CMS Star Rating

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In late July the Centers for Medicare & Medicaid Services (CMS) released Overall Hospital Quality Star Ratings for all hospitals in the United States.  The Star Rating is designed to help individuals, their family members, and caregivers compare hospitals in an easily understandable way. Over the past decade, CMS has published information about the quality of care across the five different health care settings that most families encounter.  The new Star Data incorporates more measures and allows consumers to compare hospitals side by side which increases transparency.

The new Star Rating methodology takes 64 existing quality measures already reported on the Hospital Compare website and summarizes them into a unified rating of one to five stars. The rating includes quality measures for routine care that the average individual receives, such as care received when being treated for heart attacks and pneumonia, to quality measures that focus on hospital-acquired infections, such as catheter-associated urinary tract infections.

The rating system has come under scrutiny because some hospitals contend that socioeconomic data does not factor in.  Patient’s who do not have ready access to healthcare services either because they do not have health coverage, or services are not available in their community, are at a disadvantage.  Health outcomes are impacted by a patient’s ability to access care.  The more access a patient has to care the more likely they are to receive timely treatment.

Only 2% of hospitals received a 5 Star Rating and roughly 20% received a 4 Star Rating.  GVMH received a 4 Star Rating and compares very favorably to hospitals in this region and across the country.  GVMH was above, or at, the national average for all measures.

GVMH’s 4 Star Rating fits with our Mission: To provide exceptional health and wellness services with friendliness and compassion.

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I’m back

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The blog has been under “construction” the past few months.  It’s back now and promises to be better than ever.  By construction I mean, this blog has been neglected due to the recently opened, 93,000 square foot expansion at GVMH.

The expansion has been fully occupied.  The new Emergency Department is in service and the fast track process for patients who have less acute needs, like sore throats and ankle sprains, has been rolled out.  The purpose of the fast track is to get patients in and out of the Emergency Department in a more timely manner.  There is a special fast track waiting area inside the department and patients who don’t need a bed are never taken to a bed.

New surgery suites are in use.  We used to have four operating rooms and now we have six.  We have six of the largest, most technologically advanced surgery suites anywhere in the region.  The new operating rooms accommodate new and additional surgical procedures and quicker turnaround time between surgical cases.

The Imaging Department has a home in the expansion and now all of our Imaging Services (x-ray, CT, MRI, mammography, ultrasound, nuclear medicine and PET scan) are all in one place.  Patients needing multiple imaging services are now only steps away from the service they need as opposed to a floor away.

The Outpatient Treatment Center is up and running and we are able to host more specialty clinics like Oncology, Cardiology, Nephrology and Pulmonology.  Wound Care finally has dedicated space and is no longer borrowing space from other departments.  The infusion area now offers more privacy for patients and will accommodate 8 more patients than the previous area.

Cardiac Rehab offers patients the best view anywhere in the facility.  There is a walking track integrated into the floor and 8 additional pieces of equipment so patients no longer have to wait for a piece to free up.

The Outpatient Entrance provides easy access to many of our outpatient services and as construction continues over the next 18 months, the corridor coming off the outpatient lobby will provide convenient, easy access to all of our outpatient services.

The lobby itself is warm and friendly.  Our great volunteers greet patients when they enter, Registration is conveniently located just inside the entrance.  The artwork is beautiful and the Bistro provides great food and drink for the convenience of our patients and visitors.

Parking and services are all ground level and additional curb side parking just opened last week.  The entire outpatient expansion was created to improve access and convenience for our patients and visitors and there’s much more to come!

 

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Move in is quickly approaching

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If all goes as planned we will be providing services to patients in new space in about a week.  The flurry of activity is currently at break neck pace and I for one won’t sleep well until the doors are opened to our community.  Here you can see the exterior logo sign being installed.

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This is a picture of the new Emergency Department waiting area.  The new Emergency Department has a separate entrance and has 15 treatment bays as opposed to the 10 in the current Emergency Department.

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This picture shows the corridor that connects the Outpatient Services Expansion to the main hospital.

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Here’s a picture of the Imaging Department waiting area which is located adjacent to the main lobby.  If you’re familiar with the current Imaging waiting area you will note that this area provides for a lot more elbow room.

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A little bit further into the Imaging Department you’ll find staff break and meeting rooms.

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This picture shows one of the treatment rooms in the new Emergency Department.  The rooms are large and efficient and will provide for increased patient safety through better observation.

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If you need a Starbucks fix, don’t forget the Bistro, located in the main lobby of the expansion, will proudly serve Starbucks coffees, teas, lattes and espresso….

It’s almost here!!!!

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Less than a month

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We are approaching crunch time with the expansion.  We will begin seeing patients in the new space on June 6, specifically in the Emergency Department, Imaging Service and the new Operating Rooms.  The lobby of the expansion and admitting will open then as well.  Here are a few pictures to provide you some perspective of what’s done and what’s left to be done.

The picture above is the Woman’s Imaging Suite in the Imaging Department.  This space will house our 3D mammography unit and stereotactic biopsy equipment.

