Northfield Hospital and Clinics Board Meeting Observer Report from July 27, 2023
l. Executive Summary
ll. Call to Order
lll.Regular and Consent Agenda
lV. Reports:
Hospital Chief of Staff Report– Ben Flannery
No concerns/controversies
V. Presentations/Discussion/Action Items (Items A and B were switched in order from the original due to a mixup in presenters)
- Alternative Urban Area Review (AUAR) update (Mikayla Schmidt, City of Northfield)
The city is conducting an Alternative Urban Area Review for proposed development to the west of the hospital. This AUAR is done as an alternative to an Environmental Impact Statement and it is a community planning tool. It is believed by Ms. Schmidt that having this in place early will be beneficial to the development process. It will be used to identify cumulative impacts of a possible nearby industrial park or tech center being developed. These impacts might include wetland pollution, stormwater pollution, threats to endangered species, traffic, noise, and others. Members of the board asked about possible issues for the hospital including vibrations from construction and how traffic patterns might impact how the hospital might grow. There was also discussion about how these new developments might help generate a better tax base for Northfield.
B. Increasing Nurse Satisfaction (Lisa Bauer, Director of Inpatient Services)
Ms. Bauer presented information about her Doctoral project which was looking at increasing bedside nurse job satisfaction. She stated that issues such as the pandemic, the generational gap (boomers retiring and not enough new nurses available), and general health of the public getting worse are making things very stressful for nurses leading to huge turnover rates. From 1/1/17 to 12/31/21 there was a 75% acute care RN turnover at the Northfield Hospital and Clinics.
Ms. Bauer led a study of nurses in Northfield over a period of 10 weeks which identified areas that needed addressing to reduce stress. Some of these included getting more beds, improving the safety culture, and building resilience.
The results of the study found that the key elements that raised job satisfaction were developing a culture of respect, engaging nurses in decision making, giving some autonomy over practice, and shared decision making. It was found that when the morale of the nursing staff went up, patient satisfaction went up as well.
VI. Executive and Committee Reports
- CEO Report (Steve Underdahl, President and CEO)
The hospital is working on optimizing their communications. They have refreshed and rebuilt their NHC website, making it customer oriented– no longer a thesis statement about the institution, but rather the front door to the organization meant to easily answer customer questions.
An agreement has been made with a mental health and addiction provider to work out of Faribault starting in 2024. This site was chosen because there was ample space there. There is frustration that many emergency room visits are patients in acute mental health crises and that the hospital may be able to treat the crisis, but they are not able to provide the long term mental health care that is needed. This often results in multiple return visits. This is a state-wide if not nation-wide problem.
There is an opiate treatment program operating out of the Lonsdale Clinic.
A psychiatric medication consultation service has been added for the emergency department and providers that will help doctors navigate complicated medication interactions.
The hospital continues to find expenses outpacing revenues which is stressful for everyone. Allina has recently announced a layoff of 350 workers citing “financial challenges.”
The proposed merger between Fairview and Sanford will not happen.
A discussion was held about how the colleges affect the hospital. It was noted that Northfield has many national and international issues which are unusual for towns of this size due to so many students coming from around the country and world. Recently there was concern of Ebola exposure due to a student from Africa at one of the colleges.
- Financial Report (Eric Guth, CFO)
In June, inpatient admissions were 21% over forecast, Emergency room visits 4% over forecast, and surgery 7% under forecast. Revenues were under forecast, and operating expenses were over the forecast. It was noted that more patients do not necessarily mean more money. One major reason is that 51% of patients are on Medicare or Medicaid and the hospital is only reimbursed 27% of the actual patient costs for these patients. This is a big concern as the population ages, and Northfield becomes more attractive to retirees.
- Budget and Finance Committee (verbal) report (Fred Rogers)
The committee is evaluating possible changes to the Equity and Bond portfolio. They will hold another meeting to discuss this. They are negotiating with Community Resource Bank.
- Governance and Planning (verbal) report (Sarah Carlsen, Board Chair)
They are focusing on financial issues. A report will come in August.
- Round table/Announcements/Questions
Nothing reported or said.
At this point in the meeting there was a break before the board met in a Closed Session to discuss “marketing activity related to the hospital’s competitive position with other health care providers that offer similar services.” All non board members were asked to leave.
Respectfully submitted by observer Anne Larson.
