April 7, 2015
HHC FOR TOMORROW
Dr. Ram Raju
Thank you Melissa, for that terrific introduction, and welcome to you all.
Melissa is a special person who has overcome many difficulties in life. She has inspired me with her personal story, and has courageously given me permission to share it with you today.
Years ago Melissa was sometimes living in shelters, sometimes living on the streets. She suffered from depression…She was a victim of sexual assault. Melissa’s road to recovery began when she found her way to Kings County Hospital’s behavioral health outpatient clinic.
Over time, her treatment there allowed Melissa to grow healthier and stronger. It also made her realize that she should dedicate herself to other patients with similar problems. She became a peer counselor at Kings County Hospital.
Now Melissa spends each and every day working with our patients to make sure that their treatment is as effective and successful as her own. Melissa, and thousands of employees and volunteers across our network are our most valuable asset. Our ability to deliver patient-centric, culturally sensitive, quality care rests on Melissa’s, and all of our, shoulders.
There are many great people like Melissa in our system.
Maria Lopez-Rosado, a Spanish-language interpreter at Harlem Hospital, is another very special member of the HHC family. Her care and attention was critical to the recovery of Oscar Fernandez, the young man who was badly injured by a terrible gas explosion last year in Harlem. Maria spent countless hours at Oscar’s bedside ensuring that the care givers who mended his wounds were able to communicate effectively with him and his dad.
Maria’s commitment to Oscar’s well-being represents one of our Corporation’s greatest strengths---the compassion and cultural competence that we have always prioritized in order to deliver the best care possible.
Let me tell you about two other members of our professional family, Dr. Vincent Rizzo and Nurse Alice Raveneau. They have dedicated themselves to redesigning old procedures and adopting new practices at Queens Hospital Center. Their work engages patients better, and gives them a stronger voice in their own care.
We know well that a hospitalization is a time of great stress for our patients and their families. And we need to do more to make them part of the decision making process. Dr. Rizzo and Nurse Raveneau have transformed how physicians and nurses at Queens Hospital Center communicate with patients and respond to their needs.
At Queens, interdisciplinary rounds are now conducted every day with every patient.
The important information and decisions made during daily rounds now happen at the patient’s bedside, not outside their door.
This key change allows patients to witness first-hand the collaboration of their caregivers.
The thoughtfulness that Vincent and Alice bring to this work is getting results. Patient satisfaction scores are up. And, more importantly, it is boosting patient confidence in the care they are receiving. We are a stronger organization because of their efforts.
Such excellence is also demonstrated by so many of our talented care teams.
One perfect example of superior team work was exhibited to the entire world by the clinical team at Bellevue Hospital last fall. When people in this city were confronted for the first time with Ebola, some were scared, some panicked. Some reacted by discriminating against businesses or individuals. And some, even against health care workers.
Our clinical team at Bellevue Hospital however, stood up and said:
“You know something, we are going to roll up our sleeves, get to work to protect this patient, and all New Yorkers from this virus.”
And that’s just what they did and the City is better off as a result.
As Mayor de Blasio said at the time:
“The people who work at Bellevue are the Marines of our healthcare system. They understand what their duty is, and they are only too proud to perform it.”
I can’t think of a finer example of successful patient experience than that. The level of commitment displayed by our colleagues is our greatest strength, and the key to our future success.
The reason I’ve been mentioning these examples of phenomenal Health and Hospitals Corporation employees, and the outstanding care they provide is simple, in order to turn no one away from the healthcare they need, in order to further the Mayor’s equity agenda to increase health care access, and reduce healthcare disparities that afflict too many neighborhoods, in order for the Health and Hospitals Corporation to survive and thrive in a changing health care landscape, we must accomplish several new, important strategic goals. And these ambitious goals depend on our ability to provide a positive patient experience, a positive experience for our existing patients, and a positive experience for new patients.
These goals are interlocking. They are dependent on each other.
In other words, in order to continue carrying out our mission, we need financial stability. To secure that financial stability, we need to grow our patient base and serve more New Yorkers. And to grow our patient base, we need to retain the patients we already serve and we must attract new patients and families into our healthcare system.
There is one common thread that ties all these goals together, one fundamental component to make all this happen. And that’s our ability, our singular ability, to extend the very best experience possible to our patients and their families.
Quite simply, we need to exceed their expectations in the care they receive from every single representative of our organization that touches them.
We need to replicate the compassion and cultural competence shown by Melissa and Maria. We need to reproduce the innovation and patient-centered leadership shown by Dr. Rizzo and Nurse Reaveneau.
We need to own every patient’s experience.
