Ancillary and Support Services (6640B)

Transcription

1 5-109 Program Locator County Health Operating Budget Administration and Financial Services Quality Management Patient Care Services Ancillary and Support Services Long Term Care Services Ambulatory and Medical Services Headline Measures 100% 60% 40% 20% 0% Percent of Survey Respondents Rating Services Good or Better Patients 85% 87% Phy sicians 85% 87% 100% 60% 40% 20% Percent of OB Ultrasound Imaging Scheduling Occurring Within Two Months 0% % 90% Program Outcome Statement The Ancillary and Support Services Division supports all programs at SMMC by performing all non-surgical and non-nursing functions in order to facilitate the provision of quality health care for San Mateo County s residents. Services and Accomplishments The Ancillary and Support Services Division consists of five clinical patient treatment areas Imaging, Laboratory, Pharmacy, Rehabilitation and Creative Arts Therapy, and Food and Nutritional Services as well as five support areas including Clinical Trials and Research, Environmental Services, Facilities and Engineering, Security, and Biomedical Engineering. Ancillary and Support Services support SMMC medical and nursing staff and provide pre- and post-diagnostic inpatient, outpatient and long term care services to residents of San Mateo County. In addition, the Division partners with other County programs in achieving mutual performance objectives. The following are major accomplishments in the current year: Implemented a Pharmacy Management Program including outpatient formulary, 340B program of reduced pricing for indigent outpatients, automated medication system including robotic dispensing, and a pharmaceutical patient assistance program Implemented an on-site Mobile MRI program Added point-of-care lab services line for all clinics and phlebotomy lab services for North County and Fair Oaks clinics Implemented the transfer of Medical Center-related food and nutrition services from the Health Services Agency Expanded service lines to include patient load from the 281-bed Burlingame Long Term Care Center Implemented information technology upgrades and completely new state of the art systems, which created efficiencies in results reporting, turnaround time and accuracy of data Story Behind Baseline Performance Ancillary and Support Services has significantly improved upon its performance in the past year. New service lines have been implemented and existing lines expanded to meet patient health care needs. All service areas have managed an increase of 10-20% in outpatient services volume with the same or slightly more staff. SMMC has embarked on an initiative to monitor quality performance and improvement. As a part of the annual Quality Improvement Plan, Ancillary Services measures the satisfaction of its clients, both patients and physicians. The baseline metric is to be established in FY and monitored on a monthly basis. Results are reported to various medical and staff committees and via newsletters. Lab and Imaging will be the focus of Headline Measure 1, with the

2 5-110 expectation that scores will meet or exceed 85% satisfaction. Verbal and oral survey results will be collected and analyzed, with an attempt to address the diverse language needs of the patient population. Ultimately, the goal is to assess perception of services provided. Timely patient care is an essential component of providing appropriate medical treatment. Non-invasive medical information can prevent the need for more invasive and costly surgical treatment. In an effort to assure timely turnaround time, the Imaging Department will review availability of scheduling for Ultrasound Imaging, with the expectation that it will occur within two months after the appointment is ordered. Equipment, volume and staffing are the variables, which can determine scheduling and patient flow, all of which will be considered in management and improvement of the process. As demand for imaging services increases, Headline Measure 2 will assist SMMC in assessing the provision of timely quality care. Major challenges over the next two years will be: To recruit and retain critical, hard-to-fill positions within limited resources and in competition with often more attractive compensation packages at non-public hospitals in SMMC s marketplace To respond to increasingly frequent and more stringent surveys by JCAHO, Centers for Medicare and Medicaid Services (CMS) and other regulatory bodies within existing level of staff resources To keep pace with costly and rapid changes in medical technology through selective capital investment of limited funds Implement Initial Stages of Picture Archiving and Communications Systems (PACS) in the Radiology Department Conduct phased implementation of digital imaging project for transmission of large image files from point to point on a Local or Wide Area Network, enabling digital viewing and storage of radiology images Purchase technology for the initial roll out PACS in MRI, CT and Mammography Expand Laboratory Services to Include Burlingame Long Term Care Center Convert lab services from outsourced contracts to in-house operation to achieve economies of scale and improve efficiency and quality Evaluate additional outreach opportunities Program Priorities Ancillary and Support Services will meet performance targets by doing the following: Complete 85% of Emergency Department Lab Tests Within One Hour Monitor turnaround times to establish baseline standard Report results to Quality Improvement Committee, physicians and staff Perform 85% of OB Ultrasound Imaging Scheduling Within Two Months Monitor time from ordering of exam to appointment scheduled Review staffing and recruitment to match increase in volume Improve Turnaround Time on Outpatient Prescriptions to Less Than 72 Hours Monitor time required to fill prescriptions Review industry benchmarks and productivity standards Achieve Patient Satisfaction Levels of 85% for Patients and Physicians Provide results of patient satisfaction surveys to physicians, nursing staff and departmental managers Develop recommendations for improving the ratings

