Northfield Hospital Board Meeting of May, 26, 2011
Dave Emery, LWV Observer
1. Dr. Tim McKone, the new head of the Mayo Clinic Radiation Oncology Center in Northfield updated the Board on the progress of the building project. The project is on schedule and an open house is planned for July 27th. The Center will feature the same equipment as Mayo Rochester and Mayo trained staff, including a medical physicist. Dr.McKone spent 16 years as a radiologist and surgeon in Mason City Iowa, and he and his wife have a house under construction in Northfield. The new Mayo facility is located across North Avenue from the hospital because the State has prohibited Mayo from building in the Metro area, and North Avenue is a dividing line.
2. Mary Crow, COO, gave the board an update on the $2.2 million clinical expansion project underway at the hospital as it converts office space to new clinical space following the hospital’s expansion into the Village School property. The next on-site building project will likely take place in two years.
3. NCH is going to participate in the Minnesota Time Out campaign to improve the quality of care and patient safety. The various hospital teams will take a “time out” on every procedure to go through a safety check list.
1. The Board approved the minutes from the meeting of 4/28/2011 and the applications for medical staff membership/privileges.
1. Board members reported on the results of a Webinar (web-based seminar) on Accountable Care Organizations (ACOs). ACOs are the tool in the Health Reform bill to reorganize the delivery of medical care in the US. The legislation was very general and the details are being provided in the regulations being written to implement the act. The Board members who spoke appear to be very negative on ACOs, doubting that they will work, and questioning the financial incentives being created in the regulations.
2. Board members also reported on a Webinar on Value Based Purchasing/Reimbursement (VBP) which is a Medicare program that will incentivize the provision of higher quality care by hospitals. Hospitals who meet certain quality standards for their Medicare patients will receive a bonus. Board members questioned the survey process and the quality measures being used in the VBP program.
3. The Board continued the discussion of their Strategic Planning Retreat which was facilitated by a consulting firm, Health Care Futures. Topics included:
- The Mayo relationship and future directions
- Building a culture of patient-centered care
- Branding the Northfield Hospital and co-branding with Mayo
- Relationships with the City
A Board member suggested that the topic of “the role of the hospital in improving community health” be added to the list. Mark Henke discussed the role of the hospital administration in addressing the Board’s concerns with a plan of action, which will be brought to the Board at a later meeting.
1. Admissions and revenue for the month were below budget again, but operating (net) income was again positive and above budget. The COO commented that the “product mix” delivered by the hospital is changing with less inpatient care being delivered and a wider variety of outpatient services being provided so revenue targets can be achieved even as inpatient day targets are not met.
2. The hospital is implementing electronic medical orders for MDs. Each physician must personally enter all requests for services and prescriptions on line. Physicians commented that it was a challenge for some, but that the IT staff of the hospital was doing a great job in facilitating the change. The purpose is to eliminate medical errors in prescribing. One of the physicians present discussed some of the informal feedback received from other physicians.
3. There was a fairly lengthy discussion regarding the recent loss of 2 physicians from the clinical system. One of the factors cited by the physicians regarding their decisions to leave was seeking a “less stressful” practice structure where they didn’t need to take “call”. A question was raised about the hospital hiring a “hospitalist” (a physician who practices only in the hospital) to cover all calls.
Observer’s comments: The meetings are getting more interesting (and I suspect more effective) as Board members raise questions and express opinions. Maybe someday we will even have an argument and a split vote on a motion.
The Board appears to be hoping that health care reform will go away or at least not impact Northfield Hospital. The problem is that if health care reform doesn’t work, Medicare will go broke even sooner than currently projected. I think the Board is pursuing a lose-lose approach. The large health delivery organizations in the Twin Cities are being much more proactive.
The Board is starting to think about doing a significant building project in 2 years which may require community support. But the Board still seems stuck in secrecy mode for events like the Strategic Planning Retreat. The justification is that the hospital is in a competitive environment and they don’t want their competitors to know their next moves. The concern is real, but listening to the discussion of the Retreat, it appears that about 90% of the topics had little or nothing to do with competitive strategy and were all about improving the operation of the hospital. This is what we talked about on retreats 20+ years ago when I was on the Board, and we didn’t need secrecy. I think the Board needs to balance the need for secrecy regarding strategic moves with the need for transparency and community trust.