COMMUNIT Y REPORT. When Seconds Count, Count On Us... Columbia Hospital. Lester O Leary Hip Replacement Surgery

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1 2010 COMMUNIT Y REPORT Columbia Hospital Lester O Leary Hip Replacement Surgery Thanks to my recent hip replacement surgery I am back on my feet and pursuing one of my life s passions as a professional chef. When Seconds Count, Count On Us...

2 O u r C o m m i t m e n t T o E x c e l l e n c e A Message From Our CEO Dear Neighbors, We are happy to present this Community Report to highlight our many achievements in 2009 which proved to be a very rewarding year for the physicians, employees, and patients at Columbia Hospital. Renovations began on our multi-million dollar expansion of the Emergency Department, and by late summer of 2010 we anticipate that the additional exam rooms and efficiently designed nursing stations will be completed providing increased privacy, security, and patient confidentiality. You can now text ER to to obtain live wait times in our Emergency Department that are updated every 30 minutes. In June 2009 our beautiful, new Breast Care Center opened. Located on the hospital s campus in the Columbia Medical Arts building, the Center features a serene and tranquil environment while offering the latest state-of-the-art technology and professional expertise in breast care. In October 2009 Columbia Hospital partnered with VITAS Hospice to open a 10-bed unit on 2West. This specialized care is a valuable service not only to our patients but also to our community. Throughout 2009 a dedicated team of physicians, nurses, and physical therapists met regularly to plan implementation of The Orthopedic & Spine Institute of the Palm Beaches. The Institute offers comprehensive, innovative, and technologically advanced solutions for many disorders of the joints, neck pain, fractures, arthritis, and back pain. The Grand Opening in January 2010 was a huge success. As a teaching hospital, Columbia has over 25 years of graduate medical education experience and is the sponsoring institution for all programs of the Palm Beach Centre for Graduate Medical Education (PBCGME) including Internal Medicine and Dermatology at Columbia, Pediatrics at Palms West, and Emergency Medicine at St. Lucie Medical Center. As the hub of PBCGME, Columbia serves as a primary teaching affiliate of Nova Southeastern University, the Philadelphia College of Osteopathic Medicine and the Kansas City University of Medicine and Biosciences. Finally, throughout the year Columbia Hospital physicians and employees logged hundreds of hours in community service both locally and abroad and held numerous fundraisers to benefit many charities in our area. We were extremely proud to have our Emergency Room physician, Dr. Michael Wolford, named 2009 Physician Hero in the International Humanitarian category by the Palm Beach County Medical Society in recognition of his many years of medical missions to some of the most remote and impoverished countries in the world. We are privileged to serve this community and take pride in pursuing our commitment to provide the highest level of health care with the utmost care and compassion. Sincerely, Valerie A. Jackson, CEO Columbia Hospital Cover photo taken at Columbia Hospital s Nutritional Services Kitchen, West Palm Beach, FL

3 C o l u m b i a H o s p i t a l Columbia Hospital West Palm Beach, Florida Columbia Hospital Leadership Valerie A. Jackson Chief Executive Officer Oon Soo Ung Chief Financial Officer Lynn Waters Chief Nursing Officer I developed the desire to be a nurse at a very young age while assisting in the care of a great uncle who was crippled with arthritis. I made it a goal to become a nurse and now 38 years after becoming an RN, I continue to love my profession. My greatest satisfaction comes in meeting even the smallest needs of a patient and/or their family. Lynann Isham, R.N., B.S.N Director of Progressive Care Unit 1