3 5-111 Performance Measures Summary Table Performance Measures FY FY FY FY FY What/How Much We Do Number of lab tests 213, , , , ,177 Number of imaging procedures 31,989 35,696 39,473 44,210 49,515 How Well We Do It (Quality) Percent of Emergency Department lab tests completed within one hour Percent of OB Ultrasound imaging scheduling occurring within two months 85% 90% 85% 90% Is Anyone Better Off? (Outcome) Percent of customer survey respondents rating services good or better - Patients - Physicians 85% 85% 87% 87% Resource Allocation Summary Revised Recommended Change Recommended Salary Resolution Funded FTE Total Requirements 30,314,875 29,654,519 36,304,038 39,683,510 3,379,472 41,456,781 Total Sources 5,784,225 4,546,416 54,980,608 60,140,217 5,159,609 63,084,910 Net County Cost 24,530,651 25,108,103 (18,676,570) (20,456,707) (1,780,137) (21,628,129) Program Net County Cost The County's General Fund contributions to the are centrally budgeted as revenue sources in the Medical Center s Administration and Finance budget. These contributions are appropriated in General Fund budget unit 5850B Contributions to Medical Center. Ancillary and Support Services is funded by patient charges and intergovernmental revenue sources. Gross patient charges are budgeted in this unit and contractual allowances (for Medi-Cal and other payors that provide reimbursement at capitated rates that are below charges) are budgeted centrally in Administration and Financial Services. FY Program Funding Adjustments The following are significant changes from the FY Revised Budget to the FY :

4 Adjustments to Provide Current Level of Services Budget adjustments have been made as follows: inclusion of merit increases and negotiated labor increases. In addition, as part of efforts to improve the information available for this department, the Medical Center budget is now presented by programmatic and support function: Administration and Finance, Quality Management, Patient Care, Ancillary and Support, Long Term Care, and Ambulatory/Outpatient Care. Positions have been reallocated among these six programs with no net overall fiscal impact. Gross Patient Charges have been updated to include a 10% rate increase, plus a projected 5% increase in clinic visits at the Ron Robinson Senior Center and a 33% increase in patient days, primarily due to increased patient census at Burlingame Long Term Care. 5,159,609 3,069, (2,089,661) (2) 2. Increase in Positions for Burlingame Long Term Care (BLTC) Six new positions have been added to meet increased service demands related to the full operation and increased census at BLTC. In the Laboratory, two Medical Technologist IIs and two Laboratorv Assistant IIs have been added. A Therapy Aide in Special Services and a Supervising Therapist In Speech therapy have also been added , , Other Staffing Adjustments Four Extra Help positions have been converted to permanent status an Imaging Specialist and two Patient Services Assistant IIs in Radiology, and a Patient Services Assistant II in the MRI unita Management Analyst III that was deleted from the Safety unit at mid-year is eliminated. In addition, appropriations have been set aside for requested position changes that will be reviewed as part of the June Revisions process , , Adjustments to Balance Budget Reductions have been made in Extra Help and Overtime appropriations across all programs to balance the Medical Center budget. 0 (511,760) 0 0 (511,760) 0 TOTAL FY PROGRAM FUNDING ADJUSTMENTS 5,159,609 3,379, (1,780,137) 7 FY Program Funding Adjustments The following are significant changes from the FY to the FY :

5 Adjustments to Provide Current Level of Services Budget adjustments have been made as follows: inclusion of merit increases and negotiated labor increases. Revenue adjustments are based on projected patient volume growth, and estimated inflationary increases ranging from 1% to 2% in certain revenue categories. Appropriation adjustments include estimated inflation increases ranging from 1% to 4%. 2,944,693 1,773, (1,171,422) 0