Board discusses EOCCO
by Samantha White
During the Harney County Health District Board of Directors meeting (held March 26), the board agreed to approve the Chief Executive Officer (CEO) Recruitment Committee charter.
The eight-person committee, which was approved by the board during its previous meeting (held Feb. 26), will work with an advisor to recruit a CEO for Harney District Hospital (HDH).
Current HDH CEO, Jim Bishop, announced that he will retire in August 2015, after almost 15 years of service to the hospital.
Board chair Dan Brown explained that the committee will not make the hiring decision. Instead, it will make recommendations to the board. (See story titled, “Hospital CEO announces he will retire next year.”)
During the March 26 meeting, CEO Bishop shared some of the information that was presented at the Eastern Oregon Coordinated Care Organization (EOCCO) meeting with the board.
Bishop reported that an “unusually large number of people” in Harney County signed up for Medicaid coverage, and most of them (more than 90 percent) are assigned to HDH Family Care.
Bishop also reported that the majority of patient costs are concentrated in a small number of people. In fact, only 5 percent of patients account for 55 percent of costs. For Harney County, that 5 percent represents 72 people, Bishop said.
Dr. Kevin Johnston explained that these are the patients who have required intensive, regular contact as a means of avoiding even more expensive treatment and wasted/duplicate testing.
Dr. Johnston said many of these patients have both mental and physical health issues, possess a limited subset of skills, and lack sufficient social support. As a result, many of them call the ambulance and go to the emergency room multiple times a week.
Dr. Johnston said these are the type of patients who may be ideally managed by primary providers and clinical care coordinators.
Clinical care coordinators are licensed health care professionals who, as part of a multidisciplinary team, provide daily care management services that are determined by individualized care plans.
However, Dr. Johnston added that the top 10 users of medical care would all have separate problems, and financial resources may need to be committed based on classes of disease.
Dr. Johnston said the goal is to find ways to save money, while helping these patients in a more appropriate way.
CEO Bishop added that patients will probably be selected based on their clinical needs, rather than just money.
“That’s what we need to do — select clinically, and the money will follow some time in the future,” he said.
Board member Tim Smith said it seems logical for care providers to focus on the conditions that they have the talent and skill set to deal with.
CEO Bishop also shared the inpatient maternity statistics from December 2012 through November 2013. These statistics, which were presented at the EOCCO meeting, show that HDH had the highest rate of Cesarean deliveries (C-sections).
However, Brown said that, because the statistics were taken from a small sample size, they aren’t really valid.
CEO Bishop agreed, stating, “If you changed three of those babies from C-sections to not C-sections, we are average.”
Dr. Johnston said, because HDH does not have a neonatal intensive care unit, doctors are willing to err on the side of calling a C-section early, rather than pushing an infant to the point that he/she has to be resuscitated or flown to another facility.
The statistics also showed that HDH had the lowest rate of infants requiring neonatal intensive care.
The board received an update from the Paragon project managers regarding the hospital’s change to the Paragon electronic health record system.
One of the project managers explained that the goal of the change is to improve the patient care experience by aligning HDH with the St. Charles Health System.
Another project manager added that the system update is taking place on an “extremely aggressive time line,” but a third manager said the update is on track to meet the June 9 deadline.
HDH CFO Catherine White said a percentage of the money that was invested into the system will be reimbursed if project deadlines are met.
Sammie Masterson (HDH human resources) said the hospital participated in the “active shooter” training that was held Friday, March 14.
“It was quite the undertaking with all the entities involved,” Masterson said. However, she added that it was “a great cooperative effort” and said she was glad the hospital participated in the training.
Masterson and Chief Nursing Officer Barb Chambers recognized HDH Safety Officer Perrilyn Wells for her role in organizing the training.
Chambers said staff from all over the facility stepped outside their regular roles to participate.
“The team work that was happening was amazing,” Chambers added.
In other business, the board:
• appointed CFO White as the budget officer;
• appointed six people to the budget committee;
• learned from HDH Development Coordinator Denise Rose that some HDH employees have expressed interest in enhancing their skills and moving to other areas of the hospital. She said some are even going back to school to earn additional qualifications. Rose said staff members’ desire to work internally to find better and more fulfilling jobs shows that they want to stay at the hospital;
• learned from Rose that HDH and Symmetry Care are working together to apply for a grant from the EOCCO to be used toward a licensed clinical social worker position. Rose said HDH has enjoyed building a relationship with Symmetry Care;
• learned from Chambers that feedback from patients regarding HDH staff has been positive.
“Staff here are doing an exceptional job in every department,” she said.
The next board meeting will be held at 6 p.m. Wednesday, April 23, in the hospital board conference room.