.
The board recognized March Employee of the Month Christina DeBaca, an RN in the Emergency Department. Also recognized was Leslie Ilg, RN, CNOR, for recently completing her national certification as an operating room nurse, as was Tiffany Boness for receiving her Associate Degree in Nursing and her RN license; and Mona Foster for recently being certified as an IV technician. New employees introduced were Josie Brown, Admissions Clerk; Sheila Enos, an LPN in GNMSS Family Medicine; and Gina Ackerman, RN in the ED and ICU.
After unanimously approving the consent calendar, Ms. Mockerman presented her Quality Management and Safety Report. She reminded the board that the visitation restriction at the hospital for 18 year olds and younger has been lifted. Ms. Mockerman also went over a review of 2012 Core Measures.
Chief of Staff Timothy Narjes, MD, reported a recent medical staff meeting was routine, with staff receiving updated information on various drugs.
Ms. Mazanec said February closed with an increase in net assets of $75,000, $335,000 less than expected. Total Patient Service Revenue of $3,145,000 was $750,000 short of the month’s projections. Year-to-date patient service revenue totals $28,436,000 and is 7% behind budget. She said initial revenue projections may have been set too aggressively when compared to actual results. February operating expenses of $2,214,000 were $278,000, or 11%, under budget. Year-to-date expenses continue to look favorable and remain under budget by $855,000, or 4.0%. February closed with operating income of $61,000, compared to $403,000 originally budgeted. The year-to-date operations have delivered a gain of $1,128,000, nearly 32% behind expectations. Taken together with revenue from non-operating sources our year-to-date increase in net assets stands at $1,500,000, 13% lower than budget predictions and $275,000 lower than results one year ago.
Mr. Griess discussed board competency during his Governance Focus, with the main focus on developing a more purposeful template to help identify the competencies of current trustees, as well as what competencies the board would like to see in future board members. He asked if the trustees were interested in developing a template specific to BBGH to determine those qualities and goals. The trustees said they were, with Mr. Griess indicating he would do so and present his suggestions to the board at a later date.
Mr. Parks reported the design team for the addition/renovation project was at BBGH the previous week. Staff members have been using the full size mockup rooms located in the former Alco building to test out various room arrangements. He said he would like to allow the rest of the staff and members of the community to visit the Alco building to see how that process worked before tearing down the mockups. Most of the design part of the project should be completed the week of April 8, going into construction documents at that point. He and Mr. Griess indicated enough information on design and construction costs should be completed over the next couple months for a “go/no go” decision at the regular meeting in May.
The board met with TeamSTEPPS Master Trainers who presented an update of activities over the past year as well as plans for future activities. The Master Trainers then asked the board to proclaim April as TeamSTEPPS Month (see photo).
Upon the request of Mr. Griess, the board approved signing a routine Construction Contract Resolution required by the USDA for the addition/renovation project. The Contract will be presented to the County Commissioners for their approval at their next board meeting.
Three board members indicated their intent to attend the 17th Annual Western Regional Trustee Symposium to be held June 5-7 in Park City, UT.
After the Trustees unanimously approved all credentialing requests, they set the next regular meeting date for Monday, March 22, at 7 p.m. in the BBGH Alliance Room. As always, the public is invited to attend.
With no further business, the board adjourned at 8:30 p.m.