4 O u r C o m m i t m e n t T o E x c e l l e n c e Community Impact Summary* Columbia s St atistics Total Patients Treated Annual Hospital Admissions Annual Emergency Visits Total Medicaid Patients Treated (ER Patients Only) Medicaid Market Share 1 Total Uninsured Patients Treated 2 (ER Patients Only) Uninsured Care Market Share 1 59,277 9,605 21,229 4,741 5% 9,251 16% (1) does not include outpatients (2) excludes Medicaid patients treated HCA East Florida Facilities and Ser vices Hospitals Surgery Centers Diagnostic Imaging Centers Psychiatric Care Facilities Regional Laboratory Graduate Medical Education Programs Number of Licensed Beds ,394 HCA East Florida Hospit al Family Total Employees Total Physicians Total Volunteers 13,260 4,333 1,749 Bringing State-Of-The-Art Technology To South Florida Columbia Hospital s Center for Breast Care offers digital mammography, which is one of the most recent advances in x-ray mammography. A major benefit is that there is no wait time for processing the films, and images are available to the technologist and radiologist within seconds. Images can be sent electronically to several treating physicians or given to the patient without a loss of quality. In addition, the computer-aided-detection (CAD) system which acts as a second pair of eyes in reading the study is utilized with digital mammography. 2

5 C o l u m b i a H o s p i t a l Columbia s Economic Impact Total Salaries & Benefits Cost of Charity & Uncompensated Care Taxes Paid: Federal Income Tax State Income Tax Indigent Care Tax Property Tax Sales Tax Unemployment Tax Other Local Tax TOTAL Taxes Capital Investment 1 Total Local Vendor Support Minority & Women Owned Business Support Physician Specialty Coverage in the ED $ 45,088,000 $ 15,150,000 $ 172,000 $ 33,000 $ 1,062,000 $ 733,000 $ 594,000 $ 32,000 $ 3,000 $ 2,669,000 $ 3,758,000 $ 10,138,000 $ 261,000 $ 319,000 TOTAL Economic Impact $ 77,122,000 (1) 5 year annual average Total Local Vendor Support 13% Capital Investment 5% Total Taxes 3% Physician Specialty Coverage for Emergency Care 1% Total Cost of Charity & Uncompensated Care 20% Total Salaries & Benefits 58% 3

6 O u r C o m m i t m e n t T o E x c e l l e n c e A partial list of the organizations benefiting from Columbia Hospital s involvement: ALS Association Alzheimer s Association American Cancer Society American Heart Association Autism Speaks Gaskov Clerge Foundation Gratitude House HCA Hope Fund HCA Haiti Relief Fund Indian Ridge School Leukemia and Lymphoma Society Mental Health Association of Palm Beach County National Alliance on Mental Illness Palm Beach County Medical Society Services Palm Beach Lakes High School Exceptional Student Education Dept. Place of Hope Susan G. Komen for the Cure United Way of Palm Beach County GIVING BACK TO OUR COMMUNITY Community Support Columbia Hospital is an affiliate of HCA East Florida. Our employees provide both financial and volunteer support to countless civic organizations, schools, colleges, city projects and nonprofit and charitable organizations in their communities. Uninsured/Underinsured Patient Education HCA East Florida Hospitals are committed to helping uninsured/ underinsured patients qualify for local and state health benefits. Each hospital offers on-site benefit education and Medicaid enrollment assistance. Step Up for Students Since 2005, HCA has redirected corporate income tax to the Step Up for Students program. Through this gift, low-income students receive a K-12 scholarship enabling them to receive a quality education tailored for their specific needs. It is well documented that a one size fits all education is not the best approach for every student. Families with the means may choose the perfect school for their child, but that s simply not an option for many people. Through this program children who qualify for the National School Lunch Program can receive scholarships. Qualifying parents can use these grants to send their child to the public or private school that best meets their child s needs. Antonio Trigo A Step Up For Students Scholarship provided Antonio with the opportunity to attend a school that could meet his learning needs and he has excelled. Now in the ninth grade, Antonio is attending Miami Union Academy on the scholarship program and he is continuing to shine. Although he is a few years away from high school graduation, he has already begun to think about his future. He plans to attend college and pursue a degree in pathology. Step Up for Students Program 1 # of Low-Income Student Scholarships (1) Represents 5 year contribution for HCA Hospitals in the state of Florida. $45,475,000 12,175 Flu Vaccine Legendary Coach Don Shula and his wife Mary Anne educate the community about the importance of getting the flu vaccine in a Public Service Announcement sponsored by HCA East Florida.

