Pharmacy staff members pictured, Margaret Bradshaw, Lois Leister, Lil Paoli, Marie George

Mendocino Coast District Hospital is 38 years old and has a great need for a new Pharmacy department.   We have a top notch staff of Pharmacists and Pharmacist Technicians who work in a Pharmacy that has changed very little in all of those years.  Thanks to our U.S. Congressman Mike Thompson and the U.S. government, grant funds have been made available so that we can upgrade and expand our pharmacy.  The first step in expanding our Pharmacy is to vacate the existing department.  That step was accomplished today with the hard work of, not only the entire Pharmacy staff, but also the tireless work of our Plant Maintenance Staff.  The Maintenance Staff handled all of the “heavy lifting,” while the well organized Pharmacy staff pulled stock from shelves and placed it on carts that were wheeled from the current department into a temporary department that will be the home for our Pharmacy for the next 6 months.

Pharmacy and Maintenance staff were assisted by volunteer staff from a variety of hospital departments who came to help.  It was truly a team effort and a marvel to behold.  On Monday, construction work will begin on our new Pharmacy department.  We can hardly wait.  One thing that I know for sure.  6 months from now there will be another moving day.  And I am certain that it will be as well organized and efficient as the one that took place today.  Congratulations to Chief Pharmacist Lois Leister and her entire department, and to John Funderburk of Plant Maintenance and his entire department.  You all did a great job today!

Reef Atwell of USDA and Riki Thoreson-Schaefer, Mammography Technician

Mr. Reef Atwell of the United States Department of Agriculture (USDA) made a visit to Mendocino Coast District Hospital on Wednesday of this week to inspect our new digital mammography equipment.  USDA awarded MCDH a $55,000 grant which has been used towards the purchase of the new equipment which is housed in the hospital’s new Diagnostic Imaging Center.  Mr. Atwell, who is based in Santa Rosa, California was performing a part of his responsibilities to check and verify that the new equipment had, indeed, been purchased and that it is working.  “I am very impressed with the new center and all of it’s new equipment,” said Atwell.  The total cost for the new digital mammography unit, including a picture archiving system was $412,783.   USDA provides millions of dollars each year for rural America.  “We are always glad to help the Mendocino Coast,” he said.  USDA has made hundreds of thousands of dollars of grants to MCDH over the years.  The last one before this was for funds to purchase a new ambulance in 2008.  We are very thankful to our Congressman Mike Thompson, who supported this grant for Mendocino Coast District Hospital and to the United States Department of Agriculture for their support of rural America.

Kitty Bruning, Case Manager

I always look forward to my Adopt a CEO Day, or as some have called it “Bring Your CEO to Work” Day.  This week I spent an entire day working with our Case Managers, Phil Sullivan, Kitty Bruning and Ann Marie Cesario.  I soon learned that Case Managers hold the keys to helping our hospital patients (and their families and loved ones) make it through the , sometimes difficult, maze of services offered by our hospital.  They are also invaluable members of the team in assisting our doctors and nurses to accomplish their jobs.   It is not unusual for a patient to receive services in our Emergency Department, ICU, Medical/Surgical Unit and even our Swing beds.  All in one stay!  So it takes careful coordination and an incredible repertoire  of skills to assist in all of these areas.  I observed Phil negotiating with a patient like a Psychologist, as well as filling in with an extra pair of helping hands as a nurse.  I also saw Kitty consoling a family through a crisis event and smoothing the way for a transfer to a larger facility.  As I watched and observed, I realized that everyone needs a helping hand once in awhile.  And when a hospital is involved, those hands can mean the difference between a very bad day and a manageable day.  Our case managers are the helping hands that help our patients, our clinical staff, and our financial staff (and more) and they are often the first line of defense when a patient or visitor is having a problem with our system.  Thank goodness for all of our Case Managers.  Our staff and our patients and visitors are all very fortunate that they are here.

Last week I had the privilege of attending the InTouch Health Company’s 6th Annual Remote Presence Clinical Innovations Forum in Santa Barbara, California.   In the 6th year of its existence, this was the largest gathering yet of institutions, educators, clinicians and administrators who come together each year to learn about the latest in technological advancement from one of our Nation’s  Clinical Technology leaders.   