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The picture above shows the treatment bays in the new Emergency Department.  The current Emergency Department has 10 treatment bays and the new space will have 15 bays.

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As you can see above, the food preparation equipment has been installed in the Bistro.  The equipment vendors and Starbucks will be on-site to provide training this week.

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The picture above is of the Imaging Department waiting room.  The plastic sheeting you see on the left of the room will be replaced with frosted glass.  The waiting area is located along the main lobby and the frosted glass will help to provide privacy to patients and families in the waiting area and will slide to close off the space after hours.

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Relocating the Imaging equipment is a major undertaking.  The photo above and the three that follow were taken when the MRI was being moved from the current facility into the expansion.  The MRI was taken out of commission, partially disassembled.  A wall was demoed and the bore, which you see above, was rolled down the hall on a specially made lift.  The bore weighs close to 10 tons and it was transported through the lobby of the expansion to the parking lot.  Once outdoors a crane was used to lift the bore and then it was placed into new space through a window.

The MRI will be back in action when we open new space, until then we will be utilizing a mobile service to meet our MRI needs.  I will continue to post updates in the days head so keep checking back.

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Where to start?

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Have you ever known you have to do something and intentionally put it off.  Like clean the garage, repair a squeaky door, wash the car or update a blog…count me guilty of the last one.  I’ve been meaning to type out a new blog for over a week but until today it hasn’t made it high enough on the “To Do List” to get attention.

All of us make to-do lists, either written or mental.  I have an a personal rule, if something takes 5 minutes or less, I do it when it comes up.  For me, those items never make the to-do list.  It used to be that when I made a list I would start with the things that are the most fun or enjoyable.  The problem with that approach was that at times the less fun and enjoyable things tended to stay on the list longer.  Those items got pushed from one day to the next and then my conscience would begin to nag me.

The other problem that approach created was, the more serious the task or issue, the passage of time usually made it even more serious.  It just wouldn’t go away – ever.  And in the meantime, I would have to deal with the nagging of my conscience and the grief that the issue was causing.

Here’s an example, when I was in graduate school I had to take a course titled Quantitative Analysis.  The course was boring and it had two components.  One component was statistics and that was mostly mathematical equations.  I’m pretty good at math and throughout the course of the semester there were weekly quizzes.  I mastered the quizzes and the math aspect without much trouble.  There was also a theory aspect and throughout the course of the semester there were reading assignments from the textbook that covered the theory portion.  The professor made it clear that the only time our understanding of the theory aspect of the course would be verified would be on the end of course exam.

The textbook was beyond boring and after about the second week of the class I found reasons to put off the reading assignment.  As the end of the semester approached I realized I had hundreds of pages to read if I were going to be prepared to take the final exam.  I spent the better part of two weeks and all of one weekend reading a text-book titled “Theory of Quantitative Analysis”.  It was brutal but if I learned nothing else, I learned a valuable lesson.  I learned not to put off unpleasant tasks.

I learned that when faced with an unpleasant task, the best approach is to deal with it as soon as possible.  A problem dealt with yesterday is far better than a problem to be dealt with tomorrow.  I learned to prioritize my to-do list, not based on the importance of the tasks, but based on how badly I don’t want to do them.  I made a resolution that I would stick to that priority.  Obviously I don’t stick to my resolution religiously (if I did this blog would have been updated earlier in the week), but I have found that when I don’t, my grief level rises proportionately.

Take it from me, you can lower your own grief level by doing the thing you’ve been avoiding the longest and you want to do the least.

I’m signing off now so that I can begin typing a blog for next week!

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Zach’s Story

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There’s no fire and that’s not a new process to clean the floor at GVMH’s Outpatient Physical Therapy Clinic on Ohio Street.  What you are looking at is staff matching a patient’s rehabilitation needs match real world activity.

Zach Morales Recovery

At age 30, Zach Morales is the youngest patient ever to receive a total knee replacement from Dr. James Womack at Golden Valley Memorial Healthcare. Zach is a resident of Clinton and is a firefighter for the Sedalia Fire Department. His job duties require a higher level of fitness than most occupations; Zach has to be able to climb ladders, lift and carry objects, crawl on the floor, and drag hose all while wearing about 70 pounds of gear. Zach began his physical therapy at GVMH Rehab & Wellness in Clinton one week after his surgery and has continued 3 days a week since. He has worked hard at physical therapy at each stage of his rehabilitation, starting with range-of-motion exercises in the beginning and progressing to job simulation activities such as lifting weights, carrying weight, and dragging weight (in this case his therapist, Jeanna Thomas, DPT).

According to Zach, “The decision to have a total knee was a difficult one for me, as well as my family. The uncertainties associated with the procedure and returning to work, given my career, were worrisome. The staff at GVMH Rehab were extremely helpful in calming those worries. They are all very professional and knowledgeable in their field, which made the rehab process much easier. They make each person’s situation important and find the best plan for each case. I hope to never need rehab again, but if I do, I won’t think twice about coming here again.”