We need to put ourselves in their shoes every day, every time. And make sure we do no less than what we would expect for ourselves, for our families, for our mothers and our own children.
We need that level of compassion to be the standard for everything we do.
This is how we will become leaders in patient experience.
This is how we will protect our mission and thrive.
Whether you are a surgeon or financial counselor, whether you are a nurse or clerk,
whether you are a hospital administrator or environmental worker, a heightened level of kindness, of caring, of cultural sensitivity extending beyond the high quality medical care we already provide, must permeate our work – your work.
That’s the new focus of our organization. And it’s why I come before you today.
I’m not here just to mark my one year anniversary back at the Health and Hospitals Corporation.
I am here to seek your help.
I am here to make a commitment that, together, together we will pursue excellence in patient experience as the most important task in front of us today and for years to come.
Can I count on you?
Of course, I can!
So let me stop for a moment to thank you for coming today, and tell you what an enormous privilege it is to lead this amazing workforce and be President of this historic and essential health care system.
Leading the Health and Hospitals Corporation has always been my dream job.
And New York, my city, this incredibly vital city, a city of dream, a city of opportunity, a city of immigrants like me, is my home.
This is the place I’ve lived most of my life.
This is where my kids were born
This is where I raised my family.
And it’s the place where, when my day comes, I hope to rest in peace.
I’m sure if you go back in your own ancestry, you will find immigrants who came, like me, to the shores of this country to begin a new life.
New York’s public hospital system has been there for so many of us.
As new immigrants came to this great country seeking political freedom, economic prosperity, or an escape from religious persecution, the public hospital system was here for them.
This is the place where they sought care, delivered babies or spent their final moments of life. So many of us and our ancestors have sought and received care in this healthcare system---which is one of many reasons that the Health and Hospitals Corporation is where my heart resides.
And I can’t tell you what a profound pleasure and joy it has been to return.
Though I enjoyed my time working in Chicago,
Let me be honest. I like Brooklyn pizza better than Chicago’s deep dish pizza. I could never root for the Cubs. And I really missed being able to buy a genuine Rolex watch for seven dollars on Canal Street.
So, it’s good to be back home.
I am grateful each day to be practicing public health here in New York with colleagues for whom I have the greatest respect and affection. Like you, I share a deep commitment to ensuring that our corporation continues to fulfill its mission well into the future.
I am delighted, and genuinely moved, to have embarked on this great journey with you.
So I’m pleased that you’ve joined me to consider where we are today, and to plot a course together for where we will head tomorrow.
We are soon approaching the fifty year mark of this bold experiment, this bold experiment we call the New York City Health and Hospitals Corporation.
When it first started, the experiment combined the quality medicine practiced at New York’s many public hospitals, into a single, more effective healthcare system.
The experiment resulted in extensive and robust medical education that over the years has trained tens of thousands of health care providers. And it placed great emphasis on culturally responsive medical care that is delivered with a deep understanding of New York’s magnificent diversity.
The experiment consolidated public hospitals under a single corporate structure, allowing their collective strengths to be leveraged,made more widely available to New Yorkers across the City.
And it was thanks to that bold experiment that we can say the City of New York has delivered, delivered on the promise of quality healthcare for all New Yorkers, and remains at the forefront of medical achievement and excellence in the delivery of that care.
Our Public Hospitals were at the forefront when we opened the nation’s first medical teaching hospital at Bellevue.
We were at the forefront when we opened first nursing school.
We were at the forefront when we developed the first surgical residency program.
We were at the forefront in the 1990s when we helped develop AIDS therapies early in the crisis.
We were at the forefront last year as New York City’s designated acute care hospital for the treatment of Ebola patients.
We remain at the forefront of health care delivery today, as the largest behavioral health and forensic psychiatric services provider in New York.
We remain at the forefront as a provider of exceptional trauma care, special enough back in 1958, for Harlem Hospital to have saved the life of Dr. Martin Luther King, special enough today to always be on standby whenever the President of the United States visits New York City.
We remain at the forefront as the only system that not only welcomes, but reaches out and responds to, the needs of those who are uninsured and those who are undocumented.
We remain at the forefront today by offering services in the way that patients are most comfortable. We treat their language, religious or cultural observances, gender preference, and dietary restrictions with respect, sensitivity, and understanding.
We remain at the forefront today because we are unique, because we are the only system where we look like our patients, and our patients look like us.
That’s true from Mott Haven to East Harlem, and from Elmhurst to Coney Island.
We’re at the forefront today. And New York City expects us to be in the forefront tomorrow.
