Johnston Memorial Hospital Inc

Programs: Johnston memorial hospital (jmh) is located in abingdon, virginia (washington county). The hospital owns and operates a 116-bed nonprofit acute care hospital and home health agency. Our primary service area encompasses 7 counties in southwest virginia. Jmh is the sole member of abingdon physician partners, a tax exempt organization that owns and operates physician practices. Jmh is part of the mountain states health alliance network. Its membership consists of mountain states health alliance (majority owner) and johnston memorial healthcare foundation, inc. (continued on schedule o). (cont'd) during fy17, 8,656 patients were admitted to our hospital, with just over 32,000 patient days. There were an additional 3,981 observation days and just under 1,400 newborn days. We experienced 234,109 outpatient visits this year. There were 41,014 visits to our emergency department. There were 6,659 surgeries performed. We delivered 624 babies. Promote community health: mountain states health alliance is one of only 32 organizations in the country that were chosen recently to be part of the u. S. Centers for medicare & medicaid services' (cms) new program aimed at improving the health of medicare and medicaid beneficiaries. The new program - cms' accountable health communities (ahc) model - will seek to improve the overall health of medicare and medicaid beneficiaries by helping to address patients' health-related social needs. The program seeks to bridge the gap between clinical and community service providers to address issues such as housing instability, food insecurity, utility needs, interpersonal violence and transportation. Mountain states will serve as the bridge organization for the project locally, leading a collaborative with multiple other organizations and care sites to bring the needed services to beneficiaries who live in southwest virginia. The virginia department of medical assistance services will also partner in the program. The ahc model provides federal funding to hire patient navigators, along with additional support staff who will be located at community services boards throughout southwest virginia. Jmh, along with four other msha virginia hospitals, will participate in the new program. App, a nonprofit physician organization owned by jmh, will also participate in the program. The united states department of health and human services made the selection near the end of our fiscal year so we were in the very early stage of planning at june 30, 2017. Our triumph cancer navigator program celebrated its 1-yr anniversary and has expanded its scope to cover all types of cancer. The program is designed to support cancer patients and their families, advocate for the patient, and to help coordinate the patient's care throughout the continuum of treatment - from diagnosis to survivorship. There is no charge for these services regardless of whether a patient chooses to receive their treatment at jmh or an unrelated facility. Those that join the program receive one- on-one assistance from specially trained oncology professionals. Our cancer navigators communicate with the patient's doctor, will coordinate transportation, set up appointment reminders and provide emotional support for both the patient and the patient's family. Our navigators will also coordinate support services such as treatment planning, prosthesis selection, nutrition counseling, and identification of resources for spiritual care, financial assistance and other needs. Our navigators participate in community events such as health fairs, cancer education events, and cancer support groups. They visit physician offices, seniors' groups, attend meetings with local business organizations, and they work with many other organizations to explain the navigation program and provide cancer awareness/education through the community. The program has made an impact, with the triumph program receiving a patient satisfaction score of 93. A collaborative project, the sepsis initiative, launched by clinical teams at jmh and msha has earned national recognition from the society of hospital medicine. The sepsis initiative is estimated to have saved more than 70 lives over the course of a year. The project team was honored by the society of hospital medicine with a 2017 award for excellence in teamwork in quality improvement, research, teaching and teamwork. Sepsis is a potentially deadly condition caused by the body's overwhelming response to an infection, which can lead to tissue damage, organ failure and death. According to the national institutes of health, severe sepsis strikes more than a million americans every year, and it's been estimated that between 28 and 50 percent of those people die - far more than the number of u. S. Deaths from breast cancer, prostate cancer and aids combined. The jmh team worked to identify sepsis quickly, then to improve communication among clinical teams. Sepsis education was made mandatory for nurse orientation and annual learning requirements. The team built protocol into the electronic medical record system in the form of sepsis screening tools, automatic alerts and sepsis-specific order sets. And because most sepsis patients come into the hospital through the emergency room, the team hardwired sepsis screening into the er triage processes. The sepsis initiative is now being used at six other msha hospitals. Our diaper assistance program provides diapers to low-income families that deliver at jmh for the first 6 months of the baby's life. We had 371 women enroll with their babies this year and incurred expense of 8,652 for this program. The outpatient diabetes care center (center) at jmh continues to experience increased volumes. After an increase of almost 170% from fy14 to fy15, our volume grew 43% in fy16 and an additional 15% in fy17. The centers for disease control and prevention identifies the counties served by jmh as being located in what is referred to as the "diabetes belt" of the u. S. Diabetes prevalence is 30% higher in washington county than the statewide rate. Jmh's diabetes center provides medical management of diabetes and diabetes-related conditions for patients aged 12 and up. A comprehensive diabetes education program that is recognized by the american diabetes association is part of the center's program of care. The jmh center for comprehensive wound care is the only facility in southwest virginia offering hyperbaric oxygen therapy - the delivery of oxygen at levels higher than atmospheric pressure in a chamber setting that stimulates the healing process. The nearest facility offering hyperbaric oxygen therapy is an hour away. Our trained staff follow a team approach to wound healing. Each patient receives a comprehensive individualized plan designed to help difficult-to-heal wounds. Jmh staff strive to address the underlying cause of the problem, control infection, and improve the overall health of our patients. The center continues to see a growth in patient volume each year. There was a 16. 7% increase in procedures from fy16 to fy17. Jmh continues the "lean" process of providing value to customers (our patients, physicians and team members) through quality improvement teams (referred to as rapid improvement events) that meet all day for several days to develop processes that will optimize care of patients, reduce resource utilization; and, oftentimes, improve both. This process of improvement is called the "value optimization system" (vos). During fy17, we continued vos activities started during fy16 and planned and began activities that will continue into fy18. New activities started during fy17 include: a focus on processes impacting patient throughput and experience from point of entry (emergency department) through discharge from the hospital. These rapid improvement events (rie) are conducted over a 12 month period to ensure the patient is the center of our continuous improvement activities. Results will not be available until fy18. Goals were established to: reduce inpatient length of stay (los); sustain observation los; improve ed patients' experience; improve physician communication; improve rn communication; improve communication about medications; and, improve communication about patient discharge. Another vos activity started during the year that will continue into fy18 focuses on cardiovascular services. This rapid improvement event developed and implemented processes to reduce avoidable readmissions for patients with congestive heart failure; improve the quality of care for patients throughout all cardiovascular services through education; improve the quality of transfers; include outside emergency medical staff in training/education (rescue squads, fire departments, etc. ); implement a limb salvage program; and, improve medication administration at discharge. Targets are set to reduce congestive heart failure readmissions, reduce cost, and improve discharge performance score. Based on community need, jmh incurr