Health and Hospitals System Board Meeting January 30, 2015

Public Speakers. A series of public speakers complained that contracted CCHHS service provider Sodexo has failed to manage effectively, with insufficient measures of performance, leadership turnovers, patient abuse, and poor performance leading to an infestation of bedbugs at Stroger Hospital. CEO Dr. Jay Shannon responded that this is an issue of serious concern. COO Peter Daniels said there have been 276 disciplinary actions against Sodexo since July of 2011 when their contract was initiated.

Recognition.  Dr. Shannon recognized Provident Hospital for its 3-year accreditation by the Joint Commission.

Committee Reports.  Board Chairman Hill Hammock has asked each board committee chairperson to present relevant metrics each month to summarize status and to highlight issues that emerge at committee meetings.  In addition, the metrics of one of the four committees will be particularly highlighted at each board meeting as a way of understanding the full scope of the issues.  Board meetings may now require 3 hours.

Quality and Patient Safety. Committee Chair Mary Gugenheim introduced Dr. Das, who presented process measures showing high compliance with appropriate procedures for various afflictions; composite compliance rose to about 95% during FY14 for Stroger Hospital.  Regarding patient experience at Stroger Hospital, no change in 2014: about 60% overall patient satisfaction, only 40% satisfaction with patient environment (noise and cleanliness are key issues), 80% with communication with doctors, 70% communication with nurses.  Dr. Das said Stroger's overall patient satisfaction level ranks with the lowest 20-30% of hospitals nationally.  Between March and September there will be an inspection of the 16 CCHHS-affiliated clinics to prepare them for certification by the Joint Commission as Medical Home Models.  Concerns were expressed regarding slow hiring at Provident, as well as parking problems.

Managed Care.  Committee Chair Wayne Lerner presented data showing that CCHHS is falling behind on CountyCare membership recertifications, attributing the problem to delays at the state and to fewer re-enrollments by younger people.  Forty percent of  CountyCare patients are cared for by CCHHS, 60% by others.  CountyCare represents more than 50% of CCHHS total revenue, a problem if more patients are seeking care elsewhere.  Another concern is that CCHHS is now caring for the patients most at risk.  Already it is caring for 3,000 of the sickest children in the county, according to Deputy CEO Doug Elwell.  "We need to get our share of healthier patients," Lerner commented.

Human Resources.  Committee Chair Dorene Wiese introduced HR Director Gladys Lopez whose data showed 874 vacancies filled in FY2014 (an increase over FY2013), of which 75% were clinical, 25% nonclinical.  Reasons to leave CCHHS: 8% discharged, 25% relocation, 61% retirement.  In FY2014, there were 6,016 staff, of which 2844 were Black, 1291 Asian, 1102 White, 607 Hispanic, 6 American Indian, unknown 226; female 70%, male 30%; average age of staff 49; 3,465 staff at Stroger Hospital.  Lopez said the greatest hiring challenges were finding physical therapists, occupational therapists, and physician assistants. She said 60-90 days is the LEAST amount of time required to fill positions due to barriers of credentialing, time to schedule interview, then report and respond.  Dr. Marsh pointed out that many applicants might well have moved on by then.

Finance.  Chair Lewis Collens' data showed a cash improvement of $101,764 compared to FY13, but key FY14 metrics were under budget, including CountyCare net income with a shortfall of over $24 million and CCHHS net income with a shortfall of $34 million as of October 31.  Financial data regarding contracts with outside providers will be available at future meetings.  Contracts were approved subject to approval by the full Cook County board.

CEO Report. Dr. Shannon reported that the redevelopment for the central campus will incorporate a new building with ambulatory services and office space; RFPs are due February 9.  Stroger Hospital is preparing for review by the Joint Commission.  Dr. Shannon alluded to a recent Crain's article citing only 27% bed occupancy at Stroger Hospital, noting that Stroger is a trauma center with 6 types of ICU beds.  Lerner pointed out that the market is moving toward a need for fewer beds; some partnerships with other hospitals may be possible.  Dr. Shannon welcomed Dr. Erica Marsh and said there is still one board vacancy.  He met with Senator Durbin and five representatives in Washington DC to stress the importance of continued Medicaid funding.  CCHHS now has new linear accelerators providing radiation therapy to cancer patients.

Meeting adjourned at 12:10.

Submitted by Linda Christianson