InTouch Health’s signature product is the RP7 “robot.”   Just like the one that we have named “Dr. Don,” that we see roaming our halls.  I saw that the same robot that we use to bring specialists to Mendocino Coast District Hospital is used in hospitals from coast to coast in some of our Nation’s finest Academic Teaching Hospitals, as well as small rural hospitals like MCDH.   I also learned that the RP7 robot can be used to enhance advanced surgical techniques in hospital surgical suites, as well as in the Emergency Department of major trauma centers.  I attended the conference because I was invited to participate in a Focus Group Session for the use of telemedicine in rural settings.   As is usually the case, I am certain that I learned more and I am bringing home more valuable knowledge than I was able to contribute.    Johnathan Linkous, CEO of the American Telemedicine Association, one of many prestigious presenters, said it best when he said “2011 is the most exciting year in telemedicine innovation and acceptance, that we have seen in the past 18 years.”  And its very satisfying to know that Mendocino Coast District Hospital is one of the hospitals that is leading the way.

Tomorrow a Nationally respected Medical Journal (the Journal of the American Medical Association) is issuing a report on “Quality of Care and Patient Outcomes in Critical Access Hospitals.”  The report uses a scientific approach to determining if there is a difference between critical access hospitals (CAHs, such as Mendocino Coast District Hospital) and non-Critical Access Hospitals when it comes to quality.  The report provides evidence that when looking at Nationally recognized hospital quality data, that critical access hospitals consistently come in with lower quality scores than non-critical access hospitals.   I have 2 reactions to the report.  First, I think that the report misses the boat by not recognizing that there are some fundamental differences between CAH hospitals and non-CAH hospitals.  The most major difference is that the CAHs exist in smaller rural markets with much less availability of physicians, specialist physicians and advanced clinical capabilities (such as cardiac catheterization labs).  Also, critical access hospitals are focused on keeping only those patients that can be treated safely in a smaller hospitals and transfering the more acutely ill patients to larger hospitals.  In the JAMA study, patients that were transfered to a larger hospital were excluded from some of the analysis.  So my first reaction is that quality in critical access hospitals needs to be measured differently than quality in urban hospitals.  My second reaction is that our hospital, Mendocino Coast District Hospital, compares very well to the National database that the JAMA article uses.   The data that they are using is available to anybody with a computer and internet access.  It’s available on a website called “Hospital Compare” on the Medicare site,  http://www.hospitalcompare.hhs.gov/   We have an ICU here, which is a big advantage for a critical access hospital (only 30% of them do, according to the report).  And in the areas of “processes of care” and “clinical outcomes” we compare pretty well.  In those 2 areas on the Medicare Hospital Compare website, we report and we consistently show as being comparable to larger hospitals.  The one caveat that I would point out is that, due to our low numbers, many of our scores have a footnote number 1.  Footnote number 1 says “the number of cases is too small to be sure how well a hospital is performing.”  So, in other words, even though the report says that our numbers are good, it is also saying that small numbers are unreliable.

My conclusions from reading the JAMA article are that (1) there needs to be more study on what constitutes high quality in critical access hospitals and (2) Mendocino Coast District Hospital is doing all of the right things to ensure that we are providing a high quality of care here on the Mendocino Coast.

Mark Scheffer and Dr. Jack Bellah

I love my job as CEO at Mendocino Coast District Hospital.  I have the honor and privilege of working with a dedicated team of health care professionals and support staff that are providing high quality medical care to our community.  Each month I take time to get out of my comfort zone of business meetings, telephone calls and paperwork to spend time working with our front line staff.  In fact I made that comment earlier today and one of our floor nurses, Amy, said “We’re like the Marines!”  I have to agree.  Our front line staff are like Marines.  No matter what, they get the job done.  On Wednesday of this week, I spent an entire day in our Surgery Department.  This was my first time visiting our Surgery Department as an employee (I have been back there twice as a patient!).  I had always heard from our patients of the skilled work that is being done “behind the closed double doors.”  This was my chance to see it for myself.  I want to thank our patients and our staff who allowed me to, not only observe, but also to work side by side with our staff.   As I usually do, I like to be productive and useful when I visit a department.  So on this day I learned how to properly clean a gurney (and prepare for the next patient) and to “sticker” charts.  The one thing that I find to be common in every department that I visit, is that our work could not be done without effective teamwork.  No where is that more true than in the operating room.  The OR teams and Outpatient Surgery crew are like precision drill teams (again like Marines!) with everyone working together and doing their parts.  Each team member is constantly watching the other members of the team to see if they need a helping hand.  I was very glad to be there to lend my helping hand.