7 C o l u m b i a H o s p i t a l Awards and Recognition In 2009 Columbia Hospital was honored to have been named Hospital of the Year by the Palm Beach County Medical for its outstanding dedication to Project Access, a program of the Medical Society which depends on hospitals and physicians to donate their services to patients who are unable to access medical care. Another prestigious honor bestowed by the Palm Beach County Medical Society was to one of Columbia s Emergency Room physicians, Dr. Michael Wolford, who was selected as 2009 Physician Hero in the International Humanitarian category. For the past eight years Dr. Wolford has traveled to numerous third world countries on medical missions where his expertise in tropical medicine has saved hundreds of lives. Additional honors received include the Luminaire Award from the Department of Health and Human Services, the Preceptor Servant-Leader Award from the Lloyd E. Gregory School of Pharmacy, and the Certificate of Distinction for Advanced Certification as a Primary Stroke Center by The Joint Commission. Hurricane Preparedness Each year Florida residents and visitors need to be ready for the effects of a hurricane or other natural disasters. For that reason, HCA East Florida arranges for comprehensive hurricane preparedness plans to ensure that our patients and staff who care for them are safe before, during and after the storm. Our hospitals have arrangements and contracts in place with vendors from around the state and nation to provide support, from on-site security, if needed, to medical supplies, additional generators, food, fuel, emergency transportation, building supplies and construction crews who can be dispatched immediately following the storm to make needed repairs to keep our hospitals operational. Consult-A-Nurse Healthcare Referral & Information Consult-A-Nurse is a free service from our HCA Hospitals designed to provide you with physician referrals and health information. Our nurses are available 24 hours a day by phone at HCA-DOCs ( ). Physician Referral Our service makes finding a doctor easier by providing information about physicians affiliated with HCA hospitals, including medical specialty, skills and experience, physicians who are accepting new patients and office hours and location. Health Information Our registered nurses 1 provide consultation and answer health-related questions. They do not diagnose conditions but provide information on many health subjects. (1) Please note that our Registered Nurses are licensed by the State of Florida and any health information is intended for individuals within the state. You should always consult with a physician in your area on any information provided. Volunteering In 2009, HCA East Florida hospital employees and volunteers dedicated 284,550 hours of patient and family support. Events include participation in building homes with Habitat for Humanity, Making Strides for the American Cancer Society, and promoting wellness and education through complimentary health screenings and lectures. We sponsor the Team Storm Riders cycling team ranked 49th in the country for raising funds for the National Multiple Sclerosis Society, with riding members from our hospitals staff and physicians. 5

8 O u r C o m m i t m e n t T o E x c e l l e n c e Quality & Patient Safety Putting Patients First is the foundation of our culture and passion for quality health care. Many of the initiatives we implement serve as national models for the industry today. n n n n hcareelectronic Health Record (EHR) - With EHR, access to patient health information is simplified by improving the quality, effectiveness and efficiency of healthcare by immediately providing clinicians with accurate information needed to provide optimum patient care. It is our belief that EHR will be one of the most fundamental support systems for optimizing the quality of healthcare that we provide in our facilities. hcare Hub/Mobility Physician Portal - The hcare hub portal integrates the Electronic Medical Record of our physician practices to our hospitals with the portal interface, allowing physicians access to their patients clinical records, allowing for more efficient use of their time and resources with information at their fingertips, both on their office computers and via smart phone mobile technology. emar Technology Computerized Physician Order Entry (CPOE) - CPOE is a patient safety technology that allows physicians to place orders directly into the clinical information system, checking each order against the patient s allergies and other pertinent clinical information. Physicians are alerted to any potential contraindications or interactions at the time the orders are placed. HCA East Florida is moving to a streamlined process that eliminates opportunities for medical error. In addition to the safety checks, physician orders go immediately to the department(s) that will implement/ initiate the order, leading to more timely and efficient patient care. The system also reduces the possibility of incorrect orders due to clinicians not having to interpret written/verbal orders. We have implemented this system in all of our hospitals Emergency Departments and as a hospitalwide pilot at St. Lucie Medical Center. Electronic Bar-Coded Medication Administration (emar) - HCA East Florida has implemented emar in all of our hospitals to reduce the risk of medication errors. The critical components of this safety technology are bar-coded armbands, bar-coded medications, and safety checks within the emar software. It is an honor for me to serve as Chairman of Columbia Hospital s Board of Trustees and to play a key leadership role alongside such talented physicians, exceptionally caring nurses and clinical staff, and very dedicated employees and volunteers. Daniel Higgins, M.D. Chairman of the Board of Trustees, Columbia Hospital, and Past President of the Palm Beach County Medical Society 6

