ALAN D. AVILES
HHC PRESIDENT AND CHIEF EXECUTIVE
REPORT TO THE BOARD OF DIRECTORS
October 26, 2006
PEDIATRIC CHRONIC CARE COLLABORATIVES
In recent months I have reported on our corporate-wide quality improvement collaboratives focusing on chronic disease management and critical care that have produced very promising results. I want to alert you that we have established a separate learning collaborative specifically to address chronic disease management for HHC’s pediatric patients, and we held our third learning collaborative session for ten pediatric clinical teams from various facilities earlier this month.
The National Institutes of Health reports that more than 20 percent of all children in the United States suffer from chronic health conditions, with asthma being the most prevalent chronic health problem. Many of our facilities already have made significant headway in the consistent prescribing of the most appropriate asthma medications and in the use of asthma action plans for our pediatric asthmatics. As a result, we had 2000 fewer pediatric emergency room encounters and more than 600 fewer pediatric hospital admissions related to asthma this past year. The teams involved in our pediatric chronic care collaborative will be deepening our work around family engagement in asthma management and will addressing the management of diabetes in children. Ours is the first quality improvement collaborative in the nation to focus on pediatric diabetes and we're working with a faculty of national experts to jointly develop best practices in this area.
I will keep the Board apprized of our teams’ progress in this important area.
HIV TESTING EXPANSION FINDS MANY NEWLY DIAGNOSED
While I have reported before on our HIV testing program expansion, earlier this month we publicly released our results for the first full year of the initiative and they are worth repeating. As you know, HHC is working to make HIV testing part of routine medical care to lessen the stigma still associated with HIV and to help reach more New Yorkers who may have the disease and not know it.
As a result of the hard work of staff across our system, HHC tested more than 92,000 patients during FY06, a 63 percent increase over the 58,000 tested in FY05. In the process, we were able to more than double the number of HIV positive patients identified from 720 patients in FY05 to 1,514 individuals in FY06. The vast majority of these newly identified HIV positive patients have been linked to care. Our success thus far results from the wide use of rapid testing methodologies and the expansion of our testing beyond the HIV and prenatal clinics, where it is commonly done, to emergency departments, outpatient clinics and inpatient units. We are committed to continuing to expand our efforts and will seek to test 150,000 patients in the next year.
TAKE CARE NEW YORK HEALTH SCREENING CAMPAIGN
Our Take Care New York health screening campaign continues through next week for the last of five Take Care New York Tuesday events. Last month I shared with you our radio public service announcement with the variety of staff voices saying “Take Care New York” in multiple languages. That radio PSA, along with the print public service ad, has resulted in more than $335,000 of free advertising placements in daily and ethnic press across the city – including significant placements in the NY Times, NY Daily News, NY Post, Hoy and numerous popular radio stations like WABC, WCBS, CD101.9, KISS FM, and WADO radio. This represents an estimated 35 million reader and listener impressions across the city that we have been able to reach with no advertising expenses. We also reached an estimated 4.5 million readers and viewers through the news media which provided significant coverage of the campaign.
300 MILLIONTH AMERICAN BORN AT HHC FACILITY
A battle over babies took place Tuesday, October 17 when Elmhurst Hospital claimed the 300 millionth American with the birth of Emanuel Plata, a 6 lbs., 15 oz. baby boy born at 7:46 a.m. – the precise time the U.S. Census Bureau expected the historic population milestone to be reached. While other area hospitals identified other baby contenders for the title, ours led in recognition with his distinct hat and blanket – including a prominently placed HHC logo – which proclaimed him the official 300 millionth American baby. While it is impossible to identify the 300 millionth American with certainty, the birth at Elmhurst was a symbolic representation of this population landmark that allowed HHC to be part of an important moment in history.
Emanuel’s parents are Gricelda Plata and Armando Jimenez, residents of Brooklyn and natives of Mexico. It’s no surprise that the 300 millionth American was born in an HHC facility to an immigrant family – after all, we deliver more than 21,000 babies a year. For all the extraordinary changes across our public hospital system, one part of our history has remained the same: we continue to be the preferred medical home for our city’s immigrant families. And we demonstrated it proudly with Emanuel’s birth. Other HHC babies came close to being the 300 millionth: Kings County delivered a baby at 7:43 a.m.; Metropolitan Hospital delivered a baby at 7:55 a.m.; Woodhull Hospital delivered a baby at 7:57 a.m.; and Jacobi Medical Center delivered a baby at 8:01 a.m.