Our patients, guests and visitors may, or may not, know that Mendocino Coast District Hospital has a system in place to recognize excellence in the care and services provided by our Hospital staff.  The system is called the “Star” Card program.  Any of us, including patients, visitors, physicians, co-workers or volunteers, may recognize excellence by picking up a Star Card in any of the convenient locations and filling out the name of the employee to be honored and why.  Each month we receive between 20-40 cards for our staff.  Every time a Star Card is received, a copy is given to the honored employee, their manager and Human Resources.  All Star Cards are posted on a bulletin board outside of the Hospital Cafeteria each month by Tanya Wyldflower.  Beginning in April, we are selecting 1 Star Card each month for the “MCDH Star Card of the Month.”  The Star Card of the Month will be based upon extraordinary excellence.  For April, we have selected Deb Hendricks, ICU Charge Nurse.  In her nomination, written by the visitor of an ICU patient, “Deb is an excellent nurse.  Very caring.  Took care of my Aunt.  Always explained in detail with her care and prognosis.  Thanks Deb.”  Thank you Deb for the wonderful care that you provide to our ICU patients every day!

I am extremely proud to announce that Mendocino Coast District Hospital has been awarded a 5-Star rating by HealthGrades, the leading independent healthcare ratings organization, for 2 of our Hospital services for 2010-2011.  The 2 services are Total Hip Replacement Surgery and Pneumonia Care.   Hospitals earn this prestigious designation by performing in the top 10 percentile of all hospitals Nationally for a low incidence of mortality and complications.   Hospitals do not apply for a favorable rating.  HealthGrades objectively analyzes the clinical outcomes data for all 5,000 hospitals in the United States.   Hospitals are then awarded a 5-Star, 3-Star or 1-Star rating, depending upon how they compare to other hospitals across the Country for favorable clinical outcomes.  HealthGrades has been studying hospitals for 13 years.  For the past 3 years, it has awarded Mendocino Coast District Hospital a 5-Star rating for total hip replacement surgery.  And it is particularly gratifying to note that Coast Hospital is the only 5-Star rated total hip replacement hospital in the 3 counties of Mendocino, Lake and Humboldt.  This is the first time that we have been awarded a 5-Star rating for Pneumonia Care.  This accomplishment is due entirely to the clinical staff at MCDH and their adherence to stringent infection control standards.  Beginning with our doctors, such as orthopedic surgerons Bill Rohr and Jack Bellah and including our surgical teams, nursing staff and our support staff.  For more information on HealthGrades, I encourage you to visit them on the web at www.healthgrades.com

BETA Healthcare Group President Tom Wander Presents Award of Excellence to representatives of MCDH OB Nursing and Medical Staff

On Tuesday night at the November Board of Directors Meeting we had a very special guest who was here for a special presentation.  Mr. Tom Wander, President of BETA Healthcare Group was here to present the BETA Award of Excellence to MCDH.  Mr. Wander announced that BETA Healthcare Group, which provides professional liability coverage for hospitals (of all sizes and types) has launched it’s “Quest for Zero” preventable birth injuries.   It’s goal is to promote best practices in the delivery of care to moms and babies for member hospitals.  35 hospitals were eligible to participate and 6, including Mendocino Coast District Hospital, have qualified to receive the Award of Excellence.  The Award of Excellence is given to BETA member hospitals that demonstrate 100% compliance with all the elements of the “Quest for Zero” OB Initiative. 

In his remarks, Mr. Wander said “On behalf of BETA Healthcare Group, and the many current and future healthy babies and happy families of newborns in this community, I would like to present Mendocino Coast with its Award of Excellence in its “Quest for Zero.  This award really goes to the administrative and clinical leadership of Mendocino Coast and, most importantly, to its OB clinicians, the doctors, the nurses, the technicians and aides who recognized the importance of this initiative and devoted their time and resources to enhance their skills, work as a team and strive for continuous improvement in one of life’s most precious moments.”  Congratulations to our entire Obstetrics Team.   All of us at MCDH are very proud of you!

Proud Parents, Lynn and Chester with New Baby Boy

One of the milestone events of each year is the arrival of the Mendocino Coast “New  Year’s Baby.”   We can probably all identify with the old man (2009) departing and the arrival of 2010.   This year’s New Year’s Baby came to us with an interesting story.  Proud parents, Lynn Williams and Chester Maiava (pictured) delivered their brand new baby boy on January 9.  (Yes.  In rural areas sometimes the new years baby arrives a few days late).    A prenatal sonogram had predicted a 90% chance that the new baby was going to be a girl and the parents had decided to name her Alexa.   Well, to everyone’s surprise “Alexa” is actually a boy.   So Lynn and Chester will, most likely, be choosing a new name.   How about Alex?  Congratulations again to Lynn Williams and Chester Maiava and our MCDH New Year’s Baby for 2010! The family is also taking home a gift basket, compliments of the Obstetrics Department Nursing Staff at MCDH.