9 C o l u m b i a H o s p i t a l n n n n Each patient receives an armband with their own unique bar code. Before a medication is administered, the bar code on the patient armband and the bar code on the medication is scanned allowing the nurse, or therapist, to verify the right patient is receiving the right drug in the right dose at the right time. The software checks each medication against the patient s drug history and lab results. If conflicts or potential drug interactions are identified, warnings alert the nurse to double check, verify and/or call the doctor before administering the medication. HCA s results with emar have been instrumental in encouraging the FDA to develop a standardized bar code system for use throughout the pharmaceutical industry and at all hospitals to reduce the risk of medication errors that can seriously harm patients. Picture Archiving and Communications Systems (PACs) & MUSE - The PACs system stores digital versions of patients clinical images such as CT and PET scans, MRIs and XRays so that they can be readily accessed by our clinicians at the hospital or remotely. The MUSE system digitizes EKG tracings also allowing for easy access for clinicians. Voice Recognition System - This system creates efficiency in our radiology departments by allowing our physicians to report their clinical findings directly on a system that recognizes their voice, eliminating the delays often caused by transcriptions. The report then gets reviewed on screen by the radiologist where it can be corrected, signed and sent for utilization by other clinicians usually within a 30 minute time frame. Emergency Department Management Module (EDM) - The Emergency Department Management Module (EDM) is used to manage the flow of patients through the emergency department from the patient s arrival into the department through their departure. Both CPOE and emar fully integrate into EDM allowing for streamlined communication of orders and medication administration between physicians and ED staff. EDM is also the technology that allows HCA East Florida to measure and track ER wait times accurately and in a timely manner. Telehealth - HCA East Florida Division is piloting at JFK Medical Center the ability to monitor patients from a distance using electronic devices to record and send measurements of patient vital signs. Telehealth technologies are evolving to provide both patients and healthcare professionals with real-time interactive health systems that can engage both patients and their care management teams more fully in the treatment of their conditions. Upon discharge, patients are monitored and managed from home. I live my life to the fullest and believe in being proactive rather than reactive. Early detection of a lump in my left breast at the young age of 25 saved my life, and with the help of my great support system including the Breast Center at Columbia Hospital, I continue to live this one life I am given with every positive energy I possess. Patricia Montoya-Lecaroz Breast Cancer Survivorr STEMI Time: 54 Minutes 7