STATEN ISLAND HEALTH PROGRAM MILESTONES
As you know, HHC has been working continuously with various stakeholders on Staten Island to establish additional primary care services for medically underserved Staten Island residents. Earlier today I joined Mayor Bloomberg at an eagerly anticipated ribbon cutting ceremony for the Community Health Center of Richmond - the new health center which has been developed to meet many of the health needs on Staten Island's north shore. The center has now added adult primary care to its existing OB/Gyn and pediatric services. Work continues on a planned expansion of the center’s current space. The center began providing services on July 5th, as previously reported to the board.
A further milestone was achieved for Staten Island residents this month when the Staten Island Health Access (SIHA) program passed the 2,000 mark at the end of September, having registered 2,006 individuals in SIHA and obtained public health insurance for more than 200 individuals. The SIHA program was initiated to offer primary and preventive health services to low-income Staten Island residents who do not qualify for other programs and it will continue to operate through June 2007.
CONEY ISLAND REACHES SOUTH ASIAN COMMUNITY WITH HEALTHY HEART CAMPAIGN
Coney Island Hospital recently launched its Healthy Heart Program targeted to the South Asian community which suffers from a high incidence of premature Coronary Artery Disease. South Asians are four times as likely as Caucasian or other Asian populations to be diagnosed with early onset Coronary Artery Disease. The program has aggressively reached out to the Pakistani, Bangladeshi and Indian communities in southern Brooklyn to encourage screening at the hospital.
HHC PROGRAMS RECEIVE NATIONAL RECOGNITION
HHC facilities continue to be recognized nationally by top professional organizations and health advocacy groups for providing outstanding patient care, leading edge medical technology and improved access for underserved communities.
The American Health Association and American
Stroke Association granted Woodhull Hospital initial performance
achievement awards for consistently following the latest scientific
guidelines related to treatment for coronary artery disease and heart
failure. The AHA/ASA gave the award to only 72 hospitals nationwide for
coronary artery disease and only 23 for heart failure.
The American Medical Association also honored
Woodhull by selecting it as one of eight facilities nationwide that are
leading the way in identifying and bridging the gaps in health care
communications for vulnerable populations with limited English
proficiency. The AMA conducted a two-day visit of Woodhull and published
its findings in a report funded by the Commonwealth Fund.
Health Imaging & IT Magazine named Queens Health Network as one of the “Top 25 Connected
Healthcare Facilities” nationwide. QHN was selected from 575 facilities
nationwide, winning the designation because of the effectiveness of its
web-based digital imaging system and its high level of utilization by
in-network and referring physicians. The magazine also acknowledged QHN as
the first public hospital system to receive the Davies Award for
excellence in the implementation and use of an electronic medical record
HHC COMPLETES 4TH YEAR AS CORPORATE SPONSOR FOR AMERICAN CANCER SOCIETY BREAST CANCER WALK
On October 15 I was proud to join approximately 1,600 HHC employees who walked in this year's "Making Strides" walk to fight breast cancer and fund important work in research, education, advocacy and support programs that benefit our patients. HHC participated in the walk as a corporate sponsor for the fourth year in a row. Participants from our facilities have steadily increased the amount raised each year, bringing in nearly $300,000 in the past three years. This year’s total, which will be finalized in several weeks, is expected to top by a wide margin the $133,000 raised last year. HHC was also a top corporate sponsor for the American Lung Association's Asthma Walk earlier this year and many individual facilities regularly build teams to support dozens of other nonprofit and community based organizations fighting against HIV/AIDS, Multiple Sclerosis, Diabetes and many other diseases. Clearly the generous and giving spirit of HHC employees extends beyond the walls of our hospitals, nursing homes and clinics and makes a real difference throughout the communities we serve.
HHC GIVES EXPERT TESTIMONY ON EFFECTIVE PROCEDURES TO IDENTIFY PROBABLE CHILD ABUSE AND NEGLECT
Dr. Van Dunn testified for HHC this morning at a City Council Hearing on “Child Abuse and Neglect Reporting Requirements by Healthcare Providers and Facilities”, giving an overview of HHC's guidelines and policies regarding the mandated reporting of suspected cases of child abuse and neglect. He was joined by Commissioner John Mattingly of the Administration for Children Services and colleagues from the New York City Department of Health and Mental Hygiene. The Council held the hearing to learn more about New York City's procedures related to enforcement of State and City Child Abuse Reporting laws and regulations. The hearing stems from an incident earlier this year where a healthcare provider, who is not part of the HHC system, failed to properly report a case of child abuse to the State Child Abuse Hotline. HHC has very thorough formal guidelines in this area and regularly trains staff on mandated reporting responsibilities. Coincidentally, we will be holding two corporate-wide teleconference training sessions for staff on this subject in early November.