And we intend to do just that.
We will be leaders in the transformation of healthcare delivery in our city.
We will influence change that measurably improves the health of communities and addresses the social factors that impact health. We will serve as a model, not just for public healthcare, but for all healthcare systems.
But securing that leadership position won’t happen automatically.
Our great yesterdays are no guarantee of a successful tomorrow.
We cannot just rest on our laurels, or the rightness of our mission.
We cannot just rest on our social value.
We cannot just rest on our exceptional medical achievements.
Because, the national healthcare landscape is changing, and changing dramatically around us.
Make no mistake. These changes have profound implications for public healthcare in New York City.
We applaud the Affordable Care Act because Americans now have more access to health than ever before. But at the same time, the ACA poses great challenges to public hospitals.
The Health and Hospitals Corporation and other public hospitals around the nation have historically received government funding to fulfill our mission. However, in this post-ACA world, traditional sources of funding are eroding and may disappear altogether.
Many New Yorkers who have traditionally been our patients, now have insurance. They have a newfound option to seek care wherever they choose.
In this new environment, the marketplace will dictate which hospitals will remain open, which hospitals will struggle, and which hospitals will close.
In this new era, satisfaction with our services, the patient experience I spoke about a few moments ago, will determine whether we hold on to our current patients, and whether we attract new ones.
My commitment to you is that the health and hospitals corporation must and will survive.
We will move aggressively on many different fronts to meet these challenges.
There was once a great healthcare policy thinker
His name was Yogi Berra. He used to say:
“It’s tough to make predictions, especially about the future.”
Well in this case, we do know what our future holds:
As never before, we will be proactive in making up for lost government subsidies.
As never before, we will embrace ambulatory care models that emphasize primary care, preventive care and population health.
As never before, we will strive to increase the access New Yorkers have to our services.
I have spent a lot of time over the past year meeting with our leadership team, touring our facilities and listening to the concerns of staff at each location. I‘ve sat with patients, volunteers, nurses, administrators, physicians and specialists, in order to help shape and develop an effective long term strategy for our Corporation’s future.
And I think we’re on the right track.
To protect our financial viability, in October, we successfully negotiated with the State and CMS to release Upper Payment Limit funding owed to us for services we provided to Medicaid patients over several years.
In December, we reached an important settlement with FEMA, which has now committed more than $1.7 billion dollars to the Health and Hospitals Corporation for Hurricane Sandy-related recovery work at several of our hospitals.
And last month, Fitch, the national credit rating agency, acknowledged our improving financial performance by affirming an A+ rating on our bonds. The Fitch report noted that our patient service revenue grew by 10 percent, and that revenue for our MetroPlus health plan grew by 6 percent.
We continue to modernize our electronic medical records system. We have ensured that the Corporation receives every cent of every Federal incentive dollar that we've earned by deploying new technology across our networks. The federal government has already provided $116 million dollars to help in this technological transformation.
And in January, Gotham Health, our reorganization of 39 Health and Hospitals Corporation outpatient centers and clinics, received Federally Qualified Health Center Look-Alike designation from the federal government. Gotham Health demonstrates the prominent role of our large outpatient care network. It is ideally aligned with our ongoing transformation to keep preventive care and wellness as the centerpiece of organizational culture.
But our work to ensure the Health and Hospitals Corporation’s successful tomorrow is only just beginning.
In order to achieve our goals, our goal to build our patient base and serve more New Yorkers,
our goal to generate the new revenue we need to carry out our mission, our goal to increase access, and to continue knocking down persistent health care
disparities, it is critical that we work even harder, and on many levels, to achieve excellence in patient experience. This means we have to do more. More than expect patients to check boxes about how satisfying their breakfast was. More than determine where to locate a survey kiosk. More than design a new waterfall in one of our atriums.
Those things are important. They certainly send a message. But improving patient experience must be deeply about a philosophy. It must be about an attitude. It must be about a promise.
It must be about appreciating that our patients come to us at some of the most frightening and distraught moments of their lives. Every single interaction with them, by every one of us, every single day, is a critical opportunity for us to ease their anxiety and to offer comfort and compassion, along with top quality medical care.
And the reason we must do these things, the reason we must improve patient experience, is because we are essential to New York City. That is our motivation.
Knowing that we are essential to New Yorkers, and knowing that fulfilling our mission is essential for the health and stability of this city.
We are essential because of the community-based, patient-centric, top-quality health care we deliver in neighborhoods across the city, from Williamsburg to the North Bronx, from Chinatown to East New York, and from Harlem to Staten Island.