10 O u r C o m m i t m e n t T o E x c e l l e n c e SPECIALIZED CARE Emergency Department Excellence For the last few years, the entire HCA East Florida Division has been working diligently to improve the effectiveness and efficiency of its Emergency Rooms. Our strong focus on enhancing care and improving ER processes has dramatically reduced wait times to below national averages. In fact, we re so successful, average ER wait times are available to the public. Using various innovative methods local residents have immediate access to average ER wait times. Patients have easy access to an estimate of how long they will have to wait to receive care in the ER, therefore providing them with the resources to make informed medical decisions about their urgent needs when seconds count. Wait times for all of our hospitals are updated every 30 minutes and are available on: Via text message: Text ER to iphone Web Application: iphone itriage Application: AppStore Roadside Digital Billboards throughout our region. The Center for Pain Care Our Center for Pain Care provides caring and respectful treatment for patients who have acute and chronic pain problems. Our physicians are dedicated to helping patients find relief by managing medications, procedural intervention, referrals for biofeedback, psychiatric services, and physical therapy. Specialists include neurologists, anesthesiologists, orthopedic surgeons, physical therapists, nurses, and psychologists. Among the chronic disorders treated are: cancer pain, low back pain, sciatica, cervical (neck) strain, reflex sympathetic dystrophy, myofascial syndrome pain caused by peripheral nerve damage, pancreatic pain and neuropathic pain. Upon my arrival at the ER until discharge I was shown genuine concern by the nursing staff. They kept me and my wife informed and aware of every single step of my care. Willie Minus General Surgical Patient 8

11 C o l u m b i a H o s p i t a l Psychiatric and Behavioral Health Services The Pavilion, an 88-bed inpatient unit located adjacent to the hospital, offers comprehensive psychiatric and behavioral health services. Psychiatric needs of children, adolescents, adults, and seniors are assessed and treated through a full range of programs that include individual therapy, group therapy, family therapy, medication management, and aftercare. An intensive outpatient program and a partial hospitalization program are also offered. The Pavilion is the only child/adolescent inpatient provider and the only licensed Baker Act receiving facility that accepts children in Palm Beach County. The Orthopedic & Spine Institute of the Palm Beaches The Orthopedic & Spine Institute of the Palm Beaches offers comprehensive, innovative technological advanced solutions for many disorders of the joints, neck pain, fractures, arthritis, joint discomfort, and back pain. Using the latest advances in the field of orthopedics and spine care, our dedicated team of professionals can attend to all of your surgical needs. Our team of experts includes board certified orthopedic surgeons and neurosurgeons with extensive training and orthopedic certified/trained professional nurses, physical therapists and technicians. The Orthopedic & Spine Institute offers support from pre-admission to post-discharge by providing classes, reading materials, support and ensures a seamless and smooth transition from hospital to home. For a free physician referral, please call or visit our website at Columbia Hospital Ortho/Spine Team VITAS Inpatient Hospice Unit In partnership with Columbia Hospital the VITAS Inpatient Hospice Unit opened in October 2009 and offers a home-like setting along with an interdisciplinary team of nurses, physicians, social workers, a chaplain, and volunteers. 9

12 O u r C o m m i t m e n t T o E x c e l l e n c e SPECIALIZED CARE (continued) General and Vascular Surgery Columbia Hospital performs highly advanced inpatient and outpatient general and vascular surgical procedures. Our surgical team utilizes surgical methods including endoscopy and laparoscopic procedures to minimize recovery time and allow a quick return to their normal routine. Many of our vascular surgeries are performed in the Special Procedures Room, which is the largest interventional vascular procedures room in West Palm Beach. Full anesthesia capabilities are built right into the room along with an advanced angiography system. Wound Management At Columbia Hospital we specialize in the treatment of non-healing wounds. Not all wounds heal with traditional medical treatment. Some wounds caused by diabetes, infection, injury or burns can last for months. Our specially trained doctors and nurses will develop an effective, up-to-date treatment plan to assist in the healing process of a specific type of wound. Your first visit will include a review of your medical history and medication usage. Blood tests and simple circulation testing may also be needed to determine the cause of the wound. Our team of caring professionals will help you with decisions about your care, including dressing instructions, home care and wound prevention education. Weekly monitoring of your progress helps us to make adjustments in your plan of care as needed to provide the fastest results possible. 10