HHC FOUNDATION FUNDS PALLIATIVE CARE
The HHC Foundation of New York City has awarded a one-year, $217,000 grant to support a corporate-wide palliative care initiative. The initiative will focus on strengthening palliative care knowledge and capabilities at each HHC facility to enhance the quality of end-of-life care for patients and their families. The overarching goal is to better support those patients and their families who face unavoidable death with an emphasis on dignity and comfort. The comprehensive approach contemplated and facilitated by this grant will involve collaboration among physicians, psychologists, social workers, nurses, Bioethics Committee members, pain management specialists, chaplains of various faiths, interpreters, dieticians, and trained hospital volunteers. We very much appreciate the HHC Foundation’s support for this initiative.
FUNDING TO EXPAND SUCCESSFUL HHC PROGRAMS
On October 9, the Avon Foundation presented a
check for $1 million to HHC to fund breast cancer early detection and
treatment programs for underserved women. The grant was evenly divided
among Bellevue, Jacobi, Metropolitan and Queens, to fund patient navigator
programs and a new digital mammography mobile van at Queens.
Cumberland’s Chemical Dependency Program was
awarded a five-year $800,000 grant to provide relapse prevention services
for parolees with substance abuse disorders.
The North Brooklyn Health Network Asthma Program
will collaborate with four partner schools, P.S. 250, P.S. 297, P.S. 23,
and P.S. 59, as part of a 5-year, $900,000 grant from the State Health
Department to develop an asthma-friendly school environment. The program
will utilize Network-developed asthma guidelines.
STRATEGIC REINVESTMENTS FOR CAPITAL IMPROVEMENT
On October 19, 2006, Metropolitan Hospital Center
held a ribbon-cutting ceremony to inaugurate the renovation of the
Inpatient Rehabilitation Unit in the Main Building. The new 20-bed unit
will provide a full range of medical rehabilitation services for patients,
including those recovering from stroke, spinal cord injury and traumatic
A ribbon-cutting ceremony will be held on November 1, 2006, at Lincoln Medical & Mental Health Center to celebrate the installation of their new state-of-the-art 64-Channel CT Scanner. The new scanner is anticipated to accommodate 15,000 procedures annually.
In the October issue of Architectural Record – one of the premiere
architectural journals in the industry – Bellevue’s Ambulatory Care
Pavilion and Kings County’s Bed Tower and Diagnostic, Treatment and
Emergency Care Pavilion are cited among 11 hospital projects nationwide as
outstanding examples of how architectural design presents a welcoming face
for the increasingly complex business of health care. The magazine also
features a five-page article about the Bellevue project, citing its
architectural restraint, successful functionality, and the perfect spatial
interface between the new building and the original hospital. Copies of
the article are included in the Board members’ packages.
HHC FOLLOWS CITY'S LEAD TO INCREASE MANAGERIAL PAY
This past month the Mayor announced an across-the-board cost-of-living increase for managerial employees at all City Agencies. These increases are intended to ensure that the City’s managers attain parity with unionized employees and the increases track the cost-of-living increases awarded in the City’s most recent collective bargaining agreements. I have directed that HHC follow the City's lead and that HHC Group 11 managerial employees receive the exact same increases, i.e., 2% retroactive to this past August 1, 2006 and another 4.392%, effective February 1, 2007. We are in the process of implementing those increases.
HHC IN THE NEWS HIGHLIGHTS
September 28- Channel 47 interviewed HHC President Alan D.
Aviles about the outreach campaign by the City Council and HHC to urge New
York parents to bring their children to public child health clinics
instead of relying on emergency rooms for primary health care.
October 17-19- Elmhurst Hospital Center's delivery of the 300 millionth American on October 17 received broad news coverage on all local English and Spanish television stations, as well as radio coverage on WADO Radio and 1010 WINS. Print coverage included The New York Times, New York Daily News, New York Post, El Diario, Hoy, Newsday, Staten Island Advance, Chicago Tribune and the Los Angeles Times.
October 24- New York Daily News reporter Julian Kesner
reported on Queens Hospital Center’s success as the first public hospital
in New York City to receive a new 64-slice scanner from GE. The scanner
performs noninvasive angiograms and can image some organs in a few
October 25- The New York Times reporter Erik Eckholm
interviewed President Alan D. Aviles about HHC's work to care for
uninsured patients and its computerized system to track chronic diseases
HHC announced its expansion of HIV testing as part of routine medical care, increasing the number of patients tested by 63 percent. News coverage included The New York Times, New York Post, Crain’s Health Pulse, New York 1 and New York 1 Noticias.
HHC launched its month-long Take Care New York campaign to encourage New Yorkers to get screened for chronic diseases. News coverage of screening sessions and interviews with HHC President Alan D. Aviles included New York 1, New York 1 Noticias, Channel 41, WCBS Radio, WADO Radio, Hoy, El Diario and the Staten Island Advance.