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Northfield Hospital Board Meeting - May 29, 2014

May 30, 2014 at 12:55 pm
By Dave Emery

Medical Staff Reports

1. Chief of Staff—Dr. O’Halloran: Dr. O’Halloran reported that the Medical Staff is still working on arranging coverage by a hospitalist

2. Clinic Medical Director Report—Dr. Flannery: Dr. Flannery reported that discussions are continuing with Allina regarding a shared call system.

3. Allina Clinic Report—Dr. Keith Olson:  Dr. Olson reported that the OB call arrangement has been extended for 1 year.  A new female OB will start at Allina in the fall.  Dr. Olson also reported that he personally had a chance to observe an EMS team in action at the hospital with a cardiac arrest patient, and that the performance was very professional.  

4.  CMO Report—Dr. Jeff Meland: No report. 

City Business Report

Mayor Graham reported that the Youth Initiative received 110 applications for positions on the various City boards, and appointments have been made to many boards.  The Mayor reported that potholes are being filled as fast as possible, and he reminded the group that Woodley is a country road, and therefore not a city responsibility.  Interviews are being conducted for new city attorneys.   

Special Presentations

A.  CEO Report—Steve Underdahl.  The financial results for April were “remarkably good.”  The Room Service program at the hospital begins this week.  Patients will receive a menu from which they may order meals, and meals can be ordered at any time.  A market research study is under way.  The hospital is transferring its telephone service from St. Olaf College to Arvig.  A work session with the City Council is scheduled for June 10th.

B.  Three physicians from Mayo were present at the meeting to begin a discussion of replacing the PSA contract between NH&C and Mayo System.  Both parties agreed that the current contract has not served either party very well and change is needed.  A new model is needed, but neither party is sure what the model should be.  A negotiating team will be assembled to map the way forward.  A mutual confidentiality agreement will be signed to provide the structure for a very open discussion of strategies.  Interim reports will be given at the July and August Board meetings, and a proposal will be brought to the Sept. Board meeting.  Board members expressed frustration with the lack of progress on a new agreement.  One of the Mayo physicians attributed the delay to the internal decision making structure within the Mayo system, and the fact that Mayo and the NH&C are trying to create something new.   The Mayo physicians said that Mayo wants to be committed to Northfield for the long term, and they want to keep patients “in the community” where their support network resides. 

C.  Mr. Jerry Ehn, COO NH&C, reported on the Service Line Evaluation project.  A consumer-oriented ambulatory network is driven by three factors: affordability, on-demand services, and tailored services. 

1. Affordability means that the hospital must develop new pricing and communication processes.  Providing a “price” to a specific customer for a specific service is difficult because each employer health insurance contract is different.  Even though the price set by the hospital is a constant, the amount to be paid by a patient will vary by employer/insurance contract.  

2. On-demand services will require better scheduling techniques, new staffing plans, adding patient navigators, and perhaps new service sites.  Primary care may evolve into a team approach where a physician works with 2-5 other team members. The forecast is for a continuing shortage of primary care physicians.  “We can’t recruit our way out of this problem.”

3. Tailored services means the development of new or extra services, such as house calls or telemonitoring, for patients who have a need and the means to pay for extra services. 

Action Items

  1. The Board approved the minutes of the April 24, 2014 Board meeting.
  2. The Board approved the applications for Medical Staff membership.  
  3. The Board approved the purchase of a Seimens 24 channel Aera 1-5 Tesla MRI system for approximately $1.8 million with remodeling costs included.  The current MRI is 11 years old and has limited capabilities compared to state-of-the-art technology. 
  4. The Board approved the purchase of Mobile C-Arm Fluoroscopic System for $175,000.   
  5. The Board approved issuance of a Reimbursement Resolution that would allow the option to purchase up to $4 million in capital expenditures.  The resolution is required by the state to preserve the option of financing the MRI and Fluoroscopic system at a later date. 
  6. The Board approved the Strategic Plan presented at prior meetings.

Discussion Items 

Information Items

A. Committee Reports.

1.  Community Relations—Steve O’Neill.  Steve reported that the committee had heard a marketing presentation on branding.  Two surveys will be undertaken, one with patients and one with community members.  The results will be available in July. The NH&C website is being redesigned.  The Committee is considering guidelines for community donation requests.  The Committee approved a grant of $750 to the Lonsdale Quick Start program.

2. Governance and Planning Committee—James Schlichting.  The Committee had met with the HR Director for NH&C.

B.  Administrative Reports.

1. CFO Report—Tim Gronseth.  April was a very good month financially; the reverse of January.  Volume was up in almost every category of services, and the payer-mix improved.   The additional volume was handled with almost no increase in staffing.  NH&C received over $100,000 of revenue recapture from MN State Tax refunds during the month.  NH&C “total income” is about $2 million above budget year-to-date. 

Other

1. The Board met in closed session following the conclusion of the regular monthly meeting to perform the annual evaluation of the CEO.  I waited for about 25 minutes for the closed meeting to conclude, but then gave up and left.  Sorry.  

Observer’s Comments: I think both Mayo and the NH&C want to continue their relationship, but the relationship is evolving.  I think Mayo and the NH&C could invent some exciting models for doing health care in a different way.   Or the negotiations could get stuck in the current rut.  I hope not; there is too much to be gained.  NH&C has an obligation to keep the community informed of the progress if they close the negotiation meetings to the public, as they appear to be considering with the confidentiality agreement.     

Comments

  • June 3 2014 at 8:58 am
    kiffi summa

    David , thanks again for the always good report and the long 'unsatisfied' wait after the closed meeting portion. I hope you, as the observer, can be influential in stressing to the LWV board the importance of close reporting and updates on the status of the hospital's and Mayo's restructuring deliberations. The fact that this IS a city owned hospital, and that we the citizens are the 'owners', is enough reason to justify a more open position in the ongoing reportage. I would hope the LWV would support the community in this...

  • June 3 2014 at 9:21 am
    Jane McWilliams

    Thanks, David, for your report. Hospital "news" is not reported elsewhere, so your work is a valuable community service. I hope it has the high visibility it deserves!.

  • June 5 2014 at 4:17 pm
    Keith Covey

    I too appreciate these monthly reports. Though I occasionally attend Hospital Board meetings, or maybe because I do, I'm very aware that there's a lot of mysterious terminology in this field. This month's puzzle for me is in Special Presentations B: What does PSA mean? If The LWV hopes to make these reports attractive to a broader public, we need to work hard to make them accessible to the general reader.

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