13 C o l u m b i a H o s p i t a l Radiology and Diagnostic Imaging Services The Radiology Department provides full-service diagnostic imaging specializing in interventional and women s imaging. We offer the latest in diagnostic imaging studies, including the new BrightSpeed 16-slice CT scanner which provides superior image quality and quicker scans. The department is staffed by registered/licensed technologists of the American Registry of Radiologic Technologists in addition to technologists with advanced certification in CT Scan Imaging. Columbia s MRI with EXCITE technology delivers breakthrough results from an image quality, application, and enhancement perspective. The combination of faster and better scanning has proven to significantly decrease the time for the patient in the magnet. The VIBRANT MRI component enables simultaneous, contrast-enhanced acquisition with high spatial resolution of both breasts. Patients no longer have to come back a second time to obtain the highest quality images. Another technological advance is the use of PACS (Picture Archiving Communication System). This system allows a team of physicians to view and manipulate images simultaneously, even from separate locations. The Breast Care Center at Columbia Hospital Our new Breast Care Center is especially designed to provide a serene and tranquil environment for our patients, staff, and physicians. The use of warm colors, textures, and natural elements including light, water, and sound help soothe the mind and calm the body. Services offered within this comfortable and compassionate environment of the Breast Care Center include: digital mammography, Computer-Aided Detection (CAD) system, serving as a second set of eyes after a mammogram, ultrasound, ultrasound guided biopsy/cyst aspiration, stereotactic biopsy, weekly breastfocused multidisciplinary conference, second opinion consultations, surgical consultations, and bone density. We are pleased to announce that Columbia Hospital s Breast Care Center is now utilizing a new device called the HydroMARK, which is FDA approved. This may be used to mark areas where breast tissue has been removed by a physician during a non-invasive breast biopsy. The HydroMARK, developed by Biopsy Sciences, is beneficial because it is made of a bioabsorbable material that can be seen under ultrasound for an extended period of time. Columbia Hospital is one of first hospitals in West Palm Beach to offer this innovative device for the comfort of our patients. 11

14 O u r C o m m i t m e n t T o E x c e l l e n c e Columbia Hospital West Palm Beach, FL Columbia Hospital is a proud affiliate of HCA East Florida Division. The East Florida division, located in Ft. Lauderdale, encompasses 12 hospitals in South Florida and the Treasure Coast area in addition to multiple ambulatory surgery centers and imaging centers, a supply chain center and an integrated regional laboratory. Almost 510,000 patients were treated in our emergency departments. The steady improvements in intake processes in the ERs at all HCA East Florida hospitals between 2007 and 2009 are a reflection of a huge team effort. Emergency Department directors, Emergency Department staff, radiology, lab, registration staff and physicians were all involved in dramatically cutting the time patients wait for a physician and total treatment time. Various innovative methods are available to local residents to access immediate average ER wait times. Wait times for all of our hospitals are available through: Text messaging: Text ER to 23000; iphone web application, iphone itriage Application: AppStore; and through roadside digital billboards throughout our region. We are also upgrading technology at an unprecedented rate to ensure we can continue to provide clinical excellence and optimal patient outcomes. From a new CyberKnife at JFK Medical Center and a Synergy S at Aventura for the latest in cancer fighting technology to the Electronic Health Record (EHR), our facilities have integrated wireless and digital technology through all modalities. Robotics is another strong focus we are now up to six Robotic programs enabling surgeons to perform precision work with very small incisions and faster recovery. Our hospitals have done an outstanding job focusing on quality and operations, with many of them now Accredited Chest Pain Centers, Joint Commission Certified Primary Stroke Centers and Cancer Centers accredited by the American College of Surgeons Commission on Cancer. All of these represent the gold standard of care today, awarded by independent accrediting organizations. 12

15 C o l u m b i a H o s p i t a l Columbia Hospital th Street West Palm Beach, FL Printed on recycled paper.

16 Columbia Hospital th Street West Palm Beach, FL To speak to a nurse regarding health questions or referrals, please call toll-free HCA-DOCs ( ).

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