HOSPITAL UPDATE: Novato Community Hospital

David Thompson, MD

It is a pleasure to provide my Marin County physician colleagues this update on Novato Community Hospital (NCH). I am pleased to be a member of a medical group that has served at NCH for 35 years. I started as a part-time emergency department physician in 2003. By 2008, I had become so committed to NCH and the Novato community that I moved my family here. Our oldest daughter begins kindergarten in the local school system this year and we are looking forward to our two boys following her.

An exciting development at NCH is the largest reorganization in the 100-plus-year history of the health system of which we are a part, Sutter Health. This reorganization has created One Sutter, changing our structure from five regions to two operating units: Sutter Health Bay Area and Sutter Health Valley Area. This redesign better aligns us with the way our patients access care. It also streamlines decision-making and keeps the organization flexible and united: One Sutter.

The new Sutter Health Bay Area operating unit comprises not only Novato Community Hospital but also the Sutter hospitals, medical groups and surgery centers throughout Alameda, Contra Costa, Lake, Marin, Napa, Santa Clara, Santa Cruz, San Francisco, San Mateo and Sonoma counties. Our patients benefit from a consistent, uniform focus on safety, quality and service.

The One Sutter concept is of particular value to our medical staff because it strengthens our ability to leverage the expertise and specialty knowledge of the entire Sutter Health network on behalf of our patients. An example is our relationship with the California Pacific Medical Center (CPMC) Neuroscience Institute. Its telemedicine stroke intervention program enables us to link a stroke patient in our emergency department with a neuroscience physician in real time, 24 hours a day, seven days a week. We can thus provide an expert diagnosis and treatment plan on site as well as determine the best follow-up care. Many residents of our community have benefitted from this service over the past five years.

A piece of stroke-related good news: NCH is proud to have achieved its second Joint Commission Advanced Certification as a Primary Stroke Center earlier this year.

Sutter Health and NCH are learning organizations that continually engage physicians and employees in the Quality Delivery System (QDS) based on the Toyota lean organization model. QDS helps focus us on error-free, efficient health care for every patient. It succeeds because it puts the power to improve in the hands of the people who actually do the work.

A major advantage to practicing at Novato is the close working relationship between physicians and clinical staff. Current projects include removing barriers for nurses so they can spend more quality time with patients, streamlining the process for total joint replacement patients, improving patient education materials, and devising new ways to help patients understand their medications.

Another piece of good news came in July when the Centers for Medicare and Medicaid Services (CMS) ranked NCH one of just 548 out of the nation’s 3,500 hospitals—the top 15%—to earn five stars for the year ending Sept. 30, 2014. CMS bases these rankings on the Hospital Consumer Assessment of Healthcare Providers and Systems surveys.

Over the last two years, NCH has been building its Bone & Joint program in concert with a three-year CMS pilot research project, a bundled payment initiative. In connection with this project, the eight orthopedic surgeons on our staff have formed a best practices group that regularly meets and shares experience and expertise to improve patient outcomes for lower extremity total joint replacement. The hospital also collaborates with home health agencies, rehabilitation and physical therapy centers to coordinate and monitor patients’ care for 30 days following discharge. As we enter the third year of this project, we are meeting and exceeding CMS benchmarks for cost control, quality and efficiency. This has enabled us to gain-share Medicare savings with our physicians. Best of all, we are achieving high levels of patient satisfaction and outcomes. We feel fortunate to have had this pilot project experience before CMS mandated a similar initiative for all Northern California hospitals in 2016. In fact, beginning in October, we have partnered with our primary care community to expand bundled payment initiatives to our sepsis and pneumonia patients.

This summer we launched a new component to the front end of the NCH Bone & Joint Program for joint replacement patients with Body Mass Index (BMI) ratings in the overweight and obese ranges. Orthopedic surgeons refer their surgery patients to this six-week evidence-based course called Let’s Get Fit. The director of the orthopedic service line, Jennifer Lehr, PT, oversees the course with the assistance of a registered nurse and a registered dietician. Participants receive one-on-one assessments and goal setting, nutrition counseling, exercises to relieve joint pain, and post-surgery follow-up. We are now measuring the impact of the program on these patients.

At NCH, we continually look for technological innovations in health care to meet the needs of our community. We are fortunate to have a committed group of citizens dedicated to strengthening the hospital’s ability to provide the best possible services close to home. This year our philanthropy organization is working to raise $250,000 to put toward a dollar-for-dollar Sutter Health matching grant. With these funds, we intend to purchase the most highly developed breast cancer screening technology available anywhere. With our new digital tomosynthesis system, we will be able to offer Marin and North Bay women this groundbreaking breast-imaging technology within the next year.

We take our mission as a community hospital seriously and are committed to putting our mission into action to enhance the health and well-being of the people in the communities we serve.

An example of our community benefit program is our longstanding partnership with Novato Unified School District. For more than two decades, we have funded a health partnership with NUSD to provide health care for underinsured students. Every year we pay for eye exams and prescription glasses, dental work and other specialty medical care.

We expanded our partnership two years ago by hiring and placing registered nurses in classrooms that have students with acute health care needs. This makes it possible for students with type 1 diabetes, spina bifida and chronic epilepsy to attend school with their peers.

During summer vacations, we provided RNs for both the Marin YMCA Summer University for ESL students and the Boys & Girls Club Summer Camp in San Rafael. As a bonus, one third-grader we support during the school year was able to go camp for the first time in her life because her nurse was there.

This fall we further strengthened our NUSD partnership by hiring and placing two athletic trainers—one in each of the district’s high schools—to assist coaches in promoting a safe sports environment. The trainers are already conducting baseline concussion evaluations of all high school students participating in sports this school year.

With One Sutter, Novato Community Hospital is taking on the changing world of health care with determination and resolve to serve our community and our patients in the very best way possible. We are embracing change and constantly learning to use it to best advantage for our patients.

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Dr. Thompson, a member of the Marin Emergency Physicians Medical Group, is Chief of Staff at Novato Community Hospital.

Email:l:thompsdf@sutterhealth.orgthompsdf@sutterhealth.orgthompsdf@sutterhealth.org