GVMH Rehab & Wellness offers services in Clinton, Warsaw and Windsor. For more information about what services are offered in your area, call 660-890-7190.

 

Photo: Zach Morales and his therapist, Jeanna Thomas, DPT identify unique exercises that will allow him to recover and perform his duties as a fireman.            

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Fighting viruses of another kind

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Hospitals and caregivers battle viruses everyday but recently a different type of virus has gained national attention.  In the past couple of weeks a couple large hospital systems fell prey to malicious malware viruses that attacked their computers, networks and connected devices.  For those two hospitals it was a major disaster.  GVMH isn’t immune from these types of attacks and we’ve been the victim ourselves.  Fortunately, we only had one computer affected and it did not contain patient information.  We have good cyber security but we all play a part in protecting our patients and their personal data.

In order to provide you with additional information here’s a recent article by The American Hospital Association.

What hospitals need to know about ransomware

AHA News Feb 22, 2016

By Mary Ellen Callahan

Over the past few weeks, several health care companies and hospitals have been hit by ransomware. For example, when patients walked into one hospital, they were greeted with the information that the hospital had no access to email, some patient data was inaccessible, and other services supported by computers, such as CT scans, lab work and the pharmacy, were offline.

These hospitals and health care companies were victims of cyber attacks − lasting for several days and up to a week. Hospitals and companies in general who have fallen prey to ransomware have had to revert to paper-based registration and medical records. Staff communicated by fax and telephone. Some patients had to be transferred to other hospitals.

Ransomware encrypts files, databases or other caches of information and what follows is a ransom demand to decrypt the data. One distinction between ransomware and other types of cyberattacks is that the perpetrators, the hackers, aren’t actually after the information. Holding the data or information captive is a means to an end – they’re hoping that the victim of the attack will pay the ransom.

Initially, hackers demanded up to 9,000 in Bitcoin, a digital currency, equivalent to somewhere between $3.4 million and $3.6 million, and in one instance, the hospital eventually provided 40 Bitcoin, or $17,000, to regain its systems.

Although no industry or sector is immune from cyberattacks in general, or ransomware in particular, health care needs to be prepared. In April 2014, the FBI Cyber Division issued a “Private Industry Notification” alerting health care systems to an anticipated increase in cyberattacks due to the transition to electronic health records. The warning extended to medical devices as well. Based on these recent public episodes of ransomware, the warnings are starting to become a reality.

According to the Symantec 2015 Internet Security Threat Report, the most common sources of ransomware are malicious email attachments that pretend to be some sort of invoice, bill or image. The end user opens the attachment, which downloads and installs the ransomware on the computer or network. Ransomware also can get onto a computer or network if the user clicks on an advertisement or visits a webpage where the ransomware is lying in wait.

Because we live in a networked world, and computers are most often connected to a network, infecting a single computer with ransomware can reach the whole network. In recent cases, the ransomware has encrypted files on the servers, not an individual computer, and brought down the whole network.

Ransomware is not confined to desktop or laptop computers. There also are ransomware attacks designed for mobile devices.

When a computer or device has been infected with ransomware, often a pop-up demands the monetary ransom in exchange for the decryption key. Although most security experts and law enforcement personnel will advise against paying the ransom, many companies do pay, particularly if the information encrypted are “crown jewels” and hard to replace.

But it’s important to understand there is never a guarantee that you will even get your data back and the hackers now know you are willing to pay the ransom. What’s to stop them from attacking you again and asking for more money next time?

Ransom demands have increased against companies, in part because the targets have become more valuable. Initially hackers using ransomware demanded only a few to several hundred dollars; that was often a price companies could consider paying without significant budgetary risk.

However, as evidenced by the recent attacks, the ransomware hackers are increasingly becoming more sophisticated in their targeting. Hospitals should be aware of this trend, and understand what their crown jewels are, how they are protected, and ensure that they are backed up regularly.

While creating a secure environment is very important, prevention through education and awareness is the most important weapon against ransomware.

Hospitals should regularly back up their data, whether it is stored on laptops, desktops, servers or mobile devices. In addition, they should ensure that anti-virus and anti-malware software is installed throughout their operations and make sure all of the devices, systems and software, including web browsers, are up to date with patches and security updates.

Everyone in health care has a responsibility. Health care administrators and staff should:

  • be trained not to click on links or open attachments in emails or messages, including social media messages, especially when they don’t know or recognize the sender.
  • never open an attachment that appears to come from a company that they have never done business with, such as an energy or utility company.
  • be educated on what to do if they believe or know they have fallen victim to ransomware, including immediately ceasing use of their computers and contacting the IT or IT Security department.

Ransomware usually cannot be hacked to override the malware. Therefore, it is important to protect your crown jewels through good cybersecurity controls and regularly backing up your data. That way, if you are the unfortunate victim of a ransomware attack and your data is lost, you have a backup copy. Information Security, technology and administrators need to work together to identify and defend against cyber incidents of all kinds, including ransomware.

Callahan is an attorney with the Washington, D.C.-based law firm of Jenner and Block, an outside counsel to the AHA.

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