Quality Services Director Lisa Andre said the hospital has opted not to pursue a relationship with Press Ganey for its inpatient surveys. Instead, the hospital has contracted with J.L. Morgan & Associates, which has promised to provide survey results from 25 inpatients monthly, including actual statements from the patients.
Lisa also said the hospital's federal Critical Access Hospital survey on July 24 was "excellent." Surveyors identified some minor preventive maintenance and medical records issues; additionally, some deficiencies--mostly related to the hospital's recent construction--were noted as part of a Life Safety Survey. A "plan of corrections" was forwarded to the surveyors last week. Overall, Lisa said staff did a great job.
Lisa updated the board on the State of Nevada's efforts to curb opioid use. In May 2015, Nevada implemented the Good Samaritan Drug Overdose Act. That was followed by the January 2018 implementation of Assembly Bill 474, which called for large-scale opioid prescribing changes. Then in May 2018, Nevada instituted overdose reporting requirements. Lisa said the intent behind AB474 is to decrease patients' pain medication use to the point they are no longer using opioids. "However, patients are having difficulty understanding that," she said. Dr. Len Perkinson added that if patients do not wish to reduce their drug intake, "we can't treat them."
Adding to the difficulty is there are a limited number of clinics that provide pain management services, and patients have to be willing to begin a drug-reduction program or the clinics will not provide treatment.
CEO Art Frable said a pain management specialist may be interested in coming to Winnemucca on an intermittent basis. He will provide updated information as it becomes available. Trustee Michelle Miller also said she would provide more information on MTM, a non-emergency transportation program for Medicaid patients.
EMR Selection Update
CEO Art Frable updated the board on the selection process for a new Electronic Medical Record (EMR) system. In 2006, Humboldt General Hospital chose to implement MEDHOST; however, many of the things the company promised did not come to fruition. Now, HGH is looking at athenahealth, which has been on site two times; a third visit to HGH is in the planning. The hospital is also considering Cerner. That company visited with medical staff during its initial visit; a second visit is also planned. The hospital may also consider Medetec, a software system designed for smaller hospitals. Additionally, several staff members will visit other hospitals and company locations to gain hands-on experience with the software.
HGH's contract with MEDHOST has expired and the hospital is paying for services on a month-to-month basis. The hospital will also have to buy out Greenway Health, an auxiliary outpatient clinic software, for $167,000, if it moves away from MEDHOST. CEO Art Frable said he and others are anxious to move forward in the interest of time and money. "We are not going to sit on this longer than we have to."
Trustee Michelle Miller said she is looking for each system to be properly vetted. She said staff "sings the praises of a software system, and six to nine months later, they can't get it implemented." She said she wants to make sure the hospital does a good job moving forward, especially since a new EMR will be a multi-million-dollar investment for the hospital.
Board Vision for Sustainability and CEO Goals
- Dr. Leon Ravin. CEO Art Frable shared details of Dr. Leon Ravin's visit to Humboldt General Hospital. As the statewide psychiatric medical director, Dr. Ravin is focused on critical health care issues such as access to mental health care, transportation of mental health patients, specialty help for rural physicians, and more. CEO Frable said he appreciated Dr. Ravin's efforts to understand the local mental health care situation better.
- Hospital Surveys. CEO Art Frable also discussed the hospital's change to J.L. Morgan & Associates for inpatient survey services. Additionally, the hospital has opted to implement its own follow-up phone calls to outpatients in other departments with the goal of increasing survey response rates.
- Pharmacy Remodel. CEO Art Frable said the committee working on the Pharmacy space remodel is considering the possibility of relocating to another departmental space, as the Pharmacy's current location will not allow for such an invasive remodeling project. CEO Frable said the board can review those recommendations during an upcoming board meeting.
- Physician Recruitment. CEO Art Frable said the hospital has a lead on a good physician. He asked the board to schedule a special meeting to discuss physician recruitment efforts overall in an effort to ensure all members have the same vision moving forward.
- Trustee Education. CEO Art Frable said the Nevada Hospital Association asked that he serve as a member of its Board Certification Committee. He said the NHA has a program in place to certify hospital board members. Chairman JoAnn Casalez said board members have always been interested in trustee education; however, accessibility has been a problem. CEO Frable said the new certification process is designed to make training more readily available, and to credit trustees for the education they receive during routine board meetings.
Chief Financial Officer Sandi Lehman presented the financial report for July 2018. The hospital ended the month on a positive note with more than $228,000 to the good. Trustee Jennifer Hood made the motion to approve the financials; Trustee Bill Hammargren was second. The vote was unanimous in the affirmative.
The hospital auditors from Dingus, Zarecor & Associates were onsite the week of August 6. They will present their findings to the board in October.