We are essential because of the unsurpassed medical education and research that our facilities make available to all New Yorkers.
We are essential because of the state-of-the-art medical treatment we deliver--- like the care provided at Jacobi in treating a victim of a tragic house fire in Brooklyn last month.
We are essential because by striving to provide health care for all in need, we put into practice the human rights and social equity that New York City represents.
We are essential because immigrants, the uninsured, and the undocumented have never stopped coming to New York.
And it is absolutely essential that there be a place that welcomes them as they seek care and treatment.
We have a duty.
We have a responsibility.
To ensure the survival of such an essential system. And I am convinced that if we really commit to delivering patient experience, with a personal touch, with the sense of connection that only we can make, because we KNOW our patients and we ARE our patients, then I have no doubt that by the year 2020 we will be able to engage even more New Yorkers than we reach today.
I know that by year 2020 we will be able to increase our reach from the 1.4 million patients we serve today, to serve 2 million New Yorkers annually who need care.
I know that by year 2020 one out of every four New Yorkers will receive care from the Health and Hospitals Corporation.
I know that if we commit to improving patient experience,
By year 2020, our inpatient satisfaction scores can reach 80 percent, and our outpatient satisfaction scores can exceed 93 percent.
By year 2020 we will have built a financially stable and viable system. Because we will be successful in doubling the number of enrollees in our Metro Plus health plan to one million New Yorkers.
And by year 2020 we will have significantly increased New Yorker’s access to health care by ensuring that 80 percent of all those MetroPlus members are connected to a primary care physician in our system.
We have what I call 2020 vision.
We are committed to achieving these benchmarks by the year 2020. And in doing so we will be building the strong foundation necessary to fulfill our mission for generations to come.
We’ve already laid the groundwork to support these goals with a number of changes linked to positive patient experience. Changes that will help ensure that our patients choose us, again and again.
For example, we continue to expand hours of operation to make it more convenient for New Yorkers to reach us on evenings and weekends.
And even as we aim to expand, reach, and serve more New Yorkers, we continue to do everything possible to reduce how long it takes to make a first appointment with a primary care physician. We are committed to reducing primary care wait time to a maximum average of 14 days, and no more than 5 days for pediatric clinics.
And, of course we must foster our own workforce with development and training. Because, a positive patient experience is not possible without a positive employee experience. Ongoing training is a critical part of who we are and what we need to be. I call it career-long training, so we are always ready to provide excellence in new and expanding areas of healthcare.
All of us in this room must keep pace with advances in research, techniques, and changes in healthcare delivery.
We are responding to this imperative by adopting strategies like expanding e-learning opportunities and leadership development programs to prepare the next generation of Health and Hospital Corporation leaders. And we’re investing in programs, to train more of us to help design systemic improvements and make strategic decisions.
Just a few weeks ago, I attended a Leadership program graduation ceremony for our mid-level managers who had completed an intensive training over the past eight months in problem solving, critical thinking, and teamwork.
I can’t tell you how proud I am of these Health and Hospitals Corporation employees, and how optimistic I am for our organization to know that colleagues with such dedication and drive are working their way up through our ranks.
So let me conclude by repeating what I’ve been saying, but in a different way.
If you are a physician, the Corporation needs you to always remember that you are treating Mrs. Jones, not just her heart disease, or Mr. Rodriguez, not just his asthma.
If you are an administrator, we need you to do the right thing, to err on the side of a patient’s comfort or reassurance, rather than the ledger book.
If you are a clerical worker, who sometimes has to repeat the same answers to the same questions, day after day, we need you to bring patience and empathy to your work—to remind yourself that the person across the intake desk may be at one of the lowest points of their lives. The generosity you show will reflect well on yourself, and on your 38,000 colleagues.
If you are a busy intensive care nurse interrupted by an anxious family member, or a dietary worker offering a meal to a patient, or a maintenance supervisor trying to keep restrooms spotless, we need you to approach your work with the caring and compassion that has always been this organization’s greatest advantage.
Playing to that strength, recommitting to it, broadly, and in every details of your job:
That is how we will improve the patient experience which is key to our survival.
That is how we will reach those benchmark goals by year 2020.
That is how we will live by, and work by, our guiding principles.
That is how we will survive and thrive in the future.
By doing these things, and by never faltering in our efforts to improve this system, this essential asset called the New York City Health and Hospitals Corporation, this bold experiment started nearly 50 years ago which strives to never turn a patient away, this safety net for the safety nets.
We will ensure that for generations to come, our doors will remain open, our mission will remain intact, and our commitment to empower all New Yorkers to lead the healthiest lives possible will endure.