HOSPITAL/CLINIC UPDATE: Novato Community Hospital

Ralph Koenker, MD

Federal health care reform is at its core a program of initiatives intended to help physicians, hospitals and other caregivers improve the safety and quality of patient care while making it more affordable. Since our fall 2011 update in Marin Medicine, Novato Community Hospital (NCH) has been extremely active in supporting the values of the Patient Protection and Accountable Care Act, strengthening our outpatient programs, and continuing our focus on clinical quality and patient satisfaction.

This past summer, NCH applied to The Center for Medicare and Medicaid Innovation (CMMI) to participate in the Bundled Payments Care Improvement Initiative. Different from Accountable Care Organizations that are designed to manage population-based health outcomes, Bundled Payment is for delivery of acute episodic care. The approach combines payments for hospital, physician and other provider services during a 30-, 60- or 90-day care episode into a single bundled payment, resulting in improved care coordination and patient outcome monitoring among partnering providers.

The hospital’s proposal, which focused on lower extremity joint replacement, was recently selected by CMMI to progress to the next stage of the application process required to launch a three-year program. The proposed project is consistent with the hospital’s commitment to providing high quality, affordable services to the community by strengthening our relationships with physicians and community providers. We look forward to the opportunity to redesign care pathways and improve efficiency with these partners as we work through the final stages of the CMMI application and the project implementation process.

Sutter Physical Therapy & Sports Fitness--located in the Terra Linda Health Plaza in San Rafael--is among the outpatient services operated by the hospital that will play a key role in the Bundled Payment program. Our program specializes in sports injury treatment and prevention, as well as individualized post-surgery plans designed to safely return patients to their former activities as soon as possible. The program is always looking for ways to fill unmet community health needs.

To that end, physical therapist Lucia Miller, MPT, recently began offering pelvic physical therapy at Physical Therapy & Sports Fitness. The National Institutes of Health estimates that one-third of women in the United States will develop a pelvic floor disorder in their lifetime.

“Physical therapists are experts in treating the musculoskeletal system, which includes the pelvis,” said Miller. “Pelvic physical therapy is a largely underserved need in health care. Many people--from teenagers to seniors--silently and unnecessarily suffer from pelvic pain and other treatable problems.” Miller’s strategies include individual assessment, treatment, education and free introductory classes.

Engaged, committed, expert clinicians like Lucia are the reason that NCH delivers best in Marin Patient Satisfaction scores as measured by the national HCAPS (hospital consumer assessment of healthcare providers and systems) survey sent to patients after discharge. NCH scores demonstrate our physicians’ and staff’s commitment to the patient care experience. For 2011, we were the only Marin County provider with 10 of 10 ratings above the California average.

All hospitals are required to participate in the HCAPS survey, and the results are reported on the HospitalCompare website at www.hospitalcompare.hhs.gov. Anyone can view up to three hospitals’ performance results side-by-side. Medicare will use these measures to determine reimbursement for acute care beginning in 2013.

NCH medical staff can be found actively participating in all of the activities and initiatives mandated by the Patient Protection and Affordable Care Act. In many areas, they are leading the charge to help other caregivers improve the safety and quality of patient care while making it more affordable. Their enthusiasm for improvement is contagious. The physicians’ value as role models and team builders cannot be overstated. It is the key to our success as we continue on this journey.

 

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Dr. Koenker, a diagnostic radiologist, is chief of staff at Novato Community Hospital.

 

Email: KoenkeR@sutterhealth.org